Background: Primary hepatic neuroendocrine carcinoma (PHNEC) is rarer than extrahepatic gastrointestinal neuroendocrine carcinoma (NEC). It is difficult to make a correct diagnosis and poses a challenge for management. Materials and Methods: Ten PHNEC patients were admitted to our hospital from June 2006 to June 2011. Laboratory tests and imaging scans were performed for diagnosis and exclusion of extrahepatic NEC. All patients were AFP - and CA199-. Seven patients had solid tumors with cystic changes on ultrasonography, CT and/or MRI. For the initial treatment, four patients received combined-therapy and six monotherapy. Considering overall treatment, six patients received combined-therapy and four patients monotherapy. Staging criteria of primary hepatocellular carcinoma (PHC, AJCC 7th edition) were used to differentiate the stage of all patients: 3 patients were stage I, 2 stageII, 4 patients stageIII and 1 stageIV. All patients were followed up and clinical data were gathered. Results: The median follow-up duration was 38.5 months. The 1-year, 2-year, 3-year and 6-year disease-free survival was 80.0%, 46.2% and 46.2% and 0% respectively. The overall survival rates were 100%, 67.1%, 67.1% and 33.6% respectively. Patients in early-stages (I/II) had similar disease-free and overall survival as those in advanced-stages (III/IV). Patients with monotherapy had significant shorter disease-free and overall survival than the patients with combination-therapy. Conclusions: PHNEC has a unique specificity during its occurrence and development. The staging criteria of PHC might not be suitable for the PHENT. More convenient and effective features need to be found in imaging and laboratory detection. Surgical resection, TACE, chemotherapy and radiofrequency ablation should be performed in combination and actively for patients with PHNEC or recurrence to get the best effectiveness; they might extend the disease-free and overall survival.
Background : Advanced thymic cancer still remains as an intractable disease. The survival rate of advanced thymic cancer could be increased through chemotherapy and radiation, but the results have not been satisfactory. Objectives : To see whether wheel balanced therapy (WBT) has the therapeutic effects or not on advanced thymic cancer patient. Methods : A patient diagnosed with progression of thymic carcinoma with pleura metastasis visited the East-West Cancer Center (EWCC) on Feb 9th, 2011. The patient was treated with WBT for a period of 9 weeks from Feb 9th to Apr 16th. She stayed 6 weeks in hospital and took oriental medicine prescribed by EWCC. Computed tomography (CT) and blood test were used to evaluate the disease progression of the patient. Results : Mass of chest CT was stable for 2 months. The patient's quality of life improved during her hospital stay. Conclusions : This case study supports WBT may have efficacy in treating advanced thymic cancer patients.
Background: The anti-tumor therapeutic effect of autologous tumor cell lysate pulseddendritic cells (DCs) was studied for non-immunogenic and immune suppressive lung cancer model. To test the possibility as an adjuvant therapy, minimal residual disease model was considered in mouse in vivo experiments. Methods: Syngeneic 3LL lung cancer cells were inoculated intravenously into the C57BL/6 mouse. Autologous tumor cell (3LL) or allogeneic leukemia cell (WEHI-3) lysate pulsed-DCs were injected twice in two weeks. Intraperitoneal DC injection was started one day (MRD model) after tumor cell inoculation. Two weeks after the final DC injection, tumor formation in the lung and the tumor-specific systemic immunity were observed. Tumor-specific lymphocyte proliferation and the IFN-${\gamma}$ secretion were analyzed for the immune monitoring. Therapeutic DCs were cultured from the bone marrow myeloid lineage cells with GM-CSF and IL-4 for 7 days and pulsed with tumor cell lysate for 18 hrs. Results: Compared to the saline treated group, tumor formation was suppressed in 3LL tumor cell lysate pulsed-DC treated group, while 3LL-specific immune stimulation was minimum. WEHI-3-specific immune stimulation occurred in WEHI-3 lysate-pulsed DC treated group, which had no correlation with tumor regression. Conclusion: The data suggest the possible anti-tumor effect of cultured DCs as an adjuvant therapy for minimal residual disease state of lung cancer. The significance of immune modulation in DC therapy including the possible involvement of NK cell as well as antigen-specific cytotoxic T cell activity induction was discussed.
The inception of targeted agents has revolutionized the cancer therapy paradigm, both for physicians and patients. A large number of molecular targeted agents for cancer therapy are currently available for clinical use today. Many more are in making, but there are issues that remain to be resolved for the scientific as well as social community before the recommendation of their widespread use in may clinical scenarios can be done, one such issue being cost and cost effectiveness, others being resistance and lack of sustained efficacy. With the current knowledge about available targeted agents, the growing knowledge of intricate molecular pathways and unfolding of wider spectrum of molecular targets that can really matter in the disease control, calls for only the just use of the agents available now, drug companies need to make a serious attempt to reduce the cost of the agents. Research should focus on agents that show sustained responses in preclinical data. More needs to be done in laboratories and by the pharmaceutical industries, before we can truly claim to have entered a new era of targeted therapy in cancer care.
The abscopal effect is a term that has been used to describe the phenomenon in which localized radiation therapy treatment of a tumor lesion triggers a spontaneous regression of metastatic lesion(s) at a non-irradiated distant site(s). Radiation therapy induced abscopal effects are believed to be mediated by activation and stimulation of the immune system. However, due to the brain's distinctive immune microenvironment, extracranial abscopal responses following cranial radiation therapy have rarely been reported. In this report, we describe the case of 42-year-old female patient with metastatic melanoma who experienced an abscopal response following her cranial radiation therapy for her brain metastasis. The patient initially presented with a stage III melanoma of the right upper skin of her back. Approximately 5 years after her diagnosis, the patient developed a large metastatic lesion in her upper right pectoral region of her chest wall and axilla. Since the patient's tumor was positive for BRAF and MEK, targeted therapy with dabrafenib and trametinib was initiated. However, the patient experienced central nervous system (CNS) symptoms of headache and disequilibrium and developed brain metastases prior to the start of targeted therapy. The patient received radiation therapy to a dose of 30 Gy delivered in 15 fractions to her brain lesions while the patient was on dabrafenib and trametinib therapy. The patient's CNS metastases improved significantly within weeks of her therapy. The patient's non-irradiated large extracranial chest mass and axilla mass also shrank substantially demonstrating the abscopal effect during her CNS radiation therapy. Following radiation therapy of her residual chest lesions, the patient was disease free clinically and her CNS lesions had regressed. However, when the radiation therapy ended and the patient continued her targeted therapy alone, recurrence outside of her previously treated fields was noted. The disease recurrence could be due to the possibility of developing BRAF resistance clones to the BRAF targeted therapy. The patient died eventually due to wide spread systemic disease recurrence despite targeted therapy.
Breast cancer is the most common cancer in Jamaican women. This study assessed the clinicopathologic features of cases in a hospital-based specialist clinic in Kingston, Jamaica. A retrospective chart review was performed for the 2-year study period and relevant clinical and surgico-pathologic data were recorded and analyzed. Median age of the 121 breast cancer patients was 52 years (range 22-84, IQR 20) and there was 1 case of male breast cancer. Most patients (65%) were referred from the surgical service after definitive breast cancer surgery, 20% were referred for pre-operative systemic therapy, and 15% had a diagnosis of metastatic disease. The surgico-pathologic group comprised 78 women who were referred for adjuvant therapy. The majority had presented with a palpable breast lump (91%), with median tumour size 3.5cm (range 0.4-13, IQR 4). Most tumours were node positive (56%). Approximately one-third of patients had stage III disease (33%). Most women presented with large palpable tumours and had lymph node involvement confirmed on surgicopathological evaluation, indicative of limited early breast cancer detection. A national screening mammography programme is recommended for detection of earlier lesions. Pre-operative systemic therapy should be considered as an option for eligible patients.
In Korea, liver cancer is the sixth most prevalent malignancy and the second leading cause of cancer-related mortality. The peak incidence of liver cancer deaths occurs between the ages of 40 and 59. (e.g. Yoon et al. 2021) The patient is a 69-year-old female with bronchiectasis as an underlying condition. She underwent left lower lobe resection for the disease, and in 2009 she was diagnosed with liver cancer and experienced a recurrence after a full recovery. In the case of such patients, the most effective OCNT prescription is recommended.
We investigated the prognostic value of pituitary tumor transforming gene 1 (PTTG1) expression according to clinicopathological features among localized or locally advanced prostate cancer cases receiving hormone therapy. A retrospective study involved 64 patients receiving combined androgen blockade treatment was performed. PTTG1 expression was determined by immunohistochemical staining using initial needle biopsy specimens for diagnosis. Associations of PTTG1 with various clinicopathological features and disease-free survival were examined via uni- and multivariate analyses. No association between PTTG1 expression and clinical T stage, Gleason score, pretreatment PSA levels, risk groups was found (p =0.682, 0.184, 0.487, 0.571, respectively). Univariate analysis revealed that increased PTTG1 expression, T3 stage and high risk group were associated with increased risk of disease progression (p =0.000, 0.042, and 0.001), and high PSA level had a tendency to predict disease progression (p =0.056). Cox hazard ratio analysis showed that PTTG1 low expression (p =0.002), PTTG1 high expression (p =0.000) and high risk group (p =0.0147) were significantly related to decreased disease-free survival. In conclusion, PTTG1 expression determined by immunohistochemical staining in needle biopsy specimens for diagnosis is a negative prognostic factor for progression in localized or locally advanced prostate cancer receiving hormone therapy.
Background: Breast cancer is a treatable disease, but some women reject conventional treatment in favor of unproven "alternative therapies," which may have serious implications for their survival. Therefore, a process is needed to lead them to more appropriate treatment choices. Case presentation: Here, we present the case of a 51-year-old Korean female diagnosed with early-stage breast cancer (stage IIB, T2N1M0) in Nov. 2015. She refused a standard surgical resection together with chemotherapy and opted instead for moxibustion by nonmedical personnel. Consequently, her preference for alternative therapy without conventional treatment exacerbated her disease. Just a little over a year later, integrative cancer treatment, including chemotherapy based on histological founding, and complementary treatment, comprised of acupuncture, moxibustion, and herbal medicine, were administered for 5 months. Finally, she successfully underwent modified radical mastectomy showing a pathological complete response. She received only adjuvant chemotherapy without any alternative medicine afterwards, and she maintained a good status without recurrence. Conclusion: In the case of breast cancer patients who are resistant to surgery and chemotherapy, integrative therapy considering adverse effects from conventional treatment should be preferred to bitter opposition to alternative medicine.
The purpose of this study wsa to necessitate auricular acupressure therapy as an independent nursing intervention on cancer paitents by confirming its effectiveness. Method: The experimental study was unequivalently controlled pre-post measure study. The subjects were 40 cancer patients who were hospitalized in K medical center in Seoul. The experimental group (20) and the control group (20) were randomly assigned. As measured tools, Spielberger's State-trait Anxiety (1976) measured tool by Kim's transplation (1978). The auricular acupressure therapy was applied to experimental group, and the pre-post measure was performed to both group. The data was analyzed by using SPSS computer program that included descriptive statistics, 2-test, and t-test. Result: 1) The experimental group with the auricular acupressure therapy showed lower trait anxiety scores in comparison with the control group (t= 8.036, p=.000). 2) The experimental group which applied the auricular acupressure therapy showed lower state anxiety scores in comparison with the control group (t= 19.616, p=.000). This result showed that cancer patients with the auricular acupressure therapy applied cancer patients decreased state anxiety and trait anxiety. Therefore , effectiveness of the auricular acupressure therapy was confirmed through this study. Conclusion: According to the result, anxiety of cancer pateint should be decreased and controlled by the auricular acupressure therapy as independent nursung intervension. In addition, the auricular acupressure therapy will provide effective independent nursing intervention that will decrease anxiety on patient with other disease and will improve quality of their lives.
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