Journal of Cancer and Tumor International

Background: Cervical cancer is an important public health problem globally and in Ghana. Cure rates are high if the condition is diagnosed early. Screening plays a role in early diagnosis, but uptake of screening is low in Ghana.

Aims: To examine women's awareness and factors affecting utilization of cervical cancer screening services in the Ejisu-Juaben municipality of Ghana.       

Materials and Methods: A descriptive and cross-sectional study was conducted at Juaben, Ejisu and Onwe Government Hospitals in the Ejisu-Juaben municipality of Ghana, January to June 2015.

Tools: Data were collected using closed structured questionnaires. 395 questionnaires, based on completeness were analyzed. A multivariable logistic regression analysis was done to determine the association between socio-demographic characteristics and knowledge level and the uptake of cervical cancer screening services.

Results: Only 7.8% of the women surveyed had screened for cervical cancer.  86.8% had not heard about cervical cancer screening and 86.8% had no idea of the place to access cervical cancer screening services. 88.4% of the women had no knowledge of cervical cancer and compared to women with low knowledge of cervical cancer, having a good knowledge of cervical cancer was associated with higher odds of cervical cancer screening (aOR [adjusted odds ratio], 95%CI; 7.56, 2.36-24.14). Women who were 35years or older had lower odds of utilizing cervical cancer screening services compared to those who were younger (aOR, 95%CI; 0.19, 0.05-0.68).

Conclusion: The awareness and uptake of cervical cancer screening are very low in the Ejisu-Juaben municipality of Ghana.

Recommendation: Interventions to increase uptake of cervical cancer screening should be implemented so as to improve access to the service in Ghana.

Aim: To assess the impact of lymphadenectomy on overall survival (OS) and progression-free survival (PFS) in patients with epithelial ovarian cancer (EOC).

Study Design: Retrospective observational study.

Place and Duration of Study: All patients diagnosed with epithelial ovarian, fallopian tube or primary peritoneal cancer treated in the Department of Gynecologic Oncology in a tertiary care hospital in South India from January 2012 onwards. All patients’ follow up data was prospectively updated till 30 April 2017.

Methodology: We included 83 patients who met the inclusion criteria. The patients were classified into two groups based on the number of lymph nodes (LN) harvested (< 30 lymph nodes and > 30 nodes). Lymphadenectomy was considered systematic (SLND) when the harvest was > 30 nodes on the pathologic specimen.

Results: Out of the 83 cases, complete SLND was done in 43 (51.8%) cases and the median number of removed lymph nodes was 44 (IQR 25– 75%: 38–52). Among the women who underwent a complete SLND, the median OS was 55.7 months vs 49.0 months among those where the lymph node harvest count was < 30 (P value – 0.16). The median PFS in the complete SLND group was 49.0 months and 43.46 months for the other group with no significant difference (P value – 0.18). Though there was no significant difference in OS and PFS, there was a trend towards improved survival with complete SLND group beyond 500 days.

Conclusion: Complete SLND group showed a trend towards improved OS and PFS, though statistically not significant. Further investigation is warranted.

Background: Malignant diseases have become more prominent in Nigeria over the past years with urological malignancies contributing significantly to cancer related morbidity and mortality. Cancers of the prostate, bladder, kidney, testis and penis are documented as the most common group of non-cutaneous cancers. This study was carried out to document the pattern and distribution of urological malignancies seen in a tertiary hospital in Calabar, South-southern Nigeria over a 10-year period.

Materials and Methods: This was a retrospective study carried out in the Department of Urology, University of Calabar Teaching Hospital, Nigeria. Cases of all pathologically proven urological malignancies managed between January 2006 and December 2015 were included. Data were retrieved from patients' case notes, operation registers and histopathology records. The histological slides of all cases were retrieved and reviewed. Patients' demographic data, tumour site, histologic diagnoses as well as pathologic grades of malignancies were extracted and analysed.

Results: A total of 617 cases of urological malignancies were included in the study over the 10 years under review, comprising of 598 (96.9%) males and 19 (3.1%) females giving a male: female ratio of 31.5:1. There were 600 adults (97.2%) and 17 children (2.8%). The median age was 43 years with range of 1-100 years. The frequency of urological cancers showed prostate cancer to be the most common urologic cancer as follows: Prostate cancer constituted 564 (91.4%), Kidneys 27 (4.4%), Urinary bladder 9 (1.5%), Testis 8 (1.3%), Scrotum 5 (0.8%), Penis 2 (0.3%) and Urethra 2 (0.3%). The most common histologic type of prostate cancer was adenocarcinoma with Gleason Grade III being the commonest grade. Out of the 17 childhood urological malignancies recorded, 13(76.47%) were kidney malignancies, 3 (17.65%) were testicular malignancies and 1 (5.88%) was bladder malignancy.

Conclusion: Prostate cancer is by far the commonest urological malignancy, with renal cancer being a distant second in Calabar, ahead of bladder cancers. Childhood urological malignancies in Calabar are predominantly nephroblastomas. The need for increased effort in creating awareness about prostate cancer and for routine screening is reiterated.

Objectives: Persistent pain and sensory disturbances following surgical treatment for breast cancer is a significant clinical problem. The goal of this study was to investigate the incidence and clinical characteristics of persistent postmastectomy pain (PPMP) and its impact on quality of life. Methods: Between 1998 and 2013, one hundred thirty-five patients who had undergone a mastectomy operation for breast cancer by the same surgeons were evaluated. Patients who had more than one operation or died during follow up were excluded. All patients were contacted by telephone and were questioned about the presence of PPMP. Patients who had PPMP were invited for face to face interview and assessed with a Pain Questionnaire Form and LANSS Pain Scale.

Results: 99 out of 135 patients (73.3%) were contacted by telephone. The incidence of PPMP was 16.2%. Pain Questionnaire revealed that 50% of the patients had mild pain, 37.5% had moderate pain, and 12.5% had severe pain. The rate of neuropathic pain symptoms varied between 25% and 81%. According to LANSS Pain Scale, neuropathic mechanisms were likely to be contributing to the patient’s pain in 56% of the patients. 56% of the patients with pain needed analgesia, 12.5% reported that their pain was their worst medical problem limiting their daily activities.

Conclusion: The incidence of PPMP was 16.2% and the contribution of neuropathic mechanisms was 56% in our study. About 50% of the patients with PPMP had moderate to severe pain necessitating analgesia.

Aims: Pain being the commonest symptom in cancer, its prevalence and pattern needs to be studied. The aim of this study was to evaluate the prevalence and pattern of cancer pain in admitted patients.

Study Design: Prospective observational study.

Place and Duration of Study: This study was carried out at Cancer Research Institute, Swami Rama Himalayan University, Dehradun, India, between January 2018 and April 2018.

Methodology: After institutional ethical clearance and written informed consent 393 patients were enrolled in the study. We prospectively evaluated patients admitted with diagnosis of cancer for presence, severity and pattern of pain, using clinical assessment and numerical pain scale at admission and at discharge. Chi-square test was used for categorical data and multivariate analysis was performed with multinominal regression and ANNOVA tests.

Results: In 393 patients prevalence of pain, moderate-severe pain, neuropathic pain (NPP), mixed pain was 67%, 47.8%, 10.2% and 31.9% respectively. More than one pain site was present in 43% of patients. The median numerical pain score was 2 overall, 4 in patients with pain and 7 in patients with NPP or mixed pain. Prevalence of severe pain and NPP or mixed pain was highest in hepatobilliary, lung, head and neck and genitourinary cancers. As many as 42.97% (113/263) patients had more than one pain site. On multivariate analysis severity of pain was significantly associated with primary tumor site (P=0.002), NPP (P=0.000), number of metastatic sites (P=0.02) and number of pain sites (P=0.009); NPP with primary tumor site (P=0.000), number of pain sites (P=0.000) and severity of pain(P=0.014). The proportion of patients with moderate-severe pain reduced from 47.8% before admission to 10.7% at discharge with adequate analgesic management.

Conclusion: The prevalence of cancer pain and moderate-severe pain is high in admitted patients. Various patient, disease and pain variables need to be considered for an adequate cancer pain assessment and management. Team approach with active participation of primary medical team, adjunct support from palliative care specialist is desirable for cancer pain management.