Chronomodulated therapy or chronotherapy has gained popularity, beyond a fancy term, as a novel and logical method to exploit the best, by administering anti-cancer treatment at an optimal timing according to circadian rhythms of their anti-cancer action and/or repair mechanism of cancer & normal cells. Understanding of chronobiology and the results of clinical studies back up this new concept. Chronotherapy seems to have all the potential to become tomorrow’s accepted, refined oncology practice without adding much to the cost of existing...
Peripheral neuropathy is a structural or functional abnormality of peripheral nerves giving rise to neuropathic symptoms. Neuropathic symptoms can be motor, sensory and autonomic or varied combination of these major categories. Chemotherapeutic agents frequently cause various neuropathic symptoms and signs depending upon culprit agent, its dose and duration. Chemotherapy-Induced Peripheral Neurotoxicity is a common, disabling and dose-limiting side-effect of cancer treatment and its assessment is difficult. Some patients complain of tingling, numbness and pain in distal extremities while others may also develop motor and autonomic symptoms. Some patients remain symptomatic even after discontinuation of offending drugs. Patients with chemotherapy induced neuropathy bear higher healthcare cost than cancer patients without neuropathy. As new chemotherapeutic agents are being developed it is important to measure chemotherapy induced peripheral neuropathy accurately so that it can be recognized at an earlier stage, the treatment can be modified appropriately and disease progression can be monitored. An added advantage would be a possibility of reliable comparison between neuropathic side effect of newer and older chemotherapeutic...
Partial nephrectomy is performed more commonly for small, low-stage renal tumors. The main advantage of partial nephrectomy over radical nephrectomy is the avoidance of renal insufficiency. The major disadvantages are the possibility of local recurrence and perioperative complications. In this article, we discuss the technical aspects of the nephron-sparing surgery and review the literature pertaining to it, in order to put the management of renal cancer into a modern...
Intensity modulated radiation therapy (IMRT) is a technique to deliver a highly conformal radiation dose distribution, that too with wide spectrum ranging from conventional IMRT, through Volumetric Modulated Arc Therapy (VMAT) to most advanced form called Dense Angularly Sampled and Sparse Intensity Modulated Radiation Therapy (DASSIM-RT). The article intends to overview the current status of the technology....
Primary renal Non-hodgkin lymphoma is rare. Most of the cases are unilateral though bilateral cases have been reported. Extrarenal involvement is to be excluded by imaging/ staging laprotomy for definitive diagnosis. We are presenting a case of 40-year-old Indian female who was attended with history of right flank pain for 3 years, found to have right renal mass on CT scan, underwent right radical nephrectomy and six courses of chemotherapy with CHOP (Cyclophosphamide, Doxorubicin, Vincristine, Prednisolone) regimen subsequent to histo-pathological confirmation. Patient is asymptomatic on follow up of 18...
CONCOMITANT CHEMORADIATION IN LOCALLY ADVANCED CARCINOMA CERVIX: COMPARING DOUBLET VERSUS SINGLE AGENT CHEMOTHERAPY.
Abstract Purpose: To compare the efficacy and toxicity of two definitive concomitant chemoradiotherapy schedules (doublet combination and single agent) along with radical external beam radiotherapy (EBRT) in the management of locally advanced carcinoma of the uterine cervix (LACCx). Material and method: Previously untreated, 60 patients of LACCx (FIGO stage IIB-IIIB) were taken for definitive treatment by concurrent chemo-radiation. These patients were randomly assigned either; Study group I, the Doublet chemotherapy(Gemcitabine + Cisplatin) administration and Control group II, the Single-agent chemotherapy(Cisplatin) administration group. EBRT was given as 50Gy/ 25Fr/ 5 weeks. Chemoradiation was followed by weekly HDR Intra-cavitory brachytherapy (ICBT), 3 sessions of 700cGy each. Observations were made at the end of treatment and 6 months of follow up. Response to treatment and toxicity were investigated. Results: At the end of treatment, disease response in study and control respectively at the end of treatment was as follows: Stage IIB (CR- 52.63% versus 38.09%), Stage IIIA (CR- 100% versus 100%) and Stage IIIB (CR- 55.56% versus 25.0%). Overall disease response for the group I and II, at the end of sixth months follow up was as follows: CR- 93.33% versus 83.33%, PR- 3.33% versus 13.33%, and recurrence- 3.33% versus 3.33% respectively. Most severe acute hematological toxicity observed was Grade 2 in 40.0% versus 16.67% patients, respectively. Similar was the trend of acute skin & mucosal reactions and acute gastrointestinal toxicity. Though a higher number of patients in the study group experienced more acute toxicities, these were acceptable and manageable. Skin and mucosal reactions at 6 months follow up were not significantly higher in the doublet group compared to the single agent group. Conclusion: Administration of doublet combination chemotherapy; is better compared to single-agent chemotherapy administration in terms of disease control (though not statistically significant)with manageable toxicity profile; given concurrent with EBRT, for management of locally advanced carcinoma cervix. A larger study may establish the very role of the new regimen, especially in a resource-limited setup where patients present with advanced/ bulky...
CoQ10 tissue levels. CoQ10 therapy has no serious side effects in humans and new formulations have been developed that increase CoQ10 absorption and tissue distribution. CoQ10 has a role in carcinoma breast, cervix, lung, prostate, melanoma, cancer chemotherapy and cancer related fatigue. Future trends involving CoQ10 in many cancers needs more clinical trials for better understanding of CoQ10 efficacy.. Oral CoQ10 administration can correct CoQ10 deficiency since it increases CoQ10 tissue levels. CoQ10 therapy has no serious side effects in humans and new formulations have been developed that increase CoQ10 absorption and tissue distribution. CoQ10 has a role in carcinoma breast, cervix, lung, prostate, melanoma, cancer chemotherapy and cancer related fatigue. Future trends involving CoQ10 in many cancers needs more clinical trials for better understanding of CoQ10...
ABSTRACT Fine needle aspiration cytology, though, is a reliable, minimally invasive procedure with high sensitivity, specificity and diagnostic accuracy, still it has its limitations in making out diagnosis of thyroid nodules. Here we present an uncommon case of 52 years old Indian female with complaint of mass on antero-medial aspect neck. Fine needle aspiration cytology was suggestive of colloidal goiter. For cosmetic indication, thyroidectomy was done and histopathological examination sought to confirm the cytological diagnosis. The incidental finding was uncommon, revealing papillary thyroid microcarcinoma. Worth emphasizing is the possibility of uncommon malignant disease like thyroid microcarcinoma, in view of limitations of fine needle aspiration cytology in apparently benign thyroid...
Abstract Nodular hidradenoma or clear cell hidradenoma is a rare skin adnexal tumor arising from eccrine sweat glands. Skin adnexal tumors situated in breast parenchyma are very rare and is one of differential diagnosis of breast masses. We report a case of 60 years old female with a left breast lump and bloody nipple discharge being suspected as a malignant breast mass. A final diagnosis of nodular hidradenoma breast was made after excision biopsy and immunohistochemistry study. A patient is a diagnosed case of carcinoma endometrium and underwent panhysterectomy in 2007. Postoperative histopathology revealed well-differentiated endometrial adenocarcinoma without invasion of the myometrium. She received postoperative radiation therapy and intravaginal brachytherapy in 2008 and is on regular follow-up since...
With the advent of effective and intensive chemotherapy, we are able to achieve better response rates as well as improved survival but the side effects remain a constraint. This article intends to discuss one of the side effects of chemotherapy i.e. neuropathy; culprit agents, mechanism and therapeutic strategies to manage it.