PSYCHO-ONCOLOGY AND SPIRITUALITY

Psycho-oncology is a branch of medicine which, combining psychiatry and oncology, studies the biological and psychological factors related to the onset and treatment of carcinoma. The struggle with this life-threatening disease requires an adaptation to a new life situation characterized by changed routines of everyday life and dynamics of personal relationships. The psycho-oncological approach is a multidisciplinary one, as modern medicine recognizes more and more the role of spirituality in the treatment and recovery from various pathological conditions. Spirituality is the adaptive capability of intelligent beings to retain the will for life in spite of adversities and awareness of the imminence of death. Faced with a challenge of malignant disease people are nevertheless able to react with positive personality changes, which leads them to a more meaningful and substantial life. The so-called posttraumatic growth is a feature which enables an individual to assume control over his own reactions to disease, which in turn can have a positive influence on the treatment outcome. An essential role in this process is played by the spiritual growth of an individual. Malignant disease can represent an opportunity for spiritual growth, a dimension often neglected by contemporary lifestyles. Religion, as an important constituent part of spirituality, can offer the believer a meaning of suffering and thus turn the disease into an opportunity for self-knowledge and development of a more mature spirituality. Christian spirituality can represent a path which helps an individual to cope with malignant disease. Modern medicine should be based on a multidisciplinary approach to the patient and encompass all the human dimensions (rational, emotional and spiritual), whereas treatment itself must be both personalized and participatory

Co-delivery of salinomycin and curcumin for cancer stem cell treatment by inhibition of cell proliferation, cell cycle arrest, and epithelial-mesenchymal transition

Malignant cancer is a devastating disease often associated with a poor clinical prognosis. For decades, modern drug discoveries have attempted to identify potential modulators that can impede tumor growth. Cancer stem cells however are more resistant to therapeutic intervention, which often leads to treatment failure and subsequent disease recurrence. Here in this study, we have developed a specific multi-target drug delivery nanoparticle system against breast cancer stem cells (BCSCs). Therapeutic agents curcumin and salinomycin have complementary functions of limiting therapeutic resistance and eliciting cellular death, respectively. By conjugation of CD44 cell-surface glycoprotein with poly(lactic-co-glycolic acid) (PLGA) nanoparticles that are loaded with curcumin and salinomycin, we investigated the cellular uptake of BCSCs, drug release, and therapeutic efficacy against BCSCs. We determined CD44-targeting co-delivery nanoparticles are highly efficacious against BCSCs by inducing G1 cell cycle arrest and limiting epithelial–mesenchymal transition. This curcumin and salinomycin co-delivery system can be an efficient treatment approach to target malignant cancer without the repercussion of disease recurrence

The role of midfacial degloving in modern rhinological practice

The midfacial degloving approach has been available for twenty five years and is slowly increasing in popularity in the management of extensive benign lesions of the sinonasal region, for selected malignancy in this area and to afford access to the nasopharynx and infra-temporal fossa. The advantages, applications and low complication rate are presented in a cohort of 86 patients, ranging from three to 79 years of age with a mean follow-up of 5.5 years. Seventy-seven per cent of the group had benign pathology of which juvenile angiofibroma was the commonest (40 cases). The 20 cases of malignant disease were a heterogeneous group histopathologically including adenoid cystic carcinoma (four cases), malignant schwannoma (two cases), rhabdomyosarcoma (two cases) and squamous cell carcinoma (two cases). Five underwent bilateral radical maxillectomies combined with orbital clearance in one patient. Complications include ore-antral fistula (three cases) and epiphora (three cases) all of which were successfully treated

Early Investigations and Recent Advances in Intraperitoneal Immunotherapy for Peritoneal Metastasis.

Peritoneal metastasis (PM) is an advanced stage malignancy largely refractory to modern therapy. Intraperitoneal (IP) immunotherapy offers a novel approach for the control of regional disease of the peritoneal cavity by breaking immune tolerance. These strategies include heightening T-cell response and vaccine induction of anti-cancer memory against tumor-associated antigens. Early investigations with chimeric antigen receptor T cells (CAR-T cells), vaccine-based therapies, dendritic cells (DCs) in combination with pro-inflammatory cytokines and natural killer cells (NKs), adoptive cell transfer, and immune checkpoint inhibitors represent significant advances in the treatment of PM. IP delivery of CAR-T cells has shown demonstrable suppression of tumors expressing carcinoembryonic antigen. This response was enhanced when IP injected CAR-T cells were combined with anti-PD-L1 or anti-Gr1. Similarly, CAR-T cells against folate receptor α expressing tumors improved T-cell tumor localization and survival when combined with CD137 co-stimulatory signaling. Moreover, IP immunotherapy with catumaxomab, a trifunctional antibody approved in Europe, targets epithelial cell adhesion molecule (EpCAM) and has shown considerable promise with control of malignant ascites. Herein, we discuss immunologic approaches under investigation for treatment of PM

HUMAN PAPILLOMAVIRUS AND ITS NATURE OF INFECTION: AN OVERVIEW

Human papillomavirus (HPV) belonging to Papillomaviridae (family of Papillomavirus). HPV infection causes various types of disorders and diseases including cervical, vaginal, anal, penile, oropharyngeal, and lung cancer also cancer in head and neck along with some malignant and benign warts. HPV also found to be responsible for respiratory papillomatosis. Epidermodysplasia verruciformis, an orphan disease termed as tree man disease, is also occurred by the HPV infection. Vaccines show benefit nowadays. Some surgery and adjuvant therapy is also showing response in the treatment of HPV caused cancers. In this abstract, we summarized the types, structures, genomic organization, mode of transmission of the virus along with type of infections, and protection and modern treatment approaches

A brief review of the literature on the malignant ureteral obstruction

Malignant ureteral obstruction (MUO) caused by a primarily urological tumor or secondary to a late-stage malignancy can be difficult for the urologist to manage. Due to a lack of clinical data on the management of MUO, every case is particular and should be aborted individually. Lack of specific treatment, either palliative or definitive, can severely damage renal function and lifetime expectancy in patients, causing even more damage that could otherwise be avoided. Prompt management directed at the recovery of renal function is the main goal in such cases. Even after urinary flow is restored, life threatening post-obstructive diuresis needs to be managed

BEV-IP : perioperative chemotherapy with bevacizumab in patients undergoing cytoreduction and intraperitoneal chemoperfusion for colorectal carcinomatosis

Background: Selected patients with peritoneal carcinomatosis (PC) from colorectal cancer (CRC) benefit from cytoreductive surgery (CRS) combined with intraperitoneal chemoperfusion (IPC). However, even after optimal cytoreduction, systemic and locoregional recurrence are common. Perioperative chemotherapy with bevacizumab (BEV) may improve the outcome of these patients. Methods/Design: The BEV-IP study is a phase II, single-arm, open-label study aimed at patients with colorectal or appendiceal adenocarcinoma with synchronous or metachronous PC. This study evaluates whether perioperative chemotherapy including BEV in combination with CRS and oxaliplatin-based IPC results in acceptable morbidity and mortality (primary composite endpoint). Secondary endpoints are treatment completion rate, chemotherapy-related toxicity, pathological response, progression free survival, and overall survival. Discussion: The BEV-IP trial is the first prospective assessment of the safety and efficacy of perioperative chemotherapy combined with anti-angiogenic treatment in patients undergoing CRS and IPC for colorectal peritoneal metastases

Cancer in Ancient Human Populations: Methods and Practice in Bioarchaeology and Paleopathology

Best Undergraduate Writing in Anthropology Award, 2019-2020Despite its prevalence in contemporary public health, research on the paleopathology of cancer is still extremely limited. Successful methods have been employed to identify cancer in human remains which show a very small fraction of the existing archaeological record to contain signs of cancer. This current evidence would indicate that cancer was much rarer in antiquity than it is now, and this would suggest that cancer is a product of modern day environments and lifestyles. However, this conclusion is based upon very narrow research utilizing a methodology that is limited in its reach. Current methods rely solely on gross observation of skeletal material, which fails to account for the wide range of factors that influence the growth and development of carcinomas. This methodology is insufficient in providing a detailed history of the growth and development of cancer in human antiquity. This project aims to determine an interdisciplinary methodology for the study of ancient human cancers, incorporating approaches employed in bioarcheology, epidemiology, and more contemporary cancer genomics.No embargoAcademic Major: Anthropological SciencesAcademic Major: Englis

Genomic profiling of malignant peritoneal mesothelioma reveals recurrent alterations in epigenetic regulatory genes BAP1, SETD2, and DDX3X.

Malignant mesothelioma is a rare cancer that arises from the mesothelial cells that line the pleural cavity and less commonly from the peritoneal lining of the abdomen and pelvis. Most pleural mesotheliomas arise in patients with a history of asbestos exposure, whereas the association of peritoneal mesotheliomas with exposure to asbestos and other potential carcinogens is less clear, suggesting that the genetic alterations that drive malignant peritoneal mesothelioma may be unique from those in pleural mesothelioma. Treatment options for all malignant mesotheliomas are currently limited, with no known targeted therapies available. To better understand the molecular pathogenesis of malignant peritoneal mesothelioma, we sequenced 510 cancer-related genes in 13 patients with malignant mesothelioma arising in the peritoneal cavity. The most frequent genetic alteration was biallelic inactivation of the BAP1 gene, which occurred in 9/13 cases, with an additional two cases demonstrating monoallelic loss of BAP1. All 11 of these cases demonstrated loss of BAP1 nuclear staining by immunohistochemistry, whereas two tumors without BAP1 alteration and all 42 cases of histologic mimics in peritoneum (8 multilocular peritoneal inclusion cyst, 6 well-differentiated papillary mesothelioma of the peritoneum, 16 adenomatoid tumor, and 12 low-grade serous carcinoma of the ovary) demonstrated intact BAP1 nuclear staining. Additional recurrently mutated genes in this cohort of malignant peritoneal mesotheliomas included NF2 (3/13), SETD2 (2/13), and DDX3X (2/13). While these genes are known to be recurrently mutated in pleural mesotheliomas, the frequencies are distinct in peritoneal mesotheliomas, with nearly 85% of peritoneal tumors harboring BAP1 alterations versus only 20-30% of pleural tumors. Together, these findings demonstrate the importance of epigenetic modifiers including BAP1, SETD2, and DDX3X in mesothelial tumorigenesis and suggest opportunities for targeted therapies