புற்றுநோய் மருத்துவ பரிசோதனைகளின் இதழ்

Cancer is a formidable adversary, affecting millions of lives worldwide. While common cancers like breast, lung and prostate cancers dominate the public health landscape, there exists a group of malignancies that are far less prevalent but equally devastating - rare cancers. These rare cancers pose unique challenges for both patients and healthcare providers. However, there is hope on the horizon, as clinical trials are making significant progress in the face of rarity, offering new possibilities for those affected by these less common but often aggressive diseases. Rare cancers, also known as orphan cancers, are those with a lower incidence compared to more prevalent malignancies. Although no universal consensus defines the threshold for rarity, the American Cancer Society suggests that cancers with an incidence of fewer than six cases per 100,000 people per year fall into this category. Some examples of rare cancers include cholangiocarcinoma (bile duct cancer), mesothelioma and sarcomas.

Cancer clinical trials have long been the cornerstone of medical research, providing critical insights into the effectiveness of novel treatments and therapies. Traditionally, clinical endpoints in these trials have relied heavily on objective measures, such as tumor size reduction or progressionfree survival. While these measures are undeniably valuable, they often fall short in capturing the full impact of cancer and its treatment on patients' lives. This is where Patient Reported Outcomes (PROs) come into play, offering a more comprehensive and patient-centered approach to understanding the human element of cancer clinical trials. PROs encompass a wide range of self-reported data, including patient perspectives on symptoms, functioning, quality of life and treatment side effects. By collecting and analyzing PROs in clinical trials, researchers can gain a deeper understanding of how patients experience cancer and its treatments beyond mere clinical metrics. This patient-centric data is invaluable in assessing treatment efficacy, making informed decisions and improving the overall cancer care journey.

Breast cancer is a complex and heterogeneous disease that affects millions of women worldwide. While traditional treatment modalities such as surgery, chemotherapy and radiation therapy have been cornerstones in the fight against breast cancer, the landscape of breast cancer treatment is evolving rapidly. Two promising avenues in this evolution are immunotherapy and targeted therapies. These innovative approaches have shown great promise in improving treatment outcomes, reducing side effects and offering new hope to breast cancer patients. Immunotherapy is a groundbreaking approach that harnesses the body's own immune system to target and destroy cancer cells. In breast cancer, immunotherapy has gained significant attention, particularly in cases that are resistant to conventional treatments. The future of immunotherapy in breast cancer looks promising. Ongoing research aims to refine patient selection, develop novel combination therapies and optimize treatment regimens. Advancements in understanding the tumor microenvironment, the role of the immune system and the genetics of breast cancer will continue to drive progress in this field.

Genetics plays a pivotal role in our susceptibility to various diseases and one of the most well-known connections between genetic mutations and cancer risk is the link between BRCA gene mutations and ovarian cancer. The discovery of these mutations has transformed our understanding of hereditary ovarian cancer and opened the door to proactive risk management and early detection strategies. BRCA1 and BRCA2 are tumor suppressor genes that are instrumental in DNA repair. Mutations in these genes increase the risk of developing breast and ovarian cancers. The BRCA1 gene is located on chromosome 17, while BRCA2 is situated on chromosome 13. These genes encode proteins that help repair damaged DNA, preventing the accumulation of genetic errors that can lead to cancer.

Lung cancer is one of the most prevalent and deadly cancers globally, accounting for a significant portion of cancer-related deaths each year. While smoking remains the primary risk factor for lung cancer, it is essential to recognize that several environmental factors play a crucial role in the development and progression of this disease. Understanding these factors is vital not only for prevention but also for addressing the growing incidence of lung cancer in non-smokers. Lung cancer is a formidable and often fatal disease that has long been associated with smoking. While cigarette smoking remains the leading cause of lung cancer, it's crucial to understand that this deadly disease can also affect non-smokers due to a range of factors, including genetics, environmental exposures and occupational hazards.

Cancer clinical trials play a pivotal role in advancing our understanding of cancer and developing new treatments. These trials are meticulously designed to evaluate the safety and efficacy of novel therapies. One critical aspect that underpins the success of these trials is the quality and integrity of the data collected. Ensuring data quality and integrity in clinical trial is of paramount importance to draw valid and reliable conclusions, make informed decisions and ultimately improve patient outcomes. Cancer research has made significant strides in recent years, leading to a better understanding of the disease and the development of innovative treatments. Data quality and integrity are fundamental aspects of this progress. Reliable data collection, management and analysis are essential for drawing accurate conclusions, making informed decisions and advancing cancer research. In this article, we will explore the critical role of data quality and integrity in cancer research and the strategies employed to ensure their maintenance.

Cancer research is a complex and multifaceted field, requiring the collaboration of diverse experts and resources to make meaningful advancements. In the quest to understand, diagnose and treat cancer, multicenter trials have emerged as a crucial tool for managing complexity. These trials involve multiple institutions, researchers and patients working together to investigate the intricacies of cancer. This article delves into the significance of collaboration and the management of complexity in cancer research through multicenter trials. Cancer is not a single disease but rather a collection of diseases characterized by abnormal cell growth. It can manifest in various forms, with diverse causes, risk factors and outcomes. This inherent complexity necessitates a multifaceted approach to unravel its mysteries and develop effective treatments. Cancer research involves understanding the molecular underpinnings, identifying potential biomarkers, developing diagnostic tools and conducting clinical trials to evaluate therapeutic interventions.

Bladder cancer is a formidable adversary, affecting millions of people worldwide and causing substantial morbidity and mortality. However, the field of bladder cancer research has made remarkable progress in recent years. Before delving into recent advancements, it's crucial to understand the basics of bladder cancer. This form of cancer begins in the bladder, the organ responsible for storing urine. Bladder cancer typically starts in the urothelial cells that line the interior of the bladder, but it can also develop in other cell types. Risk factors for bladder cancer include smoking, exposure to certain chemicals, chronic bladder inflammation and genetic predisposition. The immune system is the body's natural defense against foreign invaders, including cancer cells. However, cancer can sometimes evade the immune system's surveillance, allowing it to grow and spread. Bladder cancer, like many other cancer types, can create an immunosuppressive microenvironment, making it challenging for the immune system to recognize and combat the disease.

Cancer is a complex and multifaceted disease that affects millions of lives worldwide. While the diagnosis of cancer can be devastating, the progress made in cancer research and treatment offers hope to patients and their families. Clinical trials, often referred to as the gold standard for evaluating new cancer therapies, play a pivotal role in this ongoing battle against the disease. Behind every successful clinical trial lies an essential component: clinical trial management. Clinical trials are carefully designed, controlled experiments that assess the safety and efficacy of new treatments, drugs, or interventions. These trials involve a diverse range of patients, each with a unique set of circumstances and medical history. Proper management is crucial to ensure the success and integrity of these trials.

Hepatitis, a group of viral infections that target the liver, has long been recognized as a silent threat to global public health. This insidious disease affects millions of people worldwide, often going undetected until it progresses to severe stages. What many people don't realize is that hepatitis can have a direct and deadly link to liver cancer. Hepatitis is a viral infection that primarily targets the liver, the body's detoxifying and metabolic powerhouse. There are several forms of hepatitis, with hepatitis A, B, C, D and E being the most common. Each type is caused by different viruses and is transmitted through various means. While hepatitis A and E typically result in acute infections that resolve on their own, hepatitis B and C can lead to chronic infections that may persist for years, often causing extensive liver damage. Liver cancer, also known as hepatocellular carcinoma (HCC), is a malignancy that originates in the liver. It is a significant global health concern due to its high mortality rate and often latestage diagnosis.

Purpose: Poorly controlled pain is a significant quality of life issue for patients with advanced cancer. Patients often suffer from uncontrolled pain or intolerable side effects of treatment despite receiving multi-modal care with stepwise escalation of opioids. Interventional procedures impacting central pain pathways have demonstrated promise in treating pharmacologically intractable cancer pain and may be underutilized, especially in patients with escalating opioid use. The aim of this study was to assess effectiveness of bilateral anterior cingulotomy a minimally invasive neurosurgical procedure in patients with refractory malignant cancer pain through describing opioid use trends pre- and post-procedure and by comparing pain scores.

Methods: This is a retrospective review of a case series of six patients with refractory malignant pain who underwent bilateral anterior cingulotomy. Response to procedure was measured by percent change of pain scores and average daily opioid dose reduction. In addition, demographics, oncologic history, discharge disposition, survival time post-procedure, and complications were reported.

Results: Six unique patients underwent seven total procedures between 2019-2022. Average daily OME (oral morphine equivalent) dose 48 hours prior to procedure was 4411 mg. At discharge, average daily OME dose was 250 mg, an 89% dose reduction from 48 hours prior to procedure. Pain scores reduced by 43% during this same time period.

Conclusion: Cingulotomy effectively reduced pain scores with a concurrent reduction in opioid dosing in our cohort of patients with medically refractory malignant cancer pain. Further research is warranted to identify advanced cancer patients who may benefit most from this procedure and inform clinical adoption.