• 제목/요약/키워드: Secondary cancer

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Low Coverage and Disparities of Breast and Cervical Cancer Screening in Thai Women: Analysis of National Representative Household Surveys

  • Mukem, Suwanna;Meng, Qingyue;Sriplung, Hutcha;Tangcharoensathien, Viroj
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권18호
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    • pp.8541-8551
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    • 2016
  • Background: The coverage of breast and cervical cancer screening has only slightly increased in the past decade in Thailand, and these cancers remain leading causes of death among women. This study identified socioeconomic and contextual factors contributing to the variation in screening uptake and coverage. Materials and Methods: Secondary data from two nationally representative household surveys, the Health and Welfare Survey (HWS) 2007 and the Reproductive Health Survey (RHS) 2009 conducted by the National Statistical Office were used. The study samples comprised 26,951 women aged 30-59 in the 2009 RHS, and 14,619 women aged 35 years and older in the 2007 HWS were analyzed. Households of women were grouped into wealth quintiles, by asset index derived from Principal components analysis. Descriptive and logistic regression analyses were performed. Results: Screening rates for cervical and breast cancers increased between 2007 and 2009. Education and health insurance coverage including wealth were factors contributing to screening uptake. Lower or non-educated and poor women had lower uptake of screenings, as were young, unmarried, and non-Buddhist women. Coverage of the Civil Servant Medical Benefit Scheme increased the propensity of having both screenings, while the universal coverage scheme increased the probability of cervical screening among the poor. Lack of awareness and knowledge contributed to non-use of both screenings. Women were put off from screening, especially Muslim women on cervical screening, because of embarrassment, fear of pain and other reasons. Conclusions: Although cervical screening is covered by the benefit package of three main public health insurance schemes, free of charge to all eligible women, the low coverage of cervical screening should be addressed by increasing awareness and strengthening the supply side. As mammography was not cost effective and not covered by any scheme, awareness and practice of breast self examination and effective clinical breast examination are recommended. Removal of cultural barriers is essential.

Phase II Study of Compliance and Morbidity with 4 Cycles of Taxotere Followed by 4 of Doxorubicin-Cyclophosphamide for Adjuvant Treatment of Operable Breast Cancer Patients

  • Yaghan, Rami Jalal;Dagher, Nawaf Mahmood
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권8호
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    • pp.4031-4035
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    • 2016
  • Background: In the adjuvant treatment of breast cancer, anthracycline and taxane based regimens can be used concomitantly or sequentially. The best order in the sequential regimens has yet to be well established. This study evaluated the feasibility of 4 cycles of adjuvant taxotere ($100mg/m^2$) every 3 weeks followed by 4 cycles of doxorubicin ($60mg/m^2$) and cyclophosphamide ($600mg/m^2$) every 3 weeks. The primary outcome was the safety profile. Secondary outcomes were disease free survival (DFS) and overall survival (OS). Materials and Methods: This non-randomize prospective phase II stud was performed at Jordan University of Science and Technology and its affiliated King Abdulla Teaching Hospital between July 2009 and August 2010. Data collection was closed on May $31^{th}$, 2015 giving a median follow up period of 62 months. The study was approved by the institutional review board and a written informed consent was obtained for each patient. Results: Fifty patients were enrolled. The median age was 53.1 years (range 34-76). One patient (2%) had stage I disease, 17 (34%) stage II, and 32 (64.0%) stage III. Forty-six patients were evaluable for efficacy analysis. The completion rate was 95.7%. No dose modifications were needed. The incidences of grade 3-4 neutropenia and febrile neutropenia were 14 % and 10%. No grade 3-4 non-hematological adverse events were encountered. At a median follow up time of 62 months the OS and the DFS rates were 76.1% and 56.5%. Those for stages I and II combined were 100% and 75%. Conclusions: Taxotere first followed by doxorubicin-cyclophosphamide appears a feasible regimen as evidenced by an acceptable completion rate, a satisfactory safety profile, and an OS and DFS rates comparable to other studies.

High-grade Cervical Histopathology in Women with Atypical Glandular Cell Cytology

  • Watcharanon, Waranya;Luanratanakorn, Sanguanchoke;Kleebkaow, Pilaiwan;Chumworathayi, Bandit;Temtanakitpaisan, Amornrat;Kietpeerakool, Chumnan
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권1호
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    • pp.135-138
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    • 2016
  • This study was undertaken to evaluate the prevalence of underlying significant lesions among women referred for colposcopy after atypical glandular cell (AGC) smears and the associated risks. The present study reviewed data from women with AGC smears undergoing colposcopy at the Colposcopy Clinic, Faculty of Medicine, Khon Kaen University, Thailand between January 2001 to December 2014. Significant lesions included cervical intraepithelial neoplasia grade 2-3, adenocarcinoma in situ, endometrial hyperplasia, and cancer. During the study period, 170 women with AGC cytology were reviewed. The mean age was 45.7 years. Thirty-eight women (22.4%) were postmenopausal. Eighteen smears (10.6%) were further subclassified as AGC-favor neoplasia (AGC-FN). In total, significant lesions were noted in 27 women (15.9%; 95%CI, 7.8%-18.3%). Thirteen women (7.6%, 95%CI, 4.1%-12.7%) were found to have cervical cancer or endometrial cancer. Two variables were independently associated with an increased risk of significant histopathology results: level of educational attainment (secondary level or lower versus bachelor degree or higher) and types of AGC (AGC versus AGC-FN). Women who had low level of education and those with AGC-FN were at the higher risk of significant lesions (OR, 3.16; 95%CI 1.10-9.11 and OR, 4.62; 95%CI, 1.54-13.85, respectively). In conclusion, the rate of significant lesions among women referred for colposcopy after AGC smears is considerably high. Low education and smear subtypes appear independently associated with a higher risk of significant lesions.

Village Voices: Lessons about Processes for Disease Prevention from a Qualitative Study of Family Health Leaders in a Community in Northeastern Thailand

  • Jongudomkarn, D;Singhawara, P;Macduff, C
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권10호
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    • pp.4401-4408
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    • 2015
  • Background: Cancer is a primary source of concern in Thailand and other countries around the world, including the Asian-Pacific region. Evidence supports that an important contributing cause of cancer and other chronic illnesses such as stroke, diabetes, and hypertension is excessive alcohol consumption. Studies conducted in Thailand reveal a worrisome rise in the number of new and regular drinkers in communities. Therefore, actions for primary, secondary and tertiary prevention of problem drinking are necessary. In recent years nurses in North East Thailand have been developing and implementing the Khon Kaen Family Health Nursing model to embed disease prevention in communities through the actions of family health nurses and local family health leaders. Aim: The aim of this qualitative research was to better understand the experiences of the local family health leaders using this model and to synthesize lessons learned. Materials and Methods: As part of a participatory action research approach involving analysis of focus group discussions and individual interviews, the experiences of 45 family health leaders were synthesized. Results: Four main themes were identified, namely: i) Family first: role modeling beginning at the personal and family level. ii) Local leverage: using village community forums to reduce alcohol drinking. iii) Gentle growth: making the first step and treading gently; and iv) Respect, Redemption, Rehabilitation: valuing the person to re-integrate them in the village society. Conclusions: As alcohol consumption in the village declined significantly following the prevention program, these findings illuminate how low-tech integrated prevention approaches may be very useful, particularly in rural communities. The lessons learned may have relevance not only in Thailand but in other countries seeking to prevent and mitigate behavior that conduces to diseases such as cancer.

Health-promoting Lifestyle Behaviour for Cancer Prevention: a Survey of Turkish University Students

  • Ay, Semra;Yanikkerem, Emre;Calim, Selda Ildan;Yazici, Mete
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권5호
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    • pp.2269-2277
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    • 2012
  • Background: Health risks associated with unhealthy behaviours in adolescent and university students contribute to the development of health problems in later life. During the past twenty years, there has been a dramatic increase in public, private, and professional interest in preventing disability and death through changes in lifestyle and participation in screening programs. The aim of the study was to evaluate university students' health-promoting lifestyle behaviour for cancer prevention. Method: This study was carried out on university students who had education in sports, health and social areas in Celal Bayar University, Manisa, Turkey. The health-promoting lifestyles of university students were measured with the "health-promoting lifestyle profile (HPLP)" The survey was conducted from March 2011 to July 2011 and the study sample consisted of 1007 university students. T-test, ANOVA and multiple regression analyses were used for statistical analyses. Results: In the univariate analyses, the overall HPLP score was significantly related to students' school, sex, age, school grades, their status of received health education lessons, place of birth, longest place of residence, current place of residence, health insurance, family income, alcohol use, their status in sports, and self-perceived health status. Healthier behaviour was found in those students whose parents had higher secondary degrees, and in students who had no siblings. In the multiple regression model, healthier behaviour was observed in Physical Education and Sports students, fourth-year students, those who exercised regularly, had a good self-perceived health status, who lived with their family, and who had received health education lessons. Conclusion: In general, in order to ensure cancer prevention and a healthy life style, social, cultural and sportive activities should be encouraged and educational programmes supporting these goals should be designed and applied in all stages of life from childhood through adulthood.

여성 유방암 환자의 림프부종 감소와 조절을 위한 운동의 효과: 체계적 고찰과 메타분석 (Exercise for reducing and controlling lymphedema in Women with breast cancer: A systematic review and meta-analysis)

  • 김경희;오기영
    • 한국산학기술학회논문지
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    • 제17권4호
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    • pp.512-520
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    • 2016
  • 유방암은 여성에서 가장 흔한 악성종양이며, 림프부종은 가장 흔한 유방암수술 후 합병증 가운데 하나이다. 따라서 림프부종과 같은 치료 후유증의 위험도 감소와 적절한 관리는 유방암 생존 환자와 의사에게 있어서 그 중요성이 점차 커지고 있다. 이러한 림프부종의 발생을 예방하기 위하여 흔히 운동이 처방된다. 그러나 그러한 운동의 시기와 효과에 대해서는 각각 상반된 결과들이 보고되어 왔다. 저자들은 림프부종에 대한 운동 효과를 점검하여 환자 치료에 최선의 근거를 도입하기 위해 최신문헌과 상호 심사된 출판물, 전문 기구의 웹사이트를 체계적으로 고찰하여 림프부종의 예방이나 치료를 위해 시행되는 운동의 효과를 검토하였고, 그 결과 이미 림프부종이 발생해 있는 환자들에서는 임상적인 부종진행의 차이점에 유의성이 없었지만, 발생 전 환자들에서는 운동 혹은 훈련이 이차성 림프부종의 발생을 감소시키고 진행을 변경시키는 양상을 볼 수 있었다. 암치료의 발전, 암과 운동 연구, 림프부종의 관리를 위해서는 현재까지 도출된 근거들에 대한 고찰과 이해가 있어야 임상의사들이 적절한 환자 교육과 전문가의뢰를 시행할 수 있을 것이다.

암 환자 가족의 호스피스 요구도 (The Need for Hospice Care in Families of Patients with Cancer)

  • 김신정;김영순;강경아
    • 지역사회간호학회지
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    • 제15권4호
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    • pp.639-647
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    • 2004
  • Purpose: The purpose of this study was to analyze the need for hospice care programs in families of patients with cancer. Method: The study surveyed 98 families who were taking care of patients with cancer. This survey was conducted from August 2004 to October 2004 at two general hospitals in Seoul. The data were collected through a self-reporting questionnaire of 22 items. The items were classified into five areas by factor analysis to identify the construct validity. The reliability of the tool was established by Cronbach's alpha as .93 and the data collected were analyzed by descriptive statistics, t-test and ANOVA. Results: 1) The degree of need for hospice care of the subjects showed a high average of $3.26({\pm}3.7$). The need for 'emotional care of patients showed the highest mean' (M=3.47), 'management of terminal physical symptoms' (M=3.34), 'control of secondary physical problems' (M =3.26), 'acceptance of the family's difficulty' (M=3.12), 'spiritual care for preparing for death' (M=2.96), respectively. 2) With respect to the demographic characteristics of the subjects, there were statistically significant differences in hospice care needs, according to the onset of diagnosis (F=3.110, p=.030). Conclusion: Hospice care must be provided considering the needs of families of patients with cancer. In this sense, this country's needs as well as hospice nurses' higher concern and support for hospice care of patients require further education and program development to meet the current demands.

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Upregulation of long non-coding RNA XIST has anticancer effects on epithelial ovarian cancer cells through inverse downregulation of hsa-miR-214-3p

  • Wang, Changhong;Qi, Shan;Xie, Cheng;Li, Chunfu;Wang, Pu;Liu, Dongmei
    • Journal of Gynecologic Oncology
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    • 제29권6호
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    • pp.99.1-99.11
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    • 2018
  • Objective: The present study is to evaluate the biological functions of long non-coding RNA (lncRNA), X-inactive specific transcript, X-inactive specific transcript (XIST) in human epithelial ovarian cancer (EOC). Methods: XIST was upregulated in EOC cell lines, CAOV3 and OVCAR3 cells by lentiviral transduction. The effects of XIST overexpression on cancer cell proliferation, invasion, chemosensitivity and in vivo tumor growth were investigated, respectively. Possible sponging interaction between XIST and human microRNA hsa-miR-214-3p was further evaluated. Furthermore, hsa-miR-214-3p was overexpressed in XIST-upregulated CAOV3 and OVCAR3 cells to evaluate its effect on XIST-mediated EOC regulation. Results: Lentivirus-mediated XIST upregulation had significant anticancer effects in CAOV3 and OVCAR3 cells by suppressing cancer cell proliferation, invasion, increasing cisplatin chemosensitivity and inhibiting in vivo tumor growth. Hsa-miR-214-3p was confirmed to directly bind XIST, and inversely downregulated in XIST-upregulated EOC cells. In EOC cells with XIST upregulation, secondary lentiviral transduction successfully upregulated hsa-miR-214-3p expression. Subsequently, hsa-miR-214-3p upregulation functionally reversed the anticancer effects of XIST-upregulation in EOC. Conclusion: Upregulation of lncRNA XIST may suppress EOC development, possibly through sponging effect to induce hsa-miR-214-3p downregulation

조위승기탕으로 호전된 암 환자의 마약성 진통제로 인한 변비 치험 1례 (A Case Report on Opioid-Induced Constipation in a Patient with Cancer Treated by Jowiseunggi-tang)

  • 윤지현;박수빈;김은혜;이지영;윤성우
    • 대한한방내과학회지
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    • 제43권2호
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    • pp.229-236
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    • 2022
  • Objective: Jowiseunggi-tang (JWSGT) is a traditional herbal medicine commonly used for purgative activity in constipation. This study evaluates JWSGT for the treatment of opioid-induced constipation (OIC), the most common and debilitating gastrointestinal effect of opioid use. Methods: A 64-year-old man with floor of mouth cancer was hospitalized for OIC, and JWSGT was administered orally twice a day for 10 days, along with acupuncture, moxibustion, and cupping. The primary outcome measures were defecation type according to the Bristol Stool Form Scale (BSFS) and the frequency of bowel movements. The Brief Fatigue Inventory (BFI) and the Functional Assessment of Cancer Therapy-General (FACT-G) were used as secondary measures. Results: After three days of JWSGT administration, spontaneous bowel movements were observed two to three times per week with improved BSFS from type 2 to 4. A reduction in BFI score (8.7 to 2.0) and an increase in FACT-G score (44.3 to 59.0) suggested an improvement in fatigue level and quality of life. Conclusion: This is the first report to assess the efficacy of JWSGT for the management of OIC in patients with cancer, and JWSGT may be an effective option to improve symptoms and quality of life in this group.

A1E Induces Apoptosis via Targeting HPV E6/E7 Oncogenes and Intrinsic Pathways in Cervical Cancer Cells

  • Ham, Sun Young;Bak, Ye Sol;Kwon, Tae Ho;Kang, Jeong Woo;Choi, Kang Duk;Han, Tae Young;Han, Il Young;Yang, Young;Jung, Seung Hyun;Yoon, Do Young
    • Journal of Applied Biological Chemistry
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    • 제57권2호
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    • pp.103-111
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    • 2014
  • A1E is an extract from traditional Asian medicinal plants that has therapeutic activities against cancers, metabolic disease, and other intractable conditions. However, its mechanism of action on cervical cancer has not been studied. In order to ascertain if A1E would have pronounced anti-cervical cancer effect, cervical cancer cells were incubated with A1E and apoptosis was detected by nuclear morphological changes, annexin V-FITC/PI staining, cell cycle analysis, western blotting, Reverse-transcription polymerase chain reaction, and measurement of mitochondrial membrane potential. Expression of human papiloma virus E6 and E7 oncogenes was down-regulated in A1E-treated cervical cancer cells, while p53 and retinoblastoma protein levels were enhanced. A1E also perturbed cell cycle progression at sub-G1 and altered cell cycle regulatory factors in SiHa cervical cancer cells. A1E activated apoptotic intrinsic pathway markers such as caspase-9, caspase-3 and poly ADP-ribose polymerase, and down-regulated expression of Bcl-2 and Bcl-xl. A1E induced mitochondrial membrane potential collapse and cytochrome c release, and inhibited phosphatidylinositol 3-kinase (PI3K)/Akt, key factors involved in cell survival signaling. Taken all these results, A1E induced apoptosis via activation of the intrinsic pathway and inhibition of the PI3K/Akt survival-signaling pathway in SiHa cervical cancer cells. In conclusion, A1E exerts anti-proliferative action growth inhibition on cervical cancer cells through apoptosis which demonstrates its anti-cervical cancer properties.