Journal of Integrative Oncology

Introduction: Lung cancer is responsible for the highest mortality caused by malignant solid tumors. Chemotherapy remains one of the most important modality of treatment. Methods: This retrospective study analyzed the records of 42 patients’ treatment with pemetrexed, used in second, third and fourth line chemotherapy for advanced non-squamous non-small cell cancer (NSCLC). Kaplan Meier curve was used for calculation of overall survival. Results: The median overall survival in the second-line was 10 months and in third- and fourth-line was 6.5 months. Discussion: We discuss the similar study with pemetrexed in mono-chemotherapy or combination, study with similar results. Also we make a reference to the new therapy with best results but with much higher cost and effective only for a part of patients. Conclusions: This result and other results presented in similar studies encourage us to recommend pemetrexed in the third and fourth line chemotherapy for well-selected patients.

Background: There is a lifetime risk of developing another de novo malignancy in diagnosed cancer patients. Detection of new primary has increased due to advances in both diagnostic and treatment modalities. This article aims to analyze the pattern of presentation of second primary neoplasm and to review the relevant literature. Materials and Methods: We analyzed patients presenting with histologically proven synchronous or metachronous second primaries from July 2011 to July 2016. Warren and Gate's criteria have been used to designate a case as second primary neoplasm. Various details such as age at diagnosis, sex, whether synchronous or metachronous, site, stage, histopathology, treatment were collected. Results: Over a period of 5 years total 40 cases were observed, out of which 13 were synchronous (33%) and 27 (67%) were metachronous. The median age at the diagnosis of primary malignancy was 65.5 years (range 27-84). Out of the 40 patients, 28 (70%) were males and 12 (30%) were females. The most common site of primary tumor was head and neck and genito-urinary, 11 cases each. Among the second malignancy most common site was gastrointestinal tract (11 cases), followed by genitourinary (10 cases) and lung (9 cases). Conclusion: The likelihood of diagnosis of second malignancy has increased with the advent of newer diagnostic modalities as well as increased compliance to follow up and progress in the management. Appearance of new signs and symptoms should raise a suspicion and early detection of the disease leads to appropriate management.

Typhoid fever is an infection caused by a strain of bacteria called Salmonella typhi, which is related to the bacteria that causes salmonella food poisoning. The infection can affect the whole body and damage multiple organs. Unless treated, this infection can have life threatening consequences. A 20 year old girl was examined suffering from high fever from one week and abdominal pain for few days. The patient had suffered from typhoid fever last year. Ultra-sonogram of abdominal, hematology-cell analysis, serology (widal test), urine analysis and blood culture were performed for accurate diagnosis. Ultra-sonogram shows multiple organ infection by Salmonella typhi. Hematological analysis shows the elevated level of t- lymphocytes and anemia. In widal test, patient serum was agglutinated with the bacterial antigen i.e. lipopolysaccharide and flagellar proteins. The typhidot test was positive for IgG. The patient was diagnosed with typhoid fever. Patient possesses multi drug resistance and the rational treatment was with ceftriaxone for one week and patient recovered.

The tumor of unknown origin constitutes 3-7% of the cancers studied and is one of the 10 most frequent cancer diagnoses. It is a malignant tumor whose first origin or identification is not done in the clinical history, in the clinical exploration or in the complementary studies. At present, the effort in the primary search for the origin of the cancer that will be directed at specifying these entities and recognizing them as soon as possible is arduous. Today we have several techniques among which we highlight immunohistochemistry, molecular biology and radiodiagnosis that greatly facilitate the work of the clinician in detecting the origin of tumors, although none of them is conclusive.

The Chernobyl accident that occurred 30 years ago was one of the worst nuclear disasters ever. Although it’s effects have been the subject of several articles, the role of its repercussions in the etiology of hematological disorders is not clearly revealed. Studies have shown a causal relationship between radiation exposure and the incidence of thyroid cancers but in the case of acute lymphoblastic leukemia a correlation could not have been made. However, due to its increasing incidence, there seems to be differences between adult and in utero exposure. Through its geographical position, Romania was affected especially in the North East region. We present the case of acute lymphoblastic leukemia of a patient from Iasi with exposure during pregnancy, post-partum period and the effects on her and the fetus.

Clinical and experimental data suggest that carcinoembryonic antigen (CEA, CD66e, CEACAM-5) plays a key role in the formation of hepatic metastasis from colorectal and other types of epithelial cancers. The molecular events involved in CEA-induced metastasis have yet to be defined. Our group first cloned the gene (CEAR) for CEA-binding protein from the surface of fixed liver macrophages, (Kupffer cells). In this study to further elucidate the role of CEAR in colorectal cancer progression, its expression in colorectal cancer cells was suppressed by short hairpin RNAs (shRNAs) in CEA-overexpressing and CEA - negative MIP-101 colorectal cancer cell lines. The data show that targeted suppression of endogenous CEAR in tumor cells resulted in changes in cell invasiveness. RT-PCR data indicated reduced levels of E-cadherin, Snail, MMP-2, and Oct-4 in the clones with suppressed CEAR suggesting a role in the epithelial mesenchymal transition. The comparative analysis of tumorigenic activity to the liver of the cell lines with suppressed CEAR has also been conducted using an intrasplenic injection model in immuno-deficient mice. This data shows a decrease in tumor progression associated with CEAR suppression. In summary the results of this study revealed a novel role for CEAR gene in the regulation of colorectal cancer cell invasiveness and progression.