New Cases Of Cancer Research Articles

Risk factors of childhood cancer in Armenia: a case-control study

IntroductionChildhood cancer (CC) is a leading cause of death among children aged 0–19 years worldwide. Each year, 400,000 new cases of CC are diagnosed globally. Given the between-country differences in CC incidence rates, types and trends, this study aimed to identify possible risk factors for CC in Armenia.MethodsWe used a case-control study design and enrolled participants from the only specialized pediatric hematology and oncology center in Armenia. Cases included patients ≤ 14 years old diagnosed and treated with a malignant disease between 2017 and 2020 in the centre. Controls included patients diagnosed and treated in the center during the same period for a non-malignant disease. We conducted telephone interviews with mothers of cases and controls. Independent risk factors of cancer were identified using multivariable logistic regression analysis.ResultsOverall, 234 participants (117 cases, 117 controls) were included in the study. Based on the fitted model, maternal usage of folic acid during pregnancy was protective against CC, almost twice decreasing its odds (OR = 0.54; 95% CI: 0.31–0.94). On the contrary, experiencing horrifying/terrifying event(s) during pregnancy (OR = 2.19; 95% CI: 1.18–4.07) and having induced abortions before getting pregnant with the given child (OR = 2.94; 95% CI: 1.45–5.96) were associated with higher odds for a child to develop cancer.ConclusionDespite the limited sample size of the study, significant modifiable risk factors for CC in Armenia were identified, all of which were linked to the period of pregnancy. The data from this study adds to the limited information available from etiological CC research throughout the world, and it will increase understanding of CC risk factors in settings with small populations and low resources. Although these findings may be helpful for future research, they should be taken with caution unless validated from further larger-scale studies.

Phototherapy: A Conventional Approach to Overcome the Barriers in Oncology Therapeutics.

Cancer disease has outgrown a life-threatening disease. Having reference to preceding reports provided by the International Agency for Research on Cancer, an estimated 9.6 million deaths transpired from cancer worldwide in 2018. Similarly, about 18.1 million new cases of cancer are being reported. The rise in conventional treatments akin to surgeries, chemotherapies, and radiotherapies was enormously observed to eradicate cancer tumors. These studies have shown unfavorable side effects in clinical treatments. Drug resistivity and drug cytotoxicities are also major issues to overcome. Considering these, researchers are developing alternative methods that are robust, economical, and safe. The use of light for therapeutic purposes shows a great history in vitiligo treatment. The combination of an effective activating agent and phototherapy could result as the best alternative with a great outcome to minimize adverse effects on healthy tissues. The utilization of light in the deletion of tumors using photothermal agents, and photosensitizers, hence the phototherapies in oncology were discovered and rapidly involved in the advancement of clinical approach. Here, in this article, we tried to highlight the recent trends in phototherapy and reviewed different types of phototherapy methods in cancer treatments and their latest clinical, preclinical, and in vivo studies.

The Role of Nutritional Modulation of Immune Function in Cancer – What About It?

In recent years there has been an increase in the number of new cases of cancer. Malnutrition in cancer patients is a consequence of the increase in inflammatory cytokines associated with cancer, metabolic alterations, and concomitant inadequate availability of nutrients, due to anorexia caused by the disease and systemic treatments. Nutrition can guide both the growth and progress of inflammatory disorders and their prevention and treatment. Irrevocably, it is indispensable to pair the diet with physical activity, balance nutritional status and prime a healthy lifestyle. An increased understanding of the instruments linked to nutrients and the immune system is a breathtaking and exceptional field for the future. The gut microbiota is now known as a fundamental factor disturbing the host´s anti-cancer immunosurveillance and capacity to respond to immunotherapy. Diet is one of the most powerful modulators of microbiota, and therefore nutritional intervention could be used to increase host anti-cancer immunity. A rising body of data has also highlighted that the gut microbiota may have a constructive impact on cancer prevention or treatment, particularly via improved host immunosurveillance of cancer as well as patients ‘capacity to respond to chemotherapy or immunotherapy. The sway of nutrition on the immune system is a territory that remains under investigation. Nutrition and immunity are closely related. An expanded understanding of the mechanisms connected to nutrients and the immune system is a breathtaking and gifted field for the future.

The economic cost of cancer treatment in Iran.

With more than 12 million new cases of cancers and nearly 7.6 million deaths worldwide in 2020, cancer is currently the third leading cause of mortality in the world. The costs spent on treating patients with cancer account for a significant amount of healthcare costs. Healthcare expenditures for cancer treatment have also increased significantly and are projected to skyrocket further over the next decade. This study was conducted to determine medical and non-medical direct costs for the prevention of cancer in patients hospitalized in 10 selected educational hospitals in Iran. The study employed a cross-sectional design and was conducted in 10 selected educational hospitals in Tabriz, Tehran, Isfahan, Mashhad, and Shiraz in 2020. Using a researcher-made questionnaire, we assessed direct medical costs and direct non-medical costs of cancer in patients over 20 years old with kinds of breast, prostate, leukemia, lymphatic, stomach, liver, lung, bladder, uterine, and intestine cancers who undertook oncology treatments (n = 2410). Data were analyzed using descriptive statistics including mean and standard deviation and analytic statistics such as Kolmogorov-Smirnov, analysis of variance, and t-test, using SPSS 18 and P ≤0.05. The mean direct non-medical cost paid out of pocket per month was $99.6 ± $10.81 USD, and the mean direct medical cost per month was $1029.4 ± $68.5 USD. The total cost paid by the patients was $889.4 ± 69.81 USD per month. Given the increasing number of patients with cancer, it is necessary to increase the number of special centers for the prevention and treatment of cancers. Dissemination of information about the costs of illnesses and their complications enables decision-makers to make a proper comparison between different uses of resources. Moreover, to support the patients, the health system must implement plans to decrease out-of-pocket payments by patients.

Сytotoxic effect of CAR-T cells against modified MCF-7 breast cancer cell line.

The most often diagnosed and fatal malignancy in women is breast cancer. The International Agency for Research on Cancer (IARC) estimates that there are 2.26 million new cases of cancer in 2020. Adoptive cell therapy using T cells with chimeric antigen receptor shows potential for the treatment of solid tumors, such as breast cancer. In this work the effectiveness of CAR-T cells against monolayer and three-dimensional bioprinted tumor-like structures made of modified MCF-7 breast cancer cells was assessed. The cytokine profile of supernatants after co-cultivation of MCF-7 tumor cell models with CAR-T cells was also measured to reveal the inflammatory background associated with this interaction.

Estimation of cancer incidence in the state of São Paulo, Brazil, based on real data

This study aims to evaluate the feasibility of applying a method of estimating the incidence of cancer to regions of the state of São Paulo, Brazil, from real data (not estimated) and retrospectively comparing the results obtained with the official estimates. A method based on mortality and on the incidence to mortality (I/M) ration was used according to sex, age, and tumor location. In the I/M numerator, new cases of cancer were used from the population records of Jaú and São Paulo from 2006-2010; in the denominator, deaths from 2006-2010 in the respective areas, extracted from the national mortality system. The estimates resulted from the multiplication of I/M by the number of cancer deaths in 2010 for each region. Population data from the 2010 Demographic Census were used to estimate incidence rates. For the adjustment by age, the world standard population was used. We calculated the relative differences between the gross incidence rates estimated in this study and the official ones. Age-adjusted cancer incidence rates were 260.9/100,000 for men and 216.6/100,000 for women. Prostate cancer was the most common in males, whereas breast cancer was most common in females. Differences between the rates of this study and the official rates were 3.3% and 1.5% for each sex. The estimated incidence was compatible with the officially presented state profile, indicating that the application of real data did not alter the morbidity profile, while it did indicate different risk magnitudes. Despite the over-representativeness of the cancer registry with greater population coverage, the selected method proved feasible to point out different patterns within the state.

État des lieux du risque de survenue de troubles musculosquelettiques dans une unité de production

In 2018, according to the latest report from the French National Cancer Institute (INCa), approximately 400,000 new cases of cancer in France were identified. Fifty-four percent were represented by men and 46% by women. The number of new cases increased between 2010 and 2018 (+6,000 cases for men and 23,000 for women). Hospital pharmacies caring for cancer patients must absorb this flow without having additional human resources or without being able to increase the capacity of the chemotherapy reconstitution unit. And this always while ensuring a quality according to the legal requirements. This increase of activity and the centralization of chemotherapy preparations bring with it new problems: musculoskeletal disorders (MSDs). The objective of this work is, through the improvement of work quality, to prevent and monitor the appearance of MSDs in pharmacy technician team. Initially, using the Nordic questionnaire, an inventory of the pain and genes felt by the staff according to location and duration was conducted with pharmacy technician team. Secondly, an assessment of the risk of occurrence of MSDs in the pharmacy technician team according to the tasks performed was carried out using the Borg CR10 scale and the Occupational Safety and Health Administration (OSHA) checklist. The prevalence of musculoskeletal complaints over the last twelve months and the last seven days within the sample was highest for the wrists/hands (67% and 56%) and head/neck (56% and 33%). The severity index of musculoskeletal problems at work was 50% for the elbow region and 33% for the wrist/hand region. According to the OSHA checklist, the workstations for the preparation of cytotoxics and the workstations for the preparation of analgesics intended for the intrathecal route obtained a score greater than 5, which is equivalent to a risk of occurrence of MSDs. On the positions evaluated using Borg's CR10 scale, the following body regions saw a significant increase in the strain felt after a day of production: head/neck (P-value 0.04), upper back (P-value 0.03), lower back (P-value 0.03) and legs (0.04). This work made it possible to produce a map of the body regions affected, to identify the positions at risk and to assess the level of risk. Several approaches have been defined to prevent MSDs for the pharmacy technician team. Staff training, by one of the physiotherapists, in muscle warm-ups before a production day is planned. In the continuity of this approach, an expertise by an ergonomist, which could not be carried out due to the health situation and the preventive measures would be essential in order to put in place additional preventive and curative actions.

Cancer and diabetes co-occurrence: A national study with 44 million person-years of follow-up.

The number of new cases of cancer is increasing each year, and rates of diabetes mellitus are also increasing dramatically over time. It is not an unusual occurrence for an individual to have both cancer and diabetes at the same time, given they are both individually common, and that one condition can increase the risk of the other. In this manuscript, we use national-level diabetes (Virtual Diabetes Register) and cancer (New Zealand Cancer Registry) data on nearly five million individuals over 44 million person-years of follow-up to examine the occurrence of cancer amongst a national prevalent cohort of patients with diabetes. We completed this analysis separately by cancer for the 24 most commonly diagnosed cancers in Aotearoa New Zealand, and then compared the occurrence of cancer among those with diabetes to those without diabetes. We found that the rate of cancer was highest amongst those with diabetes for 21 of the 24 most common cancers diagnosed over our study period, with excess risk among those with diabetes ranging between 11% (non-Hodgkin's lymphoma) and 236% (liver cancer). The cancers with the greatest difference in incidence between those with diabetes and those without diabetes tended to be within the endocrine or gastrointestinal system, and/or had a strong relationship with obesity. However, in an absolute sense, due to the volume of breast, colorectal and lung cancers, prevention of the more modest excess cancer risk among those with diabetes (16%, 22% and 48%, respectively) would lead to a substantial overall reduction in the total burden of cancer in the population. Our findings reinforce the fact that diabetes prevention activities are also cancer prevention activities, and must therefore be prioritised and resourced in tandem.

PSRTTCA: A new approach for improving the prediction and characterization of tumor T cell antigens using propensity score representation learning

Despite the arsenal of existing cancer therapies, the ongoing recurrence and new cases of cancer pose a serious health concern that necessitates the development of new and effective treatments. Cancer immunotherapy, which uses the body's immune system to combat cancer, is a promising treatment option. As a result, in silico methods for identifying and characterizing tumor T cell antigens (TTCAs) would be useful for better understanding their functional mechanisms. Although few computational methods for TTCA identification have been developed, their lack of model interpretability is a major drawback. Thus, developing computational methods for the effective identification and characterization of TTCAs is a critical endeavor. PSRTTCA, a new machine learning (ML)-based approach for improving the identification and characterization of TTCAs based on their primary sequences, is proposed in this study. Specifically, we introduce a new propensity score representation learning algorithm that allows one to generate various sets of propensity scores of amino acids, dipeptides, and g-gap dipeptides to be TTCAs. To enhance the predictive performance, optimal sets of variant propensity scores were determined and fed into the final meta-predictor (PSRTTCA). Benchmarking results revealed that PSRTTCA was a more precise and promising tool for the identification and characterization of TTCAs than conventional ML classifiers and existing methods. Furthermore, PSR-derived propensities of amino acids in becoming TTCAs are used to reveal the relationship between TTCAs and their informative physicochemical properties in order to provide insights into TTCA characteristics. Finally, a user-friendly online computational platform of PSRTTCA is publicly available at http://pmlabstack.pythonanywhere.com/PSRTTCA. The PSRTTCA predictor is anticipated to facilitate community-wide efforts in accelerating the discovery of novel TTCAs for cancer immunotherapy and other clinical applications.

Maternal obesity and resistance to breast cancer treatments among offspring: Link to gut dysbiosis.

About 50 000 new cases of cancer in the United States are attributed to obesity. The adverse effects of obesity on breast cancer may be most profound when affecting the early development; that is, in the womb of a pregnant obese mother. Maternal obesity has several long-lasting adverse health effects on the offspring, including increasing offspring's breast cancer risk and mortality. Gut microbiota is a player in obesity as well as may impact breast carcinogenesis. Gut microbiota is established early in life and the microbial composition of an infant's gut becomes permanently dysregulated because of maternal obesity. Metabolites from the microbiota, especially short chain fatty acids (SCFAs), play a critical role in mediating the effect of gut bacteria on multiple biological functions, such as immune system, including tumor immune responses. Maternal obesity can pre-program daughter's breast cancer to be more aggressive, less responsive to treatments and consequently more likely to cause breast cancer related death. Maternal obesity may also induce poor response to immune checkpoint inhibitor (ICB) therapy through increased abundance of inflammation associated microbiome and decreased abundance of bacteria that are linked to production of SCFAs. Dietary interventions that increase the abundance of bacteria producing SCFAs potentially reverses offspring's resistance to breast cancer therapy. Since immunotherapies have emerged as highly effective treatments for many cancers, albeit there is an urgent need to enlarge the patient population who will be responsive to these treatments. One of the factors which may cause ICB refractoriness could be maternal obesity, based on its effects on the microbiota markers of ICB therapy response among the offspring. Since about 40% of children are born to obese mothers in the Western societies, it is important to determine if maternal obesity impairs offspring's response to cancer immunotherapies.

Recent advancements in deep learning based lung cancer detection: A systematic review

Cancer is considered to be a key cause of substantial fatality and morbidity in the world. A report from the International Agency for Research on Cancer (IARC) states that 27 million new cases of cancer are expected before 2030. 1 in 18 men and 1 in 46 women are estimated to develop lung cancer over a lifetime. This paper discusses an overview of lung cancer, along with publicly available benchmark data sets for research purposes. Recent research performed in medical image analysis of lung cancer using deep learning algorithms is compared using various technical aspects such as efficiency, advantages, and limitations. These discussed approaches provide insight into techniques that can be used to perform the detection and classification of lung cancer. Numerous techniques adapted in the acquisition of the images, extraction of relevant features, segmentation of region affected, selection of optimal features, and classification are also discussed. The paper is concluded by stating the clinical, technical challenges and prominent future directions.

The Rising Global Cancer Pandemic–Complete Book

Cancer is the first or second cause of death in 134 countries, the leading cause of death in most high-income countries (i.e., 10 million deaths in 2020), and the leading cause of death by disease in American children. An estimated 19.3 million new cases of cancer are diagnosed across the world each year, and this number is expected to rise to 29 million by 2040. Most of the increase will occur in low- and middle-income countries, the countries least capable of confronting the cancer pandemic or affording expensive therapies. Cancer is unjust. Striking inequities can be traced within and between countries in cancer incidence and survival by race, ethnicity, and socio-economic-status. Survival is much higher among the wealthy than among the poor. In the US, outcomes are much more favorable among Whites than among Blacks and Latinos. Scientific contributions and ethical inquiry should help civil society in identifying and naming these inequities and, at the same time, recognizing successful strategies to promote health and articulate further constructive proposals. To examine the cancer pandemic and its inequities, this book—The Rising Global Cancer Pandemic: Health, Ethics, and Social Justice—gathers a selection of contributions presented, in an initial form, at the international conference hosted at Boston College, on October 2, 2021, by the Program for Global Public Health and the Common Good in partnership with the Schiller Institute for Integrated Science and Society and the Theology Department of the Morrissey College of Arts and Sciences. Both the conference and this volume also aim to celebrate the 50-year anniversary of the National Cancer Act signed into law by the US President Richard M. Nixon on December 23, 1971.

Impact of wallet cards compared to conventional chemotherapy education in patients with newly-diagnosed cancer.

363 Background: According to American Cancer Society, 1.9 million new cases of cancer were diagnosed in year 2021, majority of who will undergo chemotherapy (1). With these treatments, there is often an overwhelming amount of information given to patients. We will first assess the percentage of new cancer patients that can recall their cancer treatments with the current patient education format. We then aim to improve patient understanding of their treatment with the introduction of a chemotherapy wallet card. Methods: This is a single center prospective cohort study at the University of Louisville, Brown Cancer Center. In phase one 50 new patients will be recruited from various oncology clinics who will receive conventional verbal chemotherapy education. On cycle two of their treatment, we will administer a survey (figure 1) to assess their understanding of their regimen. In phase two we will recruit 50 new patients and introduce a chemotherapy wallet card filled by the pharmacist to be given during their chemotherapy education and administer the survey on cycle two. We will then compare these two populations to evaluate the impact of the chemotherapy wallet cards. Results: Preliminary results from the first phase have been obtained of 15 newly diagnosed cancer patients. Surveys obtained on cycle two revealed 100% patients correctly identified their cancer diagnosis and 60% were able to correctly name their chemotherapy regimen. 53% of patients were able to identify three correct treatment side effects. Conclusions: Preliminary results show 60% of patients have suboptimal identification of their chemotherapy regimens. Previous studies have shown many patients will visit the emergency department in their first year of treatment. This is of concern as patients may not be able to provide accurate information of their current treatment to these providers resulting in suboptimal care. Our goal will be to see if chemotherapy wallet cards will help to increase patient knowledge and improve patient quality of care.[Table: see text]

Modern scientific and clinical developments in the treatment of malignant neoplasms of the upper gastrointestinal tract: results of ASCO-2022

Introduction. Malignant neoplasms of the upper gastrointestinal tract occupy the 6th position in terms of the frequency of detection of new cases of cancer. Within the framework of the Federal project “Fight against oncological diseases”, state tasks have been set that provide for a significant reduction in mortality from neoplasms, including malignant ones, to 185 cases per 100,000 people. The development, standardization and algorithmization of medical methodologies for drug treatment of cancer aimed at improving the quality of oncological care is underway. In early June 2022, the results of the latest clinical developments, including targeted and immune therapy for upper gastrointestinal tumors, were presented at the Annual Congress of the American Society of Clinical Oncology (ASCO). Popularization of innovative approaches to the treatment of cancerous tumors of the gastrointestinal tract fully meets the objectives of the Federal project.
 Materials and methods. This material was the result of a study of innovative clinical developments in drug therapy for tumors of the upper gastrointestinal tract, presented at the ASCO Annual Congress - June 2022 and the digital platform MEDTalks.nl: the Korean clinical trial K-Umbrella; the German-Swiss Phase 2b DANTE clinical trial; French national randomized trial GERCOR.
 Discussion and Conclusions. The results of the presented clinical developments demonstrate positive effects and an acceptable drug safety profile, which opens up prospects for their implementation in practice as part of innovative medical methodologies for the treatment of patients with malignant neoplasms of the upper gastrointestinal tract.

Oropharyngeal cancer: a clinical case report

Introduction: The National Cancer Institute (INCA) estimates that for each year of the triennium 2020/2022, 15,190 new cases of cancer in the mouth and oropharynx are diagnosed in Brazil. In the global context, oropharyngeal cancer (OPC) is in the sixth position of cancer incidence. The most frequent form, about 90%, is squamous cell carcinomas. Objective: It was to present a clinical case report of oropharyngeal cancer in an octogenarian patient, to present the main diagnostic and treatment procedures in advanced age. Methods: The present study was elaborated according to the rules of the CARE case report. Scientific search engines: PubMed, Embase, Scopus, Google Scholar, Scientific Electronic Library Online (Scielo), published in Portuguese in the last 10 years. Case report and Conclusion: Based on the objective of this study and the literary findings, it showed that knowledge about OPC is essential for dental professionals, which plays a fundamental role in the diagnosis of oral cancers, requiring incisional biopsy. From the case described, it became evident the need for a partnership with a licensed psychologist, for the psychological preparation of the patient who will receive the news of the positive result for oropharyngeal cancer and the follow-up of the same throughout the treatment.

P02-16 Implementation of a program based on adapted physical activity and recommendations for second cancers prevention for adolescents and young adults with cancer: PREVAPAJA study

Background/ObjectivesAbout 1,000,000 new cases of cancer in Adolescent and Young Adults (AYAs) are diagnosed annually worldwide. . While their long term survival is about 80%, they are six times more likely to develop a second primary cancer (SPC) compared to their peers. This risk is multifactorial and depends on the type of first cancer, treatment received and prevalence of risk factors. PREVAPAJA aimed to implement a clinical program based on physical activity (PA) and cancer prevention recommendations for AYAs with cancer at Centre Léon Bérard-AYAs Department.MethodsThe study was conducted at Leon Berard Comprehensive Cancer Centre among patients aged 15-25 years. AYAs attended PA sessions during the active treatment period and were individually informed on SPC risk prevention. PA, sedentary, anthropometrics, quality of life and fatigue were assessed at baseline (T1) and at the end of treatment (T2). PA level and intention of changes in health behaviors were assessed by phone 1 year after T1.Results68 AYAs (median age=19 years) were enrolled in 2016-2017). The results showed an improvement in PA level during and at distance of the intervention, with also a reduction of sitting time. Fatigue decreased between T1 and T2 (p>0.003) and overall quality of life improved significantly between T1 and T2 (p>0.001).ConclusionsThis study showed the feasibility of implementing a clinical program based on PA intervention and cancer prevention recommendations for AYAs with cancer. It responded to AYAs' needs for support and discussions regarding PA recommendations and ways to prevent SPC. Beneficial outcomes of this program should encourage to systematically proposing PA intervention in combination with information exchanges with AYAs with cancer.

Impact of 10-Day Fulbright Specialist Program and Project Pink Blue Education Sessions on Medical Oncology Knowledge Among Physicians Who Treat Cancer in Nigeria.

Despite an estimated population of over 201 million and over 115,950 yearly diagnosed new cases of cancer, Nigeria does not have dedicated medical oncologists. Most oncology care is delivered through surgical and clinical oncologists, who are trained in both radiation and medical oncology and they number fewer than 50 in the country. With a limited number of oncology professionals, cancer patients in Nigeria experience poor health outcomes, with an estimated cancer mortality rate of 75,000 deaths per year. Participants from 15 Nigerian states were selected to attend the medical oncology training. Through the support of Fulbright Specialist Program and Project PINK BLUE, two of the authors delivered 10days of lectures based on ASCO, ESMO, and NCCN guidelines. Mean scores of both the pre- and post-course tests as well as a 1-year follow-up test were compared using GraphPad Prism 7.0a by paired t-tests. Forty-four clinical oncologists were selected for participation. Twenty-five (57%) completed the pre- and post-course tests. Of the 25 that completed both tests, percentage of correct answers increased from 45 to 59% (2-sided p-value < 0.0001). Improvements were seen in attending doctors 45 to 59% (p = 0.0046) and resident doctors 45 to 59% (0.0007). Eleven doctors responded to the 1-year follow-up test. Although not statistically significant, a numerical pattern for the benefits was maintained 1year after the program (45% pre-course versus 52% post-course correct answers, Fisher's exact, p = 0.4185). In the short term, the training improved medical oncology knowledge in Nigeria, regardless of the participant's carrier stage. Long-term benefits were not sustained in a small sample of participants, and continuing education strategies are necessary. Similar models may be employed across Africa.

Changing Pattern of Childhood Cancers at Korle Bu Teaching Hospital, Accra, Ghana

Background: Worldwide, the incidence of childhood cancers is increasing and majority of children with cancers live in developing countries. The main aim of the study was to determine the current pattern of childhood malignancies at Korle Bu Teaching Hospital(KBTH), Accra.Methods: A retrospective review of registry data from the KBTH paediatric oncology unit between January 1, 2008 and December 31, 2011 was conducted, and results analysed.Results: Out of 495 new cases of cancer, lymphomas (30.7%), leukaemias (18.8%) and retinoblastomas (15.8%) were the commonest cancers diagnosed. CNS tumours were rare (3.4%). Overall, the male: female ratio was 1.3:1. Most patients (232/495; 47%) were inthe 5-10 year age group and majority of embryonal tumours were diagnosed in the 0-4 year age group. The peak ages for Burkitt’s lymphoma and acute lymphoblastic leukaemia were similar, in contrast to reports from developed countries.Conclusion: The number of children diagnosed with cancers at KBTH has increased significantly. Concerted efforts and advocacy towards improving childhood cancer care are required.

Case report: treatment of metastatic renal cell carcinoma with nivolumab plus cabozantinib in routine clinical practice

According to GLOBOCAN, there were about 18 million new cases of cancer and 9.6 million deaths from malignancies worldwide in 2018. Renal cell carcinoma is a malignant tumor characterized by the loss of the VHL gene, which leads to increased angiogenesis. The potential of immuno-oncology and anti-angiogenic drugs has significantly improved outcomes for patients with metastatic renal cell carcinoma. The phase III CheckMate 9ER study compared the efficacy and safety of nivolumab plus cabozantinib versus sunitinib in the first-line treatment of patients with metastatic clear cell renal cell carcinoma. The advantages of nivolumab plus cabozantinib over sunitinib in terms of progression-free survival, overall survival, and objective response rate were generally similar across subgroups based on IMDC risk, PD-L1 expression, and the presence or absence of bone metastases. We present a case report of metastatic renal cell carcinoma. The patient has been on cabozantinib plus nivolumab therapy for 12 months, with a partial response achieved. Treatment was well tolerated; the profile of adverse events was consistent with that in the clinical study.

Cancer: The Most Feared Disease

With an estimated 21 million people, Pakistan is a heavily populated, developing nation. The general population's lack of awareness, an unclean lifestyle, and unsanitary circumstances in populated regions are the main causes of Pakistan's endemic prevalence of various infectious and non-communicable diseases. Studies on the prevalence and incidence of cancer in Pakistan are extremely rare. Only Karachi and Lahore previously had cancer registers, but in 2015 the Pakistan Health Research Council (PHRC) in Islamabad launched a national cancer registry. Females have a significantly higher age-standardized ratio for cancer (172/100000) than males have (145/100000). Recently, Pakistan has seen 150,000 new cases of cancer, with 60–80 percent of patients dying. In Pakistan, between 7000 and 7500 kids are diagnosed with cancer each year. In Pakistan, communicable illnesses and malnutrition are the leading causes of child mortality. Better diagnostic tools have led to cancer being a significant cause of morbidity and mortality in children. Data readily available indicates that 10% of all cancer cases reported in 2017 were juvenile malignancies. According to Pakistan's Karachi Cancer Registry, the two most common children cancers are leukaemia (31%) and lymphomas (20%). According to data from the Punjab Cancer Registry, lymphomas (31%) are more common than leukaemia (23%) overall. The recently established PHRC National Cancer Registry has very little information available at this time that demonstrates the prevalence of children cancers. An accurate surveillance system for cancer incidence and death is absolutely necessary. Population-based cancer registries are quite rare in the nation. There ought to be more cancer registries in a nation with more than 21 million citizens. In Pakistan, the most often diagnosed cancers are head and neck carcinoma, colon, prostate, lung, breast, and liver cancers. Different malignancies have varying chances of being cured. But every malignancy requires a unique approach to treatment. Different methods of fighting cancer include surgery, chemotherapy, radiation treatment, bone marrow transplant, immunotherapy, hormone therapy, targeted medication therapy, and cryoablation. The mechanism for gathering data needs to be improved, and the data should be pooled at the national level. Only when such data are available will it be possible for policymakers to allocate priceless healthcare resources sensibly.