Body Mass Index and Colorectal Cancer

Colorectal cancer (CRC) is one of the most common cancers in the world. Obesity is an established risk factor for colorectal carcinogenesis. Many epidemiological and experimental studies support this link and tumor-promoting effects of obesity. Body mass index (BMI) is a marker of general obesity. Obesity is also a global health problem and is defined by World Health Organization as BMI > 30 kg/m2. In this chapter, we give a general review about the mechanisms of obesity on colorectal carcinogenesis and the effects of obesity on clinical outcomes such as disease-free survival (DFS), progression-free survival (PFS) and overall survival (OS), in adjuvant setting and metastatic disease, respectively

A case of pathologic complete response after neoadjuvant triplet chemotherapy for locally advanced colon cancer with mismatch repair enzyme proficiency

Patients with potentially resectable colon cancer and expected to have negative margins should undergo resection rather than neoadjuvant chemotherapy. Recent studies have suggested that neoadjuvant immunotherapy may be an option for tumors with mismatch repair enzyme deficiency (dMMR), but standard treatment for locally advanced colon cancer with mismatch repair enzyme proficiency (pMMR) is still unclear. A 37-year-old male patient was diagnosed with clinical stage IIIC (T4b N1a M0) transverse colon cancer. Mismatch repair proteins were proficient. After 3 cycles of oxaliplatin (85 mg/m2, day 1), irinotecan (150 mg/m2, IV, day 1), leucovorin (200 mg/m2, IV, day 1), and 5-fluorouracil (3000 mg/m2, 46 hours of continuous infusion initiating from day 1), there was a remarkable reduction in the tumoral mass on the abdominal computed tomography. A right hemicolectomy was performed. A pathologic complete response was obtained. Although there is no consensus on which patients are suitable for neoadjuvant therapy in pMMR locally advanced colon cancer, triplet chemotherapy may be a reasonable option in selected patients

Effects of adjuvant therapy on body composition measurements in women with early breast cancer

Aim: This study aimed to determine the effects of adjuvant therapy on body mass index (BMI) and body fat (BF) measurements inwomen with early-stage breast cancer (ESBC).Material and Methods: We prospectively evaluated BMI and BF measurements including trunk fat mass kilograms (kg), trunk fatmass (%) and total body fat (%) on a bioelectric impedance analyzer in 29 women with stages I-III breast cancer. All of the patientsreceived anthracycline-based adjuvant chemotherapy (ACT). Six patients were hormone receptor (HR)-negative. Twenty-threepatients were HR-positive and received adjuvant endocrine therapy (AET) following ACT. Eleven HR-positive postmenopausalpatients were treated with an aromatase inhibitor (AI), and the remaining twelve HR-positive premenopausal patients were treatedwith tamoxifen (TMX). A total of 3 measurements were performed in the beginning of chemotherapy, at 6th, and 12th months.Results: Although the BMI was significantly increased, there was no significant change in the BF during chemotherapy in patientsreceiving only ACT. Both BMI and BF measurements were significantly increased in premenopausal patients receiving TMX afterACT. However, no significant change was observed in BMI and BF measurements in postmenopausal patients receiving AI after ACT.Conclusions: ACT increased both BMI and BF measurements in patients with HR-positive premenopausal ESBC. Treatment withTMX or AI after ACT did not enhance the changes due to chemotherapy on body composition. Therefore, especially patients withHR-positive premenopausal ESBC should be careful not to gain weight during ACT

The preliminary effects of henna on chemotherapy-induced peripheral neuropathy in women receiving oxaliplatin-based treatment: A parallel-group, randomized, controlled pilot trial

Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) may frequently occur in patients receiving oxaliplatin-based treatment. The aim of the present parallel-group, randomized, controlled pilot trial was to investigate the effect of henna on CIPN in women receiving oxaliplatin-based treatment. Method: Sixty female patients receiving oxaliplatin-based treatment were randomly divided into two groups, i.e., one intervention group (n = 30) where henna was applied topically and one control group (n = 30) that received routine treatment and care. Women in the intervention group were provided a pack of henna prepared by the investigators following each treatment course (2nd, 3rd, and 4th courses) and were instructed to apply the henna on their palms, fingers, and soles. The chemotherapy-induced peripheral neuropathy assessment tool (CIPNAT) was completed by women subsequent to the 2nd (baseline), 3rd, and 4th courses of treatment. Results: The intragroup assessment performed for the intervention group revealed that the total CIPNAT score significantly declined in the intervention group (p < 0.05). The score changes by time in the intervention and control groups were in favour of the intervention group, and the effect size for group x time interaction was eta(2) = 0.169. Similarly, regarding the symptoms intervention section of the tool, a positive change by time in the intervention group was observed, and the effect size concerning this change was large, i.e., eta(2) = 0.284. Conclusions: The present study results showed that henna application on hands and feet has a beneficial effect on peripheral neuropathy. Applying henna is a promising approach in CIPN management

Adjuvan tedavisonrasi veya tanıda izole beyin metastazı olan hastların klinkopatolojik karekteristikleri ve sağ kalımlarının değerlendirilmesi

SSS metastazı meme kanserinin geç dönemlerinde ortaya çıkar. Klasik yaklaşım, semptomatik olunca tedavi etmektir. Adjuvan tedavi sonrası veya başlangıçta tanıda, yalnızca beyin metastazı olan hastaların, klinikopatolojik karekteristiklerini inceledik ve sağkalımı değerlendiridik. Yazarlar, retrospektif olarak iki üniversite hastanesinden 3600 meme kanserli hastayı değerlendirip, içlerinden sadece ve tek olarak beyin metastazlı olan 31 hastayı çalışmaya aldılar. ER, PR, cerbB2 durumu, T , N evresi , grad, adju van taksan, trastuzumab, hormonal tedaviler, trastuzumab ve palatinin beyin metastazından sonra kullanımı sağ kalımı etkileme di. Cerrahi ve tüm beyin ışınlaması cerbB2 negatif hastlarda, tüm beyin ışınlaması ise cerB2 pozitif hastlarda daha etkili olabilir. (p0.06). Sağ kalım pre ve perimenapozallerde daha iyi olabilir. mOS pre ve perimenapozallerde 17.7 ay postmenapozallerde 10.3 ay bulundu. (p0.06) Lapatinib izole beyin metastazlı hastlarda mOSı etkileyebilir. Bazı prognostic faktörler, hangi tadaviden, hangi hasta gurubunun faydalanacağını öngörmemizi sağlayabilir. Daha çok hasta içeren çalışmalara olan ihtiyaç açıktır.CNS metastases usually appears late in the progression of metastatic breast cancer. Classical approach is evaluating and treat&shy;ing them when symptoms become evident. We evaluated the survival and described clinicopathologic characteristics of patients in whom the brain metastases after adjuvant treatment or at initial diagnosis are the first and the only side. Authors retrospec&shy; tively evaluated about 3600 patients with breast cancer treated in two university hospitals. In those 31 patients with first and only metastases to brain and no other metastases were evaluated. ER, PR, cerbB2 status T, N stage, grade, adjuvant taxane, trastuzumab, hormonal treatment, trastuzumab and platine use after brain metastases didnt effect the survival. Surgery and WBRT may be more effective in cerbB2 negative patients, WBRT in cerbB2 positive ones. (p0.06). The survival outcome may be better in pre and perimenouposal women. The mOS of pre and perimenopausal, postmenopausal women were 17.7 months and 10.3 months respectively (p0.06) and lapatinib may affect the mOS of patients with isolated brain metastases. Some prognostic factor may help us to foresee which group may benefit more from which treatment modality. The need for studies with larger groups of patients is obvious

patients with cancer in Turkey

Background: In the practice of oncology, effective communication between physician and patient is very important. Although many studies have indicated that a large majority of physicians, especially from Western countries, tell the truth about diagnosis and prognosis, little is known about attitudes of physicians in Turkey toward truth-telling.Objective: In this study, we tried to determine the truth-telling practice of physicians and explore potential related factors with a self-reported questionnaire.Design: Using a questionnaire, 131 cancer specialists were interviewed during the 15th National Oncology Meeting in April 2003.Results: The percentage of physicians who never, rarely, generally, and always prefer truth-telling about a cancer diagnosis were 9%, 39%, 45%, and 7%, respectively. In univariate logistic regression analysis for the truth-telling practice, significant variables included "'do not tell" requests from family, experiences from medical training and clinical practice, and medical specialty. In the multivariate analysis, "'do not tell" requests from relatives and medical training factors retained their significance.Conclusion: Professional training in breaking bad news is important and is associated with the self-reported truth-telling practices of physicians