Development of a Predictor Model for Quality of Life in Cancer Patients with Adverse Drug Reactions due to Cancer Chemotherapy.

Cancer is one of the leading causes of morbidity and mortality worldwide. There are various detrimental symptoms experienced by a cancer patient due to the disease and the undergoing treatment which adversely affects the Quality of Life (QOL) in these patients. Therefore, QOL and its evaluation have turned out to be progressively vital in the health care system. Hence, the aim of our study was to develop a predictor model to predict the QOL in cancer patients receiving chemotherapy. The study was carried out in the Department of Radiotherapy and Oncology, Kasturba hospital, Manipal, a tertiary care hospital. Predictor model was developed to predict the Quality of Life Scores (QOLS) using multivariate regression analysis. A total of 387 patients participated in the study. Mean age of the patients was 50.85 ± 11.82 years (95% CI, 49.66-52.03). In our study, 16.54% had poor global health status/QOL, 72.35% had average and 11.11% had a high global health status/QOL. A significant difference was found in the QOLS based on the age group, site of cancer, drugs used in treatment of cancer, age as a predisposing factor and organ system affected due to ADRs (respiratory system, sensory system, skin and appendages). In the predictor model, the Coefficient of determination R-square (R2) was found to be 0.3267 indicating that 32.67% of the variation in the ‘quality of life score’ is explained by the independent variables included in the model. The F (45, 341) = 3.67, p < 0.001 indicating the overall significance of the regression model. Thus, the study showed that there are various predictors that can assess the QOL in cancer patients which can further serve as a guide to implement timely interventions to improve patients QOL.

Effectiveness of pranayama on the levels of serum protein thiols and glutathione in breast cancer patients undergoing radiation therapy: A randomized controlled trial.

The effect of Pranayama on the levels of protein thiols and glutathione was studied among breast cancer patients receiving radiation therapy. 160 patients were randomised into experimental and control group using block randomisation. The experimental group received fractionated radiation for five days a week and performed Pranayama (Nadishodhana, Brahmari and Sheethali) for 30 minutes twice daily for five days a week. The control group received only radiation. Blood samples were collected from both the groups at the end of six weeks of radiation therapy and analysed for the levels of serum protein thiols and glutathione. An independent sample ‘t’ test showed a significant difference in the level of serum protein thiols between the two groups (t = 4.43 p 0.001). A Mann- Whitney U test showed a significant difference (z = –3.07 p 0.002) in the level of glutathione as well. These Pranayama techniques improve the antioxidant status of breast cancer patients receiving radiation therapy.

Effect of exercise training on functional capacity & quality of life in head & neck cancer patients receiving chemoradiotherapy.

Background & objectives: Patients with head and neck cancer (HNC) undergoing chemoradiotherapy (CRT) suffer from fatigue causing a decrease in functional capacity and quality of life (QoL). Limited research in the field of exercise training among these patients demanded the need for this study to assess the effects of exercise training on functional capacity and quality of life. Methods: A randomized controlled trial was conducted on 48 patients with HNC undergoing CRT. The exercise group received an individually tailored, supervised, exercise programme for six weeks, while the control group did not receive any form of exercise. Functional capacity and QoL were assessed at baseline and at the end of the intervention using the six minute walk distance (6MWD) and medical outcomes survey short form 36 (SF 36). Results: The mean age of patients was 52 yr with 42 males. After six weeks, the 6MWD improved by 42 metres (P<0.05) in the exercise group while the control group showed a decrease by 96 metres (P<0.001). There was an improvement on the mental component score (MCS) of SF36 for the exercise group (4.8; P<0.05) and the physical component score (PCS) remained almost the same, while a decrease in PCS and MCS was seen in the control group (-5.9; P=0.064 and -17.3; P<0.05). When 6MWD and SF36 were compared between the groups, there was a statistically significant difference (P<0.001) seen after six weeks. Interpretation & conclusions: Our results showed that the functional capacity and QoL decreased among those not receiving a supervised exercise program, while exercise training improved functional capacity and QoL in HNC patients undergoing CRT.

An overview on applications of optical spectroscopy in cervical cancers.

Despite advances in the treatment modalities, cervical cancers are one of the leading causes of cancer death among women. Pap smear and colposcopy are the existing screening methods and histopathology is the gold standard for diagnosis. However, these methods have been shown to be prone to reporting errors, which could be due to their subjective interpretation. Radiotherapy is the mainstay of treatment for the locally advanced stages of cervical cancers. The typical treatment regimen spans over 4 months, from the first fraction of radiation to clinical assessment of tumor response to radiotherapy. It is often noticed that due to intrinsic properties of tumors, patients with the same clinical stage and histological type respond differently to radiotherapy. Hence, there exists a need for the development of new methods for early diagnosis as well as for early prediction of tumor radioresponse. Optical spectroscopic methods have been shown to be potential alternatives for use in cancer diagnosis. In this review, we provide a brief background on the anatomy and histology of the uterine cervix and the etiology of cervical cancers; we briefly discuss the optical spectroscopic approach to cervical cancer diagnosis. A very brief discussion on radiation therapy and radiation resistance is also provided. We also share our experiences with the Raman spectroscopic methodologies in cervical cancer diagnosis as well as in the prediction of tumor radioresponse.

Evaluation of intraperitoneal vincristine in malignant peritoneal effusion.

The efficacy and safety of intraperitoneal administration of vincristine sulphate was determined in mice bearing Ehrlich ascitic carcinoma. The tumor bearing animals were administered with 0.5 mg/kg body weight (b.wt) of freshly prepared vincristine sulphate intraperitoneally on day 6 after tumor transplantation followed by drug administration once daily 5 days a week consecutively. The observations regarding the survival, alteration in the volume of peritoneal fluid, increase in life span and pathological changes in the liver, kidney, gastrointestinal tract and bone tissues were made. The vincristine sulphate treatment reduced the malignant cell population significantly and there were no significant changes in the histological picture of liver, kidney, bone, except the intestine, where atropy of villi demonstrating nests and cords of uniform small round cells were observed. Our experimental data suggests that intraperitoneal administration of vincristine is beneficial in malignant peritoneal effusion.

Primary squamous cell carcinoma of the breast in a young woman--a case report and review of literature.

A thirty-four years old woman presented with pure squamous cell carcinoma of the breast, a very rare occurrence in the younger age group. A simple mastectomy with axillary clearance was performed, followed by adjuvant radiotherapy & chemotherapy. The patient is doing well, with no evidence of recurrence thirty months (2 1/2 years after the treatment. Primary pure squamous cell carcinoma of the breast is a very rare disease. The exact histogenesis still remains obscure. There seems to be no specific prognostic correlation with the morphological characteristics of squamous cell carcinoma of the breast. The clinical behaviour of this tumor is also uncertain. Thus, further study is required to determine whether primary pure squamous cell carcinoma of the breast is to be treated as a separate entity or as the common type of breast cancer (i.e. adenocarcinoma or adenocarcinoma with squamous metaplasia.)

Aniridia-Wilms' tumour syndrome--a case report.

Wilms' tumour is rarely associated with sporadic non-familial congenital aniridia. A child with sporadic aniridia has a 25% chance of subsequently developing Wilms' tumour. Unawareness of this association can lead to a delayed diagnosis of Wilms' tumour. One such case in a 2 year old is reported. Wilms' tumour, one of the common childhood malignancies, is associated with other congenital anomalies in about 15% of cases. These include hemihypertrophy, genitourinary abnormalities, mental retardation, aniridia etc. Sporadic non-familial aniridia was noted in only 1.1% of 547 children with Wilms' tumours evaluated by the National Wilms' Tumour study group. Unawareness on the part of a clinician about these associated anomalies can lead to an avoidable delay in diagnosing Wilms' tumour. One such case in a two year old girl is being reported.

Clinico-pathological profile of lymphomas in south India: a prospective rural referral hospital study of 103 cases.

A prospective clinical and histopathological study of 103 patients with lymphomas is reported. Of these, 72 (69.9%) had non-Hodgkin's lymphoma (NHL) and 31 (30.1%) had Hodgkin's lymphoma (HL). The median age at presentation was 34 and 43 years for Hodgkin's and non-Hodgkin's lymphoma respectively, which is lower than that seen in the West. Fever and superficial lymphadenopathy were the commonest presenting features and 'B' symptoms were present in over 60% of both groups. Seventy-five per cent of NHL and 64.5% of HL presented in stages III and IV of the disease.

Primary mediastinal embryonal cell carcinoma.

It is now widely accepted that germinal cell tumors can arise primarily in the mediastinum. Primary extragenital seminoma has been documented arising in the mediastinum but very few reports are available about primary mediastinal embryonal cell carcinoma. We report a case of this rare condition with radiological and CT features.