MyMedR

Five-year survival and median survival time of nasopharyngeal carcinoma in Hospital Universiti Sains Malaysia

Siti-Azrin AH, Norsa'adah B, Naing NN

Asian Pac J Cancer Prev, 2014;15(15):6455-9.

BACKGROUND: Nasopharyngeal carcinoma (NPC) is the fourth most common cancer in Malaysia. The objective of this study was to determine the five-year survival rate and median survival time of NPC patients in Hospital Universiti Sains Malaysia (USM).

METHODS: One hundred and thirty four NPC cases confirmed by histopathology in Hospital USM between 1st January 1998 and 31st December 2007 that fulfilled the inclusion and exclusion criteria were retrospectively reviewed. Survival time of NPC patients were estimated by Kaplan-Meier survival analysis. Log-rank tests were performed to compare survival of cases among presenting symptoms, WHO type, TNM classification and treatment modalities.

RESULTS: The overall five-year survival rate of NPC patients was 38.0% (95% confidence interval (CI): 29.1, 46.9). The overall median survival time of NPC patients was 31.30 months (95%CI: 23.76, 38.84). The significant factors that altered the survival rate and time were age (p=0.041), cranial nerve involvement (p=0.012), stage (p=0.002), metastases (p=0.008) and treatment (p<0.001).

CONCLUSION: The median survival of NPC patients is significantly longer for age≤50 years, no cranial nerve involvement, and early stage and is dependent on treatment modalities.

Matched MeSH terms: Nasopharyngeal Neoplasms/therapy

Doxorubicin-loaded magnetic gold nanoshells for a combination therapy of hyperthermia and drug delivery

Mohammad F, Yusof NA

J Colloid Interface Sci, 2014 Nov 15;434:89-97.

PMID: 25170601 DOI: 10.1016/j.jcis.2014.07.025

In the present work, nanohybrid of an anticancer drug, doxorubicin (Dox) loaded gold-coated superparamagnetic iron oxide nanoparticles (SPIONs@Au) were prepared for a combination therapy of cancer by means of both hyperthermia and drug delivery. The Dox molecules were conjugated to SPIONs@Au nanoparticles with the help of cysteamine (Cyst) as a non-covalent space linker and the Dox loading efficiency was investigated to be as high as 0.32 mg/mg. Thus synthesized particles were characterized by HRTEM, UV-Vis, FT-IR, SQUID magnetic studies and further tested for heat and drug release at low frequency oscillatory magnetic fields. The hyperthermia studies investigated to be strongly influenced by the applied frequency and the solvents used. The Dox delivery studies indicated that the drug release efficacy is strongly improved by maintaining the acidic pH conditions and the oscillatory magnetic fields, i.e. an enhancement in the Dox release was observed from the oscillation of particles due to the applied frequency, and is not effected by heating of the solution. Finally, the in vitro cell viability and proliferation studies were conducted using two different immortalized cell lines containing a cancerous (MCF-7 breast cancer) and non-cancerous H9c2 cardiac cell type.

Matched MeSH terms: Breast Neoplasms/therapy*

Fulltext Potentially malignant disorders of the oral cavity: current practice and future directions in the clinic and laboratory

Dionne KR, Warnakulasuriya S, Zain RB, Cheong SC

Int J Cancer, 2015 Feb 1;136(3):503-15.

PMID: 24482244 DOI: 10.1002/ijc.28754

Despite commendable progress in the prevention, detection, and treatment of a wide variety of solid tumor types, oral squamous cell carcinoma (OSCC) remains a significant health burden across the globe. OSCC carcinogenesis involves accumulation of genetic alterations that coincide with the multistep malignant transformation of normal oral epithelium. OSCC is often first diagnosed at late stages of the disease (advanced regional disease and/or metastasis). Delayed diagnosis precludes successful treatment and favorable outcomes. In clinical practice, opportunities exist to identify patients with oral potentially malignant disorders (OPMDs), which precede the development of cancer. This review addresses the current status of laboratory and clinical research on OPMDs, with emphasis on leukoplakia and erythroplakia. OSF is also presented, though there is a paucity of published studies on this disorder. We focus on findings that could translate into earlier diagnosis and more efficacious treatment of those lesions with significant malignant potential. We explore how markers of OPMD malignant transformation might be implemented into current diagnostic practice to help clinicians objectively stratify patients into treatment/follow-up groups according to relative risk. We provide an overview of recently concluded and ongoing OPMD chemoprevention trials. We describe laboratory OPMD models that can be used to not only to reveal the genetic and molecular intricacies of oral cancer but also to develop novel screening methods and therapeutic approaches. Finally, we call for targeted screening programs of at-risk populations in order to facilitate diagnosis and treatment of OPMD and early OSCC.

Matched MeSH terms: Mouth Neoplasms/therapy*

Clinical depression while caring for loved ones with breast cancer

Nik Jaafar NR, Selamat Din SH, Mohamed Saini S, Ahmad SN, Midin M, Sidi H, et al.

Compr Psychiatry, 2014 Jan;55 Suppl 1:S52-9.

PMID: 23706655 DOI: 10.1016/j.comppsych.2013.03.003

The period of the cancer patients undergoing treatment is also the most stressful time for their family caregivers. This study aimed to determine the rates of major depressive disorder and dysthymia; and their associated factors in the caregivers during this time.

Study site: Oncology centre, Pusat Perubatan Universiti Kebangsaan Malaysia

Matched MeSH terms: Breast Neoplasms/therapy

Complementary and Alternative Medicine (CAM) use by Malaysian oncology patients

Farooqui M, Hassali MA, Abdul Shatar AK, Shafie AA, Seang TB, Farooqui MA

Complement Ther Clin Pract, 2012 May;18(2):114-20.

PMID: 22500849 DOI: 10.1016/j.ctcp.2011.09.003

The current study sought to evaluate Malaysian oncology patients' decision making about the use of Complementary and Alternative Medicine (CAM) for the management of their care. Patients were interviewed across three major Malaysian ethnic groups, Malay, Chinese and Indian. Thematic content analysis identified four central themes: Conceptualizing CAM, the decision making process; rationale given for selecting or rejecting CAM and barriers to CAM use. Participants generally used the term 'traditional medicine', referred to locally as 'ubat kampung', meaning medicine derived from 'local traditions'. Mixed reactions were shown concerning the effectiveness of CAM to cure cancer and the slow progression of CAM results and treatment costs were cited as major barriers to CAM use. Concerns regarding safety and efficacy of CAM in ameliorating cancer as well as potential interactions with conventional therapies highlighted the importance of patients' knowledge about cancer treatments.

Matched MeSH terms: Neoplasms/therapy*

Fulltext Reproductive function after treatment of ovarian germ cell malignancy

Abdullah NA, Rushdan MN

Med J Malaysia, 2012 Feb;67(1):71-6.

PMID: 22582552 MyJurnal

This study was undertaken to evaluate the reproductive and oncologic outcomes of patients diagnosed with Ovarian Germ Cell Malignancy (OGCM) who underwent fertility preserving surgery and adjuvant chemotherapy treated in Gynaecology Oncology Unit, Sultanah Bahiyah Hospital, Kedah, Malaysia.

Matched MeSH terms: Ovarian Neoplasms/therapy

Fulltext scFv antibody: principles and clinical application

Ahmad ZA, Yeap SK, Ali AM, Ho WY, Alitheen NB, Hamid M

Clin. Dev. Immunol., 2012;2012:980250.

PMID: 22474489 DOI: 10.1155/2012/980250

To date, generation of single-chain fragment variable (scFv) has become an established technique used to produce a completely functional antigen-binding fragment in bacterial systems. The advances in antibody engineering have now facilitated a more efficient and generally applicable method to produce Fv fragments. Basically, scFv antibodies produced from phage display can be genetically fused to the marker proteins, such as fluorescent proteins or alkaline phosphatase. These bifunctional proteins having both antigen-binding capacity and marker activity can be obtained from transformed bacteria and used for one-step immunodetection of biological agents. Alternatively, antibody fragments could also be applied in the construction of immunotoxins, therapeutic gene delivery, and anticancer intrabodies for therapeutic purposes. This paper provides an overview of the current studies on the principle, generation, and application of scFv. The potential of scFv in breast cancer research is also discussed in this paper.

Matched MeSH terms: Breast Neoplasms/therapy*

Seven-year review of prostate carcinomas diagnosed by TRUS biopsy in a single Malaysian institution

Hong GE, Kong CH, Singam P, Cheok LB, Zainuddin ZM, Azrif M

Asian Pac J Cancer Prev, 2010;11(5):1351-3.

PMID: 21198291

INTRODUCTION: Analysis of epidemiological as well as survival differences among the multiethnic population of Malaysia with prostate cancer is important.

METHODS: Patients confirmed by transrectal-ultrasonographic-guided-biopsy performed from 2002 to 2008 were enrolled and analysed according to ethnicity, age, PSA level, Gleason score, stage of disease and survival.

RESULTS: Among 83 patients, there were 38 Malay, 40 Chinese, 3 Indians and 2 others. Median age at diagnosis was 69.9 (range: 59-93), 43 patients (51.8%) being diagnosed before the age of 70. The median PSA level upon diagnosis was 574 ng/ml (range: 1-8632) and the median Gleason score was 7 (range: 2-10). Over half were already in Stage 4 when diagnosed. The most common site of metastasis was the bone. As a result the commonest prescribed treatment was hormonal manipulation. Five patients underwent radical prostatectomy and a further thirteen patients had radical radiotherapy (stage I: 1 patient, stage II: 7 patients and stage III: 5 patients). Ten patients defaulted follow-up. The median disease-specific survival was 21.9 months (range: 1-53).

CONCLUSIONS: Prostatic carcinoma is a disease of the elderly and it is frequently diagnosed late in Malaysia. Greater efforts should be made to educate Malaysians regarding prostate cancer.

Matched MeSH terms: Prostatic Neoplasms/therapy

Fulltext Head and neck follicular dendritic cell sarcoma: disease associations and treatment review

Amin Z, Suhaimi Y, Ahmad R

Med J Malaysia, 2010 Mar;65(1):77-9.

PMID: 21265258 MyJurnal

Currently, of less than 50 cases of head and neck follicular dendritic cell (FDC) sarcoma reported in the literature, 5 have been found to occur in the background of Castleman disease. We report another case of head and neck FDC sarcoma with emphasise on its associated lesions and review the outcome of treatment from the existing cases in the literature.

Matched MeSH terms: Head and Neck Neoplasms/therapy

Multiple subcutaneous puncture and stoma bag drainage for gross lower limb edema: a case report

Beng TS, Chin LE

J Palliat Med, 2010 Aug;13(8):1037-8.

PMID: 20712471 DOI: 10.1089/jpm.2009.0314

We present a case of gross lower limb edema in a 21-year-old man with an intra-abdominal malignant fibrous histiocytoma. He had a 1-month history of lower limb edema secondary to inferior vena caval obstruction. His edema failed to respond to a combination of diuretics, oral frusemide 40 mg daily and oral spironolactone 100 mg daily. Subcutaneous drainage of both lower limbs with butterfly needles was performed with minimal improvement. However, he gained significant symptomatic relief with multiple subcutaneous punctures and stoma bag drainage. A total of 12.8 L of serous fluid was drained with this simple and effective method. This is the first report of the use of this method.

Matched MeSH terms: Retroperitoneal Neoplasms/therapy

Fulltext Primary lymphoma of the thyroid: diagnostic and therapeutic considerations

Sarinah B, Hisham AN

Asian J Surg, 2010 Jan;33(1):20-4.

PMID: 20497878 DOI: 10.1016/S1015-9584(10)60004-8

Primary thyroid lymphoma is uncommon and accounts for less than 2-5% of all thyroid malignancies. The aim of the present study was to review our experience and management of primary thyroid lymphoma and to discuss the diagnostic and therapeutic considerations.

Matched MeSH terms: Thyroid Neoplasms/therapy*

Initial symptoms and delayed diagnosis of osteosarcoma around the knee joint

Pan KL, Chan WH, Chia YY

J Orthop Surg (Hong Kong), 2010 Apr;18(1):55-7.

PMID: 20427835

To identify initial symptoms of osteosarcoma around the knee joint.

Matched MeSH terms: Bone Neoplasms/therapy

Primary non-Hodgkins lymphoma of the lacrimal sac: mortality-related epiphora

Maharajah KR, Hussein A, Mohamad H, Khan SA, At LS

Orbit, 2009;28(5):306-8.

PMID: 19874126 DOI: 10.3109/01676830903044346

We report a case of primary non-Hodgkins lymphoma of the lacrimal sac in a 60-year-old Asian lady, who presented with persistent epiphora and recurrent medial canthal swelling. Primary lymphoma of the lacrimal sac is rare and it can be easily misdiagnosed. Delayed in diagnosis may be related to mortality. To minimize the risk of overlooking specific pathology it is important to assess the appearance of the lacrimal sac and its surrounding structures intraoperatively. Biopsy of the lacrimal sac is required in cases where specific pathology is suspected.

Matched MeSH terms: Eye Neoplasms/therapy

Objective and subjective nutritional assessment of patients with cancer in palliative care

Kwang AY, Kandiah M

Am J Hosp Palliat Care, 2010 Mar;27(2):117-26.

PMID: 19959839 DOI: 10.1177/1049909109353900

This study aimed to evaluate the nutritional status of patients with cancer in palliative care and to examine the interrelationship between objective and subjective nutritional assessment measures. Patients' nutritional status in a palliative care unit of a Malaysian government hospital and a hospice facility were assessed using anthropometric measurements, weight loss at 1/6 months, and the scored patient-generated subjective global assessment (PG-SGA). Moderate-to-severe malnutrition was observed in a range from 31% to 69% using both measurements. Common nutritional impact symptoms were pain, xerostomia, and anorexia. Patient-generated subjective global assessment scores were significantly correlated with anthropometric measurements (P < .050). The PG-SGA is equally informative as objective indicators and is recommended as a quickly applied tool for nutritional status assessment of patients with cancer in palliative care.

Matched MeSH terms: Neoplasms/therapy*

Fulltext Survival analysis of Malaysian women with breast cancer: results from the University of Malaya Medical Centre

Mohd Taib NA, Yip CH, Mohamed I

Asian Pac J Cancer Prev, 2008 Apr-Jun;9(2):197-202.

PMID: 18712958

BACKGROUND: Breast cancer is the commonest cancer amongst Malaysian women but local survival data are scarce. The present study was therefore conducted to assess overall survival and prognostic factors in Malaysian breast cancer patients.

METHODS: The research sample was a prospective cohort of 413 patients diagnosed with breast cancer in the University of Malaya Medical Centre between 1993 to 1997. Survival data were obtained from the National Registry of Birth and Deaths in December 2000. The clinico-pathological variables studied were age, ethnic group, stage, tumour size, lymph node status, oestrogen receptor status and grade. The data were analysed utilizing Splus statistical software. The important prognostic factors were identified by fitting the Cox's proportional hazard model to the data set. Survival probabilities were estimated using the Kaplan-Meier method and differences were compared by the log-rank test.

RESULTS: The overall 5-year survival was 59.1%. The Cox's proportional hazard model identified stage, lymph node status, size and grade as factors that correlated with prognosis. Age was not a significant prognostic factor. The Cox regression model by stepwise selection showed stage, nodal status and grade of tumour to be independent prognostic factors, whereas ethnicity, age and ER status were not.

INTERPRETATION: The overall survival in our centre was low. Recognizing factors that affect prognosis of breast cancer patients in Malaysia may improve delivery of health care to at-risk groups by strategizing interventions as survival depends on early detection and effective treatment.

Matched MeSH terms: Breast Neoplasms/therapy

Fulltext New registry: National Cancer Patient Registry--Colorectal Cancer

Wendy L, Radzi M

Med J Malaysia, 2008 Sep;63 Suppl C:57-8.

PMID: 19230248

Colorectal cancer is emerging as one of the commonest cancers in Malaysia. Data on colorectal cancer from the National Cancer Registry is very limited. Comprehensive information on all aspects of colorectal cancer, including demographic details, pathology and treatment outcome are needed as the management of colorectal cancer has evolved rapidly over the years involving several disciplines including gastroenterology, surgery, radiology, pathology and oncology. This registry will be an important source of information that can help the development of guidelines to improve colorectal cancer care relevant to this country. The database will initially recruit all colorectal cancer cases from eight hospitals. The data will be stored on a customized web-based case report form. The database has begun collecting data from 1 October 2007 and will report on its first year findings at the end of 2008.

Matched MeSH terms: Colorectal Neoplasms/therapy

Chemoreduction for intraocular retinoblastoma in Malaysia

Menon BS, Juraida E, Alagaratnam J, Mohammad M, Ibrahim H, George TM, et al.

J Pediatr Hematol Oncol, 2007 Jan;29(1):2-4.

PMID: 17230058

In the last decade, chemotherapy in combination with focal therapy (chemoreduction) has been increasingly used in intraocular retinoblastoma to avoid enucleation and radiotherapy. The aim of this study was to assess the feasibility and outcome of chemoreduction in Malaysian children with retinoblastoma. This was a prospective study from August 2001 to January 2006. Twenty children (25 eyes) were given 4 cycles of chemoreduction, after which the response was assessed. Fourteen eyes showed a complete response, 10 eyes showed a partial response, and 1 eye had progressive disease. Twelve eyes developed progressive disease later, 9 after an initial complete response and 3 after a partial response. Overall, progressive disease occurred in 52%. There were 2 treatment failures, in Reese-Elsworth groups 3 and 4. Both eyes required enucleation. One eye in group 5 required second line chemotherapy to achieve a complete response. No eyes were irradiated. Five children (25%) defaulted follow-up, one of whom returned with disseminated disease. In conclusion, 4 cycles of chemoreduction achieved a durable complete response in only 12% of eyes. Chemoreduction is feasible in Malaysia but requires good patient compliance and close follow-up.

Matched MeSH terms: Retinal Neoplasms/therapy*

Challenges in the management of breast cancer in low- and middle-income countries

Yip CH, Taib NA

Future Oncol, 2012 Dec;8(12):1575-83.

PMID: 23231519 DOI: 10.2217/fon.12.141

The incidence of breast cancer is rising in low- and middle-income countries (LMICs) due to 'westernization' of risk factors for developing breast cancer. However, survival remains low because of barriers in early detection and optimal access to treatment, which are the two main determinants of breast cancer outcome. A multidisciplinary approach to treatment gives the best results. An accurate diagnosis is dependent on a reliable pathology service, which will provide an adequate pathology report with prognostic and predictor information to allow optimal oncological treatment. Stratification of clinical practice guidelines based on resource level will ensure that women will have access to treatment even in a low-resource setting. Advocacy and civil society play a role in galvanizing the political will required to meet the challenge of providing opportunities for breast cancer control in LMICs. Collaboration between high-income countries and LMICs could be a strategy in facing these challenges.

Matched MeSH terms: Breast Neoplasms/therapy*

Fulltext Cutaneous malignant melanoma: clinical and histopathological review of cases in a Malaysian tertiary referral centre

Pailoor J, Mun KS, Leow M

Malays J Pathol, 2012 Dec;34(2):97-101.

PMID: 23424771 MyJurnal

Melanoma is a lethal skin cancer that occurs predominantly among Caucasians. In Malaysia, the incidence of melanoma is low. This is a retrospective study of clinical and histopathological features of patients with cutaneous melanoma who were seen at the University Malaya Medical Centre from 1998 to 2008. Thirty-two patients with cutaneous melanoma were recorded during that period. Of these, 24 had sought treatment at the onset of disease at our centre. Chinese patients constituted the largest group (19 cases). The median age of these 24 patients at the time of presentation was 62 years. 16 patients had melanoma involving the lower limb with 12 affecting the sole of the foot. None had melanoma arising from the face. Histopathology showed nodular melanoma in 22 cases (91.6%), with superficial spreading and acral lentiginous melanoma diagnosed in 1 case each. The majority of patients (62.5%) were found to be in Stage III of the disease at the time of diagnosis.

Matched MeSH terms: Skin Neoplasms/therapy

Malignant cervical teratoma in an adult presenting with impending airway obstruction

Lukman MR, Jasmi AY, Sarinah B, Nurismah MI, Aishah MA

Asian J Surg, 2005 Jul;28(3):227-9.

PMID: 16024322

Extragonadal teratomas and germ cell tumours are uncommon. Most teratomas of the head and neck present in the paediatric age group. Occurrence of such tumours in an adult is extremely rare and, to date, less than 40 cases have been reported in the literature. We report a case of a young man presenting with impending airway obstruction secondary to a malignant teratoma of the neck.

Matched MeSH terms: Head and Neck Neoplasms/therapy

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