Journal of Cancer & Allied Specialties <p>The <em>Journal of Cancer &amp; Allied Specialties </em>is a double blind peer-reviewed open access electronic journal which focuses on all aspects of <em>cancer care</em>.</p> en-US <p>Authors retain copyright and grant the Journal of Cancer &amp; Allied Specialties (JCAS) right-of-first publication. In addition, the work will be simultaneously licensed under a <a href="">Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International license</a>. This license allows others to share the work in whole or part (for non-commercial purpose), with an acknowledgement of the work’s authorship and initial publication in JCAS.</p> <p>Furthermore, authors are free to enter into separate contractual arrangements for the non-exclusive distribution of the journal’s published version of the work, with an acknowledgement of its initial publication in this journal.</p> <p>Authors are permitted and encouraged to share their work online or in medical or scientific conferences prior to or during submission process.</p> (Khawaja S. Nasir) (Ms Sana Qamar) Mon, 06 Jul 2020 01:37:27 -0700 OJS 60 Notice of Retraction <p>The Journal of Caner &amp; Allied Specialties will be retracting "Histopathological Correlation Between Prostatic Adenocarcinoma in Transrectal Ultrasound Guided Biopsies and Radical Prostatectomy Specimens" by Muhammad Faisal and Hina Tariq.</p> Khawaja Shehryar Nasir Copyright (c) 2020 Khawaja Shehryar Nasir Mon, 11 May 2020 21:17:47 -0700 Late Morbidity Among Survivors of Childhood Cancers; Experience at Tertiary Care Cancer Hospital <p><strong>Background: </strong>Long-term survivors of childhood malignancies are at increased risk of experiencing treatment-related morbidities. Survival into late adulthood in these children provides ample time for the acquisition of long-term sequelae. This study aimed to determine late adverse effects among long-term survivors of childhood cancer from a low-income country perspective. <strong>Methods: </strong>Data were retrospectively collected from review of charts of patients aged under 18 years at the time of their primary diagnosis between January 1, 1995, to December 31, 2008, and who survived for at least 5 years after completion of their treatment. Analyzed data included demographics, cancer type, treatment modality, types of chemotherapy agents administered and specific late morbidities including frequency of azoospermia, oligospermia, endocrine abnormalities, hearing and pulmonary function impairment, and cardiac dysfunction among the long-term survivors of cancer. <strong>Results: </strong>The total number of patients was 300 with a mean age of 18 ± 2 years. The male to female ratio was 2.7:1. Median follow up duration was 18 years (range: 5-25 years). Seventy-seven percent of patients were from Punjab, 20% were from Khyber Pakhtunkhwa and 3% were from other provinces. Fifty percent had a diagnosis of Hodgkin Lymphoma, 17% Acute Lymphoblastic Leukemia, 13% Non-Hodgkin Lymphoma, 10% Germ cell tumors and 10% had other tumors. Fifty-seven percent received chemotherapy, 23% chemotherapy and radiotherapy, 15% chemotherapy and surgery, 3% chemotherapy, surgery and radiotherapy and 2% had only surgery. Notable long-term documented sequelae were; azoospermia/oligospermia in 64%, endocrine abnormalities in 25% with hypothyroidism in 13.5% and follicle-stimulating hormone and luteinizing hormone abnormalities in 11.5%, ototoxicity in 6.5%, impaired pulmonary function tests in 4.6%, cardiotoxicity in 2.4% and second malignancies (acute myeloid Leukemia and myelodysplastic syndrome)&nbsp; in 1%. <strong>Conclusion</strong>: Childhood cancer survivors are at increased risk of adverse treatment-related sequelae and a long-term follow-up plan should be in place in centers where they receive treatment for their primary disease.</p> Najma Shaheen, Mir Rooh Jan, Saghir Khan, Shazia Riaz Copyright (c) 2020 Najma Shaheen, Mir Rooh Jan, Saghir Khan, Shazia Riaz Tue, 12 May 2020 04:45:36 -0700 Effectiveness of Nerve Blocks for Management of Head and Neck Cancer Associated Neuropathic Pain Disorders; a Retrospective Study <p><strong>Introduction: </strong>A portion of patients with head and neck cancer (HNC)-associated pain may not experience relief in symptoms with non-invasive modalities. A nerve block is a procedure in which a local anesthetic agent is injected along the nerve track to preferentially block sensory transmission. The literature on the effectiveness of nerve blocks in the management of HNC-related pain is limited. The purpose of this study was to determine the effectiveness of nerve blocks in management of breakthrough HNC-associated trigeminal or cervical neuropathic pain disorders.&nbsp;<strong>Materials and Methods: </strong>A retrospective chart review of patients who underwent a nerve block or infiltration procedure in the regions of head and neck for management of breakthrough HNC-associated trigeminal or cervical neuropathic pain disorders in the Orofacial Pain Medicine clinic, Shaukat Khanum Memorial Cancer Hospital and Research Centre, between November 2018 and November 2019 was completed. Information regarding demographics, diagnosis, and pain characteristics was extracted and reviewed. The Fisher-exact test and Mann-Whitney U test were used for analysis between independent and dependent variables.&nbsp;<strong>Results: </strong>A total of 27 participants were included in the investigation, of which 66.7 % were males. The average pre-procedure pain score was 6.85 ± 2.54. Following intervention, 81.5 % of the participants experienced greater than 75 % relief in pain for longer than 48 hours. The mean immediate post-procedure pain score was 0.26 ± 1.02 and the average duration of relief was 6.10 ± 6.50 weeks. The significant effect of nerve blocks was found to be statistically associated with the concurrent use of amitriptyline (<em>p </em>= 0.017).&nbsp;<strong>Conclusion: </strong>Nerve blocks, as an adjunctive therapy to pharmacologic treatment, can provide significant relief to patients with breakthrough HNC-associated trigeminal and cervical neuropathic pain disorders. However, the duration of relief experienced by the participants is inconsistent. The beneficial effect of nerve blocks appears to be more common in patients that were concurrently using amitriptyline.</p> Khawaja Shehryar Nasir, Haroon Hafeez, Arif Jamshed, Raza Hussain Copyright (c) 2020 Khawaja Shehryar Nasir, Haroon Hafeez, Arif Jamshed, Raza Hussain Wed, 20 May 2020 01:35:46 -0700 Reasons for Admission and Outcome to an Acute Palliative Care Unit in Patients with Advanced Malignancy in a Cancer Hospital <p><strong>Introduction:</strong> The alleviation of suffering is a primary goal of palliative care team for patients with terminal cancer. In some cases, patients experience symptoms requiring inpatient care. The purpose of this investigation was to assess the clinical presentation and outcomes of hospitalization in patients that were admitted to the acute palliative care service. <strong>Materials and Methods</strong>: This is a retrospective descriptive study looking at admissions to an acute palliative care unit in a single center over a 24-month period. Medical records of all patients, admitted in palliative care unit from 1st January 2013 till 31st December 2014, were reviewed for reason of admission and outcome. <strong>Results:</strong> A total of 226 patients were identified and included in the present investigation. Among these 55.5 % (125) were females. The median age of the cohort was 48 (15 - 86) years. The most common reasons for admission were alteration in consciousness (19.5 %), respiratory tract infection (18 %), diarrhea and/or vomiting (14.2 %) and respiratory distress (not related to infection) (13.4 %). The median duration of hospital stay was 4 (0-27) days. Majority of the patients were discharged home (65.1 %). However, a significant portion (33.1 %) of the patients did not survive the hospitalization. Following discharge from the hospital, at 4-weeks follow-up the survival rate was 38.7 %. This dropped to 21.7 % at 8-weeks. <strong>Conclusion</strong>: Patients with advanced disease have a multitude of reasons to seek acute inpatient care. Majority of the patients were discharged following care. However, the survival rate of patients following discharge was low.</p> Irum Ghafoor, Abdul Hanan Ali Rasheed, Aun Raza, Arif Jamshed, Haroon Hafeez Copyright (c) 2020 Irum Ghafoor, Abdul Hanan Ali Rasheed, Haroon Hafeez, Aun Raza Sat, 30 May 2020 00:09:20 -0700 High Grade B-Cell Non-Hodgkin’s Lymphoma Masquerading as Thyroid Carcinoma; a Case Report <p><span class=""><strong>Introduction:</strong> High grade B-cell lymphoma and diffuse large B cell exhibiting myelocytoma (MYC) translocation with B-cell lymphoma 2 (BCL2) and/or B-cell lymphoma 6 (BCL6) re-arrangements, also known as double and triple hit lymphomas, are aggressive entities. World Health Organization update 2017 includes this cytogenetically defined category of “High grade B cell lymphoma with myelocytoma MYC and BCL2 and/or BCL6 rearrangements” as a distinct entity on their own. We present an interesting case of an obese patient presenting with a neck mass, suspected to be an aggressive thyroid carcinoma, which eventually turned out to be a high grade B-cell lymphoma. </span><span class=""><strong>Case description:</strong>&nbsp;A 64 years-old male presented with complaints of neck pain for 10 weeks and a huge swelling in front of neck for 4 weeks. Respiratory system evaluation revealed cough, pleuritic pain and expectoration. Rest of the systemic review was unremarkable. Baseline reports showed hypothyroid status. Ultrasonography (USG) thyroid showed right upper pole Thyroid Imaging Reporting and Data Systems - 4 (TIRADS-4) nodule with bilateral cervical lymphadenopathy for which correlation with fine needle aspiration cytology (FNAC) was advised. Magnetic resonance imaging (MRI) films were submitted for review which showed overall features of locally invasive primary thyroid malignancy. Case was discussed in a multi-disciplinary team (MDT) meeting and suspicion arose of non-thyroidal origin of tumor. Patient underwent Positron emission tomography/computed tomography (PET/CT) as per MDT recommendations. PET/CT findings were highly suggestive of lymphomatous disease as opposed to thyroidal malignancy suspicion early on, which was confirmed on histopathology of cervical nodes. </span><span class=""><strong>Practical implications:</strong> High grade B-cell lymphoma is an aggressive entity and can be very deceptive in its presentation, as evident from this case report. Functional imaging modalities such as Fluorodeoxyglucose (F-18 FDG) PET/CT can provide crucial assistance in unmasking a deceptive disease entity masquerading as some other, thus changing the management plan completely.</span></p> Ali Jamal, Rizwan Bilal, Imran Khalid Niazi, Humayun Bashir Copyright (c) 2020 Authors Tue, 12 May 2020 01:26:47 -0700 Intracranial Extra-axial Undifferentiated Pleomorphic Sarcoma; a Case Report <p><strong>Introduction:</strong> Head and neck sarcomas result in high mortality rates. A lot of new cases of sarcomas are diagnosed every year constituting about 1 % of all head and neck malignancies. Undifferentiated pleomorphic sarcomas (UPS) are high grade soft tissue malignant tumors which occur primarily in limbs and retroperitoneal cavities. These tumors can often metastasize to the central nervous system. However, in rare instances, soft tissue sarcomas may develop as a primary lesion within the intracranial compartments. <strong>Case description:</strong> A young male presented to the clinic with occipital headache and blurring of vision. Initial workup included brain contrast enhanced computed tomography (CECT) and magnetic resonance imaging (MRI). The CECT suggested that there was an extra-axial mass present which was pressing against the adjacent left frontal lobe. Overlying frontal bone of the left side showed remodeling effect and associated mild periosteal reaction. MRI scan showed intracranial extra-axial lobulated mass with T1 intermediate to low signal intensity and intermediate to high signals on T2 sequences. Heterogeneous enhancement on post-contrast sequences was also seen. The lesion had a broad-based attachment with dura mater and was closely applied to the orbital roof without orbital invasion. Staging Positron emission tomography–computed tomography (PET/CT) scan showed a solitary site of disease in an intracranial location. Final diagnosis was confirmed by histopathology following excision of mass as undifferentiated pleomorphic sarcoma. Post-surgery MRI brain showed satisfactory postoperative appearance without any residual disease. Patient remained asymptomatic for 2 years and 6 months following the resection of the tumor. <strong>Practical implications: </strong>Most of the extra-axial intracranial soft tissue tumors arise from the meninges with meningiomas making the substantial bulk; however, possibility of other relatively rare tumors of meningeal origin must not be ignored. Intracranial soft tissue sarcomas mostly arise from meninges thus require a good understanding of clinical presentation as well as acquaintance with morphological features on radiological imaging to differentiate from other tumors. These can be treated with excision and radiotherapy along with sequential follow-ups to look for recurrence. Tissue sampling is mandatory followed by complete staging scan in case of sarcomas to rule out possible primary or secondary disease.</p> Muhammad Omer Altaf, Saad Khalil Chaudhry, Palwasha Gul, Waqas Ahmad, Atif Naveed, Islah Ud Din Copyright (c) 2020 Muhammad Omer Altaf , Palwasha Gul , Waqas Ahmad, Saad Khalil Chaudhry; Atif Naveed, Islah Ud Din Tue, 12 May 2020 02:13:36 -0700