Archives of Surgical Oncology

My colleagues and I have been studying an anomalous relapse pattern in breast cancer. This project started in 1993 when data from Italy and UK showed that 50 to 80% of all relapses in patients treated only with surgery occurred in an early wave of relapses in the first 3 years post-surgery. We proposed a reasonable explanation. It appears that the surgery to remove a primary tumour causes systemic inflammation for a week. During that time, dormant single malignant cells and avascular deposits escape from dormancy and appear as relapses within 3 years. The multi-national authors of our reports include medical oncologists, surgeons, anaesthesiologists, physicists, and other scientists from several fields. A potential solution seems to exist based on our analysis. That therapy is the common inexpensive analgesic ketorolac administered as iv at the time of surgery and perhaps as oral drug for a few days after surgery. We edited a book and published a number of papers including one recently (1). Two animal models support our findings (2,3). Another paper suggests a way to prevent some late relapses (4) and a second retrospective clinical trial was reported (5).

Background: Cervical cancer is a preventable disease. Yet in India more cases are detected in advanced stages and the morbidity and mortality in women due to this cancer is high. Objective: To use our experience of Pap smear screening and integrative medicine to promote prevention of cervical cancer through early detection of cervical precancer and non-invasive integrative management (NIIM) when possible. Methods: i) Screening with conventional Pap smears of all women above 30 years of age in a general charitable hospital serving under-privileged women ii) Identification of cervical cancer, and precancerous lesions, other gynaecological cancers iii) Advocacy for colposcopy, sonography, when necessary and appropriate referrals iv) Innovative non-invasive integrative management (NIIM) of Low-Grade Squamous Intraepithelial Lesions (LSIL) using knowledge base of Traditional Ayurvedic medicine. Results: i) Cases in the Ayurvedic general hospital have been screened since1999 but the program for NIIM for precancer started in 2008 ii) Review of spontaneous or induced regression of cancer, in vitro, in vivo, anticancer activity of medicinal plant extracts of Curcuma longa (CL) and Inspira cordifolia (TC) iii) Preclinical, Volunteer studies for safety iv) Exploratory clinical studies on activity and safety of NIIM of LSIL with oral extracts of CL following standard antimicrobials for genital infections. These confirm the role of NIIM in inducing regression in abnormal Pap smears. Conclusions: In view of persistence, recurrences and some complications after surgical treatment of cervical precancerous lesions (e.g., cervical stenosis or incompetence, premature deliveries) we propose the use of safe, non-invasive integrative treatment of cervical precancer lesions with antimicrobials and standardized Curcuma longa extracts as a feasible option. This is clinically important because many of these women are in younger age group (childbearing), and many women do not have the monetary or community means to access surgical treatment by trained personnel due to expenses or nonavailabilit

Aims: The present study was conducted to assess awareness and knowledge of Indian Oral and Maxillofacial diagnostician-‘s regarding application of stem cells for the treatment of oral premalignant disorders. Settings and Design: The present study included a rapid, short cross-sectional online survey. It was conducted using web-based survey platform called Google Forms. Methods and Material: A total of 203 maxillofacial diagnostician-‘s were selected by simple random method for participating in the study. A selfadministered, 10-point questionnaire in the form of online survey was used, to assess the awareness and knowledge of diagnosticians. Statistical analysis used: Results were documented and statistically analysed using chi-square test. Results: Overall awareness and knowledge was found to be more in the participants above 29years of age, having specialty practice and experience of more than 5years. Conclusions: During the course of the study, high level of awareness and knowledge regarding application of stem cells for the treatment of oral premalignant disorders was noted among diagnostician-’s. A significant association between age and area of work with awareness and knowledge was observed.

Problem statement: The high prevalence of breast cancer in Brazil in parallel with the increase in consumption of ultra-processed foods suggests a close relationship between these factors. The purpose of this study is to describe the consumption of ultra-processed foods by women survivors of breast cancer, identifying their contribution and making associations with the intake of specific nutrients. Methodology and Theoretical Guidance: Cross-sectional study with 100 women with breast cancer followed up in an oncology treatment center, from which we collected sociodemographic, clinical and anthropometric information. To assess food consumption, we used a food frequency questionnaire, from which food items were grouped in natura, processed and ultra-processed, following the NOVA classification. The energy contribution of each food group was given by the ratio between calories from the group and total calories. We categorized patients into high and low consumption of ultra-processed and the differences between the two groups were tested by Pearson's X2. The relationship between the intake of calories from ultra-processed foods and the intake of energy and specific nutrients was based on crude linear regression models and adjusted for age, education and body mass index. Conclusion and Meaning: Women survivors of breast cancer have one third of their diet composed of ultra-processed foods associated with a reduction in the consumption of fresh products, proteins and fibers and an increase in the intake of total fat and sodium. We suggest health education actions related to healthy food consumption in the follow-up of breast cancer survivors.

Cyber knife is an advanced robotic Stereotactic Radiosurgery technology that is used in Radiation oncology to treat brain and body tumours in cancer patients. The aim of this study was to find out how Cyber knife Image guided technology is being used in two cyber knife centres to provide treatment to patients with brain and other cancers. The views of a medical physicist and a Medical radiation therapist with clinical experience of using Cyber knife in two separate institutions based in Australia and USA were captured using an E-questionnaire. This study assessed clinical, technical, organizational and Educational strategies and resources employed to provide Cyber Knife treatment. This study showed current status of the state-of-the-art Cyber knife technology