Background: Basal and squamous cell carcinoma (BCC and SCC) are the most common skin cancers worldwide and distinction between the two may sometimes be very difficult in routine histopathology. The present study was aimed to evaluate a reliable diagnostic method for these cancers based on immunohistochemistry (IHC). Materials and Methods: IHC was used with antibodies to Bcl-2, CD10, CEA, and EMA biomarkers, which despite non-specificity are easily available for detection of various types of tumors in pathology sections and can be used as a panel for differentiation. In this descriptive and analytic study, paraffin-embedded blocks of 29 SCC patients and 29 BCC patients were collected and sectioned for IHC staining. The results were analyzed by the STATA (version 8) statistical package using the Chi-square test. Results: BCC patients were 100%, 75.8%, 0% and 0% positive for Bcl-2, CD10, CEA and EMA markers, respectively, and for SCC patients were 3.5%, 0%, 34.5% and 82.7% positive, respectively. Using simultaneously Bcl-2 and CD10 as positive markers, detection of BCC with 88% accuracy and 100% specificity was possible, while application of CEA and EMA positivity could detect SCC with 67% accuracy and 100% specificity. Conclusions: SCC and BCC have different immunostaining profiles; therefore, Bcl-2, CD10, CEA and EMA markers can be helpful to distinguish between them.
Peters, Cheryl E.;Koehoorn, Mieke W.;Demers, Paul A.;Nicol, Anne-Marie;Kalia, Sunil
Safety and Health at Work
/
v.7
no.3
/
pp.208-212
/
2016
Background: Outdoor workers are at risk of high ultraviolet radiation exposure, and may have difficulty using sun protection. The objectives were to determine the prevalence of sun protection behaviors in a sample of outdoor construction workers, and to assess which factors predict better sun protection practices. Methods: Participants were recruited via construction unions. Workers answered a questionnaire on demographics, skin cancer risk, sun protection behaviors, and job. Sun protection behavior scores (from questions on sunscreen use, sleeved shirt, hat, shade seeking, sunglasses) were calculated by converting Likert-scale answers to scores from 0 to 4, and taking the mean (separately for work and leisure). Determinants of sun protection behavior scores were examined for work and leisure using generalized linear models. Results: Seventy-seven workers had complete questionnaire data (participation 98%). Sun protection behaviors used most often were hats (79% often/always) and sleeved shirts (82% often/always); least prevalent were shade-seeking (8% often/always) and sunscreen (29% often/always). For both work and leisure scores, the strongest predictor was skin type, with fairer-skinned individuals having higher sun protection behavior scores. Workers had higher scores at work than on weekends. Workplaces that required hats and sleeved shirts for safety purposes had higher protection behavior scores. Conclusion: This high-participation rate cohort helps characterize sun protection behaviors among outdoor workers. Workers practiced better sun protection at work than on weekends, suggesting that workplace policies supportive of sun protection could be useful for skin cancer prevention in the construction industry.
Background: Breast cancer is the most common cancer among women worldwide. A very important factor in the timely treatment and prevention of progression is high breast cancer awareness. Rural women are at risk of latte stage breast cancer due to poor education and lack of access to medical facilities. Materials and Methods: This cross-sectional-descriptive study was conducted on 266 women (out of 300) aged over 18 in rural areas of Zabol, Southeastern Iran during July 2015 to October 2015. The data collection tool was a researcher-made questionnaire that measured participant knowledge of breast cancer in four aspects (general awareness, risk factors, mammography, and symptoms). SPSS 22 was used for statistical analysis. Results: Out of 266 participants, age information was available for 261. The age range was between 19 and 62, with a mean of $27{\pm}2.1years$. Most participants (154, 57.9%) had an average overall awareness of breast cancer. In the general awareness dimension, most participants (130, 48.9%) had poor scores. Most (166, 62.4%) also had average awareness about risk factors and many (137, 51.5%) had good awareness about mammography. Most participants did not know that changes in breast shape (232, 88.2%), dimpling of breast skin (192, 72.3%) and nipple discharge (183, 69.6%) are the main symptoms of breast cancer. ANOVA statistical analysis showed a significant relationship between awareness level and participant education and occupation (P<0.05). Conclusions: This study indicated average awareness of participants about breast cancer. Since rural women have lower levels of education, it is recommended that educational courses with contents about breast cancer, its risk factors, and symptoms be held for these women.
Breast cancer is the most common cancer among females, worldwide, accounting for 22.9% of all cancers (excluding non-melanoma skin cancer) in females. Mammography is a sensitive (77-95%) and specific (94-97%) screening method for breast cancer. Previously, females between the 40-50 years old were recommended to have mammograms every one to two years. However, based on current evidence, in 2009, USPSTF recommended that the decision to start regular, biennial screening mammography for females younger than 50 years should be an individual decision and take patient context into account, including the patient's values regarding specific benefits and harms. This decision was based on findings regarding radiation exposure, false-positive and false-negative rates, over-diagnosis, and pain and psychological responses. The goal of this paper is to focus on evidence for updating the U.S. Preventive Services Task Force (USPSTF) recommendation against routine mammography for females between 40-49 years of age.
Background: The standard radiotherapy (RT) fractionation practiced in India and worldwide is 50Gy in 25 fractions over 5 weeks to the chest wall or whole breast followed by tumour bed boost in case of breast conservation (BCS). A body of validated data exists regarding hypofractionation in breast cancer. We here report initial results for 135 patients treated at our center with the START-B type of fractionation. Materials and Methods: From May 2011 till July 2012, women with all stages of breast cancer (excluding metastatic), who had undergone BCS or mastectomy were planned for 40Gy in 15 fractions over 3weeks to chest wall/whole breast and supraclavicular fossa (where indicated) followed by tumour bed boost in BCS patients. Planning was done using Casebow's technique. The primary end point was to assess the acute toxicity and the cosmetic outcomes. Using cosmetic scales; patients were assessed during radiotherapy and at subsequent follow up visits with the radiation oncologist. Results: Of the 135 patients, 62 had undergone BCS and 73 mastectomy. Median age of the population was 52 years. Some 80% were T1&T2 tumours in BCS whereas most patients in mastectomy group were T3&T4 tumours (60%). 45% were node negative in BCS group whilst it was 23% in the mastectomy group. Average NPI scores were 3.9 and 4.9, respectively. Most frequently reported histopathology report was infiltrating ductal carcinoma (87%), grade III being most common (58%), and 69% were ER positive tumours, and 30% were Her 2 Neu positive. Triple negative tumours accounted for 13% and their mean age was young (43 yrs.) The maximum acute skin toxicity at the end of treatment was Grade 1 in 94% of the mastectomy grouppatients and 71% in BCS patients. Grade 2 toxicity was 6% in mast group and 23% in BCS group. Grade 3 was 6% in BCS group, no grade 3 toxicity in mastectomy patients and there was no grade 4 skin toxicity in any case. Post RT at 1 month; 39% of BCS patients had persisting Grade I skin reaction which was only 2% in mastectomy patients. At 3 months post RT, 18% patients had persisting hyperpigmentation. At 6 months 8% patients had persisting erythema in the BCS group only. Some 3% BCS and 8% mastectomy patients had lymph edema till the date of evaluation. Cosmetic outcome in BCS patients remained good to excellent 6 months post surgery and radiotherapy. 1 patient of BCS and 3 patients of mast had developed metastatic disease at the time of evaluation. Conclusions: Hypofractionated RT is well tolerated in Indian population with reduced acute skin toxicity and good cosmetic outcome. Regimens such as these should be encouraged in other centers to increase machine output time. The study is on-going to assess long term results.
Background: According to increase in elderly populations, and change in lifestyle and cancer-causing behavior, the global burden of cancer is increasing. For prevention and control of disease, knowledge of population statistics of cancers and their trends is essential. This study aimed to investigate the epidemiology and trends of cancer in the province of Kerman: southeast of Iran. Materials and Methods: This analytical and cross-sectional study was carried out based on cancer registry data at the Disease Management Center of the Health Ministry from 2004 to 2009 in the province of Kerman in Iran. Common cancers were defined as the number of reported cases and standardized incidence rates. To compute the annual percentage change (APC), joinpoint 4.1.1.1 software was applied. Results: Of 10,595 registered cases, 45.3% (4802 cases) were in women and 56.7% (5,793 cases) occurred in men. The standardized incidence rates for both females and males were increasing during the six years studied. The most common cancers in both sexes during six years of studied were skin (13.4%), breast (9.35%), bladder (7.8%), stomach (7.45%), leukemia (7.05%), colorectal(5.57%), lung(4.92%), trachea(3.51%) and prostate(2.48%). Conclusions: Our findings revealed that the cancer incidence is demonstrating increasing trends in both sexes in the province of Kerman. This may be because of changes in lifestyle, increasing exposure to risk factors for cancer and increase of life expectancy. If this is the case, increasing public awareness of cancer risk factors is a high priority, together with introduction of large-scale screening techniques.
Cancer preventive activities of green tea and its main constituent, (-)-epigallocatechin gallate (EGCG) have been extensively studied by scientists all over the world. Since 1983, we have studied the cancer chemopreventive effects of EGCG as well as green tea extract and underlying molecular mechanisms. The first part of this review summarizes groundbreaking topics with EGCG and green tea extract: 1) Delayed cancer onset as revealed by a 10-year prospective cohort study, 2) Prevention of colorectal adenoma recurrence by a double-blind randomized clinical phase II trial, 3) Inhibition of metastasis of B16 melanoma cells to the lungs of mice, 4) Increase in the average value of Young's moduli, i.e., cell stiffness, for human lung cancer cell lines and inhibition of cell motility and 5) Synergistic enhancement of anticancer activity against human cancer cell lines with the combination of EGCG and anticancer compounds. In the second part, we became interested in cancer stem cells (CSCs). 1) Cancer stem cells in mouse skin carcinogenesis by way of introduction, after which we discuss two subjects from our review on human CSCs reported by other investigators gathered from a search of PubMed, 2) Expression of stemness markers of human CSCs compared with their parental cells, and 3) EGCG decreases or increases the expression of mRNA and protein in human CSCs. On this point, EGCG inhibited self-renewal and expression of pluripotency-maintaining transcription factors in human CSCs. Human CSCs are thus a target for cancer prevention and treatment with EGCG and green tea catechins.
Purpose: This analysis was conducted to evaluate the efficacy and safety of icotinib based regimens in treating patients with non-small cell lung cancer (NSCLC). Methods: Clinical studies evaluating the efficacy and safety of icotinib-based regimens with regard to response and safety for patients with NSCLC were identified using a predefined search strategy. Pooled response rates of treatment were calculated. Results: With icotinib-based regimens, 7 clinical studies which including 5,985 Chinese patients with NSCLC were considered eligible for inclusion. The pooled analysis suggested that, in all patients, the positive reponse rate was 30.1% (1,803/5,985) with icotinib-based regimens. Mild skin itching, rashes and diarrhea were the main side effects. No grade III or IV renal or liver toxicity was observed. No treatment-related death occurred in patients treated with icotinib-based regimens. Conclusions: This evidence based analysis suggests that icotinib based regimens are associated with mild response rate and acceptable toxicity for treating Chinese patients with NSCLC.
Background: The aim of this study was to investigate whether electrochemotherapy is a clinically and cost-effective treatment option against skin tumors. Materials and Methods: We performed an analysis of the current literature based on database searches in PubMed/MEDLINE and we included articles till July 2012. Terms used for the search were 'electrochemotherapy', 'skin cancer', 'recurrence', and 'cutaneous and subcutaneous tumors'. Only papers published in English were included. In addition, we performed an analysis of the cost effectiveness of the method. Results: The combination of physics and chemistry is the foundation for electrochemotherapy and its efficacy, independent of the tumor histology. Clinical data showed that ECT is well tolerated and can be used in difficult cases without other available treatment options. The analysis also showed that the treatment is feasible and cost-effective. Conclusions: Electrochemotherapy is a clinically efficient safe and cost-effective treatment and clinicians should not hesitate to use it as alternative therapeutic modality or as palliative treatment.
Background: Little is known about the news coverage of cancer risk factors in Korea. This study aimed to examine how the news media encompasses a wide array of content regarding cancer risk factors and related cancer sites, and investigate whether news coverage of cancer risk factors is congruent with the actual prevalence of the disease. Materials and Methods: A content analysis was conducted on 1,138 news stories covered during a 5-year period between 2008 and 2012. The news stories were selected from nationally representative media in Korea. Information was collected about cancer risk factors and cancer sites. Results: Of various cancer risk factors, occupational and environmental exposures appeared most frequently in the news. Breast cancer was mentioned the most in relation to cancer sites. Breast, cervical, prostate, and skin cancer were overrepresented in the media in comparison to incidence and mortality cases, whereas lung, thyroid, liver, and stomach cancer were underrepresented. Conclusions: To our knowledge, this research is the first investigation dealing with news coverage about cancer risk factors in Korea. The study findings show occupational and environmental exposures are emphasized more than personal lifestyle factors; further, more prevalent cancers in developed countries have greater media coverage, not reflecting the realities of the disease. The findings may help health journalists and other health storytellers to develop effective ways to communicate cancer risk factors.
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