Changes in daily activities of cancer patients after diagnosis: how do canadian and Iranian patients perceive the change?

BACKGROUND

Being diagnosed with cancer has major impacts on a patient's life. This study was conducted to explore how specific daily activities of patients change as a result of cancer diagnosis or its treatment and how these patients feel about such changes.

METHODS

This was a cross-sectional descriptive study. Cancer patients referred to our clinics and by completing a questionnaire, they reported their daily activities and how they changed after diagnosis. A total of 201 patients in Canada and 167 patients in Iran completed the questionnaire. The research setting was the outpatient cancer clinics of the Jewish General Hospital in Montreal, Canada (February to April 2008) and Imam Reza Hospital and Ghaem Hospital in Mashhad, Iran (March to August 2008).

RESULTS

More than 40 percent of the patients reported changes after the diagnosis in at least 8 out of 22 daily activities listed in the questionnaire. While a negative perception towards the changes was more common, some patients also perceived some changes as positive. More than half of the participants (56.9%) who were employed at the time of diagnosis experienced changes in the amount or type of their paid work after being diagnosed with cancer.

CONCLUSION

The impact of a cancer diagnosis and treatment on a patient's daily activities is drastic. There is a need to provide support and interventions to help patients maintain daily activities they need and/or like. Further studies are needed to better understand the nature of such interventions.

Comparison of early and delayed lymphoscintigraphy images of early breast cancer patients undergoing sentinel node mapping

OBJECTIVE

We compared early and delayed lymphoscintigraphy images using intradermal injection of (99m)Tc-antimony sulfide colloid, which has small particles.

METHODS

Eighty patients with early-stage breast cancer were included into the study. Intradermal injection of (99m)Tc-antimony sulfide colloid was used for sentinel node mapping. After radiotracer injection, 30 min and 20 h later, lymphoscitigraphy images were obtained in lateral and anterior views. After the completion of each image sets, the location of the visible nodes in the axilla was marked on the skin. Two nuclear medicine specialists reviewed the images independently and the number and location of detected nodes were recorded.

RESULTS

At least one hotspot was detected in the axillary region in 78 (97.5%) and 79 (98.75%) patients on the early and delayed images, respectively. No extra-axillary drainage was noted in the patients. The number and location of detected hot spots were the same in 77 patients on both image sets. In one patient the early image did not show any axillary hot spot despite its visualization on the delayed image set and in one patient no hot spot was noted on either images. In one patient an additional axillary hot spot was noted on the delayed image, which was not apparent on the early image.

CONCLUSION

Our study showed that a delay of up to 20 h in sentinel lymph node biopsy using intradermal injection of (99m)Tc-antimony sulfide colloid does not result in washout of the tracer from the true sentinel node or migration of the radiotracer into second-echelon nodes.

The efficacy of Tc-99m sestamibi for sentinel node mapping in breast carcinomas: comparison with Tc-99m antimony sulphide colloid

BACKGROUND

To study the value of periareolar intra-dermal injection of Tc-99m sestamibi (MIBI) for sentinel node mapping in breast carcinoma.

MATERIAL AND METHODS

Fifty patients with early-stage breast cancer were included in our study. 17.5 MBq Tc-99m-MIBI was injected intradermally to 25 patients and the remainders were injected with the same dose of Tc-99m-antimony sulphide colloid. Anterior and lateral static images were taken at 2 minutes. If sentinel lymph node was not detected, delayed imaging by up to 180 minutes was carried out. The patients were operated on 2-4 hours post-injection. Sentinel lymph node biopsy was performed by the aid of gamma probe and blue dye during surgery.

RESULTS

In the Tc-99m-MIBI group, 23 patients had lymph nodes on scintigraphy images, and sentinel nodes were detected during surgery in all 23 patients. In the Tc-99m-antimony sulphide colloid group, 24 patients had lymph nodes on scintigraphy images, and sentinel nodes were identified during surgery in 24 patients.

CONCLUSIONS

We concluded that 99mTc-MIBI is a suitable radiopharmaceutical for sentinel node detection.

Clinical relevance of HER-2/neu overexpression in patients with testicular nonseminomatous germ cell tumor

INTRODUCTION

Recent scientific attention has focused on the role of growth factors in the progression of cancer. HER-2/neu is an epidermal growth factor receptor that is demonstrated to have correlation with poor prognosis of many cancers. This study evaluated the overexpression of HER-2/neu protein and its clinical importance in nonseminomatous germ cell tumors of the testis.

MATERIALS AND METHODS

Testis specimens of 54 patients with testicular nonseminomatous germ cell tumors, referred to Omid Hospital from 2001 to 2007, were re-evaluated and the patients' records were reviewed. Patients' age, tumor subtype, tumor stage, tumor markers, therapeutic response, and disease-free survival were assessed and the specimens were evaluated for the degree of HER-2/neu expression using an immunohistochemistry method.

RESULTS

Immunohistochemical staining was performed for 54 specimens. Overexpression of HER-2/neu was seen in 33.3% of the patients with nonseminomatous germ cell tumors, especially in those with teratocarcinoma subtype compared to those with mixed germ cell tumors or embryonal cell carcinoma. However, HER-2/neu overexpression did not show any correlation with tumor stage, therapeutic response, disease-free survival, age, beta-human chorionic gonadotropin, or alpha-fetoprotein.

CONCLUSION

We observed overexpression of HER-2/neu receptor in teratocarcinoma subtype of germ cell tumor. We suggest further studies to evaluate the clinical importance of this finding.