سرطان

Fever and neutropenia are common complications and significant causes of hospitalization in cancer patients. These conditions can increase the mortality rates among patients. The aim of this study was to investigate the etiologies of fever in neutropenic cancer patients admitted to the teaching hospitals affiliated with Abadan University of Medical Sciences.

This study was a descriptive-analytical, retrospective investigation. A total of 206 cancer patients presenting with fever and neutropenia, who were referred to the teaching hospitals affiliated with Abadan University of Medical Sciences in 2022, were included in the study. Patient information was collected through medical records and data retrieved from the Hospital Information System (HIS) using a structured checklist, and subsequently analyzed statistically.

The mean body temperature in patients who had received chemotherapy was significantly higher than that in patients who had not undergone chemotherapy (P<0.001). The mean temperature of patients with a fever duration of more than five days was also significantly higher than that of patients with a fever duration of less than five days (P= 0.024). A significant and inverse relationship was observed between body temperature and white blood cell (WBC) count on both the first and last day (P= 0.001 and P= 0.01, respectively). In addition, there was a significant and inverse relationship between body temperature and neutrophil count on both the first and last day (both P = 0.04). A significant relationship was also found between splenectomy and body temperature in patients with fever and neutropenia (P< 0.001).

Overall, fever duration, chemotherapy, and splenectomy were significantly associated with elevated body temperature. In addition, the findings indicated that neutrophil and white blood cell counts on both the first and last day were significantly associated with body temperature, such that this relationship was inverse, a decrease in neutrophils and white blood cells was associated with an increase in temperature.

Cancer is one of the most challenging diseases, affecting millions of individuals worldwide. This disease is caused by the abnormal and uncontrolled growth of cells, which leads to damage to various tissues and organs of the body. The formation of vascular-like structures (vascular mimicry) is one of the most important reasons for cancer metastasis and drug resistance. These structures are formed by tumor cells without the involvement of endothelial cells. Melatonin, a natural hormone in the human body, can exert its antitumor effects through antioxidant, antiproliferative effects, induction of apoptosis, and inhibition of invasion and metastasis of cancer cells. The anticancer effects of apatinib have been approved as an antiangiogenic drug and VEGF receptor inhibitor. Apatinib is first used for advanced or metastatic cancers, such as gastric cancer, that have not responded to standard treatments. In addition, induction of apoptosis, inhibition of metastasis, and invasion have also been confirmed by treatment with apatinib in cancer. Considering the antitumor effects of melatonin and apatinib, it seems that the drug apatinib and the hormone melatonin are effective in inhibiting the formation of vascular mimicry and overcoming the therapeutic limitations caused by these structures. This review study examined the effects of melatonin and apatinib on the formation of vascular mimicry structures in various cancers. It is suggested that these two compounds enter the animal and then human study phases, and if the results are positive, they could be used as a treatment for patients with metastatic cancer.

Cancer is a chronic and debilitating disease and one of the prevalent side effects of cancer treatment is fatigue. The aim of this study was to determine the effectiveness of education base on Pender's health promtion model on the level of fatigue and lifestyle of cancer patients.

The present study is an experimental before-and-after study with a control group. This interventional study involved 78 cancer patients selected through convenience sampling in 2023 and then randomly allocated to intervention and control groups using block randomization. All participants in both groups completed demographic information forms, the Cancer Fatigue Scale to assess demographic characteristics and fatigue levels before and after the intervention. Data were analyzed using independent and paired t-tests, and non-parametric tests including the Mann-Whitney U and Wilcoxon tests. All analyses were conducted using SPSS20 (p=0.05).

The intervention and control groups were homogeneous in terms of demographic indices and fatigue level before the intervention (P<0.1). After the intervention, the results indicated an improvement in all dimensions and a reduction in fatigue levels in the intervention group compared to the control group (P<0.05).

Education based on Pender's health promotion model has a significant effect on reducing the fatigue of patients undergoing chemotherapy and can help to improve physical and mental conditions and increase the quality of life of these patients along with drug treatments.

Doxorubicin increases oxidative stress and cardiac damage. ERK1/2, PI3k, and IL-18 seem to play an important role in increasing cardiac damage. The aim of the present study was to investigate the effect of eight weeks of interval training with curcumin on ERK1/2, PI3k, and IL-18 in the heart tissue of cancer mice treated with doxorubicin.

In this experimental study, Fourteen days post-cancer induction, a total of 40 rats aged between 4 to 6 months were divided into 5 distinct groups: cancer control+doxorubicin, cancer control+no drug, cancer+intermittent exercise+doxorubicin, cancer+curcumin+doxorubicin, and cancer+intermittent exercise+curcumin+doxorubicin. Curcumin was administered to two of these groups at a dosage of 100 mg/kg, one hour after training sessions. The high-intensity interval training (HIIT) protocol consisted of six intervals each lasting 3 minutes and 20 seconds at 80%-95% of VO2max, interspersed with 2 minutes of active recovery at 30%-35% of VO2max. Enzyme-Linked Immunosorbent Assay (ELISA) was utilized to examine variables, and the statistical analyses were conducted using SPSS software version 16, applying ANOVA along with Bonferroni post hoc tests.

ERK1/2 was significantly increased in the cancer control + doxorubicin group compared to the cancer control + no drug group (P=0.001). In the interval training + curcumin + doxorubicin group, ERK1/2 was significantly decreased compared to the cancer control + doxorubicin group (P=0.001). PI3K was significantly decreased in the cancer control + doxorubicin group compared to the cancer control + no drug group (P=0.001). PI3K was significantly increased in the interval training + curcumin + doxorubicin group compared to the cancer control + doxorubicin group (P=0.001). IL-18 was significantly increased in the cancer control + doxorubicin group compared to the cancer control + no drug group (P=0.001). In the interval training + curcumin + doxorubicin group, IL-18 was significantly decreased compared to the cancer control + doxorubicin group (P=0.001).

The administration of doxorubicin resulted in elevated levels of ERK1/2 and IL-18 while reducing PI3K in the heart tissue of cancer-affected mice. In contrast, the combination of curcumin administration and exercise reduced ERK1/2 and IL-18 levels while increasing PI3K. While both curcumin and exercise individually showed considerable benefits in enhancing these factors, their combined effect produced even more effective outcomes.

Due to the widespread prevalence of cancer, the number of parents with cancer who have a dependent child is increasing. Cancer in parents creates challenges for teenagers in the family and exposes them to mental and physical problems caused by the diagnosis of cancer in parents. In order to prevent negative consequences in children, it is necessary to understand more regarding the impact of parental cancer on children and their psychosocial needs. The present research was conducted to explain the psychosocial problems of adolescents whose parents suffer from cancer.

The current research was conducted using the qualitative content analysis approach. A total of 18 teenagers with cancer-afflicted parents were selected by targeted sampling method from the medical education centers of Tehran, and semi-structured interviews were conducted with them. At the same time as the data was collected, the findings were analyzed using the content analysis method and with the help of MAXQDA10 software.

After analyzing the interviews, 12 subcategories and five main categories, including "Mental rumination," "caregiving pressure," "parental cancer-related problems," "volatile social interactions," and "obstacles and facilitators of adaptation to the disease," were extracted, which can depict teenagers' experiences of having a parent with cancer.

The results of this research indicated that teenagers face many challenges in the field of coping with their parents' cancer. The results of the current study can be applied to help formulate and implement educational intervention programs to reduce teenagers' mental conditions.

Supportive care is providing necessary and necessary services for living with cancer in order to meet the needs of patients in all stages of the disease, which will not happen without a good understanding of the needs of patients. Therefore, the present study was conducted to determine the correlation between unmet supportive care needs and demographic characteristics in patients with various types of cancer.

This descriptive-analytical study was conducted on 350 cancer patients referred to medical centers affiliated to Tehran Islamic Azad University of Medical Sciences using available sampling in 2023. The questionnaire of supportive care needs of cancer patients (supportive care needs survey) was used, which had five areas of physical needs and daily functioning, health and information system, support and patient care, mental and sexual. Data analysis were done using SPSS version 26 and descriptive and inferential statistics.

The patients had the most need in the physical area and daily functioning (101.52±27.7) and the least need in the sexual area (53.91±33.5). There was a significant statistical correlation between the variables of marital status, occupation, lifestyle, addiction and level of education with supportive care needs in cancer patients (p<0.001).

This study showed that the unmet needs of cancer patients are high in physical and daily functioning. Although the confirmation of these findings requires more studies

Emergency Departments (EDs) visits reflect medical needs and demands or the only care available to patients. Many ED visits are potentially preventable with access to high-quality, community-based health care. Given the higher incidence of emergency conditions in patients with cancer the global increase in cancer will pose a challenge for emergency services. Therefore, this study was conducted with the aim of epidemiological investigation of emergency department visits by cancer patients in several centers.

In this cross-sectional study, the triage form and hospital file of known patients with various cancers, who visited in Eds of valiasr and Amir al Momenin hospitals in Arak, Hazrat Rasool Akram and Lolagar hospitals in Tehran, and Shahid Sadouqi and Shah vali hospitals in Yazd, From April to September 2017. To measure the urgency of ED visits, the emergency severity index and triage form were used, and the outcome of the emergency visit was extracted from the patient's file and recorded in the data collection checklist. Multivariate logistic regression analysis was used to examine the association of patient, hospital and potentially preventable factors.

In this study, 1107 patients, 550 men (%49.7) and 577 women (%50.3) with cancer were were studied. Age 65 and older had the most emergency visits. The most common reason for patients to visit was: pain in different organs (18.2%), fever (8.7%), weakness and malaise (7.5%). A total of 617 (55.7%) visits were potentially preventable. Age 17 years and younger (OR, 3.172; 95% (CI), 2.409-4.021) and presence of more than 1 comorbidity (OR, 3.610; 95% (CI), 3.611-4.521) were positively associated with potentially preventable visits.

In this study, 50.7% of ED visits among patients with cancer were identified as potentially preventable, and the most common reason for patient visits was general and non-specific symptoms such as pain, weakness, and malaise. These findings highlight the need for palliative care and evidence-based interventions in outpatient settings.

Cancer is one of the most lethal and challenging diseases globally. Due to its increasing prevalence, significant attention has been directed towards identifying preventive factors for this disease. Diet plays a crucial role in cancer prevention, and accumulating scientific evidence suggests that seafood consumption can be an effective preventive factor in reducing the risk of various cancers, including breast, colorectal, prostate, and lung cancer. Seafood, especially fish, is a rich source of bioactive compounds essential for human health. Omega-3 fatty acids (such as DHA and EPA), vitamin D, selenium, and antioxidants present in these foods are chemical compounds that can inhibit the growth of cancer cells and reduce the risk of cancer by decreasing inflammation and strengthening the immune system. However, study results indicate that the impact of seafood consumption on cancer prevention is definitively dependent on factors such as the type of food, its quality, cooking methods, and even the individual's genetic conditions. For instance, frying fish can reduce its protective effects, while healthier cooking methods such as steaming and grilling can preserve its beneficial properties. Despite abundant evidence supporting the beneficial effects of seafood in cancer prevention, there is a need for more research and long-term studies to better understand the biological mechanisms and long-term impacts of these foods. Additionally, analyzing the effects of seafood consumption in different population groups and under various geographical and cultural conditions can contribute to a better understanding of this relationship. Ultimately, this article concludes that consuming seafood, especially fish, can be considered an effective strategy for reducing the risk of cancer. However, it is recommended that this consumption be done in moderation and with the use of healthy cooking methods to maximize the benefits.

Mothers of children with cancer are more exposed to psychological and emotional problems and mental health threats in general than mothers of healthy children. This research was conducted with the aim of presenting a model of effective factors in the conceptualization of emotion regulation strategies in mothers with children with cancer.

This research was done with qualitative method and grounded theory method. Subjects were selected through the purposeful sampling method and continued until new information was obtained during the interview. Finally, 13 mothers with children with cancer were selected and analyzed through a semi-structured interview and using the constant comparison method of Strauss and Corbin.

The results showed that ambivalent emotion regulation was the central category of mothers' emotion regulation pattern. Causal conditions were obtained for disease-based emotion and disease state. For the intervention conditions, pressure factors of treatment cost and external cooperation were extracted. Calming and positivity strategies were obtained as strategies of the qualitative model, and finally, the final results derived from the research were the transformation of the mother's attitude, the actions of other children, and the transformation of relationships.

It is suggested to use the results of this model to improve emotion regulation in mothers with children with cancer.

Being informed about cancer is worrying for anyone and causes changes in the health and quality of life (QoL) of the affected person. Improving the quality of life in patients with chronic diseases such as cancer has been one of the important points, especially in the last two decades. Spiritual therapy is a valuable care to improve the quality of life and mental health of cancer patients. However, there are still differences regarding the effect of different types of spirituality- and religion-based treatments on the results of studies. This study aimed to systematically review the results of studies related to the effect of spiritual/religious interventions on improving the mental health and QoL of patients with cancer in Iran.

This study was conducted by systematic review and meta-analysis methods. An electronic search was conducted in PubMed, Scopus, Web of Science, Magiran, and SID from 2001 to September 2023. Characteristics of the included interventions and data for meta-analysis were extracted. The quality of the included study was assessed using the Cochrane Collaboration risk of bias tool. The standardized mean difference effect was calculated using a random effects model with 95% confidence. Data was analyzed using RewMan-5 software.

In the first phase of the search, 713 articles were identified. Nineteen studies met the eligibility criteria. Spiritual and religious interventions were compared with a usual care control group or other psychosocial interventions. Compared to the control group, the standardized mean difference in the post-test for the effect of spiritual and religious interventions on mental health (SMD = 1.60, 95% CI = [2.67, 0.54]) and QoL (SMD = 1.93, 95% CI = [1.03, 2.83]) was obtained. The percentage of heterogeneity between the results of studies in mental health (95%) and QoL (93%) was high.

The meta-analysis results indicate that spiritual-religious interventions have a significant positive impact on the mental health and QoL of patients with cancer. Oncology nurses, psychologists, counselors and assistants increasingly recognize the significance of the spiritual domain of care. The current study indicates that facilitating awareness and spiritual needs may be a valuable intervention for cancer patients. Thus, the use of spiritual and religious-based interventions is suggested as a good way to improve spiritual and mental health in patients with cancer.

Breast cancer, one of the most prevalent cancers among women, can pose numerous psychological challenges for patients. In this context, the Quranic lifestyle, as a rich source of religious teachings, can play a significant role in promoting mental health and quality of life among patients.

This cross-sectional analytical study was conducted on 85 breast cancer patients in the summer of 2023. A questionnaire with eight items in two dimensions was designed. Face validity was determined using the Item Impact Score (IIS), and content validity was assessed using the Content Validity Index (CVI) and Content Validity Ratio (CVR). Exploratory factor analysis was employed to categorize items and identify dimensions for evaluating construct validity. Cronbach's alpha coefficient was used to determine internal consistency and test-retest reliability was assessed using the Pearson correlation coefficient and Intraclass Correlation Coefficient (ICC).

The mean (standard deviation) of participants age was 42.50 (11.58) years. The final version of the scale consisted of 8 items in 2 dimensions. The overall Cronbach's alpha was 0.94, and for each dimension, it was greater than 0.80. The confirmatory factor analysis results showed the appropriate fit of the latent variable model.

The validity and reliability of the scale were confirmed in this study. Therefore, this 8-item scale is proposed as a suitable and efficient tool for measuring attitudes towards the Quran, hope, and quality of life in breast cancer patients undergoing radiotherapy.

This study examines the impact of group emotional schema therapy on resilience and self-efficacy among cancer patients.

The research employed a quasi-experimental design with a pre-test and post-test follow-up alongside a control group. The statistical population comprised all cancer patients visiting Shariati Hospital in Tehran in 2020 (year 1399). Forty volunteer participants who met the inclusion criteria were selected through convenience sampling. After final screening, 20 individuals were randomly assigned to two experimental groups (emotion-focused schema therapy) and one control group. Participants were assessed before and after the intervention using Sherer's General Self-Efficacy Scale (GSE-17) (1982) and the Connor-Davidson Resilience Scale (2003). The intervention consisted of 12 online group sessions (via Skype), each lasting two and a half hours. Data analysis was performed using SPSS software version 24, employing covariance analysis methods. This study is part of a doctoral thesis in health psychology, approved on 29/09/1399 (IR.IAU.TON.REC.1399.074) at the Islamic Azad University, Tonkabon Branch.

The findings revealed that emotional schema therapy significantly improved resilience and self-efficacy in cancer patients (p < 0.01)..

Emotional schema-based therapy can serve as an effective psychological intervention to enhance resilience and self-efficacy in individuals with cancer.

Cancer, as a chronic physical-psychological condition, challenges the regular and continuous process of life and has numerous behavioral consequences for the child. Based on this, the present study was conducted to investigate the effect of mentalization therapy on behavioral problems in children with cancer. In this way, the subjects' baseline was determined. In the next step, mentalization therapy for children was carried out for 12 sessions of 45 minutes individually and in parallel for the child and the mother.

The method of this research was semi-experimental with a single case structure and A-B-A design. The statistical population of the research was all children aged 9 to 12 with cancer in Seyed al-Shohda Hospital in Isfahan city in 1402, from among them, four children were selected by available sampling method. Before the intervention, the performance of the subjects was evaluated for three sessions, using the child behavior list of Achenbach et al. and during this period, no intervention was provided to improve the performance of the subjects. In this way, the subjects' baseline was determined. In the next step, mentalization-based therapy for children was carried out for 12 sessions of 45 minutes individually and in parallel for the child and the mother, and at the end of the sessions, their performance was measured using research tools. After the completion of the intervention sessions, the performance of the subjects was examined again in three separate times. Visual analysis of graphs and trend index, stability index, percentage of non-overlapping data, and percentage of overlapping data were used for data analysis utilizing SPSS and Excel software version 24.

The result of the data analysis indicated the positive effect of this intervention on behavioral problems, including internalized and externalized behavioral problems in children with cancer; So, the scores of behavioral problems of the participants in the intervention phase were reduced compared to the baseline phase. The percentage of non-overlapping data was also reported as 75 to 12.5 percent and the percentage of overlapping data from 87.5 to 25 percent. Also, the effect size for these children varied from 0.09 to 1.43, which is considered a favorable effect size.

Based on the findings of the research, mentallization-based therapy for children was effective in reducing the behavioral problems in children with cancer. Therefore, it is suggested that psychologists and counselors use this new method of psychotherapy as a useful and effective tool to reduce the behavioral problems in children with cancer.

For over a decade, cancer has emerged as the second leading cause of death among Iranians, coinciding with a rise in cancer-related fatalities. This study examines the changes in the incidence and patterns of cancer-related deaths in Iran and their impact on life expectancy at birth.

This study utilized data on total mortality and cancer-related mortality in Iran, categorized by age and gender, for the years 2000 and 2019, sourced from the Global Burden of Disease (GBD) Study 2019. After age- and sex-specific death rates using the life table technique, life expectancy at birth was determined for all ages in years 2000 and 2019. Subsequently, the Arriaga decomposition technique was employed to assess the contribution of cancer to changes in life expectancy.

The proportion of cancer-related deaths among men and women in the country increased from 2000 to 2019 across all age groups and both sexes. For both men and women, the contribution of cancer deaths to changes in life expectancy was approximately -0.1. Among all cancer types, stomach cancer (0/04 year) has had the most favorable impact on life expectancy. Conversely, lung cancer has been a significant factor contributing to reduced life expectancy in Iran, particularly among middle-aged and older individuals.

Considering the changes in the age structure of the population in Iran, it is expected that the trend of rising cancer-related deaths will persist. Therefore, cancer, as a significant component of non-communicable diseases, poses a critical health challenge in Iran and is expected to become increasingly prominent in the coming decades, which should be considered comprehensively.

The purpose of this research is to explore the viewpoints of knowledgeable individuals regarding the solutions to improve common nutritional issues faced by patients with cancer, presented as a qualitative study.

The main stakeholders in this study included oncologists, nurses, and nutritionists. Individual interviews were conducted in a semi-structured format, and data collection continued until data saturation was reached. Finally, 16 participants took part in the study.

Six main categories emerged regarding strategies to improve the nutritional status of patients with cancer: "the necessity of including a nutrition consultant in the treatment team and oncology department", understanding the importance of management of the food department, the preparation, and distribution of meals", "the significance of training in improving the nutritional status of patients", "the role of charitable contributions and support from social workers", "the importance of monitoring and evaluation", and "the need to increase staffing levels".

Addressing nutrition-related issues in patients with cancer requires a multi-faceted approach. Effective solutions necessitate adequate funding, public engagement through non-governmental organizations and charities, the recruitment of skilled personnel, inter-sectoral collaboration among medical universities, health centers, and hospitals, as well as comprehensive, evidence-based health management at the national level.

 Considering the growing trend of cancer in Iran, the development and implementation of digital health literacy systems accelerates the capabilities of digital health and the self-management process of patients. Digital health literacy means the ability to effectively and consciously use digital technologies to access health-related information and services. This skill plays an important role in accessing medical information, disease management, improving the quality of life of people, especially cancer patients. Digital health literacy is considered as one of the most key factors of equal access to digital health information. The purpose of the present study was to formulate the requirements of the digital health literacy system with a focus on cancer.

The present study was conducted in two phases of literature review and validity and reliability of requirements in 2023. In the first stage, a literature review was conducted with the keywords of digital health literacy, cancer, requirements, system and application in databases such as PubMed, Scopus, Google Scholar, academic Jihad scientific database and specialized websites. To check the content validity of the survey, 62 experts were surveyed and CVI and CVR were calculated.

Hundered and twenty seven functional and non-functional components were approved. Requirements in the functional section was divided in six main dimensions information literacy module (8 functional components), information and communication technology literacy module (18 functional components), media literacy (5 functional components), public, specialized and population-oriented health literacy module (47 functional components) ), digital health literacy module (28 functional components), and digital health literacy module in cancer (6 functional components) were divided. In the section of digital health literacy in cancer, the main components of needs assessment, digital health literacy training, evaluation and monitoring of the effectiveness of digital interventions and information search skills were approved. Fifteen non-functional components were also approved. Cronbach’s alpha coefficient obtained (92%) indicated high reliability and reproducibility.

Digital health literacy systems can facilitate health care services. Considering the acceptable validity and reliability of the study, the defined requirements can be used to implement digital health literacy systems centered on cancer.

The experience of existential distress, along with other forms of distress, is one of the common experiences in end-of-life patients. Therefore, the purpose of this research is to review related studies and conceptualize existential distress in palliative care of cancer patients.

This study was a systematic review, which was conducted from May 1 to July 31, 1402 at Allameh Tabatabai University and search strategy was written and performed in MEDLINE, Web of Science/PubMed and Scopus databases from the beginning of 2003 to the end of 2022. The inclusion criteria included all quantitative, qualitative, mixed and review studies that focused on the experience of adult patients. Lack of access to the full text of the article and studies in non-English language, clinical trial (randomized and non-randomized), letter to the editor, case report and protocol were excluded from the list of studies. After removing duplicate articles, two research authors reviewed the studies independently according to the inclusion and exclusion criteria, and the differences between them were resolved by discussion.

After searching, screening and selecting articles based on inclusion and exclusion criteria, finally 22 articles were included in the study, of which three were review articles, eight were quantitative and 11 were qualitative. Terminally cancer patients experience existential distress, and the data are significant for estimating the prevalence of these symptoms, especially in the severe category. In addition to examining the prevalence of this symptom, patients have described their experience of existential distress in several categories: Feelings of loneliness and isolation (or loss of support system), relationship concerns (concerns about family, changes in relationships, and conflictual relationships), loss of control/autonomy (physical control, cognitive and emotional control), burden on others, loss of sense of continuity (loss of roles, pleasurable activities and sense of self), uncompleted life tasks, hopelessness/helplessness, dissolving of the future, uncertainty and frightening ambiguity, feeling guilt/ regret about the past, lack of meaning, inevitable thoughts of death.

It seems that the themes raised beyond cultural differences show the universal human suffering, whose accurate conceptualization can help to develop effective therapeutic interventions to reduce existential distress.