Background: Delay in diagnosis of breast cancer is associated with a poorer survival and a pivotal contribution to this delayed diagnosis comes from patient delay in presenting at a clinic. Reasons involved must be evaluated in order to decrease this reducible delay. Objectives: i) To evaluate the reasons for patient delay in diagnosis of breast cancer; ii) to investigate any association with other variables. Materials and Methods: A 6 month cross sectional study (from July 2012 to Dec 2012), was carried out in Surgical and Oncology Units of Civil Hospital, Karachi. A total of 100 females diagnosed with breast cancer of any histological type were interviewed after informed consent and relevant data were collected. Due ethical clearance was obtained. Results: Mean age was $47.5{\pm}12.1$ years with a range from 25-77 years. Mean duration of delay was $5.13{\pm}4.8$ months, from shortest 1 month to longest 36 months. Duration of delay was observed to be no delay (<1 month) in 28%, short delay (1-3 months) in 30% and long delay (>3 months) in 42% of patients. Considering the symptoms as "harmless" (39%) was the most frequent reason of delay followed by "temporary" (20%) and the "use of traditional methods" (12%). Most common reason for later approaches was an increase in the size of the lump (41%). Statistically significant association (p-value <0.05) of longer patient delay was obtained with being single, being illiterate, painless breast lump as the first symptom, negative family history of breast cancer and vague attribution of the symptoms. Conclusions: Significant delay in approach to health care facility was observed in our study due to variable reasons given by women. Sufficient awareness regarding breast cancer, its symptoms and favorable effects of a timely diagnosis on prognosis must be imparted to our general population.
Objectives : To report and demonstrate the effect of decreasing ascites volume by SB intraperitoneal injection to a refractory ascites patient with synchronous colorectal liver metastasis and metachronous peritoneal carcinomatosis. Methods : Two cycles of intraperitoneal and intravenous SB injection were conducted. Each injection cycle was made up of 4 days. Nine vials of SB were injected to the patient every day. To compare the volume of ascites between pret- and post-treatment, follow-up computed tomography was done on June 3, 2013. To observe other therapeutic effects of SB injection, laboratory tests were conducted periodically. Results : On the follow-up computed tomography images, the amount of ascites and pleural effusion had decreased compared to the April 30, 2013 computed tomography images. The levels of aspartate transaminase, alanine aminotransferase and lactate dehydrogenase decreased significantly from May 9, to May 30, 2013. The amount of oral intake increased constantly during hospitalization. The patient's symptoms such as abdominal distension, abdominal pain and dyspnea were improving until discharge. Conclusions : Even if thiese results cannot be applied to every synchronous colorectal cancer liver metastasis patient, we demonstrated that SB intraperitoneal injection has ascites-decreasing effect to refractory ascites patients with synchronous colorectal liver metastasis and metachronous peritoneal carcinomatosis.
Objectives: This study reports on the effect of Integrative Medicine Therapy (IMT) on a patient with pancreatic cancer with liver metastasis. Methods: One pancreatic cancer with liver metastasis patient was treated using IMT in conjunction with Gemcitabine/Abraxane since September 2019. The cycle was repeated every four weeks for a total of 11 times. At the same time, the patient was treated with IMT. Tumor size was measured by scanning with Computed Tomography (CT). Adverse events were evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0. Results: After treatment with Gemcitabine/Abraxane and IMT for eight months, the size of the body and tail of the cancer tumor and several hepatic metastatic regions decreased (partial response, [PR]), size, and number of multiple nodules in both lungs decreased. No evidence of newly developed metastatic lesions was found. The patient has maintained a good treatment outcome and has shown prolonged overall survival. Conclusions: This case demonstrates that treatment with IMT may have substantial benefits for patients with end-stage pancreatic cancer.
Background: To determine surgical outcomes, perioperative complications, and patient outcomes in gynecologic cancer patients undergoing robotic surgery. Materials and Methods: Surgical outcomes, including docking time, total operative time, console time, estimated blood loss (EBL), conversion rate and perioperative complications were retrospectively reviewed in 30 gynecologic cancer patients undergoing robotic surgery. Patient outcomes included recovery time and patient satisfaction, as scored by a visual analogue scale (VAS) from 0-10. Results: The operations included 24 hysterectomies with pelvic lymphadenectomy (PLD) and/or para-aortic lymphadenectomy, four radical hysterectomies with PLD, and two radical trachelectomies with PLD. Mean docking time was $12.8{\pm}9.7min$, total operative time was $345.5{\pm}85.0min$, and console time was $281.9{\pm}78.6min$. These times were decreased in the second half of the cases. There was no conversion rate. Three intraoperative complications, including one external iliac artery injury, one bladder injury, and one massive bleeding requiring blood transfusion were reported. Postoperative complications occurred in eight patients, most were minor. Only one patient had port herniation that required reoperation. Mean hospital stay was $3.5{\pm}1.7days$, and recovery time was $14.2{\pm}8.1days$. Two-thirds of patients felt very satisfied and one-third felt satisfied; the mean satisfaction score was 9.4 +0.9. Two patients with stage III endometrial cancer developed isolated port site metastasis at five and 13 months postoperatively. Conclusions: Robotic surgery for gynecologic cancer appears to be feasible, with acceptable perioperative complication rate, fast recovery time and high patient satisfaction.
Objective: Ortho-Cellular Nutrition Therapy (OCNT) Experiential treatment for Breast Cancer, lymphedema Patients Methods: The patient is a Korean woman aged 50 years. She was diagnosed with stage 3 breast cancer, the right lymph node was removed, resulting in lymphedema and pain. Results: After nutritional therapy, lymphedema improved. Conclusion: The patient's lymphedema improved, and she regained her daily vitality.
Background: There are various patient and professional factors responsible for the delay in start of treatment (SOT) for head and neck cancers (HNC). Materials and Methods: This retrospective study was conducted on data for HNC patients registered at the hospital cancer registry in North-East India. All cases diagnosed during the period of January 2010 to December 2012 were considered for the present analysis. Educational levels of all patients were clustered into 3 groups; illiterates (unable to read or write), qualified (school or high school level education), and highly qualified (college and above). Results: In the present analysis 1066 (34.6%) patients were illiterates, 1,869 (60.6%) patients were literates and 145 (4.7%) of all patients with HNC were highly qualified. The stage at diagnosis were stage I, seen in 62 (34.6%), stage II in 393 (12.8%), stage III in 1,371 (44.5%) and stage IV in 1,254 (40.7%). The median time (MT) to the SOT from date of attending cancer hospital (DOACH) was, in illiterate group MT was 18 days, whereas in the qualified group of patients it was 15 days and in the highly qualified group was 10 days. Analysis of variance showed there was a significant difference on the mean time for the delay in SOT from DOACH for different educational levels (F=9.923, p=0.000). Conclusions: Educational level is a patient related factor in the delays for the SOT in HNCs in our population.
HYE KYUNG HONG;DAE HEE PYO;TAE WON KIM;NAK HYEON YUN;YEO SONG LEE;SU JEONG SONG;WOO YONG LEE;YONG BEOM CHO
Oncology Letters
/
v.42
no.5
/
pp.2029-20238
/
2019
In vitro culture of patient-derived tumor cells offers many advantages in the development of novel therapies for colorectal cancer. Although various culture systems have been developed, the long-term expansion of patient-derived tumor cells remains challenging. The present results suggested that tumor cells isolated from colorectal cancer patient-derived xenografts can be efficiently immortalized in conditioned medium from irradiated feeder cells containing Y-27632, a rho-associated coiled-coil containing protein kinase (ROCK) inhibitor. Patient-derived tumor cells proliferated rapidly, reaching 90-95% confluence in ~6 days. Short tandem repeat analysis suggested that these tumor tissues and cultured cells presented 13 identical short tandem repeat loci, including Amelogenin, Penta E, Penta D, D2S1338 and D19S433. Their epithelial phenotype was confirmed by staining for epithelial cell adhesion molecule and cytokeratin 20, whereas vimentin was used as a mesenchymal marker. When cells were transferred to 3D cultures, they continued to proliferate, forming well-defined tumor spheroids. Expression levels of human telomerase reverse transcriptase and C-Myc mRNA were increased in cultured cells. Finally, immortalized cells were used for the screening of 65 anticancer drugs approved by the Food and Drug Administration, allowing the identification of gene-drug associations. In the present study, primary culture models of colorectal cancer were efficiently established using a ROCK inhibitor and feeder cells, and this approach could be used for personalized treatment strategies for patients with colorectal cancer.
Even though the anticarcinogenic effect of dietary factors especially beta - carotene has been reported by various investigators, the mechanism of the action of ${\beta}-carotene$ has not yet been identified. We carried out the present study to determine the possibilities of relative cancer risk related to dietary intake of vitamin A ( both ${\beta}-carotene$ and retinol ) and blood levels of vitamin A among Koreans. The subjects were divided into two groups; cancer patients and controls. Blood levels for ${\beta}-carotene$ and retinol were analyzed by alumina column chromatography and colorimetry. Dietary intake was examined by food profile and convenient method for evaluating nutritional status through recalling 10 years of food habits. The results obtained are as follows : 1 ) Calorie, protein, fat, and carbohydrate intakes of cancer patient were lower than those of control. Calorie and carbohydrate intakes showed no significant difference but protein and fat intakes were significantly lower in cancer patients. According to cancer sites, in stomach cancer only fat intake was significantly lower than that of control. In lung and larynx cancer calorie, protein, fat and carbohydrate intakes showed similar trend as in control. 2 ) Vitamin A intake of cancer patient was significantly lower than that of control. It was estimated that 83.6% of total Vitamin A intake were provided by ${\beta}-carotene$ for control and cancer patient respectively. 3 ) The mean intake of dietary ${\beta}-carotene$ in cancer patient was significantly lower than that in control ( $7002\;\mu}g/day$ versus $10326\;{\mu}g/day$ ) According to cancer sites in mean intake of dietary ${\beta}-carotene$ was significantly lower in all but stomach cancer compared with that of control. Lung and larynx cancer showed lowest ${\beta}-carotene$ intake with mean value of $5855{\mu}g/day$ and $5492{\mu}g/day$ respectively. 4 ) The mean intake of dietary retinol in cancer patient was significantly lower than that in control ( $245{\mu}g/day$ versus $338{\mu}g/day$ ), but the difference was not significant. 5 ) The relative risk of all cancers in the first (lowest) to the forth quartile level of ${\beta}-carotene$ consumption such as $0-5999{\mu}g/day$. $6000-8999{\mu}g/day$, $9000-11999{\mu}g/day$/ day and $12000-20000{\mu}g/day$ was 85 : 1.7 : 20 : 1.0. The relative risk of all cancers in the first (lowest) to the forth quartile level of retinol consumption, such as $0-299{\mu}g/day$, $300-599{\mu}g/day$, 600-899${\mu}g/day$, and $900-1200{\mu}g/day$, was 1.14 : 067 : 0.21 : 1.0. 6 ) The various food group consumption of cancer patient were significantly lower than those of control in green leafy vegetables, fruits, sea weeds, milk and cheese and eggs. But the Kimchie consumption in cancer patient was three fold higher than that of control ( $1840\;{\mu}g/day$ versus $562\;{\mu}g/day$ ) and in the stomach cancer, Kimchie consumption was the highest, ( $1890\;{\mu}g/day$) According to cancer sites, the consumption of green leafy vegetables was significantly lower in all but stomach cancer compared to control and other vegetables showed no difference between two. In lung and larynx cancer, green leafy vegetables consumption was lowest ( $6094{\mu}g/day$$5921{\mu}g/day$) and milk and cheese consumption was also( $5\;{\mu}g/day$ and $11{\mu}g/day$) 7 ) The recovery of ${\beta}-carotene$ from human serum by alumina column chromatography was $94.4{\pm}2.3%$. 8 ) Cancer patients showed significantly lower serum retinol ($56.4{\pm}18.1\:{\mu}g/100ml$ versus $72.2{\pm}21.8\:{\mu}g/100ml$) and ${\beta}-carotene$ ($48.9{\pm}33.8\:{\mu}g/100ml$ versus $72.2{\pm}42.6\:{\mu}g/100ml$) concentrations than in controls. 9 ) But breast cancer patients were not significantly different from controls in their serum retinol and ${\beta}-carotene$ concentrations.
Kim, Kyung Hee;Kim, Chan Gyoo;Kim, Young-Woo;Moon, Hae;Choi, Jee Eun;Cho, Soo-Jeong;Lee, Jong Yeul;Choi, Il Ju
Journal of Gastric Cancer
/
v.16
no.3
/
pp.195-199
/
2016
Phlegmonous gastritis is a rare and rapidly progressive bacterial infection of the stomach wall, with a high mortality rate. Antibiotics with or without surgical treatment are required for treatment. We present a case in which phlegmonous gastritis occurred during the diagnostic evaluation of early gastric cancer. The patient showed improvement after antibiotic treatment, but attempted endoscopic submucosal dissection failed because of submucosal pus. We immediately applied argon plasma coagulation since surgical resection was also considered a high-risk procedure because of the submucosal pus and multiple comorbidities. However, there was local recurrence two years later, and the patient underwent subtotal gastrectomy with lymph node dissection. Considering the risk of incomplete treatment immediately after recovery from phlegmonous gastritis and that recurrent disease can be more difficult to manage, delaying treatment and evaluation until after complete recovery of PG might be a better option in this particular clinical situation.
Kim, JeeHye;Bae, KyeoRe;Park, JiHye;Park, SoJung;Cho, ChongKwan;Yoo, HwaSeung
Journal of Korean Traditional Oncology
/
v.21
no.1
/
pp.15-25
/
2016
Objective : The purpose of this study is to report the possibility of treatment of Cancer of Unknown Primary Site (CUPS) patient with Traditional Korean Medicine based Samchilchoongcho-jung and Gunchilgyebok-Jung following chemotherapy. Methods : The patient is a female, who was diagnosed with CUPS, suffering from left flank pain, abdominal discomfort, nausea, vomiting and fatigue after chemotherapy. The patient was treated with acupuncture, pharmacoacupuncture, moxibution, herbal medicine and enema used with herbal decoction for 15 days. The clinical outcomes were measured by numeric rating scale(NRS). Results : After treatment, left flank pain had disappeared and nausea and vomiting was decreased from NRS 4 to NRS 1 respectively. Fatigue was also improved. Conclusion : This case study suggests that Traditional Korean Medicine is effective for treatment of CUPS patients and can improve the quality of life.
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