Design and Implementation of a Cancer Screening Program for a Health District in Sub-Saharan Africa: A Pilot Study
Sylvester Adeh Nsoh,
Paul Mobit,
Nicholas Ade,
Mc Che Joe Brown,
Ambe Yancho,
Isabella Fri Tayong
Issue:
Volume 7, Issue 4, December 2022
Pages:
83-88
Received:
10 August 2022
Accepted:
17 September 2022
Published:
16 November 2022
DOI:
10.11648/j.ijcocr.20220704.11
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Abstract: The incidence of cancer in Sub-Saharan Africa is increasing and most cancers are diagnosed at advanced stages where treatment is usually less effective, more expensive, and more disabling. Early detection can reduce the burden of this health problem. This paper describes a pilot study to assess the feasibility of implementing a cancer screening program at the Dibombari Health District in Cameroon. A privately owned modern oncology center (Cameroon Oncology Center) located within the health district just outside the city of Douala in the Republic of Cameroon conducted the study. A total of 103 participants including 88 females and 15 males with a median age of 38 years (mean, 41.4 years; range, 17–82 completed years) were screened for cervical, breast and prostate cancers from October 24th to November 12th, 2021. Clinical examination of the breast and prostate for males, and breasts and genitals for females including visual inspections of the cervix with acetic acid then Lugol’s iodine (VIA-VILI) were performed. Thirty-eight (representing 36.9%) of the screened participants had cancer suspicious lesions and accordingly received the following management plans: follow-up breast ultrasound (17 participants); follow-up pelvic ultrasound (7); follow-up microbiopsy (2); follow-up biopsy (1); follow-up Pap smear (9); and prostate-specific antigen test (4 males with enlarged prostate). The remaining 65 participants (63.1%) had no suspicious lesions, and were booked for a review in one year. Our study shows that most of the screened participants with suspicious lesions were asymptomatic. Our findings therefore highlight the feasibility of implementing a comprehensive cancer screening program in the health district given its effectiveness in lessening the burden of this health problem.
Abstract: The incidence of cancer in Sub-Saharan Africa is increasing and most cancers are diagnosed at advanced stages where treatment is usually less effective, more expensive, and more disabling. Early detection can reduce the burden of this health problem. This paper describes a pilot study to assess the feasibility of implementing a cancer screening pro...
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Experience in the Management of Patients with Advanced or Recurrent BRCA1/2 Mutated Ovarian Cancer with Olaparib at the National Oncology Institute of Panama
Kayra Sanchez Munoz,
Jose Pinto Llerena,
Cristiane Martin
Issue:
Volume 7, Issue 4, December 2022
Pages:
89-92
Received:
24 October 2022
Accepted:
7 November 2022
Published:
16 November 2022
DOI:
10.11648/j.ijcocr.20220704.12
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Abstract: Introduction: Epithelial ovarian cancer includes high-grade serous histology (HGSOC), which represents 90% of patients and at the time of diagnosis and presents in an advanced stage in 75% of patients. The BRCA1/2 mutation is present in 10-15% of women with this diagnosis. Objective: To describe the clinicopathological characteristics of patients with ovarian cancer with BRCA1/2 mutation and our experience in terms of objective response and survival with the use of olaparib. Methodology: We performed a retrospective review of the electronic records of patients with advanced-stage BRCA 1/2 mutated ovarian cancer or recurrent disease treated with olaparib. Results: 18 patients presented with a BRCA1/2 mutation from 2018 to May 2022, with a mean age of 60 years, and 100% had high-grade serous carcinoma histology. Germline BRCA1 mutations were found in 11 patients and somatic BRCA2 mutations were identified in patients. Fourteen patients were treated in the second line with olaparib, and four were treated in the first line setting. Fifteen patients achieved a partial response to platinum, and the rest had complete responses. With olaparib, the objective response rate was 30%, with the best response being a partial response in six patients (33.3%). The median PFS was 12 months, and the median OS was 29 months in the second line treatment. Conclusions: The incidence of BRCA mutated ovarian cancer appears to be low in patients at our institution; however patients with BRCA1/2 mutation show favorable outcomes following second-line treatment with olaparib. This finding supports a therapy change for patients with this indication to first line olaparib treatment in our institution.
Abstract: Introduction: Epithelial ovarian cancer includes high-grade serous histology (HGSOC), which represents 90% of patients and at the time of diagnosis and presents in an advanced stage in 75% of patients. The BRCA1/2 mutation is present in 10-15% of women with this diagnosis. Objective: To describe the clinicopathological characteristics of patients w...
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Helicobacter Pylori-Negative Gastric Mucosa-Associated Lymphoid Tissue Lymphoma Treated with Radiation Therapy Alone
Jose Ma. Hermoso Zaldarriaga,
Don Peter Santiago Dator,
Kenneth Cortez Sy
Issue:
Volume 7, Issue 4, December 2022
Pages:
93-98
Received:
19 November 2022
Accepted:
6 December 2022
Published:
15 December 2022
DOI:
10.11648/j.ijcocr.20220704.13
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Abstract: This is a case of a 60-year-old Filipino gentleman with a six-month-history of nonspecific gastric symptoms which would be ascribed to gastroesophageal reflux disease. Each time, the patient would be prescribed proton pump inhibitors, but with only temporary and minimal relief. Eventually, further investigation would reveal that the patient actually had gastric mucosa-associated lymphoid tissue lymphoma (MALToma). Peculiar, however, is that the patient’s gastric MALToma is Helicobacter pylori-negative. The patient subsequently underwent involved-site radiation therapy to the entire stomach. A total of 3000 cGy in 20 fractions (150 cGy per fraction) was prescribed to the planning target volume, delivered using 6-megavoltage photons via volumetric modulated arc therapy (VMAT) modality in a Varian Halcyon linear accelerator. All the target criteria and organs-at-risk dose constraints were successfully met. Treatment was delivered daily, Mondays to Fridays. For every session, the patient was likewise asked to be nil per os 4 hours prior, similar to when he was simulated. Cone beam CT (CBCT) image verification was performed in every treatment session. The patient was prescribed Ondansetron 8 mg/tablet, 1 tablet orally, 1-2 hours prior to every radiation session, as prophylaxis against nausea and vomiting. The entire course of radiation therapy was well-tolerated. There were no treatment interruptions. The patient did not report any subjective complaints during and even after the course of treatment. Post-radiation therapy, there was complete clinical and endoscopic response.
Abstract: This is a case of a 60-year-old Filipino gentleman with a six-month-history of nonspecific gastric symptoms which would be ascribed to gastroesophageal reflux disease. Each time, the patient would be prescribed proton pump inhibitors, but with only temporary and minimal relief. Eventually, further investigation would reveal that the patient actuall...
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