Open Access Case Study

Inguinal Lymphadenopathy in Carcinoma Gall Bladder: An Unusual Site of Metastasis

Ajas Ibrahim, Debanjan Sikdar, Sagar N Raut, Jaydeep Jain, Sweety Gupta, Amit Gupta, Prashant Joshi, Manoj Gupta

International Research Journal of Oncology, Page 1-4

Gall bladder cancer carries a dismal prognosis especially in advanced cases. Common sites of metastases include liver, lung and unusual sites have also been reported like orbit, cutaneous, adrenal, kidney, breast and thyroid. 66 years female diagnosed case of metastatic carcinoma gall bladder presented with bilateral inguinal lymphadenopathy. Cytology aspirate from inguinal node reported metastatic adenocarcinoma. Inguinal node metastases from gall bladder cancer is very rare and few case reports have been published. We present a case of a woman with advanced cancer of the gall bladder, who presented with bilateral inguinal metastases.

Open Access Original Research Article

Implications of Molecular Estimation of Allelic Burden of JAK2 V617F Mutant Allele in Essential Thrombocythemia and Polycythemia Vera Diseases

Bakhtiyar Alam Syed, Krishna H. Goyani, Shalin Vaniawala, Harsh Parekh, Arpan Acharya, Pratap N. Mukhopadhyaya

International Research Journal of Oncology, Page 1-16

Aims: Development of a JAK2 Allelic burden estimation kit using Taqman probes and determine trend in shifting of JAK2 V617F allelic burden in and its use in analysis of patients with essential thrombocythemia (ET) and polycythemia vera (PV) to predict thrombotic complications.

Methodology: Through a retrospect study, a total of 412 ET and PV patient, divided into 3 groups (0-2, 2-5 and 5-10 years) based on time of detection of the disease, were tested in retrospect for presence of the JAK2 V617F mutant allele burden using an in-house developed Taqman probe-based kit, trend in shifting of the mutant allele burden was studied  and segregated into ET (n=167) and PV (n=126) group based on their disease profile. It was then categorized into 3 time periods (0-2, 2-5 and 5-10 years) based on time of detection of the disease. 

Results: Around 293 (71%) were positive for JAK2 V617F while 59 (14.2%) and 8 (1.9%) positive for CALR exon 9 frame shift & MPL mutations (W515L/W515K) respectively. The 1-25% allelic burden group size gradually fell in ET population over time and this trend continued in the PV population also.  In the former the fall was 7% & 11% for 2-5 & 5-10 years category while in the later, it was 1% and 15% respectively for the same time period-category. 

Conclusions: There is a distinct molecular continuum in the JAK2 V617F allelic burden in the ET & PV patients which followed a predictable trend and was associated with increasingly complicated vascular events.

Open Access Original Research Article

Three Cycles versus Six Cycles of Neoajuvant Chemotherapy in Stage II and III Breast Cancer: 3 Years Overview

Shoukri Hassan Elazab, Mohamed Saad Elzahy, Shimaa E. Attia

International Research Journal of Oncology, Page 1-6

Background: The majority of breast cancer patients is diagnosed at a young age and present with locally advanced stage which limit the response to treatment and the frequency of conservative surgery. Neoadjuvant chemotherapy increasingly used to achieve better results. The number of cycles which should be given is addressed in this study.

Aim: To study the efficacy of increasing number of cycles of neoadjuvant chemotherapy (three versus six cycles of (FAC) protocol) as regards pathological complete response {p(CR)} and frequency of conservative breast surgery.

Methods: 260 breast cancer patients were included into 2 groups and treated with neoadjuvant chemotherapy, group A (132 cases) received 3 cycles, and group B (128 cases) received 6 cycles.

Results: At the end of neoadjuvant chemotherapy protocol, all cases were underwent surgery either modified radical mastectomy (MRM) or conservative breast surgery (CBS) and were pathologically assessed. The p(CR) was statistically different between the 2 groups. In group B 39 patients (30.5%) achieved p(CR) compared to 12 patients (9.1%) in group A (P value<0.05). Also conservative surgery was more frequent in group B (89 patients) (69.5%) compared to group A (52 patients) (39.4%) which is also statistically significant. The protocol was generally well tolerated, febrile neutropenia was noticed in only 7% of cases in group A and 9% in group B.

Conclusion: 6 cycles of FAC protocol of neoadjuvant chemotherapy are better than 3 cycles when used in advanced breast cancer patients as regards p(CR) and frequency of conservative surgery.

Open Access Original Research Article

Impact of Pain, Body Image Disturbance and Distress on Coping Abilities of Patients with Skin Cancer

Mohamed. S. Zahi, Wafaa Abdel-Hakim El-Bahaey, Esraa Awad Barkat, Warda Fathy Aboelez

International Research Journal of Oncology, Page 1-11

Background: Currently, between 2 and 3 million non-melanoma skin cancers and 132,000 melanoma skin cancers occur globally each year. Skin cancer patients suffer from multiple psychological problems, including pain, body image disturbance and distress. Coping with these problems is a key for determining the quality of life for such patients.

Aim: To determine the impact of pain, body image disturbance, and distress on the degree of coping style in patients with skin cancer.

Methods: This study was cross sectional survey done on skin cancer patients who presented to the clinical oncology and nuclear medicine departments at Mansoura University Hospital (MUH) compared with healthy control people in the same age and gender. The study was run from March 2016 to June 2018. 39 patients were included to answer the questionnaires for Numerical Rating Scale for pain assessment (NRS), Body Image Scale (BIS), Hospital Anxiety and Depression Scale (HADS), and Brief Cope Scale, and compared to healthy group.

Results: There is no significant difference between skin cancer patients and healthy control group in the demographic data. There was significant difference in pain, body image, and Hospital Anxiety and depression scales between subject and control group. And this was also reflected as significant difference in all scales of Brief Cope in which healthy control group able to use most coping scales more than skin cancer group except substance abuse and self blame.

Conclusion: Pain, body image disturbance, anxiety, depression, and poor use of coping skills are significantly more common in skin cancer patients when compared to the healthy control group.

Open Access Original Research Article

Awareness, Knowledge and Attitude towards Breast Self-examination: A Cross-sectional Study among Female Pharmacy Students in Malaysia

Abdul Nazer Ali, Foong Ji Yuan, Chuah Hui Ying, Nazer Zulfikar Ahmed

International Research Journal of Oncology, Page 1-10

Aim: The aim of this study was 1) to assess awareness and knowledge towards breast cancer (BC) and breast self examination (BSE) among female pharmacy students in Malaysia. 2) to assess attitude towards practise of BSE among female pharmacy students in Malaysia and 3) to understand the association between awareness, knowledge and attitude towards breast self examination among socio-demographic variables.

Study Design: Cross sectional study.

Place and Duration of Study: Female students from Faculty of Pharmacy, AIMST University, Kedah State, Malaysia between September, 2018 and May, 2019.

Methodology: A pre-validated questionnaire containing socio-demographic details of the study participants, six awareness based items regarding breast cancer (BC), fourteen knowledge based items regarding breast self-examination (BSE) and fifteen attitude based items towards BSE behaviour. The questionnaire was distributed in class room setting after obtaining informed consent forms signed by participants. Summary statistics for categorical variables was used with chi-square test to see if there was any association between the variables.

Results: The overall response rate was 92% (183/200). The average age of participants was 22 years (22.8 ± 1.1). Nearly 82% were Chinese, 30% belonged to year-4 tertiary education, 12% had family history of BC and 45% were from town areas. The overall awareness of the participants towards BC was moderate (64%, P < .05), whereas, knowledge towards BSE was poor (51%, P < .05). There was an overall positive attitude (62%, P < .001), followed by 29% neutral and only 9% with negative attitude regarding BSE practise. There were no association found between awareness, knowledge and attitude among any socio-demographic variables.

Conclusion: This study results confirm that the study participants had a fair awareness, poor knowledge and positive attitude. Educational interventions directed to help young women familiarize with their breast self awareness (detect changes early) to start a lifetime habit of breast self-care, including BSE is important. Health education programs tailored to educate the correct BSE techniques are essential to encourage and improve women practise BSE for early identification and treatment initiation to reduce morbidity and mortality of BC.