Pattern of Head and neck malignancies in Central Sudan-(study of 314 cases)

Objective: The objective of this work is to study the patterns of head and neck malignancies (HNM) in central Sudan and to compare it with international published series. Methods: This is a retrospective study conducted at the Institute of Nuclear Medicine, Molecular Biology and Oncology (INMO)-University of Gezira; Wadmedani, Sudan. The data were collected through reviewing of patients records over 6 years. Parameters analyzed were age, sex, topography and tumor histology. Results: The total number of patients records reviewed was 314. Age distribution ranged from 11 to 90 years with mean age of 48.79 and median age of 50 years. The male to female ratio was 1.7:1. The most common affected sites in order of frequency were nasopharynx (41.1%), hypopharnx (20.4%), larynx (11.2%), oral cavity (10.5%), salivary glands (4.8%), lips (4.5%), tongue (4.1%) and paranasal sinuses (3.5%). The most common histological types were squamous cell carcinoma (90.77%) followed by salivary gland tumors and lymphomas. Conclusion: HNM are common in Sudan, affecting all age groups with predominance in males. Nasopharynx is the commonest site. Further studies for identification of possible risk factors are recommended. Population-based cancer registry is recommended to reflect on the epidemiology of cancer in Sudan. Keywords: Nasopharynx, oropharyngeal, squamous, carcinomas, epidemiology, snuffed tobacco.Sudan Journal of Medical Sciences Vol. 3 (2) 2008: pp. 105-10

Pathological response for neoadjuvant chemotherapy in locally advanced breast cancer at NCI, Sudan: 6 years’ experience

Background: Breast cancer is the leading cancer in Sudanese females.Objectives: This study was done to evaluate the clinical response to neoadjuvant chemotherapy for patients treated at National Cancer Institute (NCI) and to compare it with the published literature.Methods: This is a retrospective study conducted in National Cancer Institute (NCI), Gezira State, Sudan during the period from April 2005 to August 2011. We studied the data for all patients who have locally  advanced breast cancer and treated at NCI during study period. Patients who remained inoperable after treatment were considered as having no response to therapy. Data were introduced and analyzed using SPSS software. Data evaluated includes Patient age, disease stage,  chemotherapy regimens, and number of cycles, tumor histology, grade and histopathology after chemotherapy.Results: A total of 110 patients who received neoadjuvant chemotherapy and fulfilled criteria for inclusion during the period 2005 to 2011 were evaluated. Majority of patients were between 30-50 years of age (63%). Patients who achieved response and had surgery were 65%. Among those who underwent surgery 22% have complete pathological response. Most of patients who achieved complete histopathological response had six cycles of chemotherapy.Conclusion: this study demonstrated that neoadjuvant systemic therapy is an accepted approach for women with locally advanced breast cancer for whom immediate surgery is inappropriate, and we achieved results similar to the international literature.Key words: breast cancer, neoadjuvant, chemotherapy, response, NCI, Sudan

From Community Laywomen to Breast Health Workers: A Pilot Training Model to Implement Clinical Breast Exam Screening in Malawi

BACKGROUND:Breast cancer burden is high in low-income countries. Inadequate early detection contributes to late diagnosis and increased mortality. We describe the training program for Malawi's first clinical breast exam (CBE) screening effort. METHODS:Laywomen were recruited as Breast Health Workers (BHWs) with the help of local staff and breast cancer advocates. The four-week training consisted of lectures, online modules, role-playing, case discussions, CBE using simulators and patients, and practice presentations. Ministry of Health trainers taught health communication, promotion, and education skills. Breast cancer survivors shared their experiences. Clinicians taught breast cancer epidemiology, prevention, detection, and clinical care. Clinicians and research staff taught research ethics, informed consent, data collection, and professionalism. Breast cancer knowledge was measured using pre- and post-training surveys. Concordance between BHW and clinician CBE was assessed. Breast cancer talks by BHW were evaluated on a 5-point scale in 22 areas by 3 judges. RESULTS:We interviewed 12 women, and 4 were selected as BHWs including 1 breast cancer survivor. Training was dynamic with modification based on trainee response and progress. A higher-than-anticipated level of comprehension and interest led to inclusion of additional topics like breast reconstruction. Pre-training knowledge increased from 49% to 91% correct (p<0.0001). Clinician and BHW CBE had 88% concordance (kappa 0.43). The mean rating of BHW educational talks was 4.4 (standard deviation 0.7). CONCLUSIONS:Malawian laywomen successfully completed training and demonstrated competency to conduct CBE and deliver breast cancer educational talks. Knowledge increased after training, and concordance was high between BHW and clinician CBE