Cancer Symptoms Research Articles

New Insights into Colorectal Cancer through the Lens of Precision Oncology and Personalized Medicine: Multi-Omics Helps Aging of Predisposed People.

Recently, there has been a significant evolution in our understanding of the molecular pathways causing the genesis and progression of cancer via the inter-individual variations. Thus, one-size-fits-all methods for cancer treatment have been replaced by precision oncology (PO) targeting individual cancer symptoms, offering increased effectiveness, and decreased safety concerns and cost load. The identification of novel actionable indications, rapid, precise, and comprehensive detection of complex phenotypes in every individual, pioneering clinical trial projects with enhanced response feedback, and widespread availability of innovative targeted anticancer management for every patient are vital for the effective implementation of next-generation precision oncology. Additionally, the emergence of precision medicine has altered the perspective of oncologic biomarkers, drug discovery, drug development, and, improvements for cancer patients. This paper narratively reviewed to identify actionable abnormalities, Genomic profiling of tumors employing clinical next-generation sequencing (NGS) from both tumor tissues and liquid biopsies along with the multi-omics strategies as the key component of PO. Our increasing information on tumor biology, specifically microenvironment and heterogeneity- associated data, would improve our understanding of the resistance of targeted drugs and specific mechanisms of action, as well as help enhance existing metastatic colorectal cancer (mCRC) treatment strategies. Collectively, this paper indicated the current and innovative strategies for prognosis, diagnosis, and treatment of various cancer types based on PO overview with a groundbreaking emphasis on CRC suggesting the integrations of multi-omics, highlighting Genomics, and utilizing AL and ML algorithms with targeted therapies. Notably, these findings can help improve the life-span and ageing of the predisposed people.

Bladder cancer: a retrospective audit at a single radiation oncology unit of an academic hospital in Johannesburg, South Africa

BackgroundBladder cancer (BCa) is one of the most common urological cancers and remains a leading cause of cancer-related mortality worldwide. Bladder cancer is associated with a range of risk factors, with smoking being one of the most significant contributors. In addition to smoking, exposure to certain chemicals, particularly aromatic amines found in industries such as dye, rubber, leather, and textiles, also increases the risk of bladder cancer. In low-and-middle countries with lower Human Development Index (HDI), data on the underlying causes, incident rate, modes of presentation, treatment, and prognosis of bladder cancer remains unclear and often appear to be inadequate. This study aimed to assess the prevalence, mode of presentation, treatment, and risk factors associated with bladder cancer in Johannesburg, South Africa. By examining these factors, the study seeks to identify possible patterns or predisposing factors that contribute to the development and progression of bladder cancer, which could generate insights that could help to reduce the significant morbidity and mortality associated with this cancer.MethodsThis retrospective study analyzed secondary data from 115 patients who were treated in the radiation oncology unit of an academic hospital between January 2010 and December 2020. By reviewing the medical records of these patients, the study aimed to gather comprehensive information on the prevalence of bladder cancer, modes of presentation, treatment approaches, and associated risk factors. Bladder cancer in this study was assessed using a comprehensive analysis of patient data on demographics, risk factors, clinicopathological aspects, and the specific therapies received. A comparison of patients with squamous cell carcinoma (SCC) and transitional cell carcinoma (TCC) of the bladder was conducted as part of this study. This comparison aimed to explore differences in demographic profiles, risk factors, clinicopathological characteristics, and treatment outcomes between these two histological subtypes.ResultsA total of 115 patients presenting with bladder cancer symptoms were referred to the academic hospital for evaluation and treatment. The incidence rate of bladder cancer was highest among patients with a mean age of 60.7 ± 14.9. Males constituted 60.9% of the cases, resulting in a male-to-female ratio of 1.6:1. The most common risk factors associated with bladder cancer complications included smoking, being male, black ethnicity and increasing age. Transitional cell carcinoma remained the most prevalent histological subtype at the academic hospital, compared to squamous cell carcinoma (SCC). Patients with transitional cell carcinoma (TCC) were more likely to be older (odds ratio (OR): 1.03, 95% Confidence Interval (CI): 1.01–1.06, p = 0.029), male (OR: 2.60, 95% CI:1.10–6.04, p = 0.030). The study also found that most of the TCC cases were among black patients, though white patients were four times more likely to present with TCC compared to SCC (OR:4.22, 95% CI: 1.43–12.48, p = 0.009).ConclusionBladder cancer is still widespread in LMICs, with lower HDI, with elderly males being at risk. To aggressively prevent mortality and morbidity from bladder cancer, bladder cancer health awareness must be maintained to improving prevention, as well as early detection, management and comprehensive patient care and health services for bladder cancer patients. These findings highlight the importance of targeted screening and prevention strategies for high-risk groups, particularly older males with a history of smoking.

Construction of a nomogram risk prediction model for depressive symptoms in elderly breast cancer patients

The primary objective of this study was to identify the factors associated with the development of depressive symptoms in elderly breast cancer (BC) patients and to construct a nomogram model for predicting these symptoms. We recruited 409 patients undergoing BC treatment in the breast departments of two tertiary-level hospitals in Jiangsu Province from November 2023 to April 2024 as our study cohort. Participants were categorized into depressed and non-depressed groups based on their clinical outcomes. Univariate and multivariate logistic regression analyses were employed to identify independent risk factors for depression among BC patients. Multivariate analysis revealed that monthly income, pain score, family support score, and physical activity score significantly influenced the onset of depression in older BC patients (P < 0.05).The risk prediction model, constructed using these identified factors, demonstrated excellent discriminatory power, as evidenced by an area under the ROC curve (AUC) of 0.824. The maximum Youden index was 0.627, with a sensitivity of 90.60%, specificity of 72.10%, and a diagnostic threshold value of 1.501. The results of the Hosmer-Lemeshow goodness-of-fit test (χ² = 3.181, P = 0.923) indicated that the model fit the data well. The calibration curve for the model closely followed the ideal curve, suggesting a strong fit and high predictive accuracy. Our nomogram model exhibited superior predictive performance, enabling healthcare professionals to identify high-risk patients early and implement preventative measures to mitigate the development of depressive symptoms. This study is a cross-sectional study that lacks longitudinal data and has a small sample size. Future research could involve larger samples, multicenter studies, and prospective designs to build better clinical predictive models.

Deciphering the Therapeutic Applications of Nanomedicine in Ovarian Cancer Therapy: An Overview.

The majority of deadly cancers that afflict the female reproductive system occur in the ovary. Around 1,40,000 women worldwide die from ovarian cancer each year, making it the sixth most common cancer-associated deceases among females in the United States. Modern, cutting-edge treatments like chemotherapy and surgery frequently produce full remissions, but the recurrence rate is still very high. When this crippling condition is diagnosed, there are frequently few therapeutic choices available because of how quietly it manifests. Healthcare practitioners must have a fundamental grasp of the warning signs and symptoms of ovarian cancer, as well as the imaging techniques and treatment choices available, to give the patient the best care possible. The discipline of medical nanotechnology has gained a lot of momentum in recent years in resolving issues and enhancing the detection and treatment of different illnesses, including cancer. This article gives a brief summary of types, risk factors and approaches to ovarian cancer treatment. We subsequently discussed the pathophysiology of ovarian cancer with the risk factors. This review also emphasizes the various signalling pathways involved in ovarian cancer. Our comprehensive integration of recent findings in fundamental research in the nano arena reveals the strong interest in these nanomedicines in ovarian cancer treatment. However, these nanomedicines still require more research, as indicated by the comparatively small number of clinical trials ongoing. This article will provide a reference for ovarian cancer treatment.

Overshooting the mark? Readability of online patient resources for postmenopausal bleeding as a symptom of endometrial cancer

Overshooting the mark? Readability of online patient resources for postmenopausal bleeding as a symptom of endometrial cancer

Oral cancer perceptions amongst adult attendees of a Dental Hospital in the Republic of Ireland: A cross-sectional pilot study

Objectives This study aimed to assess (i) awareness of the signs and symptoms of oral cancer and its risk factors and (ii) awareness and attitudes towards oral cancer screening, in an Irish cohort. Methods A cross-sectional self-administered survey was used in a convenience sample of patients &gt; 18 years with no cancer history attending the Dublin Dental University Hospital. The data were analysed using descriptive statistics, Pearson’s Chi-squared and Fisher’s exact tests. Results 124 responses were received. 83.7% reported knowing little/nothing about oral cancer risk factors. 12.8% did not identify smoking, 35.3% alcohol consumption, 90.5% betel nut, 35.3% age and 80.2% male gender, as risk factors. 46% were unaware that a dentist is trained to check for oral cancer. Participants were more likely to seek advice regarding a persistent oral white or red patch from their doctor than their dentist but were more likely to attend their dentist in relation to a persistent ulcer, swelling or pain. The study did not find any statistically significant relationship between gender, age, educational level and either awareness of the signs and symptoms of oral cancer and its risk factors, or with experiences and attitudes towards oral cancer screening. Conclusions The study demonstrated a lack of knowledge of the risk factors, signs and symptoms of oral cancer, and of awareness of the role of dentists in screening for oral cancer. It should be repeated in a larger cohort in non-dental settings to inform the development of oral cancer awareness programmes that address those areas where awareness is lacking.

Double Vision as the Presenting Symptom of Metastatic Breast Cancer in an 83-Year-Old Lady

Breast cancer is the most common type of malignant tumor that occurs in women. Despite this, physicians report that they screen elderly patients for breast cancer less than young patients, regardless of cancer history. This case report describes an elderly patient who presented with diplopia, eyelid swelling, and restricted eye movement, leading to the discovery of a diffuse orbital tumor and Stage IV left breast carcinoma with metastases to bone, liver, and peritoneum. The patient had been told to stop mammograms years prior to her diagnosis despite her past history of uterine cancer. The case underscores the possibility of orbital metastasis from breast cancer and highlights the necessity of diligent cancer screening in elderly women.

Patient-reported gastrointestinal symptoms in gastric cancer after laparoscopic distal gastrectomy

PurposeThis study aimed to compare postoperative gastrointestinal symptoms between patients who underwent laparoscopic distal gastrectomy with Roux-en-Y (R-Y) and Billroth-II with Braun (B-II B) reconstruction.MethodsThis observational study retrospectively analyzed 151 patients (110 in R-Y group and 41 in B-II B group) who underwent laparoscopic distal gastrectomy from January 2020 to December 2021. A comparison was made regarding surgical outcomes, perioperative nutritional and inflammatory markers, postoperative dietary patterns, and gastrointestinal symptoms between the two groups.ResultsThe operation time was longer in the R-Y group than the B-II B group (261.00 ± 56.17 min versus 239.88 ± 57.78 min, p = 0.046). However, there were no significant differences in the length of hospital stay, ASA classification, complications, nutritional and inflammatory indexes, or recovery of postoperative diet between the two groups. Additionally, there were no significant differences in the occurrence of postoperative gastrointestinal symptoms in the post-discharge week (PDW) 1 and postoperative month (POM) 1 between the B-II B and R-Y groups.ConclusionsAbdominal distention emerged as the main gastrointestinal symptom burden in patients with gastric cancer undergoing laparoscopic distal gastrectomy. Both Billroth-II with Braun and R-Y reconstructions exhibited a high and similar incidence of gastrointestinal symptoms in the short term. Therefore, medical staff should pay attention to the management of gastrointestinal symptoms in these patients postoperatively.

Patient factors associated with complementary and alternative medicine use among cancer patients at a county referral hospital, Kenya

BACKGROUND Despite numerous global reports on the use of complementary and alternative medicine (CAM), no studies have been published regarding its use at Machakos Level 5 Hospital. Therefore, this study aims to identify patient-related factors associated with CAM use among cancer patients at this Level 5 hospital in Kenya. METHODOLOGY A mixed method, cross-sectional design was implemented at Machakos level five hospital in Kenya. A Census was carried out, using a face-to-face researcher-administered questionnaire among 80 cancer patients receiving treatment at the clinic. Critically ill and mentally unstable patients were excluded. A Chi-square test assessed variable associations, considering p &lt; 0.05 as statistically significant. Logistic regression analyzed variable relationships. RESULTS Gender was significantly associated with CAM use (p=0.014). Regression analysis revealed that Male patients were 79% less likely to use CAM (OR=0.21, 95% CI 0.042-1.003, p=0.050). Patients who had received radiotherapy were likely to use CAM (p=0.032), however, on regression analysis there was no significant association. Believes that CAM improves health (χ2=9.231, p-0.010), supports conventional treatment (χ2=15.620, p-0.001), cures cancer (χ2=12.661, p-0.002), manages treatment side effects (χ2=11.045, p-0.004), relieves cancer symptoms (χ2=9.008, p-0.011), promotes self-healing (χ2=16.969, p-0.001), and gives hope (χ2=17.512, p-0.001) were significantly associated with CAM use. CONCLUSION AND RECOMMENDATION. There was a significant association between patient characteristics and CAM use among cancer patients. Improving patient-healthcare worker communication could encourage reporting of CAM usage. Further research is needed to explore the efficacy, safety, and tolerability of CAM in cancer patients.

The structural Basis of NMN synthesis catalyzed by NadV from Haemophilus ducreyi

NMN is a precursor in the biosynthesis of NAD+, a molecule that plays a crucial role within cells. Supplementation with NMN can elevate NAD+ levels in the blood, improving symptoms of diabetes, neurodegenerative diseases, and cancer, as well as providing anti-aging benefits. Escherichia coli was engineered to heterologously express nicotinamide phosphoribosyltransferase (Nampt), enabling the recombinant E. coli to synthesize NAD derivatives from nicotinamide. The 3D structure of Nadv complexed with NAM and NMN was determined to explore the molecular mechanism by which Nadv catalyzes NMN synthesis. NAM binds at two sites: one at the catalytic site and one at the allosteric binding site, while NMN binds exclusively at the catalytic site. In both structural models, a loop between β15 and β16 is missing, likely due to its high flexibility, leading to diffuse electron density. Compared with other resolved Nampt structures, an additional 12-amino-acid loop was identified after α-helix 12 near the catalytic site. This study lays the groundwork for the engineering of Nadv, facilitating its efficient application in biological synthesis of NMN.

Mammography screening among women attending primary healthcare centers in Monastir, Tunisia

Abstract Background Breast cancer is the leading cancer among women worldwide. Early detection through mammography screening improves prognosis and enhances survival rate for this disease. The aim of this study was to identify the factors associated with mammography screening utilization among women attending primary healthcare centers. Methods A cross-sectional study was conducted in four primary healthcare centers in Monastir governorate in October 2023 using a pre-tested questionnaire. Women aged over 45 years-old were included as they were the target group in the breast cancer screening strategy. Univariate then multivariate analyses were performed in order to identify the factors associated with mammography screening utilization. Data was analyzed by SPSS 21.0. Results A total of 192 women were included in the study with a mean age of 56.7±8.8 years-old. Among them, 79.7 % (n = 153) were married and 51.6% (n = 98) had three children and less. A total of 55.3 % (n = 94) had a primary education level. Regarding participants’ practices of breast cancer screening, 35% of our participants have had mammogram. Univariate analysis showed that the knowledge about breast cancer symptoms (p = 0.015), practicing Breast self-examination (BSE) (p = 0.002), being aware about mammography (p = 0.001) and the recommended age of the screening at 45 years-old (p = 0.001) were significantly associated with adherence to breast cancer screening. Multivariate analysis revealed that practicing BSE (ORa=2.60 [95%CI: 1.22-5.55] and knowing the recommended age of mammography screening (ORa=2.28 [95%CI: 1.17-4.45] were significant (P &amp;lt; 0.05) predictors of mammography screening utilization. Conclusions Mammography screening rate is low. This study had provided some informations about factors influencing mammography screening. Policymakers and public health practitioners should consider the identified factors when developing intervention programs to improve breast cancer screening. Key messages • There is a need to conduct education sessions in schools to raise awareness about breast cancer screening at an early age. • Social media can be a tool for health education on mammography screening.

COMMUNITY EMPOWERMENT IN THE SADARI PROGRAM (BREAST SELF-EXAMINATION)

Background: Cancer is currently one of the leading causes of death worldwide. One of the most common cancers and with the highest incidence is breast cancer. There are still many PKK Mojosongo Jebres Surakarta mothers who are not aware of the importance of early breast examination. This Breast Self-Examination (BSE) has been proven to be culturally acceptable, religiously friendly, and inexpensive. BSE is one way of action to find early symptoms of breast cancer that can be detected by mothers themselves, does not require experts to find breast cancer early, and is part of prevention efforts. Objective: This community service is to improve BSE knowledge and skills through community empowerment which will have an impact on increasing awareness and efforts to prevent breast cancer in Mojosongo. Methods: This activity begins with a regional visit to find out the existing problems, and a meeting with the PKK Chairperson to coordinate the implementation, the sampling technique uses a total sampling of all PKK mothers totaling 50 people who are given education and practice on how to do self-examination at home. Results: Community service can improve the ability of PKK mothers to do BSE independently. Conclusion: SADARI Education and Training improves the ability of knowledge and skills independently and has a positive impact on maternal health. The Recommendations, need to encourage and follow up on education and training on SADARI examinations by adding periodic follow-up sessions, this is done so that knowledge and practice of SADARI continue to be implemented.

Knowledge and Misinformation About Breast Cancer Risk Factors, Symptoms, and Prevention Among Healthy and Affected Women: A Study on 2375 Italian Participants

Background: Breast cancer is the most common cancer among women worldwide and remains the leading cause of death among Italian women. Despite increased breast cancer awareness and improved diagnostic techniques, mortality rates remain high globally. In Italy, despite the availability of screening programs by the National Health System (NHS) for all Italian women aged 50–69 every two years, the participation rate remains relatively low. The low uptake of screening may be attributed to a lack of general cancer knowledge among women, including awareness of risk factors, symptoms, and prevention measures. This study investigates the knowledge and misinformation in a population of Italian women regarding breast cancer risk factors, symptoms, and prevention. Methods: From March 2021 to January 2022, we conducted a survey targeting the female population in Italy, with a total of 2375 participants willingly participating in the study. To investigate factors linked to variations in attitudes toward breast cancer, the participants were categorized into two groups: the general population (Group A, n = 2235) and women who have had or currently have breast cancer (Group B, n = 140). Statistically significant differences were identified between these two groups. Results: The findings revealed considerable confusion regarding both the symptoms and causes associated with cancer, as well as prevention measures. This confusion was particularly prominent among women in the general population and those with lower levels of education. Conclusions: Given these insights, it remains crucial to promote accurate health information concerning risk factors, symptoms, and prevention strategies related to this devastating disease, emphasizing the ongoing importance of disseminating correct health information.

Factors influencing delayed cancer health seeking in Meghalaya, Northeast India: A qualitative study

Background &amp; objectives India accounts for about seven per cent of the global cancer burden with the highest cancer incidence reported from the North-Eastern Region (NER), including Meghalaya. Despite this, there is paucity of published studies on health seeking behaviour for cancer in the NER. To address this gap, this study used a qualitative approach to document patient, caregiver and provider perspectives to understand the factors influencing healthcare seeking for cancers in Meghalaya. Methods In-depth interviews were undertaken with 37 individuals diagnosed with one of the top five cancers in Meghalaya, namely, oesophageal, breast, oral, cervical and lung cancer. They were identified from the State referral cancer hospital. Twelve caregivers and five healthcare providers were also interviewed. All interviews were conducted in the local language using semi-structured interview guides. Transcripts were translated to English, coded, categorized and analyzed using thematic framework content analysis approach. Results A key factor influencing delayed cancer treatment in Meghalaya included misconceptions regarding the causes of cancer and cultural concepts such as bih and skai (Khasi language), i.e. notions of a figurative ‘poison’ or ill intent that makes one susceptible to illness. A general reluctance to discuss cancer diagnoses, perceived stigma, apprehension of treatment methods influenced their decision. Other factors included negligence and misinterpretation of early symptoms of cancer, self-management, preference for traditional medicines, financial constraints and health system-related factors. Interpretation &amp; conclusions This study underscores the importance of addressing barriers to cancer diagnosis and treatment in indigenous populations in northeast India, advocating for culturally appropriate messaging, capacity building for healthcare workers, integration of traditional healers, and community involvement to enhance early healthcare seeking and improve outcomes.

SERPINH1 as a Novel Biomarker for Colon Cancer Bone Metastasis with Machine Learning and Immunohistochemistry Validation.

Background: Bone metastasis (BM) is a serious clinical symptom of advanced colorectal cancer. However, there is a lack of effective biomarkers for early diagnosis and treatment. Method: RNA-seq data from public databases (GSE49355, GSE101607) were collected and normalized and batch effects were removed using the combat package. Differential expression analysis was performed to identify significant genes. Robust Rank Aggregation and machine learning algorithms were used to pinpoint candidate biomarkers. These biomarkers were validated using immunohistochemistry and further analyzed for survival rates. Enrichment analysis was conducted to explore biological mechanisms. Additionally, drug sensitivity and immune infiltration analyses were performed to provide insights into potential therapeutic targets. Results: Analysis results revealed 386 genes elevated in primary versus normal tissues and 26 genes varying between primary and BM. Serpin Protease Inhibitor Clade H1 (SERPINH1) as a novel biomarker for colon cancer metastasis. High SERPINH1 expression correlates with poor survival outcomes and is linked to high lymphatic invasion and advanced cancer stages. Additionally, SERPINH1 expression influences immune infiltration and is not predictive of chemotherapy response, but potential new drugs are suggested for high-expression cases. The gene also enriches classical cancer pathways such as Hedgehog and transforming growth factor-β. Conclusions: We identified novel colon cancer BM markers, including SERPINH1, using machine learning algorithms combined with traditional transcriptomic data and validated their expression through immunohistochemistry. This biomarker could significantly assist clinicians in making more precise treatment decisions.

Roles of microRNA-486-5p in the diagnosis and the association with clinical symptoms of cervical cancer.

Aim: To explore the predictive value of miR-486-5p in early cervical cancer and the associations of miR-486-5p with different clinical symptoms.Materials & methods: A total of 185 women were recruited. The relative expression levels of serum miR-486-5p were analyzed by real-time polymerase chain reaction. The receiver operator characteristic curves were utilized to reflect the predictive performance of miR-486-5p and squamous cell carcinoma antigen for early cervical cancer. Univariate logistic regression and ranked logistic regression were used to explore the associations of miR-486-5p with different clinical symptoms of early cervical cancer, with odd ratios (ORs) and 95% confidence intervals.Results: Eighty-one women (44.26%) had early cervical cancer. The relative expression of serum miR-486-5p was 1.99-fold higher in early cervical cancer patients than that in controls (p<0.0001). The predictive performance of miR-486-5p for early cervical cancer was significantly superior to that of squamous cell carcinoma antigen, with an area under the curve of 0.865 (p<0.001), sensitivity of 1.000and specificity of 0.804. In addition, overexpressed miR-486-5p was associated with high odds of maximum tumor diameter increase (OR=1.30, 95%CI: [1.01-1.66]).Conclusion: MiR-486-5p may be a potential biomarker for the early cervical cancer diagnosis, and was linked to the risk of maximum tumor diameter.

Navigating the challenging storms of cancer management in a national cancer centre: perspectives of female patients

BackgroundBreast, cervical, and ovarian cancers are among the top ten global cancers, affecting women, with age-standardized rates per 100,000 being 47.8 for breast, 13.3 for cervical, and 6.6 for ovarian cancer. The journey from cancer symptoms, through diagnosis and treatment, to survivorship, presents numerous challenges. These challenges encompass physical, psychological, and social aspects, significantly impacting patients' quality of life. It is crucial for research to explore not only the challenges faced by patients but also the strategies they employ to cope with these obstacles.MethodsThis study employed a cross-sectional qualitative approach. Twenty respondents, aged between 15 and 45 years and had been diagnosed with a reproductive cancer (breast, ovarian, or cervical), and were either undergoing treatment or had completed treatment within one year of the study period were purposively selected. Respondents were interviewed using a semi-structured interview guide. A thematic analysis was conducted on twenty in-depth interviews (IDIs) to understand the challenges and support systems for cancer patients.ResultsThe study identified two principal themes: the challenges faced by patients and the available support systems. The findings are based on patient narratives regarding the obstacles encountered during diagnosis, treatment, and follow-up, along with the mitigation strategies employed. Patients reported a range of challenges, categorized into financial and non-financial. Prominent among the non-financial challenges were psychological distress, body image issues, reduced sexual drive, and overall health deterioration. Support was primarily found through personal relationships and religious or spiritual beliefs.ConclusionThe research highlights the extensive psychological and social effects of cancer and it’s treatment. The study revealed the intertwined nature of financial difficulties and non-financial challenges, emphasizing the importance of social support, including religious, family, healthcare, and peer support. The findings suggest that a comprehensive, multidisciplinary management plan which encompasses both medical and supportive care is required to enhance patient well-being.

Distance-based analytical device integrated with carbon nanomaterials for sarcosine quantification in human samples.

Astraightforward distance-based paper analytical device (dPAD) was developedfor monitoring sarcosine levels in human samples for the rapid diagnosis and prognosis of prostate cancer and related symptoms. This assay eliminates the need for the expensive horseradish peroxidase (HRP) enzyme by utilizing carbon nanodots (CDs) as a peroxidase-like nanozyme. The proposed dPAD sensor consists of a sample zone pre-deposited with sarcosine oxidase (SOx) and CDs, and a detection zone containing 3,3',5,5'-tetramethylbenzidine (TMB). When a solution containing sarcosine is added to the sample zone, hydroxyl radicals (•OH) are produced through SOx oxidation and subsequent peroxidase catalysis by the CDs. The formed •OH radicals immediately flow to the detection zone via capillary force, where they oxidize TMB, resulting in a visible colour change from colourless to blue. Sarcosine quantification is effortlessly accomplished by measuring the distance of the blue colour in the detection zone. The developed dPAD offers a linear working range between 12.5 and 35.0nmol L-1 (R2 = 0.9959) and a detection limit (LOD) of 10.0nmol L-1. This covers the clinical range for urinary sarcosine determination, thereby suggesting no additional sample preparation or dilution is needed. The sensor shows high precision with the highest relative standard deviation (RSD) of 4.58% and demonstrates excellent selectivity with no observed interferences. Furthermore, recovery studies in human control urine samples ranged from 98.67 to 101.50%, with the highest RSD of 2.03%. Correspondingly, our dPAD method showed a great match with the performance of a commercial ELISA method for detecting sarcosine in human control serum. The sensor is more cost-effective, user-friendly, and accessible than previous methods. Overall, the proposed method represents a promising analytical tool for sarcosine quantification. The concept is also applicable for broader analytical applications in detecting other biomolecules.

Extent and pattern of symptom relief following surgical castration in patients with advanced prostate cancer treated at a tertiary referral hospital in Tanzania: a prospective cohort study

BackgroundAdvanced prostate cancer leads to many symptoms, notably bone pain and lower urinary tract symptoms (LUTs); however, the degree and duration of pain relief, changes in LUTs severity and underlying factors associated with the extent of symptom relief remain inadequately understood. Surgical castration has proven effective in relieving both bone pain and urinary symptoms for metastatic prostate cancer patients.ObjectiveTo determine the extent and pattern of symptom relief in advanced prostate cancer patients following surgical castration at Muhimbili National Hospital (MNH).MethodsWe conducted a prospective cohort study for a period of 6 months involving men with advanced Prostate cancer (PCa) undergoing surgical castration at MNH and followed them for 30 days. The international prostate symptoms score tool was used to assess changes in LUTs, and the pain rating scale was used for assessing changes in bone pain symptoms before and after surgery. Logistic regression model was used to determine factors associated with complete bone pain relief.ResultsA total of 210 participants with a mean age of 72.3 years were recruited. The LUTS score showed a decrease of 7.1 points after surgical castration (95% CI: 6.4 to 7.7, p < 0.001). The bone pain score showed an absolute decrease of 39.8% (95% CI: 34.7 to 44.9, p < 0.001) after surgical castration, with more than half of the patients (111, 52.9%) reporting bone pain relief within the first two weeks. Among the factors associated with greater pain relief were being in a marital union (aOR 2.73, 95% CI: 1.26 to 5.89, p < 0.011). Normal BMI was also linked to pain relief in bivariate analysis (OR 1.92, 95% CI: 1.03 to 3.61, p < 0.035). Additionally, patients with severe bone pain before surgical castration were more likely to achieve complete pain relief compared to those with mild or moderate pain (odds ratio 8.32, 95% CI: 3.63 to 19.1, p < 0.001).ConclusionSurgical castration improves both bone pain and lower urinary tract symptoms in patients with advanced prostate cancer. Notably, patients experiencing severe bone pain reported resolution of bone pain symptoms within the first and second weeks, respectively, indicating the prompt effectiveness of the surgery on these symptoms.

Multifunctional gold nanoparticles for cancer theranostics.

The diagnosis and treatment of cancer can often be challenging requiring more attractive options. Some types of cancers are more aggressive than others and symptoms for many cancers are subtle, especially in the early stages. Nanotechnology provides high sensitivity, specificity and multimodal capability for cancer detection, treatment and monitoring. In particular, metal nanoparticles (NPs) such as gold nanoparticles (AuNPs) are attractive nanosystems for researchers interested in bioimaging and therapy. The size, shape and surface of AuNPs can be modified for improving targeting and accumulation in cancer cells, for example through introduction of ligands and surface charge. The interactions of AuNPs with electromagnetic radiation (e.g., visible-near-infrared, X-rays) can be used for photothermal therapy and radiation therapy, through heat generated from light absorption and emission of Auger electrons, respectively. The subsequent expansion and high X-ray attenuation from AuNPs can be used for enhancing contrast for tumor detection (e.g., using photoacoustic, computed tomography imaging). Multi-functionality can be further extended through covalent/non-covalent functionalization, for loading additional imaging/therapeutic molecules for combination therapy and multimodal imaging. In order to cover the important aspects for designing and using AuNPs for cancer theranostics, this review focuses on the synthesis, functionalization and characterization methods that are important for AuNPs, and presents their unique properties and different applications in cancer theranostics.