Cancer Science & Therapy

ISSN: 1948-5956

Open Access

Current Issue

Volume 13, Issue 2 (2021)

    Case Report Pages: 1 - 3

    Penile Metastasis from Cancer of Prostate: A Case Report

    Rajendra Nerli

    Metastatic spread from the prostate to the penis is known to occur, though rare. A needle biopsy remains the most reliable diagnostic modality that allows for histological and immunological confirmation of metastatic spread, and evaluation of the extent of invasion. The mode of metastasis seems to be either by direct invasion, implantation, haematogenous or lymphatic spread. Treatment mainly remains palliative and improving quality of life in view of the poor prognosis and a 6-month mortality of 80%. We report a patient with castrate resistant prostate cancer who presented with obstructive voiding symptoms and reddish lesions on the glans. Biopsy proved it to be a metastasis from the prostate cancer.
    Case Report Pages: 1 - 4

    Non- Seminoma Testicular Tumors Clinical Stage I: Management Strategies

    Rajendra Nerli

    Clinical stage I is the most frequent clinical presentation of non-seminoma testicular cancer. Despite a survival rate of close to 100%, the management of patients with this disease stage is controversial. The recurrence rate is 15% to 50% for those with stage I non-seminoma. A highly sensitive and specific biomarker that can predict or confirm relapse of disease, and help to drive a definitive risk-adapted management is still not available. Lymph vascular invasion (LVI) in the orchiectomy specimen has been used as a risk factor in patients with stage I non-seminoma, however, the discriminative power of LVI is modest at best. Presently there is no definitive biomarker that can predict a recurrence following a radical orchiectomy. In situations such as this, active surveillance of these patients helps avoid overtreatment in 50% to 85% of patients, with no risk of long-term side effects in non-relapsing patients and a preserved overall survival of almost 100% after specific treatment for recurrent disease. Although active surveillance has been accepted as the preferred option for stage I low-risk non-seminoma, its role in high-risk stage I non-seminoma remains controversial.
    Mini Review Pages: 1 - 5

    Use of Enzalutamide in Carcinoma Prostate

    Rajendra Nerli

    Patients with metastatic prostate cancer are initially treated with androgen deprivation therapy as androgen receptor (AR) signalling is a key pathway in prostate cancer. Castration-resistant prostate cancer (CRPC) is a stage when patients stop responding to androgen deprivation therapy but are still dependent on AR signalling. Enzalutamide, an orally available AR inhibitor, was initially used in the treatment of patients with metastatic CRPC who had previously received docetaxel. The indications have subsequently been extended to include all patients with metastatic CRPC, and most recently to include patients with non-metastatic CRPC. On December 16, 2019, the Food and Drug Administration approved enzalutamide for patients with metastatic castration-sensitive prostate cancer (mCSPC). The most common adverse reactions that have been reported in enzalutamide-treated patients include hot flushes, asthenia/fatigue, hypertension, fractures, and musculoskeletal pain. The recommended dose is 160 mg (four 40 mg capsules) administered orally once daily, with or without food.
    Case Report Pages: 1 - 5


    Rajendra Nerli

    A renal mass/Renal cell carcinoma has a range of histologies and tumour phenotypes that it presents with a particular challenge to treat them. A renal mass can range from benign (oncocytoma) to a clinically indolent malignancy (papillary type I, chromophobe) to aggressive disease [papillary type II or high-grade clear cell renal cell carcinoma (ccRCC)]. Even among various subtypes, kidney cancers are genetically diverse with variable prognoses and treatment response rates. The key to proper management depends on the identification of these subtypes. Currently, a wide array of diagnostic, prognostic, and predictive biomarkers are available to help guide the individualized care of kidney cancer patients. This paper discusses the various serum, urine, and imaging biomarkers that are available in practice
    Research Article Pages: 1 - 8

    Integration of Chemotherapy with Brachytherapy in the Treatment of Locally Advanced Uterine Cervical Cancer

    Aishwarya Raj

    Carcinoma of Uterine cervix is the second most common cancer affecting females in India. Concurrent chemoradiation has remained the sole definitive treatment available in the locally advanced stages. Our study was planned to take the advantage of radiosensitisation accruing due to chemotherapy at the time of brachytherapy when approximately forty percent of total tumour dose is applied.Study design was prospective, randomized and comparative.100 patients with locally advanced squamous cell carcinoma of cervix (FIGO stage IIB to IVA) were included from 2017 to 2019 and divided into two arms of 50 patients each as per computer generated random number list .All were given concurrent chemoradiation followed by 3 insertions of brachytherapy as per the Manchester System, each application was 7Gy by HDR. Patients in Arm A (Study Arm) received cisplatin 40mg/m2 along with EBRT and brachytherapy and Arm B (Control Arm) received cisplatin 40mg/m2 along with EBRT only.

    Volume 13, Issue 3 (2021)

      Editorial Pages: 1 - 1

      Bone Marrow Can Give Rise to Hematopoietic Lineage Cells

      Sizwe Singwane

      Bone marrow is a semi-strong tissue found inside the light or chancellors parts of bones. In birds and well evolved creatures, bone marrow is the essential site of fresh blood cell creation or haematopoiesis. It is made out of hematopoietic cells, marrow fat tissue, and steady stromal cells. In grown-up people, bone marrow is fundamentally situated in the ribs, vertebrae, sternum, and bones of the pelvis. Bone marrow includes roughly % of complete weight in sound grown-up people, to such an extent that a man gauging kg ( lbs) will have around . kg ( lbs) of bone marrow.

      Editorial Pages: 1 - 1

      Malignant Fibrous Histiocytoma and Liposarcoma Treatment

      Cheng Zin

      A sarcoma is a threatening tumor, a sort of disease that emerges from changed cells of mesenchyme (connective tissue) origin. Connective tissue is an expansive term that incorporates bone, ligament, fat, vascular, or hematopoietic tissues, and sarcomas can emerge in any of these kinds of tissues. Sub-sequently, there are numerous subtypes of sarcoma, which are arranged dependent on the particular tissue and kind of cell from which the tumor originates. Sarcomas are essential connective tissue tumors, implying that they emerge in connective tissues. This is as opposed to optional (or "metastatic") connective tissue tumors, which happen when a malignant growth from somewhere else in the body (like the lungs, bosom tissue or prostate) spreads to the connective tissue. Causes and danger factors.

      Perspective Pages: 1 - 1

      Carcinomas can be Authoritatively Analysed Through Biopsy

      Shirley Kolata

      Carcinomas are normally organized with Roman numerals. In many arrangements, Stage I and Stage II carcinomas are affirmed when the tumour has been discovered to be little or potentially to have spread to nearby constructions as it were. Stage III carcinomas regularly have been found to have spread to provincial lymph hubs, tissues, or potentially organ structures, while Stage IV tumours have effectively metastasized through the blood too far off destinations, tissues, or organs. Carcinoma is a threat that creates from epithelial cells. In particular, a carcinoma is a malignancy that starts in a tissue that lines the inward or external surfaces of the body, and that emerges from cells beginning in the endodermal, mesodermal or ectodermal germ layer during embryogenesis.

      Commentary Pages: 1 - 1

      Clinical Order Explicitly gave to Pharmacotherapy for Malignancy

      Qingbing Zhao

      Chemotherapy (frequently shortened to chemo and now and then CTX or CTx) is a sort of malignant growth therapy that utilizes at least one enemy of disease drugs (chemotherapeutic specialists) as a component of a normalized chemotherapy routine. Chemotherapy might be given with a corrective plan (which quite often includes mixes of medications), or it might intend to drag out life or to decrease manifestations (palliative chemotherapy). Chemotherapy is one of the significant classifications of the clinical order explicitly gave to pharmacotherapy for malignancy, which is called clinical oncology.

      Research Pages: 1 - 3

      Prior Telephone Confirmation to Reduce Absenteeism in Oncological Surgeries: A Phone Call That Saves Lives

      Irami Araújo-Filho*, Danielly Acioli Galvão de Souza, Joseli Soares Brazorotto and Erika Maria Araújo Barbosa de Sena

      n assessing the quality of health services, the use of quality and resolution indicators used in the operating room stands out. The cancellation fee for operating procedures is one of the most important. Cancellations interfere with the outcome of care and increase hospital costs. In the case of cancer patients, the consequences are severe, since early surgical intervention directly influences prognosis, reducing morbidity, and mortality. Considering that surgical suspensions should be prevented, pre-anesthetic consultation and telephone confirmation days before the procedure configure strategies that can be adopted to minimize the problem. A descriptive observational study with a quantitative approach was conducted on the impact of previous telephone confirmation on the reduction of cancellation of oncologic surgeries due to absenteeism. The research was carried out at Professor Alberto Antunes University Hospital, Federal University of Alagoas (HUPAA/UFAL), city of Maceió, State of Alagoas, Northeastern Brazil. The sample consisted of 205 patients with scheduled cancer surgery from January to June 2019, after approval by the Institutional Ethics Committee. Data analysis was performed descriptively. The effectiveness of previous telephone confirmation was verified, with a 50% reduction in cancellation of elective oncologic surgeries due to absenteeism. The implementation of a call center to confirm the presence of the user consisted of an impact strategy in reducing the cancellation of previously scheduled cancer surgeries.

      Volume 13, Issue 4 (2021)

        Editorial Pages: 1 - 1

        Strategies for Early Detection of Pancreatic Cancer

        Philipa Amoako*

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        Research Pages: 1 - 4

        Management of Hodgkin’s Disease, Ino Experience 2014-2016

        Mosse B. A. Wilfried*, Kietga Georges Gaël, Messouna Mohamed, Compaoré Bertrand, Seka Evrard Narcisse, Patricia Agbanglanon, Halima Ahmut, Bouhia Hasnae, Elmajjaoui Sana and Noureddine Benjaafar

        Over the past century, Hodgkin's Lymphoma (HL) has gone from a uniformly fatal disease to a curable disease in approximately 75% of patients worldwide. The selection of therapy should balance the desire to maintain a high rate of cure with the need to minimize long-term complications. In this retrospective study, we propose to report the experience of the management of this pathology to the National Institute of Oncology (INO) in Rabat. We recorded and collected data from 152 patients admitted to the National Institute of Oncology for MDH, the average age is 36.2 +/-16.3 years with extremes of 17 and 81 years. Men made up 52%?? of the total population. The favourable localized stages (IA, IIA) represented 20.4%, we did not have enough data to classify 7 patients. ABVD (Doxorubicin, Bleomycin, Vinblastine, Dacarbazine) was the 1st line protocol in 66% of patients, BEACOPP standard 13.4% (Bleomycin, Etoposide, Doxorubicin, Cyclophosphamide, Vincristine, Procarbazine, Prednisone); some have BEACOPPP had the switcher protocol to the BEACOPP standard after 3 cures). 55.9% of patients received between 3 and 6 courses, 17.8% between 7 and 8 courses.

        27.2% of patients had curative adjuvant radiotherapy using the irradiation technique (IFRT) Field concerned Radiotherapy with doses of 20 Gy and 30 Gy depending on the response to the initial medical treatment and the initial stage. The median overall survival for all stages was 72.9% after 84 months of follow-up. All-stage event-free survival was 69.3%. The over hall survival according to the favourable localized stages (IA and IIA) was 75.1% higher than that of the unfavourable stages of 71.5% (p=0.186). Patients who had adjuvant radio therapy had overall survival (72.4%) and those who had not been irradiated 72.1% (p=0.733). All-stage event-free survival was 65.1% after 84 months follow-up 95% CI (62.2%-67.9%). Hodgkin lymphoma is a curable malignant tumor in the early and late stages. The treatment should be refined on prognostic models.

        Volume 13, Issue 5 (2021)

          Short Communication Pages: 1 - 1

          Resveratrol suppresses prostate cancer progression in transgenic mice

          Hong Cai

          Resveratrol (trans-3,4’,5-trihydroxystilbene) is a naturally occurring
          antifungal found in a variety of foods including the skin of red grapes and
          peanuts. Since the seminal report that resveratrol could inhibit multiple
          stages of carcinogenesis, it has been the subject of extensive preclinical
          investigations for the treatment and prevention of numerous pathologies
          including cancer, cardiovascular and Alzheimer’s disease, insulin resistance,
          and diabetes . Attempts to translate these findings to humans have increased
          in recent years but there are still fundamental gaps in our understanding of
          the pharmacokinetic pharmacodynamic relations and how plasma/target tissue
          concentrations correlate with clinical efficacy or beneficial effects on health
          maintenance . Such information is needed to inform the choice of optimum
          dose and formulation requirements, and to enhance understanding of the key
          modes of action for resveratrol in each pathology it is also particularly important
          given the notoriously low systemic bioavailability of parent resveratrol due to
          its rapid metabolism, which, if not taken into consideration, would affect its
          clinical utility.

          Short Communication Pages: 1 - 1

          A Compendium of Cancer Therapeutic Strategies and their Modality

          Michael Malfatti

          Pancreatic cancer arises when cells in the pancreas, a glandular organ
          behind the stomach, begin to multiply out of control and form a mass.
          These cancerous cells have the ability to invade other parts of the body. A
          number of types of pancreatic cancer are known.

          Commentary Pages: 1 - 1

          Male Breast Cancer: 37-Year Data Study at a Single Experience Center in Turkey

          Edwina N Scott

          Male breast cancer (MBC) is rare, accounting for less than 1% of all breast cancer and less than 1% of all cancer cases, with less than 0.5% of all cancer deaths in men, annually.MBC usually presents as a firm, painless mass along with palpable axillary nodes, nipple retraction, and ulceration of the skin at presentation. MBC is usually located in the subareolar region, but can also be seen in the upper outer quadrant. As is the case with women, the left breast is involved more predominantly than the right breast, and approximately 1% all of cases are bilateral. Approximately 90% of MBC are invasive ductal carcinomas. Lobular histology is rare, accounting for only 1.5% of MBC. MBC has high rates of hormone-receptor expression; approximately 90% express oestrogen receptor (ER), and 81% express progesterone receptor (PR).

          Commentary Pages: 1 - 2

          New theranostic strategies for drug-induced acute kidney cancer

          Emma Parrott

          Drug-induced predisposition to acute renal failure (ARF) is a facet of nephrotoxicity hitherto mostly uncharacterized, quite underestimated, and impossible to diagnose, which potentially has a high human and socioeconomic impact. Our study has identified urinary GM2AP as the first of a new class of biomarkers of the enhanced risk of suffering an acute renal failure after a subnephrotoxic treatment with gentamicin. Gentamicin-predisposed animals with no sign of renal cancer develop ARF when exposed to a second potentially nephrotoxic drug, also given at subnephrotoxic doses that are harmless to non-predisposed individuals. Subnephrotoxic gentamicin did not alter renal GM2AP gene expression or protein levels, determined by RT-PCR and Western blot and immunostaining, respectively, nor was its serum level modified. Further experiments indicate that, likely, the origin of the increased level of GM2AP in the urine might be a defective tubular handling of this protein as a consequence of gentamicin action.

          Perspective Pages: 1 - 1

          Surgical ovarian ablation for positive women with breast carcinoma in rural India

          Robert G Britton

          Breast cancer is cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, fluid coming from the nipple, a newly inverted nipple, or a red or scaly patch of skin. In those with distant spread of the disease, there may be bone pain, swollen lymph nodes, shortness of breath, or yellow skin.

          Volume 13, Issue 7 (2021)

            Case Report Pages: 1 - 3

            Adenoid Cystic Carcinoma of the Trachea: Case Report and Literature Review

            Maroua Benlemlih*, El Amin Marnouche, Mouhcine Hommadi, Abdelhak Maghous, Amine Bazine, Kessab Amine, Massine El Hammoumi, Oukabli Mohamed, Khalid Andaloussi, El Hassane Kabiri, Mohammed Elmarjany, Khalid Hadadi, Hassan Sifat and Hamid Mansouri

            Tracheal cancer is a rare neoplasm that accounts for only about 0.1% of all respiratory tract tumors. Cystic adenoid carcinoma (or cylindroma) represents the second histological type of tracheal tumors in order of frequency. These lesions are characterized by slow local growth, perineural invasion, and potential local and distant recurrence. Complete surgical resection offers the patient a better opportunity of prolonged survival or complete remission. The addition of photon- or electron-beam radiation seems to influence local control but does not affect survival. In this paper, we report a clinical case describing the characteristics and management of adenoid cystic carcinoma of the trachea in 59 years-old men.

            Perspective Pages: 1 - 1

            Cancer and its Associated Factors in India

            Philipa Amoako*

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            Case Report Pages: 1 - 4

            Non Metastatic Rhabdomyosarcoma in Children: Therapeutic Outcome and Prognostic Factors of a Single Institution Case Series

            Feryel Letaief Ksontini*, Dorra Tajina-Abdelmaksoud, Safia Yahiaoui, Azza Gabsi, Amina Mokrani and Amel Mezlini

            Background: Rhabdomyosarcoma (RMS) is the most common soft tissue tumor in childhood with a cure rate of 70% in localized disease. We aimed to study the prognostic factors of non-metastatic RMS in Tunisian paediatric patients.

            Methods: We reviewed data of children aged <18 years, treated in the Salah Azaiez Institute for a localized RMS during 20 years. Prognostic factors were studied and survival data analysed.

            Results: 75 patients were included. Mean follow up was 30 months. The 5-year OS and DFS were 50% and 26%, respectively. By univariate analysis, DFS was significantly correlated to chemotherapy, radiotherapy (RT) and post-surgical RT with p 0.02, 0.003 and 0.01, respectively. The surgery failed to be a significant factor. We didn`t find any factor with a significant relationship with DFS in multivariate analysis. By univariate analysis, 5-year OS was significantly and adversely influenced by 4 factors: tumour size>4 cm, non-alveolar RMS, positive regional nodes and para-meningeal location, with p: 0.050, 0.05, 0.04 and 0.04, respectively. RT and postsurgical RT were associated with a good prognosis in OS p=0.009 and 0.05, respectively. Age, histology, primary site and IRS group failed to be significant. By multivariate analysis, OS was strongly correlated to radiotherapy p=0.03, Odds Ratio (OR) 3.1, confidence interval (IC) 95% [1.05-9.3] and para-meningeal site p=0.04, (OR) 0.3, confidence interval (IC) 95% [0.1-0.9].

            Conclusions: Compared to the literature, we noticed that the prognosis of our patients was worse so we should improve it by making the treatment more personalized and encouraging research.

            Research Article Pages: 1 - 5

            Reduction of Dose to the Contralateral Breast by use of Lead Shield in Radiation Therapy for post-op Ca Breast Patients

            Richa Verma

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            Introduction: Breast cancer is the most common cause of cancer in women in India. India ranks number one in the number of healthy life years lost (DALY- Disability Adjusted Life Years ) due to breast cancer. Surgery, radiation therapy and chemotherapy (+/- hormonal therapy) constitute the multimodality approach for treatment of breast cancer. Radiation therapy is recommended as a treatment of choice for post-operative ca breast patients. Radiation doses to nearby critical normal structures like heart, lungs, and contralateral breast (CLB) increases risk of second malignancies due to increasing life expectancy of the patient. During external beam therapy unwanted radiations produced due to leakage from collimator and scatter from primary beam . It appears prudent to be aware of these potential risk and efforts must be made to maintain a dose to CLB as low as reasonably achievable. In this study, we measured doses to the CLB and studied reduction in dose achieved by use of of a 2mm lead shield. Materials and Methods: Ten number of post-operative Ca-Breast patients were taken for our study. All the patients underwent 3D conformal radiotherapy in Linear Accelerator(Make: Varian Medical Systems, Model: Clinac 2100CD) which has multi leaf collimator 40 pairs. Forward IMRT Treatment plans were performed in Eclipse Treatment planning system (Make: Varian Medical Systems, Version 13.8)As the intent is to measure the contralateral breast dose the TLD discs ( Type; CaSo4;Dy, 13mm dia, 0.8mm thick) were placed over the CB; Customized lead shields were prepared to study the reduction of dose to CB. Measurements were made with the TLD Discs with the presence and the absence of customized lead shield over the CB and doses were calculated with the help of TLD Reader (Make: Nucleonix, Hyderabad). Here we present a case of 10 ca breast patients who received radiotherapy post operatively. Radiation therapy of 40.05 Gy was planned in 15 fractions, 5 days a week, using the Eclipse Treatment Planning System version 8.9.15, with a pencil beam convolution algorithm and 6 MV photon beam. Plans were transferred to a linear accelerator (Varian 2300 CD) for execution of treatment. Twenty-four CaSO4 thermoluminescent dosimeter discs (TLDs) were used for dose measurement over the CLB. The dose was measured for each patient without a lead shield for 7 fractions and with lead shield for 7 fractions. Results: Mean doses/fractions received by the CLB without and with a lead shield were 12.62 ± 1.29 cGy and 6.42 ± 2.62 cGy, respectively, with total doses of 208.326 ± 32.43 cGy (5.14% of prescribed dose) and 113.7 ± 65.62 cGy (2.83% of prescribed dose). The average reduction in mean dose with a 2mm thick lead shield was 53.10 ± 17.18%, in the range of 20 to 80% and statistically significant (p < 0.001) Conclusion: The above study was performed for 10 number of cases and it was evident in all the patients the dose to CB has reduced to less than 50% (p value <0.05). The lead sheets were customized for individual patients and it was an effective parameter in CB dose reduction. The lead sheets are in- house customized and can be easily made in every department with minimal cost. This study will be further extended for more number of cases with increment in lead thickness. We may find an optimum lead thickness that reduces significant dose to CB without creating discomfort to the patients.

            Research advancement in cancer (2022)

              Research Article Pages: 1 - 7

              Impact of Early Palliative Care on end of life in Patients with Advanced Biliary Tract Cancer

              Margaux Miralles, Marie Muller, Christophe Borg, Sylvain Manfredi, Anne Minello, Olivier Bouché, Marlène Tambou, Didier Mutter, Pascale Chiappa, Jean-Emmanuel Kurtz, Amandine Luc and Anthony Lopez*

              DOI: 10.37421/1948-5956.2022.S8.007

              Background: Most of patient with Biliary Tract Cancer (BTC) has not access to surgery because of Advanced/metastatic disease at diagnosis (aBTC). They receive palliative chemotherapy and/or Palliative Care (PC). We studied if early palliative care referral might influence Overall Survival (OS) and the aggressiveness of end-of-life care.

              Participants: We conducted a retrospective multicentric cohort study in patients with non-curative BTC, diagnosed between 2013 and 2019 in 6 hospitals of Eastern France. PC was defined a specialist-delivered palliative care encounter.

              Results: 200 patients with aBTC were included. 87 (44%) never received PC, 30 (15%) had very early PC (<3 months after aBTC diagnosis), 20 (10%) had an early PC (3-6 months), and 63 (32%) had late PC (>6 months). The median time between referral and death was 0.9 to 1.3 months. OS were 12.4 months (no PC), 3.0 months (PC<3 m), 6.4 months (PC 3-6 m), 16 months (PC>6 m). There was no evidence for survival improvement with early PC. PC tended to reduce chemotherapy near death (37% without PC, 30% with PC<3m, 11% with PC 3-6m, 10% with PC>6m), visits in emergency department (ED) during final month (respectively: 36%, 20 %, 15%, and 7%), intensive care unit hospitalizations (ICU) near death (13%, 0%, 0%, 2%). Place of death seemed to be positively impacted by PC (conventional acute unit, respectively: 73%, 21%, 21%, 25% and ICU or ED: 8%, 0%, 5%, 2%).

              Conclusion: Referral to PC remains too late in the support of patients with aBTC. Our practice should evolve: all patients with aBTC should be referred to early PC in palliative care unit after diagnosis to improve the management of end-of-life, symptoms, and family needs.

              Research Article Pages: 1 - 8

              Analysis of the Clinical Management and Quality of Life of frail Patient’s with Cancer and Breakthrough Cancer Pain in Clinical Practice

              Gemma Soler González, Juan Pérez Cajaraville, Silvia Forcano Sanjuan, José Luis Firvida Pérez, César Margarit Ferri, Natividad Martínez Banaclocha, Antonio Javier Jiménez López, Ana Cabezón Álvarez, Ibone Huerta González and Begoña Soler López*

              DOI: 10.37421/1948-5956.2022.S8.011

              Purpose: The purpose of this study was to analyse the clinical management and Quality of Life (QoL) of frail patients with cancer, chronic background pain and Breakthrough Cancer Pain (BTcP) and to assess whether treatment was conditioned by their frailty status.

              Methods: This was an observational study in adult frail patients with cancer, chronic background pain and BTcP. Outcomes of interest collected include clinical and sociodemographic data, Karnofsky Performance Status, quality of life (EuroQoL-5D-5L), chronic pain and BTcP characteristics, as well as treatments administered for their control.

              Results: A total of 222 patients were included with a mean age of 68 years (range 24-91), 60.5% men, with a mean Karnofsky of 63.2%. The number of daily episodes of BTcP was 3.8 (95% CI 3.3-4.3), with a duration of 34.6 minutes (95% CI 28.8-40.3), and 56.8% had a gradual onset. Opioids were administered to 88.3% of patients for the chronic pain, and to 83.8% for BTcP. The treatment's daily doses administered for chronic pain and BTcP did not differ from those usually recommended. QoL was significantly worst in frail patients with cancer than EuroQol-5D-5L healthy age-matched no frail patients and was related to performance status (p<0.001) and to the social-familial status (p=0.045).

              Conclusion: BTP in frail patients with cancer presents with more episodes, of a shorter duration and more gradual onset compared to other published references of patients with BTcP. QoL was seriously affected in this group of patients. No relevant differences were seen in the doses or method of administration of treatments for chronic pain and BTP in frail patients with cancer as compared to the standard recommendations for non-frail patients. Our findings support the importance of the frailty assessment in all patients with BTcP.

              Research Article Pages: 1 - 7

              Prostate Cancer Screening in Hospitalized Patients: Results from the Nationwide Inpatient Sample

              Furqan B. Irfan*, Fahad Shabbir Ahmed, Monica V. Masucci, Angelina A. Cerimele, Thu Nguyen, Aryana Sharrak, David M Nguyen, Tooba Tariq, Hussein Baydoun, Ahmad Hasan, Mohamed E Awad, Khaled Saleh and Patrick Karabon

              DOI: 10.37421/1948-5956.2022.14.S8.009

              Objective: The aim of the study was to determine the nationwide prevalence, trends, and predictors of inpatient PCa screening in average risk patients using the National Inpatient Sample (NIS) database.

              Methods: NIS records from 2006 to 2014 were used to evaluate inpatient PCa screening encounters across United States (US) hospitals. All male patients between the ages of 45 and 69 at average risk for PCa were included. The outcome was whether a patient had an encounter for PCa as noted on their discharge record. Variables analyzed included demographic factors, hospital characteristics, and other concomitant diagnoses for prostatic or urologic problems.

              Results: The prevalence of inpatient PCa screening was 2.57 per 100,000 hospital discharges. In a multivariate setting, the following were significant factors associated with greater odds of inpatient screening: Medicare (AOR: 3.07; P=0.0016), self-pay or uninsured patients (AOR: 1.74; P=0.0371), rural (AOR: 11.9; P 0.0001) or urban nonteaching hospitals (AOR: 5.26; P 0.0001), Midwest hospitals (AOR: 4.90; P 0.0001), urinary tract infection (P=0.0367), genitourinary symptoms (P<0.0001), prostatic hyperplasia (P=0.0006), or other male genital disorder diagnoses (P<0.0001).

              Conclusion: In light of unequal access to healthcare, disparities exist in uninsured and rural populations regarding cancer screening. PSA is a minimally invasive test that can help screen individuals at increased risk for the development of prostate cancer, allowing for early detection, prevention, improved rates of cure and ultimately, decreased rates of mortality.

              Brief Report Pages: 1 - 3

              Challenges in treating Hodgkin's Lymphoma: Starting at the Beginning

              Fernanda Lagares Xavier Peres, Antônia Pardo Chaga, Natália Dassi, Thais G. Almeida, Ângela Rech Cagol, Cecília Fernandes Lorea, Pablo Santiago, Laura Garcia de Borba, Liane Esteves Daudt and Mariana Bohns Michalowski*

              DOI: 10.37421/1948-5956.2022.14.S8.010

              Standard of care and protocols for the treatment of pediatric cancer lead to a clear improvement in survival rates and quality of life. Little is known about how these treatments are implemented in Brazil. Our study aimed to evaluate children treated for Hodgkin Disease (HD) in south Brazil between 2002 and 2013 through the analysis of medical records in 6 different centers.

              Fifty-nine children and adolescents were included. The median age was 12 years (range 3-18 years). Male:Female ratio was 1.95:1. Localized disease (stage I/II) was observed in 30 patients (50.8%) while the remaining 29 (49.2%) had advanced disease (Stage III/IV).

              The chemotherapeutic treatment schema was different among services and comprised three different based protocols. ABVD schema was the most frequently used (52 children (88.1%). The number of cycles was highly variable (4-16 cycles) even at the same clinical stage and with similar clinical response.

              These data highlight the importance of turning the “best practice policies” readily available to all pediatric oncologists. Local protocols allow integrative studies among centers that would certainly maintain or improve cure rates, reduce long-term toxicity and evaluate specific biological characteristics of these diseases in our population.

              Case Report Pages: 1 - 3

              Durable Complete Response to First Line Treatment with Avelumab in an Elderly, Multimorbid Patient with Advanced Merkel Cell Carcinoma: A Case Report

              Enrico Sammarco*, Amedeo Nuzzo, Simona Manacorda, Fiorella Manfredi, Chiara Mercinelli, Marco Ferrari, Giulia Massaro, Adele Bonato, Alessia Salfi, Debora Serafin, Luca Zatteri Luca, Galli Andrea Antonuzzo and Gianluca Masi

              DOI: 10.37421/1948-5956.2022.14.S8.008

              Introduction: Metastatic Merkel Cell Carcinoma (MCC) is characterized by poor prognosis and poor response to cytotoxic chemotherapy. Immune Checkpoint Inhibitors (ICIs) were evaluated in several clinical trials, providing interesting results in terms of activity and efficacy, with a generally manageable safety profile. Limited data are available for use of ICIs in patients affected by multiple chronic diseases. We present the case of a patient with several comorbidities treated with Avelumab for advanced MCC, who developed a durable complete response.

              Case description: A 78-year-old woman with several chronic diseases was treated with Avelumab for MCC with lung and subcutaneous metastases, developing radiological complete response after 5 cycles. Treatment was well tolerated and no severe adverse events were observed.

              Conclusion: Our case shows that Avelumab is an active and safe treatment in multimorbid patients with advanced MCC. More consistent data from randomized clinical trials are needed to confirm these results in a large patient population presenting these special features.

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