Journal of Cancer & Allied Specialties

Systemic Diseases and Risk of Developing Gastrointestinal Cancer.

Naila Malkani, Muhammad Usman Rashid — Fri, 16 Jun 2023 03:38:17 -0700

Importance: Gastrointestinal (GI) cancers are the second leading cause of cancer-related deaths worldwide. Observations: The global challenges GI cancers pose are high, especially in middle- and low-income countries. Patients with these cancers present with symptoms of poor appetite, weight loss, heartburn, abdominal pain, fatigue, and anaemia. Several risk factors contribute to GI cancers, including age, gender, obesity, pathogenic infections, smoking cigarettes, alcohol consumption, and dietary habits. Most of these cancers are sporadic. However, some patients are at high risk because of a family history of GI cancers. Systemic diseases affect multiple organs, and their chronic occurrence elicits inflammatory responses at various sites. These diseases also contribute to GI cancers. Conclusion and Relevance: In this review, we discuss that untreated systemic diseases, including diabetes, hepatitis, AIDS, ulcers, and hypertension, can potentially lead to GI cancers if they remain untreated for a longer period. Systemic diseases initiate oxidative stress, inflammatory pathways, and genetic manipulations, which altogether confer risks to GI cancers. Here, we describe the association between systemic diseases and their underlying mechanisms leading to GI cancers.

Cancer in Faisalabad and Nankana Sahib, Pakistan: 2017-2019; an Observational study

Fri, 16 Jun 2023 05:57:56 -0700

Introduction: The Punjab Cancer Registry's catchment area includes the districts of Faisalabad and Nankana Sahib. It is an observational, descriptive study that covers the three years from 2017 to 2019, evaluating the distribution of cancer in these two districts. Material and Methods: Data on incident cancer cases diagnosed between 2017 and 2019 among residents of Faisalabad and Nankana Sahib in Pakistan, reported by the participating centers of the Registry, were reviewed retrospectively. Figures and proportions for adults, children, and adolescents were computed. Results: During 2017 and 2019, 5,678 cases were reported from Faisalabad and 390 from Nankana Sahib, with over 50% seen in females. In both districts combined, among adult females, cancers of the breast, reproductive system, and hepatobiliary system were commonly diagnosed, while cancer of the lip/oral cavity/pharynx, hepatobiliary system, and non-Hodgkin lymphoma were the leading diagnoses among adult males. In children and young adults (0-19 years), acute lymphoblastic leukemia, Hodgkin lymphoma, and non-Hodgkin lymphoma were the most common diagnoses. Conclusion: The cancer distribution reported from Faisalabad and Nankana Sahib is of utmost importance. However, the underreporting of cancer cases cannot be ruled out. More input from the collaborators is needed to ensure the completeness of cancer surveillance in the region.

Standardized Uptake Value (SUVmax) in Organ Confined Prostate Cancer in 68-Ga-PSMA PET-CT Scan and its Correlation with Prostate Specific Antigen level and Gleason Score

Haider Ali, Syed Rashid-ul- Amin, Abdul Hai — Fri, 16 Jun 2023 06:22:23 -0700

Introduction: A positron emission tomography (PET) scan and a computed tomography (CT) scan is an integral part of oncological imaging, and other modalities like magnetic resonance imaging, CT or bone scintigraphy have some limitations in staging the workup of prostate carcinoma. Combined with tissue-specific markers like PSMA (prostate-specific membrane antigen), positron emitter-based functional imaging results have improved. Our study aimed to determine the Standardized Uptake Value (SUVmax) in prostate adenocarcinoma that is confined to the organ in Ga-68-PSMA PET-CT scans and how it correlates with prostate-specific antigen (PSA) levels and Gleason Score (GS). Materials and Methods: This cross-sectional study was conducted at SIUT (Sindh Institute of Urology and Transplantation), Karachi, and includes subjects referred for a Ga68-PSMA PET-CT scan from September 2017 to January 2022. Histopathologic-proven adenocarcinoma prostate patients with organ-confined disease and PSA levels obtained within six weeks before the PSMA-PET-CT scan were included in the study. PET-CT images were semi-quantitatively analyzed by measuring SUVmax, and the result was interpreted using statistical software SPSS version 22.0. Results: A total of 154 patients were analyzed. The mean age of patients was 66.57 ± 8.86 years. The GS of all patients ranges from 6 to 10. The mean and median PSA levels were 32.33 ng/ml (range: 0.004-306.00) and 14.20 ng/ml, respectively. The mean SUVmax of all prostatic lesions was 14.67±12.58, and the median value was 10.76. SUVmax was higher in patients with a PSA level of more than ten than those with a <10. The correlation of SUVmax with PSA and GS showed a significant correlation. Conclusion: The SUVmax of organ-confined prostate cancer correlates well with PSA level, and GS Median SUVmax and PSA directly relate to GS.

Outcomes of Patients with FLT3 Positive Acute Myeloid Leukemia; an Experience from a Tertiary Care Hospital in Karachi, Pakistan

Fri, 16 Jun 2023 06:46:01 -0700

Introduction: Molecular genetic abnormalities in AML are essential for disease diagnosis and determining prognosis and clinical course. Mutations in FLT3 and NPM genes are the most frequent genetic abnormalities, which are also known to impact disease outcomes. FLT3 mutations have been identified in approximately 30% of denovo AML patients and are associated with poor prognoses. This study aimed to determine the response to induction chemotherapy, overall survival, and relapse rate in patients with FLT3-positive acute myeloid leukaemia. Materials and Methods: In this study, a retrospective analysis was performed of 75 newly diagnosed patients with AML registered between January 2015 and July 2022. Patient demographics and clinical-haematological parameters were noted, and molecular analysis for FLT3 ITD/TKD and NPM mutations was performed. All the patients received standard induction chemotherapy, and their response to treatment, overall survival, and relapse rate were assessed. Results: A total of 75 cases of AML were analysed. The mean age of the sample was 34.9 years, of which 65.3% were males and 34.7% were females. The patients were stratified into two groups: those who were positive for FLT3 while negative for NPM (FLT3+/NPM-), representing 17.3%, and those who were negative for both FLT3 and NPM (FLT3-/NPM-), representing 82.7% of cases. On day 28 post-induction, the complete remission rate was 69.2% in the FLT3 positive group and 77.4% in the FLT3 negative group. In the FLT3+/NPM- group, 55.6% of cases who were in remission at day 28 subsequently relapsed, compared to 50.0% of FLT3-/NPM- cases. The overall median survival time for the cohort and FLT3+ group was 1467 days, while that of the FLT3-group could not be estimated due to the very high survival rate. Conclusion: No significant differences in outcomes were observed in patients who were FLT3 positive compared to those who were FLT3 negative.

A Case Report on Rare Case of Pancreatic Metastasis from Primary Lung Adenocarcinoma: Treated Through a Non-surgical Approach

Syed Mohsin Raza, Adeel Riaz, Aqueel Shahid, Tabinda Sadaf — Fri, 16 Jun 2023 05:37:34 -0700

Introduction: Most frequent sites of metastasis from lung cancer are the liver, brain and adrenal. Pancreas is an infrequent site of solitary metastasis from the lung primary with limited treatment options. There is insufficient data on the prognosis and optimal management of such cases. Case Description: We report a case of 44 years old gentleman diagnosed with locally advanced Lung Adenocarcinoma Stage T4N3 who was treated radically with chemoradiation therapy, followed by a relapse of solitary pancreatic metastasis, which was treated with targeted therapy, erlotinib, because of the presence of EGFR mutation. Practical Implications: This case reports an excellent radiological and symptomatic response in a patient who received erlotinib for advanced non-small cell lung cancer (NSCLC). The use of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKI) has led to better prognosis and longer progression-free survival for patients with advanced NSCLC. However, the long-term survival of patients with metastatic NSCLC is limited.