Background: The International Agency for Research on Cancer (IARC) recently classified opium use as a Group 1 carcinogen. However, much remains to be studied on the relation between opium and cancer. We designed the Iranian Opium and Cancer (IROPICAN) study to further investigate the association of opium use and cancers of the head and neck, bladder, lung, and colon and rectum. In this paper, we describe the rationale, design, and some initial results of the IROPICAN Study. Methods: The IROPICAN is a multi-center case-control study conducted in 10 provinces of Iran. The cases were all histologically confirmed and the controls were selected from hospital visitors who were free of cancer, were not family members or friends of the cancer patients, and were visiting the hospital for reasons other than their own ailment. The questionnaires included detailed questions on opium use (including age at initiation, duration, frequency, typical amount, and route), and potential confounders, such as tobacco use (e.g., cigarettes, nass and water-pipe), and dietary factors. Biological samples, including blood and saliva, were also collected. Results: The validation and pilot phases showed reasonably good validity, with sensitivities of 70% and 69% for the cases and controls, respectively, in reporting opium use. The results also showed excellent reliability, with intra-class correlation coefficients of 0.96 for ever opium use and 0.88 (95% CI: 0.80, 0.92) for regular opium use. In the main phase, we recruited 3299 cancer cases (99% response rate) and 3477 hospital visitor controls (89% response rate). The proportion of ever-use of opium was 40% among cases and 18% among controls. Conclusion: The IROPICAN study will serve as a major resource in studies addressing the effect of opium on risk of cancers of the head and neck, bladder, lung, and colon and rectum.
Lung cancer is among the leading causes of cancer-related-death. Non-small cell lung cancer (NSCLC) is the most common form of lung cancer. More than 70% of NSCLC patients have locally advanced or metastatic disease in diagnosis stage, which are then being treated with platinum-based chemotherapy or epidermal-growthfactor- receptor (EGFR) inhibitors. Several molecules which target multiple ErbB receptors and EGFR have been developed, including gefitinib and erlotinib. Identification of novel agents with less toxicity is warranted. Several interesting data have been reported about the antitumor activity of curcumin in several tumors, including lung, breast and colorectal cancers. In particular, a recent phase I trial evaluated the activity of curcumin in combination with FOLFOX chemotherapy in patients with inoperable colorectal cancer. They showed that curcumin added benefit in subsets of patients when administered with FOLFOX and was well-tolerated chemotherapy adjunct. Another ongoing trial is now investigating the beneficial effects of curcumin plus gefitinib or erlotinib for EGFRmutant NSCLC. Improved understanding of molecular mechanisms behind resistance to EGFR tyrosine kinase inhibitors suggests the importance of a genotype-guided approach to therapy and inhibition of parallel and downstream pathways, using agents which target heat-shock-protein-90, poly (ADP-ribose) polymerase and PI3K/mTOR pathway. The aim of the current review is to give an overview of the possible molecular mechanisms of curcumin in the preclinical and clinical investigations in solid tumors, with particular emphasis on its combination with other chemotherapeutic agents in lung cancers.
Background and Objectives: Breast cancer is the most commonly diagnosed cancer in women which can cause spiritual distress in them. This study aims to assess the effects of mindfulnessbased schema therapy (MBST) and transdiagnostic intervention on spiritual distress of women with breast cancer. Methods: This is a quasi-experimental study (Clinical trial) with a pre-test/post-test/ followup design using a control group. Participants were 41 women with breast cancer referred to Omid and Imam Reza hospitals in Mashhad, Iran during 2017-2020, who were selected using a convenience sampling method and randomly assigned into two experimental groups and one control group. For both experimental groups, the intervention was performed at ten weekly sessions. The used instrument was the Spiritual Distress Scale of Ku et al. Data were analyzed using repeated measures analysis of variance and Bonferroni post hoc test in SPSS software, version 25 software. Results: There was a significant difference in the mean scores of spiritual distress in the experimental groups compared to the control group in the post-test and follow-up phases (P<0.001). There was no significant difference between the effectiveness of transdiagnostic intervention and MBST in the post-test and follow-up phases (P>0.05). Conclusion: Both transdiagnostic intervention and MBST can reduce the spiritual distress of women with breast cancer.
Early diagnosis and appropriate treatment is required in esophageal cancer due to its invasive nature. The aim of this study was to evaluate early post-esophagectomy complications in patients with esophageal cancer who received neoadjuvant chemoradiotherapy (NACR).This randomized clinical trial was carried out between 2009 and 2011. Patients with lower-third esophageal cancer were randomly assigned to one of two groups. The first group consisted of 50 patients receiving standard chemoradiotherapy (Group A) and then undergoing surgery, and the second group consisted of 50 patients undergoing surgery only (Group B). Patients were evaluated with respect to age, gender, clinical symptoms, type of pathology, time of surgery, perioperative blood loss, and number of lymph nodes resected as well as early post-operative complicate including leakage at the anastomosis site, chylothorax and pulmonary complications, hospitalization period, and mortality rate within the first 30 days after surgery.The mean age of patients was 55 years. Seventy-two patients had squamous cell carcinoma (SCC) and 28 patients had adenocarcinoma (ACC). There was no significant difference between the two groups with respect to age, gender, time of surgery, complications including anastomotic leakage, chylothorax, pulmonary complications, cardiac complications, deep venous thrombosis (DVT), or mortality. However, there was a significant difference between the two groups regarding hospital stay, time of surgery, perioperative blood loss, and number of lymph nodes resected.The use of NACR did not increase early post-operative complications or mortality among patients with esophageal cancer.
Breast cancer is one of the most prevalent cancers that oncologists are faced with in their clinics. The varieties of clinical features of the disease result to very different scenarios in the processes of treatment decision making. While classic factors of stage, grade, age and hormone receptor status are still the criterion for choosing treatment, a very delicate list of other prognostic and predictive factors have been entered to this field over recent two decades. The evidence-based medicine rules to treat patients based on the best evidences that have been found by powered randomized clinical trials. Different panels and guidelines gathering these evidences try to help oncologists to find the best treatment methods through the variable and sometimes contradicting results. As it is always the main objective, increasing the survival rates in addition to the ideal aim of curing the disease is usually the target. Finding the best and the most practical chemotherapy regimen against breast cancer needs to notice the biology of this disease and its varieties along with each individual patient condition. It is clear that not all patients need the most complicated and expensive treatment.
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