Ciência e terapia do câncer

1.1 Introduction: Breast cancer is the top cancer in women both in the developed and the developing world. The incidence of breast cancer is increasing in the developing world due to increase life expectancy, increase urbanization and adoption of western lifestyles. Therefore, early detection in order to improve breast cancer outcome and survival remains the cornerstone of breast cancer control. 1.2 Objective: The main intention of this study is to determine the symptom experiences and functional status among women diagnosed with breast cancer and receiving chemotherapy treatment. 1.3 Methodology: The study was conducted by using descriptive study design in Hawassa Referral health facilities from Mar/2017 to May/2017. Before data collection ethical clearance letter was obtained from Hawassa University institutional review board office. Purposive sampling technique was used to collecte the data. Data collection was done using structured questionnaire including patient information, symptom experience questionnaire and EGOC functional status Questionnaire were used. The analysis were made by using SPSS version 20.0. 1.4 Results: Majority of the respondents 56 (37.3%) were in the age group of 31-40 years followed by 40(26.7%) are identified in the age group of more than 51years. With regard to religion, majority of the respondents 66(44%) are Orthodox and 53(35.3%) of respondents belongs to Oromo in their ethnicity. Focusing on the duration of the illness, majority of the respondents 108(72%) are diagnosed within last 4 years and 98(65.3%) of the women has surgery for their breast and receiving chemotherapy. Almost all, 146(97.3%) of the respondents have care giver and 132(88%) of the respondents are identified with presence of additional illness like DVT, DM preumonia, etc nealrl third, 55(36%) were asymptomatic. with regard to their functional status 46(30.7%) of the respondents were symptomatic but completely ambulatory followed. 1.5 Conclusion: Women with breast cancer experience different variety of symptoms as a result of their diagnosis of disease, or treatment or as an effect of their treatment. Symptom experiencing is very stressful to the patient as well as family and care givers.

A 41-year-old Japanese male who had been treated for refractory hepatocellular carcinoma and liver failure was admitted with pleural empyema and subphrenic abscess. Broad spectrum antibiotics and thoracic drainage was performed but the infection and his liver failure got worse, and he developed acute kidney injury (AKI). The patient died and autopsy was performed. From the liver autopsy findings, the cause of this patient’s severe jaundice was thought to be biliary obstruction, and the kidney autopsy indicated that the cause of AKI was due to severe hyperbilirubinemia. From these findings, we concluded that the cause of AKI was bile cast nephropathy.

Background: Analysis of proliferation status in breast cancer can be associated with tumor aggressiveness. Uncontrolled proliferation has been accepted as a distinct hallmark of cancer and act as an important determinant of cancer outcome. Recently measuring proliferation used as predictive potential and crucial element of treatment decision in patients with breast cancer. Aim: We therefore aimed to assess the frequency proliferation rate by using mitotic count and Ki-67 index to associate with other prognostic markers. Methods: A prospective study of 197 newly diagnosed breast cancer tissues from women received surgery as initial management in three different hospital in Addis Ababa, Ethiopia from January 2013 to December 2015 were included in the study. Histology slides were evaluated for the histological type, grade (by modified Nottingham grade score). Mitotic count quantified as number of mitoses per 10 high power fields (HPF) at the tumor periphery. Less than and seven mitoses per 10 fields scored 1 point, 8-16 scored 2 points, and more than 17 scored 3 points. Immunohistochemical staining of Ki- 67 was performed and the proliferation rate was expressed as percentage of stained tumor cell nuclei. Associations of the Ki67 index with other prognostic factors were evaluated both as continuous and categorical variables. Results: The Mean ± SD mitotic activity index was 15.7 ± 10.6 while the median was 14/10 HPF. Mitotic count was found 0-7 mitoses per 10 HPF in 42/197 (21.3%) cases, between 8 and 14 mitoses per 10 HPF in 74/197 (37.6%) cases and >15 in 81/197 (41.1%) cases. Ductal type BC was associated with high mitotic count than lobular and other histological BC types which is statistically significant (p=0.009). High mitotic count was significantly associated with aggressive features of the primary tumors (negative hormonal receptor (ER- and PR-) p 60 yrs of old. The mean value of G2 and G3 tumor were higher than G1 tumor and it is statistically significant (p <0.001). The Ki-67 mean value was found lower in Hormone receptor posetive (ER +, PR +) than hormone receptor negative (ER-, PR-). The deference was statistically significant (p=0.001) and (p=0.005). While Her-2 posetive tumor found higher mean Ki-67 value than Her-2 negative tumor and also the difference was statistically significant (p=0.001). Conclusion: Clinical utility of Mitotic count and Ki-67 in combination with other prognostic markers can better predict breast cancer outcome. Therefore we suggest that Ki-67 index should be added to treatment plan when considering adjuvant chemotherapy and prognostic stratification.

Demographic changes, such as aging and unhealthy lifestyles have contributed to the prevalence of chronic diseases, including cerebrovascular and oncological diseases. Currently, people have one or more diseases simultaneously, which requires new models of care, able to responding at the increased complexity in health. Polpatology has profound implications for self-care, autonomy and the use of health services.

Cisplatin (cis-diammine-dichloro-platinum II) was initially discovered to prevent the growth of Escherichia coli and was further recognized for its anti-neoplastic and cytotoxic effects on cancer cells. Administered intravenously to humans, cisplatin is used as first-line chemotherapy treatment for patients diagnosed with various types of malignancies, such as leukemia, lymphomas, breast, testicular, ovarian, head and neck, and cervical cancers, and sarcomas. Once cisplatin enters the cell it exerts its cytotoxic effect by losing one chloride ligand, binding to DNA to form intra-strand DNA adducts, and inhibiting DNA synthesis and cell growth. The DNA lesions formed from cisplatin-induced DNA damage activate DNA repair response via NER (nuclear excision repair system) by halting cisplatin-induced cell death by activation of ATM (ataxia telangiectasia mutated) pathway. Although treatment has been shown to be effective, many patients experience relapse due to drug resistance. As a result, other platinum compounds such as oxaliplatin and carboplatin have since been used and have shown some levels of effectiveness. In this review, the clinical applications of cisplatin are discussed with a special emphasis on its use in cancer chemotherapy.

Metaplastic carcinomas (MC) of the breast constitute a heterogeneous group of tumors, characterized by the presence of squamous or sarcomatoid differentiation. It is a rare type of malignant epithelial neoplasm that arises from the breast, and whose diagnosis is based on histology and immunochemistry. Location in ectopic breast tissue (EBT) in axilla is extremely rare, and when it ulcerates, it can mimic squamous cell carcinoma of skin. We report an unusual clinical case of a 61-year-old woman with metaplastic carcinoma in axillary ectopic breast, falsely diagnosed as a squamous cell carcinoma of skin.