புற்றுநோய் அறிவியல் & சிகிச்சை

Carcinoma of Uterine cervix is the second most common cancer affecting females in India. Concurrent chemoradiation has remained the sole definitive treatment available in the locally advanced stages. Our study was planned to take the advantage of radiosensitisation accruing due to chemotherapy at the time of brachytherapy when approximately forty percent of total tumour dose is applied.Study design was prospective, randomized and comparative.100 patients with locally advanced squamous cell carcinoma of cervix (FIGO stage IIB to IVA) were included from 2017 to 2019 and divided into two arms of 50 patients each as per computer generated random number list .All were given concurrent chemoradiation followed by 3 insertions of brachytherapy as per the Manchester System, each application was 7Gy by HDR. Patients in Arm A (Study Arm) received cisplatin 40mg/m2 along with EBRT and brachytherapy and Arm B (Control Arm) received cisplatin 40mg/m2 along with EBRT only.

A renal mass/Renal cell carcinoma has a range of histologies and tumour phenotypes that it presents with a particular challenge to treat them. A renal mass can range from benign (oncocytoma) to a clinically indolent malignancy (papillary type I, chromophobe) to aggressive disease [papillary type II or high-grade clear cell renal cell carcinoma (ccRCC)]. Even among various subtypes, kidney cancers are genetically diverse with variable prognoses and treatment response rates. The key to proper management depends on the identification of these subtypes. Currently, a wide array of diagnostic, prognostic, and predictive biomarkers are available to help guide the individualized care of kidney cancer patients. This paper discusses the various serum, urine, and imaging biomarkers that are available in practice

Patients with metastatic prostate cancer are initially treated with androgen deprivation therapy as androgen receptor (AR) signalling is a key pathway in prostate cancer. Castration-resistant prostate cancer (CRPC) is a stage when patients stop responding to androgen deprivation therapy but are still dependent on AR signalling. Enzalutamide, an orally available AR inhibitor, was initially used in the treatment of patients with metastatic CRPC who had previously received docetaxel. The indications have subsequently been extended to include all patients with metastatic CRPC, and most recently to include patients with non-metastatic CRPC. On December 16, 2019, the Food and Drug Administration approved enzalutamide for patients with metastatic castration-sensitive prostate cancer (mCSPC). The most common adverse reactions that have been reported in enzalutamide-treated patients include hot flushes, asthenia/fatigue, hypertension, fractures, and musculoskeletal pain. The recommended dose is 160 mg (four 40 mg capsules) administered orally once daily, with or without food.

Clinical stage I is the most frequent clinical presentation of non-seminoma testicular cancer. Despite a survival rate of close to 100%, the management of patients with this disease stage is controversial. The recurrence rate is 15% to 50% for those with stage I non-seminoma. A highly sensitive and specific biomarker that can predict or confirm relapse of disease, and help to drive a definitive risk-adapted management is still not available. Lymph vascular invasion (LVI) in the orchiectomy specimen has been used as a risk factor in patients with stage I non-seminoma, however, the discriminative power of LVI is modest at best. Presently there is no definitive biomarker that can predict a recurrence following a radical orchiectomy. In situations such as this, active surveillance of these patients helps avoid overtreatment in 50% to 85% of patients, with no risk of long-term side effects in non-relapsing patients and a preserved overall survival of almost 100% after specific treatment for recurrent disease. Although active surveillance has been accepted as the preferred option for stage I low-risk non-seminoma, its role in high-risk stage I non-seminoma remains controversial.

Metastatic spread from the prostate to the penis is known to occur, though rare. A needle biopsy remains the most reliable diagnostic modality that allows for histological and immunological confirmation of metastatic spread, and evaluation of the extent of invasion. The mode of metastasis seems to be either by direct invasion, implantation, haematogenous or lymphatic spread. Treatment mainly remains palliative and improving quality of life in view of the poor prognosis and a 6-month mortality of 80%. We report a patient with castrate resistant prostate cancer who presented with obstructive voiding symptoms and reddish lesions on the glans. Biopsy proved it to be a metastasis from the prostate cancer.