Tawam Hospital, UAE
Retrospective review of TPR in rectal cancer post neo-adjuvant chemo-radiotherapy for rectal cancer:
Haytham El Salhat MD. MBA is a Consultant Surgical Oncologist and the current Head of Surgical Departments and the Head of Surgical Oncology of Mediclinic Airport Road. Founding member of the research and ethics committee, Mediclinic Middle East. Prior to his joining Mediclinic which is formerly known as Al Noor Hospital Groups, Dr. Haytham worked as a general and oncologic surgeon at Tawam Hospital Al Ain Abu Dhabi where he also lead and chaired its General Surgery and Oncology Department. He also served Tawam Hospital’s Breast Care Center as its founding member and as an interim director from 2010-2011. Up to the present, he is working as the Director of Postgraduate Advanced Laparoscopic Training in the Clinical Skills Training Center, Department of Surgery Faculty of Medicine and Health Sciences at UAE University.Haytham El Salhat is a CCST and a multiple board holder and his areas of expertise includes breast and surgical oncology. He also has a special interest in advanced oncologic laparoscopic surgery, rare malignancies, melanoma, sarcoma, gastrointestinal, visceral surgery, diagnosis and investigation of breast lumps, breast malignancies and transient constipation. Aside from his expertise and great passion in medicine, Dr. Haytham El Salhat is a well-respected teacher to his colleagues. He is currently residing in Abu Dhabi with his family.
Throughout the past century the treatment of rectal cancer has gone through a very long path of unfavorable out comes, where I call colorectal cancer as the goldilocks of the malignancies a lot of aggressive surgical approaches and, medical treatment was derived, for many years unlike the neighboring squamous cell cancer of the Anus the outcomes where not as feasible. In the past decade we started identifying feasible and promising results Total Pathological Response(TPR) post neo-adjuvant chemo-radiation therapy, which varied from 17% to 21% worldwide, that translated to a better progression free survival for our patients, and a better disease free survival.
Here we started in 2012 our retrospective review of our patients from 2010, the outcomes identified a TPR of 31%, this encouraged us to continue on a prospective follow up as well as to place our new comer patients in the registry where we had the most pleasant outcomes. After all rectal cancer is not of much different from it neighbour.
This finding was pushing us towards the watchful waiting strategy with its outcome since we do believe that the patient who visited our clinic prior to surgery is not the same patient post-surgery.
Aga Khan University Hospital, Pakistan, Pakistan
Workshop on role of imaging in gynecological oncology
Imrana Masroor is working as an associate professor and section Head Women Imaging at Radiology Department Aga Khan University Hospital. She hold the European diploma in Breast Imaging. Her areas of expertise include breast, Obstetric and gynecological imaging and image guided interventions related to them.
Shaista Afzal is working as an assistant professor at Radiology Department Aga Khan University hospital. Her areas of interest include Women imaging. She also holds a Diploma in Education and is currently, the program director of radiology residency program
Gynecological malignancies account for 9% of all female cancers worldwide and contribute considerably to mortality and morbidity. In the Arab countries breast cancer is the leading cancer in women followed by cervical cancer. Ovarian cancer ranks as fourth leading cancer in women. There are huge differences in the available resources among Arab countries. Most of the gynecological cancers are diagnosed at a later stage in Arab countries due to the lack of reproductive health awareness especially among older women combined with the cultural stigma of seeking medical advice for gynecological Imaging is crucial in gynecologic malignancies, both for diagnosis and to guide radiation therapy and other treatment modalities. Accurate imaging allows individualized, noninvasive radiation therapy and can also help direct invasive therapy. Advances in image-guided diagnosis and staging helps in treatment planning and may ultimately increase patient survival.
- Describe the role of radiology in diagnosis
- Recognize basic imaging findings in gynecological malignancies
- List the imaging options used in staging
- Describe the imaging options used in follow-up.
- Interactive case discussion
Behera Manoj Kumar
Acharya Harihar Regional Cancer Centre, India
YRF: A feasibility study of neoadjuvant chemoradiation in locally advanced carcinoma rectum on tumor
Will be updated shortly
Purpose: To evaluate the rate of sphincter preservation, tumor regression, local control and acute toxicities of Neoadjuvant chemoradiation for locally advanced distal rectal carcinoma.
Method:Patients with clinical T3 / T4 cancer of distal rectum were taken into the study to receive Combined Neoadjuvant chemoradiation followed by surgical resection. All the patients were given inj. Leucovorin (30 mg/m2) and inj. 5-FU (325 mg/m2) D1 concurrently with radiation of 45 Gy/25# @ 1.8 Gy for 5 weeks. Surgery was performed 4-6 weeks after completion of chemoradiation. The primary end points of this study are tumor regression and sphincter preservation and acute normal tissue toxicities were taken into account as secondary point.
Results: A total of 20 patients have been evaluated from July 2007 to July 2008. The study shows overall resectability rate of 86.6% and a sphincter preservation rate of 53% as 53 % of patients underwent Low anterior resection (LAR) and Abdominoperineal resectioin (APR) was done in 33%. Only 13% patients were declared inoperable in whom palliative colostomy were done. Non hematological toxicities (diarrhea of grade III – 20% and skin reaction of grade II- 20%) were main complication observed during neoadjuvant chemoradiation. Grade II hematological toxicity (neutropenia) reported only in one patient. With a median follow up period of 6 months no loco regional failure has been seen. One patient has failed distantly presenting with lung metastasis without any local failure.
Conclusion: Concurrent preoperative chemoradiation for locally advanced carcinoma rectum is associated with improved tumor respectability which results in improved sphincter preservation, local control and is relatively safe, effective and well tolerated.
Padua University, Italy
Poster: Novel radioimmunodiagnostic tools and radioimmunotherapeutic strategies for pancreatic cance
Will be updated shortly
Pancreatic cancer is the fourth commonest cause of cancer-related death worldwide with overall survival 5% at 5 years. Surgery is the only curative treatment for local tumors; however, 80% of patients present with irresectable masses or metastasis. Extra cellular matrix (ECM) of pancreatic cancer is formed of hypovascular densely fibrotic stroma with relatively low cellular content.Therefore, pancreatic cancer ECM interferes with systemic chemotherapy from well-distribution in tumor mass and so avoids reaching malignant cells. In addition, hypovascularity of ECM enhancesepithelial mesenchymal transition (EMT) activation that in turn down regulates tight junction proteins and provokes the invasiveness of malignant cells. Thus, new tools for early diagnosis and different therapeutic approaches become an essential requirement.
Several tumor-associated antigens (TAAs) are expressed in pancreatic cancer with merely no expression in normal pancreatic tissue. Supported with previous pre-clinical and clinical studies, anti-TAAs monoclonal antibodies (mAbs) were successfully radiolabeled with either positron (β+) or gamma (γ) emitter radionuclides and were able to detect small pancreatic cancer lesions. Taking the advantage of beta- (β-)cross fire effect, the selective delivery of therapeutic radionuclides to pancreatic cancer was pointed out in several studies.
Here, this poster reviews preclinical and clinical studies in pancreatic cancerthat encourage the use of novel imaging diagnostic tools and effective therapeutic approaches based on mAbs radiolabeling.
Masaryk Memorial Cancer Institute, Czech Republic
Apoptosis-inducing therapeuticals promote ectodomain shedding of hypoxia-regulated carbonic anhydras
Will be updated shortly
Carbonic anhydrase IX (CA IX) is a hypoxia-regulated transmembrane protein, implicated in cell adhesion, EMT, and tumour invasiveness, and is therefore strongly associated with cancer progression. It was previously found that shedding and release of CA IX ectodomain (ECD) into plasma of cancer patients can signify prognosis and is considered a marker for therapy success. In this work, we have investigated shedding of CA IX ECD in tumour cells undergoing apoptosis in response to cycloheximide and doxorubicin treatment.
Using flow cytometry and cell sorting, we have correlated the extent of apoptosis with the presence of cell surface CA IX in CGL3 cell line characterized by both positive and negative CA IX subpopulations, and then determined level of shed ECD by ELISA.
We have observed lower percentage of apoptotic cells in CA IX positive subpopulation after cycloheximide treatment. However, CA IX level of cycloheximide and doxorubicin-treated cells decreased during apoptotic death, suggesting an increased ECD shedding, that was not averted by inhibitors of apoptosis but decreased after metalloproteinase inhibition. These findings supported the view that prevention of CA IX ECD shedding may contribute to better cancer cell survival.
This work was supported by the grants from the Slovak Scientific Grant Agency (VEGA-2/0134/12 and VEGA 2/0108/16), from the Slovak Research and Development Agency (APVV-0658-11), from the European Regional Development Fund and the State Budget of the Slovak Republic ERDF (Biomed park project ITMS 26240220087), and by the projects MEYS–NPS I–LO1413 and P206/12/G151 for the Regional Centre for Applied Molecular Oncology (RECAMO).
Kofi Adesi Kyei
University of Ghana, Africa
YRF: Interventions for anxiety and depression in cancer patients
KOFI ADESI KYEI is in the process of completing a PhD in Walden University, USA, 2017. He has studied in Oncology from South Africa, and Radiotherapy in Ghana and currently works as a Principal Radiotherapist at the Oncology Unit of the Korle-Bu Teaching hospital. He is a lecturer in Oncology, Radiography and Radiation Therapy at the University of Ghana. His research includes areas in Oncology, Radiography and Public Health and has over 30 publications in the USA, UK, Asia, and Africa. He has received several awards and honors in several academic institutions and hospitals. He is currently serving as an editorial member and a Reviewer of several reputed journals like Omics International, Science Pg US, International Journal of Public health, Pro Journals among others. He has authored over 30 research articles, 3 books, and 8 author contribution and has attended several international conferences worldwide.
The feeling of fear, distress and uneasiness of an imminent endangerment is described as anxietyand in the setting of the proposed study, anxiety goes down to the principal feeling among patients undergoing various degree of cancer treatment. Depression is the level of symptoms which is manifested through tireless sensations of hopelessness, unhappiness, lack of concentration, lack of energy, and insomnia when a news like cancer hits an individual. It has been established that every cancer patient in his or her cancer journey or at some point will experience some degree of anxiety and depression during their treatment course and this extend even unto their families. After diagnosis have been made, there comes the phase of the emotional shock and disbelief as part of their emotional characteristics followed by anxiety.
Breast cancer accordingis one of the most feared diseases among women and it could induce the development of psychological disorders like anxiety and depression. Majority of breast cancer patients undergoing treatment at the study site are not comfortable with the trends in the treatment they receive and this has been followed with various degree of complainsleading to an intensification in their level of anxiety and triggering much level of depression.
This study was directed to look out for frameworks of various interventions for depression and anxiety among breast cancer patients in Ghana. In doing this, a mixed method design was used to gather both quantitative and qualitative data. The qualitative data was primarily interview with selected working participants whiles the quantitative data was a non-probabilistic approach using a semi-structured questionnaire to assess the severity, the frequency, the quality of life, the remedy for anxiety and depression experienced by patients undergoing breast cancer treatment in Ghana.
Results showed that breast cancer patients that come to the radiotherapy department at the Oncology Unit experienced levels anxiety and depression especially for their therapeutic services and the interviews with the team members confirmed. However, the reasons that underlay the anxiety and depression of breast cancer patients was experience an abnormal level of anxiety and depression based on the hospital anxiety and depression scale scoring.
It was concluded that anxiety and depression issues of cancer patients could be managed and curbed through a number of interventional approaches or factors. It could also be concluded thatcancer patient's that come for treatment goes some levels of anxiety and depression. It was also identified through the interviews that anxiety and depression problems and issues could be managedappropriately.