• Title/Summary/Keyword: advanced cancer

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Clinicopathologic Profile of Breast Cancer Patients in Pakistan: Ten Years Data of a Local Cancer Hospital

  • Khokher, Samina;Qureshi, Muhammad Usman;Riaz, Masooma;Akhtar, Naseem;Saleem, Afaf
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.2
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    • pp.693-698
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    • 2012
  • Breast cancer is the most frequent cancer of women worldwide, with considerable geographic and racial/ethnic variation. Data are generally derived from population based cancer registries in the developed countries but hospital data are the most reliable source in the developing countries. Ten years data from 1st Jan 2000 to 31st Dec 2009 of a cancer hospital in Pakistan were here analyzed by descriptive statistics to evaluate the clinicopathologic profile of local breast cancer patients. Among 28,740 cancer patients, 6,718 were registered as breast cancer. The female to male ratio was 100:2. Breast cancer accounted for 23% of all and 41% of female cancers. Some 46% were residents of Lahore, with a mean age of $47{\pm}12$ years. Less than 1% were at Stage 0 and 10%, 32%, 35% and 23% were at Stage I, II, III and IV respectively. Histopathology was unknown in 4% while 91%, 2% and 1% had invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC) and mucinous carcinoma respectively. Rare carcinomas accounted for the rest. Tumor grade 1, 2 and 3 was 11%, 55% and 34% among the known. Profile of breast cancer patients in Pakistan follows a pattern similar to that of other developing countries with earlier peak age and advanced disease stage at presentation. The male breast cancer accounts for higher proportion in the local population. Local women have higher frequency of IDC and lower frequency of ILC and DCIS, owing probably to a different risk profile. Use of hospital information systems and establishment of population based cancer registry is required to have accurate and detailed local data. Promotion of breast health awareness and better health care system is required to decrease the burden of advanced disease.

First Data On Direct Costs of Lung Cancer Management in Morocco

  • Tachfouti, N.;Belkacemi, Y.;Raherison, C.;Bekkali, R.;Benider, A.;Nejjari, C.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1547-1551
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    • 2012
  • Background: Lung cancer is the leading cause of cancer morbidity and mortality. Its management has a significant economic impact on society. Despite a high incidence of cancer, so far, there is no national register for this disease in Morocco. The main goal of this report was to estimate the medical costs of lung cancer in our country. Methods: We first estimated the number of annual new cases according to stage of the disease on the basis of the Grand-Casablanca-Region Cancer Registry data. For each sub-group, the protocol of treatment was described taking into account the international guidelines, and an evaluation of individual costs during the first year following diagnosis was made. Extrapolation of the results to the whole country was used to calculate the total annual cost of treatments for lung cancer in Morocco. Results: Overall approximately 3,500 new cases of lung cancer occur each year in the country. Stages I and II account for only 4% of cases, while 96% are diagnosed at locally advanced or metastatic stages III and IV. The total medical cost of lung cancer in Morocco is estimated to be around USD 12 million. This cost represents approximately 1% of the global budget of the Health Department. According to AROME Guidelines, about 86% of the newly diagnosed lung cancer cases needed palliative treatment while 14% required curative intent therapy. The total cost of early and advanced stages lung cancer management during the first year were estimated to be 4,600 and 3,420 USD, respectively. Conclusion: This study provides health decision-makers with a first estimate of costs and the opportunity to achieve the optimal use of available data to estimate the needs of health facilities in Morocco. A substantial proportion of the burden of lung cancer could be prevented through the application of existing cancer control knowledge and by implementing tobacco control programs.

Temporal Trends and Future Prediction of Breast Cancer Incidence Across Age Groups in Trivandrum, South India

  • Mathew, Aleyamma;George, Preethi Sara;Arjunan, Asha;Augustine, Paul;Kalavathy, MC;Padmakumari, G;Mathew, Beela Sarah
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2895-2899
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    • 2016
  • Background: Increasing breast cancer (BC) incidence rates have been reported from India; causal factors for this increased incidence are not understood and diagnosis is mostly in advanced stages. Trivandrum exhibits the highest BC incidence rates in India. This study aimed to estimate trends in incidence by age from 2005-2014, to predict rates through 2020 and to assess the stage at diagnosis of BC in Trivandrum. Materials and Methods: BC cases were obtained from the Population Based Cancer Registry, Trivandrum. Distribution of stage at diagnosis and incidence rates of BC [Age-specific (ASpR), crude (CR) and age-standardized (ASR)] are described and employed with a joinpoint regression model to estimate average annual percent changes (AAPC) and a Bayesian model to estimate predictive rates. Results: BC accounts for 31% (2681/8737) of all female cancers in Trivandrum. Thirty-five percent (944/2681) are <50 years of age and only 9% present with stage I disease. Average age increased from 53 to 56.4 years (p=0.0001), CR (per $10^5$ women) increased from 39 (ASR: 35.2) to 55.4 (ASR: 43.4), AAPC for CR was 5.0 (p=0.001) and ASR was 3.1 (p=0.001). Rates increased from 50 years. Predicted ASpR is 174 in 50-59 years, 231 in > 60 years and overall CR is 80 (ASR: 57) for 2019-20. Conclusions: BC, mostly diagnosed in advanced stages, is rising rapidly in South India with large increases likely in the future; particularly among post-menopausal women. This increase might be due to aging and/or changes in lifestyle factors. Reasons for the increased incidence and late stage diagnosis need to be studied.

Case Series of Advanced Non-Small Cell Lung Cancer Patients Treated with Hang-Am Plus (진행성 비소세포성 폐암환자에 대한 항암플러스의 치료효능 : 연속증례보고)

  • Zheng, Hong-Mei;Yoon, Jeung-Won;Lee, Yeon-Weol;Cho, Chong-Kwan;Oh, Dal-Seok;Yoo, Hwa-Seung
    • The Journal of Internal Korean Medicine
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    • v.32 no.1
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    • pp.113-120
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    • 2011
  • Objectives : A case series was conducted to investigate the therapeutic effects of Hang-Am Plus (HAP) on the tumor response and HRQoL (Health Related Quality of Life) in advanced non-small cell lung cancer (NSCLC) patients. Methods : Three patients were given 1,000-2,000 mg of HAP, three times a day (daily total dosage of 3,000-6,000 mg/day) for 12 weeks. Results : After the 3 month administration with HAP, three patients showed stable disease (SD) condition according to the chest computed tomography (CT), and two of the patients reported a decrease in pain levels. Conclusions : The observed NSCLC cases suggest treatment with HAP may be related to the observed tumor growth inhibition and pain reduction.

Lived Experience among Patients Newly Diagnosed with Lung Adenocarcinoma Stage IV within One Year

  • Shih, Whei-Mei Jean;Hsu, Hsiu-Chin;Jiang, Ru-Shang;Lin, Mei-Hsiang
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6633-6638
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    • 2015
  • Background: lung cancer (LC) is the fifth of the 10 leading causes of death in the world. LC is in first place for cancer-related mortality for both males and females in Taiwan. It is one of the most difficult cancers to treat and is often diagnosed at a late stage. Patients with stage IV are often unprepared for the diagnosis. Materials and Methods: To explore lived experience among patients newly diagnosed with lung adenocarcinoma stage IV within one year. Results: Twelve participants were recruited in this study. Content analysis of the interviews revealed four themes: (1) emotional roller coaster, (2) trying to find out causes, (3) adjusting my lifestyle, and (4) cancer fighter. Conclusions: This study provides new insight into the experiences of lung cancer patients y with newly diagnosed lung adenocarcinoma stage 4. These results will inform future supportive care service development and intervention research for patients with advanced stage cancer.

Two Cases of Endometrial Cancer Treated with Palliative Herbal Medication Hangam-dan (HAD)

  • Yoo, Hwa-Seung;Kim, Seung-Hyun;Lee, Yeon-Weol;Cho, Chong-Kwan;Lee, Keun-Ho
    • The Journal of Korean Medicine
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    • v.28 no.4
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    • pp.176-180
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    • 2007
  • Background : Advanced-stage endometrial cancer patients show a poor prognosis because of limited success from surgery, radiotherapy or chemotherapy. Recently, the uses of complimentary and alternative medicines have gained popularity for these patients. Cases : The first case is a 46-year-old patient with FIGO stage IVb endometrial cancer who had distant metastasis on her supraclavicular LNs area; the second, a 72-year-old stage Ib patient who could not be treated with surgery or chemotherapy because of chronic heart disease and her refusal of radiation therapy due to her advanced age. They remain alive and in stable condition under a strict traditional herbal medicine regiment 41 and 52 months, respectively, after diagnosis. Conclusion : We present two cases of endometrial cancer patients who desire to be treated by traditional herbal medication with no further development.

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5-FU or capecitabine based chronomodulated chemotherapy for advanced colorectal cancer: mata-analysis and systematic review (진행성 대장직장암 환자군에 있어서 5-FU 혹은 capecitabine의 최적 시간 치료법에 대한 체계적 고찰 : 메타분석)

  • Lee, Jee Young;Oh, Hye Kyung;Ryu, Han Sung;Yoon, Seong Woo
    • Journal of Korean Traditional Oncology
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    • v.20 no.1
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    • pp.31-44
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    • 2015
  • Background : The purpose of this study is to investigate the efficacy and safety of the circadian delivery schedule of fluorouracil or capecitabine based chemotherapy for advanced colorectal cancer. Patients and methods : A meta-analysis was performed using individual data from eight international randomized clinical trials, especially phase II or III trials, comparing 5-fluorouracil, or capeticabine in chronomodulated or conventional schedule. The data from 8 studies was composed of 692 patients receiving chronomodulated chemotheray and 684 patients receiving conventional chemotherapy. The main end point was response rate. Results : Response rate was insignificantly different from each group (RR 1.14, 95%CI 0.74-1.74, p=0.55). Overall survival and progresseion-free survival were not significant either. Chemotherapy induced anemia, diarrhea, and nausea/vomiting were worse in the chronotherapy group, with statistic significance respectively. On the other hand, chemotherapy induced thrombocytopenia, stomatitis, peripheral neuropathy, and dermatotoxicity were better but they were not statistically significant results. Conclusions : Patients lived longer but not significantly on chronomodulated chemotherapy rather than on conventional chemotherapy. Patients on chronomodulated chemotherapy experienced adverse events more. The chronomodulated chemotherapy schedule needs adjustment of its delivery schedule and further research is required.

Colorectal Cancer in the Kingdom of Saudi Arabia: Need for Screening

  • Mosli, Mahmoud H.;Al-Ahwal, Mahmoud S.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3809-3813
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    • 2012
  • Background and Objectives: Colorectal cancer (CRC) is a major health problem in the Kingdom of Saudi Arabia (KSA). Our aim was to characterize the epidemiology of CRC in the Saudi population. Design and Setting: Retrospective analysis of all cases of CRC recorded in the Saudi Cancer Registry (SCR) between January 2001 and December 2006 amongst Saudi citizens in KSA. Patients and Methods: Data were retrieved from the database of the SCR. Descriptive statistics was performed using SPSS. Results: A total of 4,201 cases of CRC were registered in the SCR. The incidence of CRC increased between 2001 and 2006. The mean age of patients at the time of diagnosis was 58 years; most patients were above 45 years of age (n=3322; 79.1%). At the time of diagnosis, 977 patients (23.0%) presented with localized disease and 1,018 (24.0%) had distant metastasis. The most frequent pathological variant was adenocarcinoma (73%), with grade 2 (moderately differentiated) being the most common grade among all variants (61%). For all cancer grades, the frequency of CRC was significantly higher among patients >45 years (P=0.004), who presented with more advanced disease (stages III and IV) (P=0.012). Based on logistic regression, age >45 years was associated with advanced regional presentation (P=0.001). Tumor grade was associated with advanced regional presentation and metastasis. Conclusions: There was an increase in the incidence of CRC between 2001 and 2006. The age at the time of diagnosis was low when compared with reports from developed countries. A nationwide approach is needed to encourage and illustrate the importance of screening programs.