Prognostic value of hemoglobin levels prior to radiotherapy for cervical cancer--Kuwait experience.

OBJECTIVE: To evaluate hemoglobin (Hb) levels before and during radiotherapy and its role as prognostic factor on treatment results of patients treated for cancer cervix. MATERIALS AND METHODS: One hundred and seven patients with cervical cancer were registered and managed at KCCC during 1995 - 1999. The pre-treatment and mid treatment Hb levels were found for 47 patients only. Follow-up was done for these cases aiming at evaluation the overall and disease-free survival. Statistical analysis was done using SPSS statistical package version 10.0. RESULTS: The median age of patients were 45 and ranged between 26-80 years. Kuwaiti patients represented 21.3% of cases. The most common stage was Stage IIb representing 51.1% followed by IIIb representing 27.7%. Stage Ib and IIa represented 12.8%. About 89.4% were squamous cell carcinoma, while adenocarcinoma was 6.4%. Treatment outcome revealed 18 relapses (38.3%). Disease-free survival for cases with pre-treatment Hb level < 12 was 16.3%, while for those with Hb level > or = 12 g/dL it was 62.9%. The difference was statistically significant (P = 0.02). CONCLUSION: Patients with pre-treatment Hb < 12 g/dL had a significantly lower disease-free survival.

Anemia in patients with advanced or metastatic non-small cell lung cancer.

OBJECTIVE: To determine the frequency of anemia in patients with advanced or metastatic non-small cell lung cancer (NSCLC) at the time of initial oncologic consultation. MATERIAL AND METHOD: We reviewed 144 consecutive charts of patients with advanced or metastatic NSCLC, who were seen in consultation at the Hamilton Regional Cancer Center (Canada) between January and June of 1998. RESULTS: Eighty nine patients had pre-treatment hemoglobin (Hb) levels available and 30 of those patients (33.7%) had levels below 12 gm/dl. The likelihood of anemia increased with advancing stage of underlying disease, found in 25% and 40.8% of stage III and IV patients respectively. CONCLUSION: Although only 89/144 patients had Hb results available, 33.7% had hemoglobin level below 12 g/dl. Anemia was more common with an increased burden of disease. Shortness of breath and fatigue were more commonly reported in anemic patients.

Planning cancer prevention strategies based on epidemiologic characteristics: an Egyptian example.

BACKGROUND AND METHODS: We describe the epidemiology, cancer prevention strategies, and educational messages to be learned from four characteristic cancers in Egypt: urinary bladder, liver, lung, and early-onset colorectal cancers. RESULTS: For bladder cancer, effective and convenient treatment of schistosomiasis, using social marketing and mass media in public and medical education has contributed dramatically to primary prevention of bladder cancer in Egypt. For liver cancer, educating hospital administrators to remove structural barriers to good practice may help the control of hepatitis transmission and related liver cancer. For lung cancer, the 50-year American experience for controlling tobacco smoking, beginning with physicians, could be very effective in Egypt and other countries with increasing smoking rates in the young so as to avert the expected epidemics of lung cancer. For colorectal cancer, more attention to physician and public education about the importance of interviewing colorectal cancer patients about a family history of cancer and the screening of at-risk families could be very effective in early detection of colorectal cancer. CONCLUSION: Countries with similar cancer epidemiology experience should make use of successful cancer prevention and education strategies that could be translated from the Egyptian experience.

A simple strategy for breakpoint fragment determination in chronic myeloid leukemia.

Molecular characterization is considered a part of the routine work-up of chronic myeloid leukemia (CML) cases. Southern blot analysis using the universal BCR (UBCR) probe on BglII-digested DNA samples is the most commonly used technique, while employing the human 3' bcr probe (PR-1) is usually considered a complementary tool. In this study, we tried to develop a simple and economic strategy for molecular characterization of CML using the 3' probe as it has been shown to be the one capable of locating the breakpoint site. Seventy-eight cases of CML were studied. Molecular analysis was performed using the Southern blot technique. DNA was digested with Bam HI, BglII, EcoRI, and XbaI. Hybridization was performed using the human 3' bcr (PR-1) probe. BamHI and BglII could differentiate fragment 1 (F1) showing rearrangement (R) with Bam HI and germline configuration (G) with BglII; F2/3 showing R with both, and F4 showing R with BamHI and G with BglII. F2/3 cases were further divided by HindIII enzyme into F2 showing (G) and F3 showing (R). Fragment 0 showed G with both, but R with EcoRI and/or XbaI, while 3' deletion gave G with all four enzymes. Our results showed a relative incidence of 6.4% for F0, 20.5% for F1, 32.1% for F2, 19.2% for F3, 15.4% for F4, and 6.4% for 3' deletion. Sixty cases were evaluated clinically and hematologically and were followed up for disease evolution and survival. They included 32 cases in early chronic phase, 24 in late chronic phase, two in acceleration, and two in blastic crisis. No significant correlation was encountered between the breakpoint site and any of the clinical and hematological data except those patients with 3' deletion who showed a very short survival. The study emphasizes Southern blotting as the method of choice for molecular characterization of CML and offers a simple and economic strategy for diagnosis and determination of breakpoint fragment.

Colorectal cancer in Egyptian patients under 40 years of age.

Although colorectal cancer is not a common cancer in Egypt, the age distribution of the disease shows that a high proportion occurs in children and adults under 40 years of age. We reviewed the records of 1,608 colorectal cancer patients treated in 4 cancer hospitals in Egypt during a period of 3 to 10 years. The hospitals in which about 85% of all colorectal cancer cases in Egypt were seen included Egypt's 2 major cancer centers, The National Cancer Institute (NCI) in Cairo and Tanta Cancer Center (TCC) in the mid-Nile Delta region, and 2 major university hospitals, Assiut University in South Egypt and Ain Shams University in Cairo. Our review showed that patients younger than 40 years represented 35.6% of all patients in the 4 cancer hospitals, and that these rates were similar among the hospitals and for the years reviewed. The male-to-female ratio increased from 1.0 to 1.7 for the age groups ranging from 0-9 and 30-39 years, and increased from 1.0 to 1.5 for the age groups ranging from 40-49 to over 60 years. More than half of all the patients had rectal tumors, and about 90% of the cancers were adenocarcinomas; 30.6% of patients younger than 40 years, compared with 13.8% of older patients, had mucin-producing tumors. This study confirmed the occurrence of a high colorectal cancer rate in young Egyptians, and it opens the door to future epidemiologic studies to identify causes and risk factors of this disease pattern in Egypt.

Automated medical records technology at the National Cancer Institute-Egypt: a case study in technology transfer.

The National Cancer Institute-Cairo, Egypt (NCI) has adopted three different approaches to the automated medical record. These approaches are: the use of an integrated hospital information system, a document scanning system, and an imaging system. This paper discusses each of these approaches with regard to its benefits, technology-implemented and technology-related issues, and the social and cultural differences between implementations in developed and developing countries.