Screening for abdominal aortic aneurysm

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EPMA position paper in cancer:current overview and future perspectives

At present, a radical shift in cancer treatment is occurring in terms of predictive, preventive, and personalized medicine (PPPM). Individual patients will participate in more aspects of their healthcare. During the development of PPPM, many rapid, specific, and sensitive new methods for earlier detection of cancer will result in more efficient management of the patient and hence a better quality of life. Coordination of the various activities among different healthcare professionals in primary, secondary, and tertiary care requires well-defined competencies, implementation of training and educational programs, sharing of data, and harmonized guidelines. In this position paper, the current knowledge to understand cancer predisposition and risk factors, the cellular biology of cancer, predictive markers and treatment outcome, the improvement in technologies in screening and diagnosis, and provision of better drug development solutions are discussed in the context of a better implementation of personalized medicine. Recognition of the major risk factors for cancer initiation is the key for preventive strategies (EPMA J. 4(1):6, 2013). Of interest, cancer predisposing syndromes in particular the monogenic subtypes that lead to cancer progression are well defined and one should focus on implementation strategies to identify individuals at risk to allow preventive measures and early screening/diagnosis. Implementation of such measures is disturbed by improper use of the data, with breach of data protection as one of the risks to be heavily controlled. Population screening requires in depth cost-benefit analysis to justify healthcare costs, and the parameters screened should provide information that allow an actionable and deliverable solution, for better healthcare provision

Role of free radical scavengers in oral malignancies treated with radiotherapy

Background: Radiotherapy has an important role in treatment of oral cancer, but it causes some deleterious effect on healthy cells. Radiation produces free radicals which cause lipo-peroxidation, alteration of protein, and DNA damage, and eventually cell death. This study is designed to evaluate protective role of antioxidants in oral malignancies treated with radiotherapy.Methods: This study is conducted in patients of oral cancer treated with radiotherapy. Patients were divided into two groups, control (n=7) and test (n=9). Patients in control group treated with radiotherapy alone and in test group were supplemented with oral antioxidants throughout the radiotherapy course. Pre and post radiotherapy levels of MDA, SOD and Glutathione reductase were measured in blood and cancerous tissue in both groups and statistically compared. TNM staging before and after radiotherapy and side effects of radiotherapy were also compared in both groups.Results: On statistical comparison of mean difference values of MDA, SOD & GR of control v/s test group, it was noticed that there was a significant reduction in MDA (p0.05) in test group in comparison to control group for both blood and tissue levels. TNM status of patients improved significantly after radiotherapy in test group. Comparison of side effects between both groups indicated that there was reduction in side effects in test group after radiotherapy.Conclusion: These findings indicated the protective role of antioxidants against free radicals produced in oral malignancies treated with radiotherapy

Influence of psychological coping on survival and recurrence in people with cancer: systematic review

OBJECTIVE: To summarise the evidence on the effect of psychological coping styles (including fighting spirit, helplessness/hopelessness, denial, and avoidance) on survival and recurrence in patients with cancer. DESIGN: Systematic review of published and unpublished prospective observational studies. MAIN OUTCOMES MEASURES: Survival from or recurrence of cancer. RESULTS: 26 studies investigated the association between psychological coping styles and survival from cancer, and 11 studies investigated recurrence. Most of the studies that investigated fighting spirit (10 studies) or helplessness/hopelessness (12 studies) found no significant associations with survival or recurrence. The evidence that other coping styles play an important part was also weak. Positive findings tended to be confined to small or methodologically flawed studies; lack of adjustment for potential confounding variables was common. Positive conclusions seemed to be more commonly reported by smaller studies, indicating potential publication bias. CONCLUSION: There is little consistent evidence that psychological coping styles play an important part in survival from or recurrence of cancer. People with cancer should not feel pressured into adopting particular coping styles to improve survival or reduce the risk of recurrence. [References: 42