Displaying publications 161 - 180 of 629 in total

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  1. Caszo B, Khair M, Mustafa MH, Zafran SN, Syazmin N, Safinaz RN, et al.
    Asian Pac J Cancer Prev, 2015;16(3):1159-64.
    PMID: 25735348
    BACKGROUND: The prevalence of smoking among secondary school children continues to remain unchanged over the last 3 decades even though awareness regarding the health effects of smoking is increasing. Common misconceptions about smoking and parental influence could be factors influencing future intentions to smoke among these students. Hence, we looked at the common misconceptions as well as student perceptions about their future intention to smoke among Form 4 students in Shah Alam, Malaysia.

    MATERIALS AND METHODS: This study was conducted by distribution of a questionnaire developed as part of the Global Youth Tobacco Survey to Form 4 student in 3 schools at Shah Alam.

    RESULTS: Prevalence of smoking (current smokers) was 7.5%. Almost half of the children came from families where one or both parents smoked and a third of the parents had no discussion regarding consequences of smoking with them. A large number of students were classified as "triers" as they had tried smoking and were unsure of whether they would not be smoking in the future. Contrary to our expectations, students generally felt smoking did make one feel more uncomfortable and helped one to reduce body weight. Most students seemed to be aware of the ill-effects of smoking on health. They felt they had received adequate information from school regarding the effects on smoking on health.

    CONCLUSIONS: Our study showed that even though Form 4 students in Shah Alam were knowledgeable about ill-effects of smoking and were taught so as part of their school curriculum, the prevalence of smoking was still high. Students in the "trier group" represent a potential group of future smokers and strategies targeting tobacco control may be aimed at tackling these vulnerable individuals. Efforts are also needed to help educate secondary school children about common misconceptions and dispel myths associated with cigarette smoking.

  2. Teoh CS, Lee SY, Chiang SK, Chew TK, Goh AS
    Asian Pac J Cancer Prev, 2018 May 26;19(5):1229-1236.
    PMID: 29801406
    Background: Diffuse large B-cell lymphoma (DLBCL) with double expression of c-MYC and BCL2 protein is
    associated with dismal outcome after treatment with R-CHOP. Local data on disease burden and survival outcome in
    DLBCL is limited. We investigated the prognostic values of c-MYC/BCL2 protein co-expression and cell of origin
    subtypes using immunohistochemistry (IHC) and to determine their associations with multiethnic groups under
    resource limited setting. Methods: This was a retrospective study which recruited 104 patients in between June 2012
    and December 2015 for IHC review and analysis. Result: We demonstrated that patients with high International
    Prognostic Index (IPI) (score 3-5) and co-expression of c-MYC/BCL2 protein had significant inferior overall survival
    (OS) and event free survival (EFS) respectively (P<0.05). c-MYC/BCL2 protein co-expression was more common in
    non-germinal center B-cell (non-GCB) (P=0.048) and contributed to adverse prognosis in this group of patients (OS,
    P=0.004; EFS, P=0.005). In multivariate analysis, double-protein co-expression was a significant independent predictor
    of inferior outcome after adjusted for IPI and cell of origin subtypes (OS hazard ratio [HR], 2.11; 95% CI, 1.01 to 4.04;
    P=0.048; EFS HR, 2.31; 95% CI, 1.05 to 5.04; P=0.036). In addition, non-GCB subtype was more common than GCB
    in Malays (60% vs 40%, P=0.106) and Chinese (81.2% vs 18.8%, P=0.042). Indians had more DLBCL without c-MYC/
    BCL2 protein co-expression compared to double-protein positive cases (66.7% vs 33.3%, P=0.414). Otherwise, the
    prognostic impact of ethnicity on survival outcome was insignificant (P=0.961). Conclusion: c-MYC/BCL2 protein
    co-expression in non-GCB subtype constituted a unique group with extremely inferior outcome regardless of ethnicity.
    Gene expression profile (GEP) may possibly provide insights into the cause of discrepancies in DLBCL subtypes and
    protein expression among the multiethnic groups.
  3. Hilmi I, Hartono JL, Goh KL
    Asian Pac J Cancer Prev, 2010;11(3):815-22.
    PMID: 21039060
    INTRODUCTION: Colorectal carcinoma (CRC) is the second commonest malignancy in Malaysia, with the highest incidence seen in the Chinese. The aim of this study is to examine the knowledge of CRC and to identify potential barriers for screening, which has yet to be carried out on a nationwide scale.
    METHODS: Subjects were recruited consecutively from friends and relatives accompanying patients to the general medical clinic in a tertiary hospital in Kuala Lumpur. Interviews were carried out using a standardized questionnaire for the Asia Pacific CRC working group based on the Health Belief Model (HBM).
    RESULTS: 991 subjects were interviewed. From our study, 414 (41.8%), 500 (50.5%) and 646 (65.2%) could not identify any of the symptoms, risk factors and screening methods for CRC respectively. Only 384 (38.7%) were agreeable to undergo screening. Independent factors associated with willingness to undergo screening were as follows; Malay and Indian race compared to the Chinese [aOR 2.73 (1.87, 3.98) and 3.04 (2.02, 4.59) respectively], perceived susceptibility, perceived barriers to screening, doctor's recommendation and personal contact with CRC.
    CONCLUSIONS: Knowledge of CRC and CRC screening is low among the Malaysian population. The majority are not willing to undergo screening, the Chinese paradoxically being the least willing despite being at greatest risk
    Study site: Medical clinics, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
  4. Sharif Nia H, Rezapour M, Allen KA, Pahlevan Sharif S, Jafari A, Torkmandi H, et al.
    Asian Pac J Cancer Prev, 2019 09 01;20(9):2803-2809.
    PMID: 31554380 DOI: 10.31557/APJCP.2019.20.9.2803
    Objectives: The Center for Epidemiologic Studies Depression Scale (CES-D) was specifically created to assess
    depression in cancer patients. However, to date, the CES-D has not been validated in Farsi. Therefore, this study aimed to
    assess the psychometric properties of the CES-D in Iranian cancer patients. Methods: During a three-month period
    (October to December, 2015), a total of 380 cancer patients completed a Farsi version of the CES-D. The construct
    validity of the scale was evaluated by exploratory factor analysis. Reliability was assessed using Cronbach’s alpha
    and McDonald Omega. All of the statistical procedure were run by SPSS 22 (SPSS Inc., Chicago, IL, USA). Results:
    The construct validity of the CES-D determined three factors (somatic affect, negative affect, and positive affect),
    which explained 65.60% of the total variance. The internal consistency was greater than 0.70. Conclusion: Findings
    revealed that the Farsi version of the CES-D has acceptable validity and reliability, which can be used to measure
    depression in Iranian cancer patients.
  5. Phua CE, Tan BS, Yong TK, Govindasamy M
    Asian Pac J Cancer Prev, 2011;12(12):3197-200.
    PMID: 22471453
    BACKGROUND: Nasopharyngeal carcinoma (NPC) is one of the commonest cancers encountered in Malaysia. This study aimed to evaluate the treatment outcomes for patients with NPC treated in Penang General Hospital with specific analysis of prognostic clinicopathological features and treatment modalities.

    MATERIALS AND METHODS: This retrospective study examined NPC patients between 1st January 2001 and 31st December 2005 in Penang General Hospital. Survival analyses were performed using the Kaplan-Meier method and comparisons between groups were made using the log-rank test. Important prognostic factors including patient demographics, tumour and treatment factors were analysed using the Cox proportional hazard model.

    RESULTS: A total of 285 patients were identified with a median age of 51 years, 72.6% being males. The majority were Chinese (66%) followed by Malays (31.9%). Primary tumour stages (T stages) 3 and 4 were present in 18.6% and 34% of patients respectively, and nodal disease was present in 80.4%. On overall AJCC staging, 29.1% had stage III and 50.2% had stage IV disease. Some 39.6% of patients had WHO type 3 histology and 7.4% had WHO type 1-2 histology with the remainder having NPC with no subtype reported. Concurrent chemo-irradiation was the commonest treatment received by patients (51.9%) followed by radiotherapy alone (41.8%). The 5 year overall survival and cause specific survival were 33.3% and 42.7% respectively. Age group, T stage, N stage and WHO histological subtype were independent prognostic factors for overall survival on multivariate analysis. For cause specific survival they were T stage and N stage.

    CONCLUSION: The 5 years overall survival rate was 33.3%. This low figure is primarily due to late presentation. Efforts to detect NPC at earlier stages in Malaysia are urgently needed. These should include public education to increase awareness of the prevalence of this highly treatable disease.

  6. Zainal NZ, Shuib N, Bustam AZ, Sabki ZA, Guan NC
    Asian Pac J Cancer Prev, 2013;14(1):463-8.
    PMID: 23534774 DOI: 10.7314/apjcp.2013.14.1.463
    BACKGROUND: Body image dissatisfaction among breast cancer survivors has been associated with psychological stress resultant from breast cancer and resultant surgery. This study aimed to examine the psychometric properties of the Malay Version of the Breast-Impact of Treatment Scale (MVBITS) and to investigate the associations of retained factors with the Hospital Anxiety and Depression Scale (HADS) and the Rosenberg Self-Esteem Scale (RSES).

    MATERIALS AND METHODS: The MVBITS was 'forward-backward' translated from English to Malay and then administered to 70 female breast cancer patients who came to the Oncology Clinic of University Malaya Medical Centre, Kuala Lumpur, Malaysia to undergo chemotherapy. Principal component analysis (PCA) with varimax rotation was performed to explore the factor structure of the MVBITS. Associations of retained factors were estimated with reference to Spearman correlation coefficients.

    RESULTS: The internal consistency reliability of MVBITS was good (Cronbach's alpha 0.945) and showed temporal stability over a 3-week period. Principal component analysis suggested two factors termed as 'Intrusion' and 'Avoidance' domains. These factors explained 70.3% of the variance. Factor 1 comprised the effects of breast cancer treatment on the emotion and thought, while Factor 2 informed attempts to limit exposure of the body to self or others. The Factor 1 of MVBITS was positively correlated with total, depression and anxiety sub-scores of HADS. Factor 2 was positively correlated with total and anxiety sub-scores of HADS. MVBITS was also positively correlated with the RSES scores.

    CONCLUSIONS: The results showed that the Malay Version of Breast-Impact of Treatment Scale possesses satisfactory psychometric properties suggesting that this instrument is appropriate for assessment of body change stress among female breast cancer patients in Malaysia.
  7. Kandiah M, Ramadas A, Shariff ZM, Yusof RM, Gul YG
    Asian Pac J Cancer Prev, 2005 Oct-Dec;6(4):553-60.
    PMID: 16436011
    Comprehensive evaluation of the large body of consistent evidence from laboratory, epidemiologic and clinical studies has led to the conclusion that modification of the dietary and lifestyle patterns of populations has considerable potential for reducing cancer risk. This paper describes a randomized-controlled trial involving a diet and lifestyle intervention for patients with history of colorectal adenomas. The primary aim of this trial is to evaluate the effectiveness of the intervention with reference to recurrence of adenomatous polyps over a two year period--the first year being the intervention period and the second year of the study allowing for post-intervention follow-up. Subjects found to fit the inclusion criteria are recruited and randomized to two groups: the intervention group and the control group. The intervention group subjects will attend a monthly lecture-discussion session for 10 months and small group counseling on modification of lifestyle behavior and diet as well as receive educational materials which were adapted from the WCRF Diet and Health Recommendations for Cancer Prevention. Control subjects will be provided with the usual care given to such patients. One hundred and sixteen patients who were diagnosed with colorectal adenomatous polyps in the previous twelve months at the Hospital Kuala Lumpur have already been enrolled in this trial. Baseline data collection is on-going.
  8. Lim KH, Idzwan MF, Sumarni MG, Kee CC, Amal NM, Lim KK, et al.
    Asian Pac J Cancer Prev, 2012;13(1):343-6.
    PMID: 22502698
    Two methods of identifying smokers with high nicotine dependence, the heaviness of smoking index (HSI) and number of cigarettes per day (CPD) were compared with the Fagerstrom test for nicotine dependence (FTND). The HSI, CPD and the FTND were administered to 316 adult Malaysian male, daily smokers aged between 25-64 years old in the Malaysian NCD Surveillance-1 Survey using a two-stage stratified random sampling of enumeration blocks and living quarters, via an interview based on a validated questionnaire. The cut-off point for classification of high nicotine dependence on the HSI was a score of four or higher, and for the heavy smoking category, smoking more than 20 cigarettes per day. Classification using each method was compared with classification by the FTND (score of six or more) as the reference standard. Sensitivity, specificity and kappa statistics for concordance between both measures and the FTND were evaluated. The HSI gave a similar prevalence rate of high nicotine dependence as the FTND. There was substantial agreement between the HSI and the FTND (kappa=0.63.), with moderate sensitivity (69.8%) and high specificity (92.5%). However, prevalence of high nicotine dependence using the CPD was 7% lower than the FTND. The heavy smoking category also showed fair agreement with the FTND (kappa=0.45) and moderate sensitivity (67.0%), but specificity was high (86.9%). The findings indicate that the HSI can be used as an alternative to the FTND in screening for high nicotine dependence among daily smokers in large population-based studies, while CPD may not be a suitable alternative to the FTND.
  9. Al-Dubai SA, Qureshi AM, Saif-Ali R, Ganasegeran K, Alwan MR, Hadi JI
    Asian Pac J Cancer Prev, 2011;12(10):2531-8.
    PMID: 22320951
    OBJECTIVES: The aim of this study was to assess awareness and knowledge of breast cancer and mammography among Malaysian women in Shah Alam.

    METHODS: This cross sectional study was conducted among 250 Malaysian women. Data were collected using a self administrated questionnaire which included questions on socio-demographic data, knowledge of breast cancer and awareness of mammography.

    RESULTS: Mean age of respondents was 28 ± 9.2 with 69.2% aged 18 to 29 years. The majority had heard about breast cancer (81.2%) and indicated books, magazines and brochures as their source of information (55.2%). However, most did not know about signs and symptoms of breast cancer and many of its risk factors. On multivariate analysis, significant predictors of breast cancer knowledge were age, race, marital status, level of education, occupation, family size and family history of other cancers (p<0.05). Fifty percent of women were aware of mammography, significant predictors being age, occupation, marital status and knowledge of breast cancer (p<0.05).

    CONCLUSION: Most women were aware of breast cancer. However, the knowledge about signs and symptoms of breast cancer and awareness of mammography were inadequate. It is recommended that the level of knowledge should be raised among Malaysian women, particularly in the less educated young.

  10. Hartono RK, Hamid SA, Hafizurrachman M
    Asian Pac J Cancer Prev, 2019 May 25;20(5):1403-1408.
    PMID: 31127899
    Background: The incident of malignant cancer due to smoking habit becomes a public health problem especially
    in the developing countries. Active smokers neglect to stop smoking even though various studies proved that smoking
    increases the risk of cancer. While, previous studies have assessed the incident risk of cancer but have not performed the
    validity of the measurement. The aim of this study is to know the number of cigarettes that contribute to the incidence
    of malignant cancer. Methods: A study with retrospective cohort design has been conducted by using a set of public
    data of Indonesia Family Life Survey (IFLS) in 2007 and 2014. All active smokers (n= 748) who were in good health
    condition in 2007, were traced in 2014 and then being diagnosed with cancer with considering age, gender, healthy
    eating habit, and regular physical activity. Data has been analysed by using logistic regression by performing Adjusted
    Risk Ratio (ARR) and the result of validity measurement. Results: The incident of malignant cancer in 2014 were skin,
    liver, stomach and oral cavity. Smoking 21-30 per day in 2007 were significantly increased risk of having malignant
    cancer in 2014 at ARR: 6.88; SE:6.13 with the accuracy were 93.8%. The risk and accuracy were higher if smoke >30
    cigarettes per day (ARR:7.523; SE:7.019; accuracy 95.5%). This study also found that the risk of cancer was significantly
    increase with age (99% CI; ARR: 1.065; SE: 0.026). Conclusions: Cigarette smoking behaviour increased the risk any
    types incident of cancer. Total number >20 cigarettes smoked per day contributes to the incidence of malignant cancer.
  11. Ezat SW, Syed Junid SM, Noraziani K, Zafar A, Saperi S, Nur AM, et al.
    Asian Pac J Cancer Prev, 2013;14(5):3357-62.
    PMID: 23803129
    The human skeleton is the most common organ to be affected by metastatic cancer and bone metastases are a major cause of cancer morbidity. The five most frequent cancers in Malaysia among males includes prostate whereas breast cancer is among those in females, both being associated with skeletal lesions. Bone metastases weaken bone structure, causing a range of symptoms and complications thus developing skeletal-related events (SRE). Patients with SRE may require palliative radiotherapy or surgery to bone for pain, having hypercalcaemia, pathologic fractures, and spinal cord compression. These complications contribute to a decline in patient health- related quality of life. The multidimensional assessment of health-related quality of life for those patients is important other than considering a beneficial treatment impact on patient survival, since the side effects of treatment and disease symptoms can significantly impact health-related quality of life. Cancer treatment could contribute to significant financial implications for the healthcare system. Therefore, it is essential to assess the health-related quality of life and treatment cost, among prostate and breast cancer patients in countries like Malaysia to rationalized cost-effective way for budget allocation or utilization of health care resources, hence helping in providing more personalized treatment for cancer patients.
  12. Mohd Isa SA, Md Salleh MS, Ismail MP, Hairon SM
    Asian Pac J Cancer Prev, 2019 Apr 29;20(4):1081-1087.
    PMID: 31030477
    Background: Cervical cancer is a preventable disease caused by human papillomaviruses. It is the third most
    common cancer to occur in women of reproductive age. The ADAM9 protein plays a role in basement membrane
    degradation and tumour metastasis in certain types of tumour. Thus, it has the potential to become a new targeted
    therapy. The objective of this study was to investigate ADAM9 expression in cervical cancer and to determine the
    factors associated with ADAM9-positive expression. Methods: This cross-sectional study was conducted in Hospital
    Universiti Sains Malaysia (HUSM) Kelantan, Malaysia from December 2010 to December 2012. Histological slides
    obtained from 95 cervical cancer cases diagnosed and/or treated in HUSM from 2000 to 2010 were analysed. The
    ADAM9 immunostain was then performed on the paraffin blocks. The statistical data entry and analysis were done
    using SPSS version 18.0. Multiple logistic regression analysis was performed to determine the factors associated with
    ADAM9-positive expression. Result: Of the 95 cervical cancer patients included in the study, 72 (75.8%) patients showed
    positive ADAM9 expression. The mean age of the patients was 53.89 (10.83) years old. Squamous cell carcinoma was
    the most common type of cervical cancer (n = 67, 70.5%). Factors that showed a statistically significant association
    with ADAM9-positive expression were tumour size (adjusted odds ratio [adj. OR]: 1.08; 95% confidence interval
    [CI]: 1.02, 1.13; p = 0.004), distant metastasis (adj. OR: 12.82; 95% CI: 1.91, 86.13; p = 0.009) and the histological
    type of cervical cancer (i.e. squamous cell carcinoma) (adj. OR: 7.39; 95% CI: 1.42, 38.51; p = 0.017). Conclusion:
    The ADAM9 immunostain was consistently positive in malignant cells. Thus, ADAM9 expression can be used as a
    prognostic/therapeutic indicator in aiding clinician decision-making regarding patient treatment (targeted therapy).
  13. Othman NH, Devi BC, Halimah Y
    Asian Pac J Cancer Prev, 2009 Oct-Dec;10(4):569-74.
    PMID: 19827871
    We studied women with cervical cancer to determine whether they had had a Pap smear within the 3 years preceding cancer development and their understanding of screening for this cancer. The study had 2 parts; Pathology Data and Survey Data. For pathology data, all cases of cervical cancer diagnosed in 2000-2006 were retrieved from eight hospitals and Pap smear history was obtained from clinical records. For the Survey data; patients who were still undergoing treatment in some of these hospitals and three others were administered structured questionnaires to determine their awareness about screening. The results showed 1431 cases of cervical cancer in women aged 25-85 were diagnosed in these hospitals. Most had not had a Pap smear within 3 years before cancer development. The percentages of patients who had had Pap smear ranged from 0-12%. Questionnaires were returned by 221 patients; 56.3% had none or only primary education and 61.1% had a household income of RM 1,000 or less. Level of education and the household income were strongly associated (p<0.05) with knowledge and having had a Pap test. The main reasons cited for not having had a Pap smear were "Never heard about it" (36.2%), "Shy" (10.4%), "Afraid to do it" (13.1%), "Think the test is not important" (8.1%) and "No encouragement from family" (4.5%). A large majority (95.9%) of the patients did not know the optimal interval. In conclusion, a large number of cervical cancer patients had not had a Pap smear within 3 years preceding cancer development and most had inadequate knowledge about this screening test.
  14. Asyary A, Veruswati M, Arianie CP, Ratih TSD, Hamzah A
    Asian Pac J Cancer Prev, 2021 Feb 01;22(2):359-363.
    PMID: 33639648 DOI: 10.31557/APJCP.2021.22.2.359
    BACKGROUND: With the increasing prevalence of teenage or school-age smokers, schools have become the main focus of the Indonesian government in tobacco control, including through the smoke-free zone (SFZ) policy. This study aims to obtain information related to the implementation of SFZ policies in schools.

    METHODS: A nationally representative survey was employed in 900 elementary, junior high, and senior high schools that were located in 60 regions or 24 provinces of Indonesia. Each school's compliance with SFZ parameters was measured using a closed-ended questionnaire. The dataset was analyzed using frequency distribution, while the chi-square was performed to analyze the measurement effect of each parameter for SFZ compliance.

    RESULTS: Java Island is the region with the largest proportion of school units (10%) studied in this study, and the largest group of the schools are high schools (36.1%). In terms of SFZ compliance, 413 (45.9%) of schools had perfect compliance scores of 8, followed by 183 schools (20.3%) with a score of 7 and 107 (11.9%) with a score of 6. It was found that parameter 5, namely cigarette butts found in the school environment, had the largest proportion when a school did not apply SFZ. Cigarette butts were found in 261 (29.0%) schools. Cigarette butts found in schools contributed 7.8 times to not applying SFZ compared to schools where no cigarette cutters were found.

    CONCLUSION: Although the SFZ compliance rate in Indonesian schools is 66.2% at least on 7 of 8 existed parameters, this means most of schools still aren't fully complying with the regulations for SFZs. This recent evidence will help decisionmakers to enforce tobacco control, particularly among youth, which form the pillar of national development.
    .

  15. Beshir SA, Hanipah MA
    Asian Pac J Cancer Prev, 2012;13(9):4427-30.
    PMID: 23167355
    Breast cancer is the most common cancer and the leading cause of cancer death among women in Malaysia. Despite the campaigns undertaken to raise the awareness of the public regarding breast cancer, breast cancer screening rates are still low in the country. The community pharmacist, as one of the most accessible healthcare practitioners, could play a role in the provision of breast cancer health promotion services to the community. However, there are no documented data regarding the community pharmacists' involvement in breast cancer related health promotion activities. Hence, this study was conducted to examine self-reported knowledge, practice and perception of community pharmacists on provision of breast cancer health promotion services and to investigate the barriers that limit their involvement. This cross-sectional survey conducted between May to September 2010, included a sample of 35 community pharmacists working in the districts of Hulu Langat and Sepang in state of Selangor. A 22-item validated questionnaire that included both closed and Lickert scale questions was used to interview those pharmacists who gave their informed consent to participate in the study. The data was analysed using SPSS. Only 11.3% of the community pharmacists answered all the questions on the knowledge section correctly. The mean overall knowledge of the community pharmacists on risk factors of breast cancer and screening recommendations is 56%. None of the respondents was currently involved in breast cancer health promotion activities. Lack of time (80%), lack of breast cancer educational materials (77.1%) and lack of training (62.9%) were the top three mentioned barriers. Despite these barriers, 94.3% (33) of the community pharmacists agreed that they should be involved in breast cancer health promotion activities. Hence, there is need to equip community pharmacists with necessary training and knowledge to enable them to contribute their share towards prevention and screening of breast cancer.
  16. Cader RA, Mei Yee AK, Yassin A, Ahmad I, Haron SN
    Asian Pac J Cancer Prev, 2018 Dec 25;19(12):3551-3555.
    PMID: 30583682
    Background: Malignancies are among the leading causes of death in Systemic Lupus Erythematosus (SLE)
    patients with studies reporting a higher prevalence of malignancy in SLE patients compared to the general population.
    We wanted to determine the frequency of cancer in a cohort of SLE patients and identify its associated risk factors.
    Methods: Cross-sectional study involving SLE patients attending the nephrology outpatient clinic, Universiti
    Kebangsaan Malaysia Medical Centre between January and June 2014. Results: We recruited 228 patients (207 female,
    21 male), aged 40.48 ± 12.86 years with mean SLE duration of 11.65 ± 6.46 years. Majority (87%) had lupus nephritis
    and were in remission with a median SLEDAI score 2 (0, 14). Majority (89%) were on corticosteroid with either a
    steroid sparing agent like mycophenolate mofetil (15.4%), azathioprine (36.8%) or ciclosporin (15.4%). One hundred
    and sixty (70.2%) patients were either receiving or had received intravenous cyclophosphamide with median dose
    of 5,173.6 ± 3,242.4 mg. Seven female patients were diagnosed with cancer during the course of their SLE with 56
    (34-78) years being median age at malignancy and SLE duration of 4 (0-12) years. Majority (5/7) had lupus nephritis
    and all patients a median dose of prednisolone 10 (2.5, 10) mg with 10 (4-24) years of steroids. Two patients had a
    family history of cancer with majority developing cancer after the diagnosis of SLE. Two patients received intravenous
    cyclophosphamide prior to the development of cancer for their SLE compared to overall cohort of 160. Three patients
    had colorectal cancer, 2 had cervical cancer, 1 had breast cancer, and one patient had germ cell tumour and one thyroid
    cancer. All patients had their cancer successful treated with no signs of recurrence. Conclusion: We found a lower
    occurrence of cancer in our SLE patients as compared with the reported literature.
  17. Chang G, Chan CW, Hartman M
    Asian Pac J Cancer Prev, 2011;12(6):1635-9.
    PMID: 22126512
    Breast cancer is the most common cancer in Singaporean women and the rate of increase in incidence is one of the highest in the world. In view of the significant contribution of delayed presentation to the disease burden in South East Asia, we reviewed the incidence of late presentation of breast cancer and the contributing factors in Singapore. Disease presentation was analysed using studies based on the Singapore Cancer Registry 2004-2008 and with data from women with breast cancer at the National University Hospital (NUH) in Singapore 1990-2007. Available literature from Singapore on factors contributing to delayed presentation was reviewed and presented here. The overall age-standardized 5-year relative survival for Singaporean women was 70% with only half diagnosed with localized cancer. Of all women diagnosed at NUH close to 20% presented at Stages III and IV. Given the magnitude of the problem of women presenting with more advanced stages of breast cancer, the National University of Singapore has joined a collaborative team with the University of Leeds (UK), the University of Malaya, and University of UAE to set up the UK-SEA-ME Psychosocial-Cultural Cancer Research Network to better understand late presentation.
  18. Al-Tayar BA, Ahmad A, Yusoff ME, Abdullah SF, Mohamad NK, Md Hashim SN, et al.
    Asian Pac J Cancer Prev, 2020 Apr 01;21(4):1005-1009.
    PMID: 32334462 DOI: 10.31557/APJCP.2020.21.4.1005
    BACKGROUND: Betel quid chewing is more common among the older generation in rural areas of Malaysia. Oral cancer in Asia has been associated with the habit of chewing betel quid and areca nut.

    OBJECTIVE:   This study aims to investigate the cytotoxic effects of betel quid and areca nut extracts on the fibroblast (L929), mouth-ordinary-epithelium 1 (MOE1) and oral squamous cell carcinoma (HSC-2) cell lines.

    METHODS: L929, MOE1 and HSC-2 cells were treated with 0.1, 0.2 and 0.4 g/ml of betel quid and areca nut extracts for 24, 48 and 72 h. MTT assay was performed to assess the cell viability.

    RESULTS: Both extracts, regardless of concentration, significantly reduced the cell viability of L929 compared with the control (P<0.05). Cell viability of MOE1 was significantly enhanced by all betel quid concentrations compared with the control (P<0.05). By contrast, 0.4 g/ml of areca nut extract significantly reduced the cell viability of MOE1 at 48 and 72 h of incubation. Cell viability of HSC-2 was significantly lowered by all areca nut extracts, but 0.4 g/ml of betel quid significantly increased the cell viability of HSC-2 (P<0.05).

    CONCLUSION: Areca nut extract is cytotoxic to L929 and HSC-2, whereas the lower concentrations of areca nut extract significantly increased the cell viability of MOE1 compared to the higher concentration and control group. Although betel quid extract is cytotoxic to L929, the same effect is not observed in MOE1 and HSC-2 cell lines. Further investigations are needed to clarify the mechanism of action.
    .

  19. Knight A, Hwa YS, Hashim H
    Asian Pac J Cancer Prev, 2015;16(8):3125-30.
    PMID: 25921108
    BACKGROUND: Breast cancer is a common cancer affecting women in Malaysia and the use of complementary/ alternative medicine (CAM) has been associated with delays in getting treatment. The aim of the study was to explore the use of CAM and the influencing factors in the Northern region of Peninsular Malaysia.

    MATERIALS AND METHODS: This was a cross-sectional descriptive study on a convenience sample of 100 Malaysian breast cancer survivors.

    FINDINGS: The reported use of CAM among the breast cancer survivors was lower than in other studies but the types of CAM used had a similar pattern with nutrition supplements/vitamins being the most common. The factors that positively influenced the use of complimentary/traditional therapy were income and getting information from television or radio. Survivors with access to internet/blogs appear to have lower odds of using complimentary/traditional therapy compared to the respondents who reported no such access.

    CONCLUSIONS: Information transmitted via television and radio appears to have a positive influence on CAM use by breast cancer patients compared to other information sources and it is important to ensure that such information is accurate and impartial.

  20. Fouz N, Amid A, Hashim YZ
    Asian Pac J Cancer Prev, 2014 Jan;14(11):6709-14.
    PMID: 24377593
    BACKGROUND: Breast cancer is a leading cause of death in women. The available chemotherapy drugs have been associated with many side effects. Bromelain has novel medicinal qualities including anti-inflammatory, anti-thrombotic, fibrinolytic and anti-cancer functions. Commercially available bromelain is obtained through tedious methods; therefore, recombinant bromelain may provide a cheaper and simpler choice with similar quality.

    MATERIALS AND METHODS: This study aimed to assess the effects of commercial and recombinant bromelain on the cytokinetic behavior of MCF-7 breast cancer cells and their potential as therapeutic alternatives in cancer treatment. Cytotoxic activities of commercial and recombinant bromelain were determined using (sulforhodamine) SRB assay. Next, cell viability assays were conducted to determine effects of commercial and recombinant bromelain on MCF-7 cell cytokinetic behavior. Finally, the established growth kinetic data were used to modify a model that predicts the effects of commercial and recombinant bromelain on MCF-7 cells.

    RESULTS: Commercial and recombinant bromelain exerted strong effects towards decreasing the cell viability of MCF-7 cells with IC50 values of 5.13 μg/mL and 6.25 μg/mL, respectively, compared to taxol with an IC50 value of 0.063 μg/mL. The present results indicate that commercial and recombinant bromelain both have anti-proliferative activity, reduced the number of cell generations from 3.92 to 2.81 for commercial bromelain and to 2.86 for recombinant bromelain, while with taxol reduction was to 3.12. Microscopic observation of bromelain-treated MCF-7 cells demonstrated detachment. Inhibition activity was verified with growth rates decreased dynamically from 0.009 h-1 to 0.0059 h-1 for commercial bromelain and to 0.0063 h-1 for recombinant bromelain.

    CONCLUSIONS: Commercial and recombinant bromelain both affect cytokinetics of MCF-7 cells by decreasing cell viability, demonstrating similar strength to taxol.

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