ABSTRACT
BACKGROUND: Cancer cervix and breast are the two major female health problems in India. A hospital-based, 5-year (2010-2014) retrospective study was conducted at a regional cancer center of Odisha to analyze the present burden of cancer cervix in this state, which has a population of more than 45.5 million at present. MATERIALS AND METHODS: All the patients suffering from cancer cervix that was treated by radiotherapy during 2010-2014 at this center were analyzed year wise for age, stage of disease, and native area. RESULTS: Based on the Census 2011 data, it was calculated and found that from the low-literacy area on an average of 4.62 cervical cancer patients per million, from the medium-literacy area 6.56 patients per million, and from high-literacy area 19.11 patients per million of population have received radiotherapy in this hospital. More than 60% of patients with cervical cancer were from stage IIIB and in the age group of 50-55 years. DISCUSSION: Odisha has 83.7% female population in rural areas with literacy rate below 50%. Due to lack of awareness and unavailability of cancer care facilities at their reach, they mainly depend on various alternative medicines in unscientific manner for their health care. CONCLUSION: Strengthening of existing regional cancer center, development of oncology wings in all medical college hospitals by providing basic radiotherapy facilities, emphasizing more on district cancer control programs, decentralizing of NGO schemes, and facilitating with more cancer screening and awareness programs may help better registration, prevention, and treatment of cancer in Odisha.
ABSTRACT
INTRODUCTION: Tru-cut Needle Biopsy (TCB) is an integral part of triple assessment of breast cancer, which includes clinical assessment, mammography and TCB or Core Needle Biopsy (CNB). The technique is reliable, simple, and reproducible, and inexpensive, which can be adapted even for low-income group of patients and in developing countries. AIM: This study was done to establish the efficacy of TCB of palpable breast lesions in a developing country where mammography is not possible in all cases. MATERIALS AND METHODS: A retrospective analysis of 892 TCBs was done in AH Regional Cancer Centre, Cuttack, Odisha, India where TCBs were performed in patients presenting to outpatient department with palpable breast lesions. The H&E stained sections were interpreted by pathologists of the same centre. Diagnosis was classified into different categories. Immunohistochemistry (IHC) for Estrogen Receptor (ER), Progesterone Receptor (PR) and Her-2/neu was done and interpreted by Allred scoring system. RESULTS: A total 892 TCBs were analysed with 23 repeat TCBs. There were 13 (1.4%) male patients. A total of 747 cases (83.6%) were diagnosed as malignant, including 735 carcinomas, nine malignant phyllodes tumour, two angiosarcoma and one case of Non-Hodgkin' Lymphoma (NHL). It was possible to diagnose special histological types such as lobular carcinoma, metaplastic carcinoma and mucinous carcinoma on TCB. A total of 21 cases were diagnosed as carcinoma on repeat biopsy. Eight of the 735 TCBs diagnosed as carcinoma were bilateral breast cancers, hence actual number of carcinoma cases were 727. IHC was done successfully on the paraffin blocks in 260 cases. In this series out of 727 patients of carcinomas 30% were in young, i.e., below 40 years of age, including four cases of carcinoma below 20 years. There were no false positive case in this study giving a specificity of 100% and sensitivity was 97%. CONCLUSION: TCBs are well tolerated by patients, can be done in OPDs and reduce cost. It is possible to give histological diagnosis of carcinoma, lymphoma, phyllodes tumour and sarcomas on TCBs. The paraffin blocks of TCBs can be used for IHC study which helps the oncologists for preoperative adjuvant therapy.
ABSTRACT
PURPOSE: Head and neck cancers are the third most common cancers worldwide. Oral mucositis is the most common toxicity seen in patients who receive chemoradiation to treat head and neck cancer. The aim of this study was to evaluate the efficacy and safety of oral glutamine supplementation in these patients. MATERIALS AND METHODS: From December 2013 to December 2014, we randomly assigned to two arms 162 patients who had squamous cell carcinoma of the head and neck. Patients in arm A were given oral glutamine once per day, whereas those in arm B served as negative control subjects. All patients received radiotherapy given as 70 Gy in 35 fractions over 7 weeks with an injection of cisplatin once per week. Patients were assessed once per week to evaluate for the onset and severity of mucositis, pain, use of analgesics, and for Ryle tube feeding. RESULTS: We observed that 53.1% of patients developed mucositis toward the fifth week in the glutamine arm compared with 55.5% of patients in the control arm at the third week. None in the glutamine arm compared with 92.35% of patients in the control arm developed G3 mucositis. Rates of adverse events like pain, dysphagia, nausea, edema, and cough, as well as use of analgesics and Ryle tube feeding, were significantly lower in the glutamine arm than in the control arm. CONCLUSION: This study highlights that the onset as well as the severity of mucositis in patients receiving glutamine was significantly delayed. None of the patients receiving glutamine developed G3 mucositis. Hence, the findings emphasize the use of oral glutamine supplementation as a feasible and affordable treatment option for mucositis in patients with head and neck cancers who are receiving chemoradiation.
