LncCDH5-3:3 Regulates Apoptosis, Proliferation, and Aggressiveness in Human Lung Cancer Cells.

(1) Lung cancer (both small cell and non-small cell) is the leading cause of new deaths associated with cancers globally in men and women. Long noncoding RNAs (lncRNAs) are associated with tumorigenesis in different types of tumors, including lung cancer. Herein, we discuss: (1) An examination of the expression profile of lncCDH5-3:3 in non-small cell lung cancer (NSCLC), and an evaluation of its functional role in lung cancer development and progression using in vitro models; (2) A quantitative real-time polymerase chain reaction assay that confirms lncCDH5-3:3 expression in tumor samples resected from 20 NSCLC patients, and that shows its statistically higher expression levels at stage III NSCLC, compared to stages I and II. Moreover, knockout (KO) and overexpression, as well as molecular and biochemical techniques, were used to investigate the biological functions of lncCDH5-3:3 in NSCLC cells, with a focus on the cells' proliferation and migration; (3) The finding that lncCDH5-3:3 silencing promotes apoptosis and probably regulates the cell cycle and E-cadherin expression in adenocarcinoma cell lines. In comparison, lncCDH5-3:3 overexpression increases the expression levels of proliferation and epithelial-to-mesenchymal transition markers, such as EpCAM, Akt, and ERK1/2; however, at the same time, it also stimulates the expression of E-cadherin, which conversely inhibits the mobility capabilities of lung cancer cells; (4) The results of this study, which provide important insights into the role of lncRNAs in lung cancer. Our study shows that lncCDH5-3:3 affects important features of lung cancer cells, such as their viability and motility. The results support the idea that lncCDH5-3:3 is probably involved in the oncogenesis of NSCLC through the regulation of apoptosis and tumor cell metastasis formation.

Salivary IL-17A, IL-17F, and TNF-α Are Associated with Disease Advancement in Patients with Oral and Oropharyngeal Cancer.

Delayed diagnosis of oral cavity and oropharyngeal cancer is associated with a poor prognosis. Despite progress in systemic therapy and radiotherapy, there has only been a slight improvement in the five-year survival rate. A non-invasive diagnostic method that consists of an assessment of specific proteins in saliva samples may significantly facilitate assessment of treatment results in patients diagnosed with oral and oropharyngeal cancer. The aim of this study was to assess the levels of IL-17 and TNF-α in the saliva of patients with oral and oropharyngeal cancer. The study was conducted prior to treatment in patients hospitalized in the Frederic Chopin Provincial Specialist Hospital No. 1 in Rzeszów, Poland. Saliva samples were collected from subjects on an empty stomach. Cytokine concentrations in the saliva were measured with ELISA and Luminex Multiplex Assays. The higher salivary concentrations of IL-17A, IL-17F, and TNF-α were significantly associated with disease advancement. Lower levels of IL-17A were associated with colonization of the oral cavity with aerobic bacteria. On the other hand, higher concentration of TNF-α was observed in patients with positive aerobic culture of oral swabs. Our results suggest that IL-17A, IL-17F, and TNF-α measured in the saliva may be a potential biomarker for cancer of the oral cavity and oropharynx.

Scientific reports concerning the impact of interleukin 4, interleukin 10 and transforming growth factor ß on cancer cells.

Cytokines are signalling proteins generated in most part by immune cells that have critical functions in cellular lifespan. Here we present recent data on three selected anti-inflammatory cytokines: interleukin (IL)-10, IL-4 and transforming growth factor ß (TGF-ß). IL-10 inhibits the synthesis of major pro-inflammatory cytokines, chemokines, and mediates anti-inflammatory reactions. IL-4 is a multifunctional cytokine which plays a crucial role in the regulation of immune responses and is involved in processes associated with development and differentiation of lymphocytes and regulation of T cell survival. Transforming TGF-ß, which in normal cells or pre-cancerous cells, promotes proliferation arrest which represses tumour growth. In this review, we focus on the influence of IL-10, IL-4 and TGF-ß on various types of cancer as well as potential of these selected cytokines to serve as new biomarkers which can support effective therapies for cancer patients. This article is presented based on a review of the newest research results.

Survival rates among women with ovarian cancers diagnosed in the area of Podkarpacie province in the years 1990-2015.

AIM OF THE STUDY: The objective of the study was to analyse the survival rate of women with malignant ovarian tumours in the years 1990-2015 in the Podkarpacie province. MATERIAL AND METHODS: The database used for calculations covered 2399 cancer incidences verified at the end of 2014. The estimated relative survival rates were calculated by means of the Hakulinen method. RESULTS: The number of recorded cases amounted to 196 in 2015 and was higher by 86.7% than in 1990. The rates of one-year, three-year, and five-year survival was 72.5%, 51.2%, and 42.4%, respectively. CONCLUSIONS: Survival rates of women with ovarian cancer in the Podkarpacie province are comparable to survivals calculated for the entire Poland region. Despite the low risk factor, women suffering from ovarian adenocarcinoma have lower survival rates than others, and as many as 42.5% of patients with adenocarcinoma were diagnosed in stage IV. Steps aimed at improvement of detectability of ovarian cancers in the earliest possible stage should be taken. This should increase survival rates in each age group.

[Rare case of slowly progressing lung cancer with colon metastases].

Lung cancer is one of the most frequent cancers in the world and the fist cause of death of neoplastic origin. In half of patients at the time of diagnosis distant metastases are determined. Most frequent localizations are bones, liver, brain and adrenal glands. In described case there was documented slow, long-term development of lung adenocarcinoma. After initial diagnosis the patient remained without treatment for three years. Aside from slow progression of the disease the fact of asymptomatic metastases to the colon as a very rare localization should draw attention. Due to a fast diagnosis of metastases and introduction of a proper treatment 3 year patient survival was achieved.

Radioembolization treatment for liver metastases.

The liver is an organ that, due to vascularisation and functions, is prone to metastases. Most liver metastases are observed in cases of gastrointestinal cancers in: stomach, colon, gallbladder, and bile ducts. Metastatic lesions are also observed in lung, breast, thyroid, kidney, and pancreatic cancer. One of the best known and most effective ways of liver lesion treatment is Metastasectomy. Unfortunately, lesions are frequently inoperable. Apart from chemotherapy, it is possible to apply local treatment such as TACE (trans-arterial chemoembolisation), RFA (Radio Frequency Ablation), and SBRT (Stereotactic Body Radiation Therapy). One of the newest methods of inoperable lesion treatment is radioembolisation (SIRT). Intravascular administration of microspheres containing radioisotope 90Y allows delivery of a higher dose of radiation directly to the tumour than traditional radiation with an external beam, while maintaining a small dose to healthy liver methods. Conducted clinical studies confirm the efficacy and safety of SIRT. It is an interesting alternative to other ways of treatment.

Brain Metastasis Prediction by Transcriptomic Profiling in Triple-Negative Breast Cancer.

BACKGROUND: Triple-negative breast cancer (TNBC) lacks expression of steroid hormone receptors (estrogen receptor α and progesterone) and epidermal growth factor receptor type 2. This phenotype shows high metastatic potential, with particular predilection to lungs and brain. Determination of TNBC transcriptomic profiles associated with high risk of brain metastasis (BM) might identify patients requiring alternative, more aggressive, or specific preventive and therapeutic approaches. PATIENTS AND METHODS: Using a cDNA-mediated annealing, selection, extension, and ligation assay, we investigated expression of 29,369 gene transcripts in primary TNBC tumor samples from 119 patients-71 in discovery cohort A and 48 in independent cohort B-that included best discriminating genes. Expression of mRNA was correlated with the occurrence of symptomatic BM. RESULTS: In cohort A, the difference at the noncorrected P < .005 was found for 64 transcripts (P = .23 for global test), but none showed significant difference at a preset level of false-discovery rate of < 10%. Of the 30 transcripts with the largest differences between patients with and without BM in cohort A, none was significantly associated with BM in cohort B. CONCLUSION: Analysis based on the primary tumor gene transcripts alone is unlikely to predict BM development in advanced TNBC. Despite its negative findings, the study adds to the knowledge on the biology of TNBC and paves the way for future projects using more advanced molecular assays.

The incidence of breast cancer in population of young women from Podkarpackie province in 2002-2011.

INTRODUCTION: Breast cancer (BC) in young women of Podkarpackie province accounts for approximately 11.0% of all diagnosed breast tumors. AIM OF THE STUDY: Aim of the study was to assess the trends in incidence of BC among women younger than 44 from Podkarpackie in the years 2002-2011. MATERIAL AND METHODS: 614 cases of malignant BC and 26 cases of cancer in situ were analyzed. The crude and the standardized incidence ratios were estimated; the percentage of histopathologically confirmed cancer cases and the percentage share of registered malignant breast tumors were calculated. The analysis of incidence in individual counties was also presented, as well as the stages of clinical advancement at diagnosis and the methods of treatment. RESULTS: The number of registered cases at 2011 was 73, and it was 37.7% higher as compared to 2002. During the period analyzed, the increase in the crude and the standardized cancer incidence ratios was observed. The percentage share of BC in the examined group increased of 5.4% in 2011. Significant variation in incidence among different counties was observed. The incidence ratios ranged from 65.8 to 93.1/100 000. BC in young women most commonly was diagnosed as locally advanced and over 70% of patients were radically treated. CONCLUSIONS: Even though the progress in diagnostics and treatment has been made, BC in young women is diagnosed later than it should be and at considerably advanced stage. It is relevant to propagate the knowledge among women and health professionals to emphasize that BC may affect young women.

[The influence of physical activity on the occurrence of cancer]. / Wplyw aktywnosci fizycznej na wystepowanie chorób nowotworowych.

UNLABELLED: Physical activity has a particularly beneficial effect on the immune system, reduces the concentration of sex hormones, effectively struggling with obesity and improves digestion and accelerates intestinal transit by reducing the risk of cancer. AIM: The aim of study was to determine whether lead an active lifestyle during childhood and adolescence may protect against the onset of cancer, a statement whether the person who contracted actively participated in physical education classes and whether practiced sport they have completed school. Also analyzed the way leisure and determined whether children and young people devote sufficient time to the activity. They attempted to determine whether their BMI contributed to the occurrence of cancer. MATERIALS AND METHODS: The study was conducted in the period from September to November 2014 and January 2015 Podkarpacki Oncology Center at the Provincial Specialist Hospital. Frederic Chopin in Rzeszow. The study included 100 patients with a diagnosis of various cancers. The average age of patients was 52.6 years. Among the respondents, 39 people lived in the countryside, and 61 in the city. Most subjects had secondary education (50% of respondents). The body mass index of 41% was normal, 38% were overweight and 17% obese. RESULTS: It was found that abnormal BMI had no impact on the incidence of cancers among respondents. Respondents are asked about whether they were active in school age in the vast majority (92% respondents) answered yes. However, the active forms of leisure declared only 35% of respondents. A large group of respondents do not devoted enough time for extracurricular physical activity as much as 48% devoted for this purpose only 0-0,5 h week. In physical education classes actively participated 82% of respondents, while sport after graduation cultivated only 10% of respondents. CONCLUSIONS: Although the current study did not confirm a statistically significant correlation between the activity of school age, and the incidence of the most common cancers can be seen that the activity was investigated in many cases insufficient. It should therefore promote the activity of making a beneficial effect not only in childhood, but also at any age. It is advisable to study on a larger group of patients.

Immunohistochemical prediction of lapatinib efficacy in advanced HER2-positive breast cancer patients.

UNLABELLED: Molecular mechanisms of lapatinib resistance in breast cancer are not well understood. The aim of this study was to correlate expression of selected proteins involved in ErbB family signaling pathways with clinical efficacy of lapatinib. Study group included 270 HER2-positive advanced breast cancer patients treated with lapatinib and capecitabine. Immunohistochemical expression of phosphorylated adenosine monophosphate-activated protein (p-AMPK), mitogen-activated protein kinase (p-MAPK), phospho (p)-p70S6K, cyclin E, phosphatase and tensin homolog were analyzed in primary breast cancer samples. The best discriminative value for progression-free survival (PFS) was established for each biomarker and subjected to multivariate analysis. At least one biomarker was determined in 199 patients. Expression of p-p70S6K was independently associated with longer (HR 0.45; 95% CI: 0.25-0.81; p = 0.009), and cyclin E with shorter PFS (HR 1.83; 95% CI: 1.06-3.14; p = 0.029). Expression of p-MAPK (HR 1.61; 95% CI 1.13-2.29; p = 0.009) and cyclin E (HR 2.99; 95% CI: 1.29-6.94; p = 0.011) was correlated with shorter, and expression of estrogen receptor (HR 0.65; 95% CI 0.43-0.98; p = 0.041) with longer overall survival. Expression of p-AMPK negatively impacted response to treatment (HR 3.31; 95% CI 1.48-7.44; p = 0.004) and disease control (HR 3.07; 95% CI 1.25-7.58; p = 0.015). IN CONCLUSION: the efficacy of lapatinib seems to be associated with the activity of downstream signaling pathways - AMPK/mTOR and Ras/Raf/MAPK. Further research is warranted to assess the clinical utility of these data and to determine a potential role of combining lapatinib with MAPK pathway inhibitors.

Statins and cancers.

Statins (inhibitors of 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase) are a group of drugs used to treat lipid disorders. They inhibit cholesterol synthesis at an early stage of the biosynthesis pathway, thus eliminating numerous metabolites involved in the cycle. Numerous studies point to different possible effects of statins on cancer cells. Statins inhibit growth of a tumor, invasion and metastasis formation. They block the production of isoprenoids, which are necessary for post-translational modifications of many proteins, including those involved in normal cell signaling. They also contribute to the reduction in the expression of vascular endothelial growth factor, sensitize tumor cells to NK cell activity, and modify the body inflammatory response. Due to different pharmacokinetic properties of individual statins, they may have opposite effects on the risk of cancer. Currently, most information on the effects of statins on the risk of developing cancer is obtained from observational studies. The studies have different results depending on the location of cancer. The protective effect of statins was observed in the meta-analysis of numerous studies including prostate cancer, stomach cancer, esophagus cancer, and hepatocellular carcinoma; however, it has not yet been confirmed that statins influence the risk of developing colorectal cancer, breast cancer, or lung cancer. The protective effect of statins on the development of many kinds of cancer can be a valuable and easy way to reduce morbidity. However, further research is necessary to thoroughly determine the value of this group of drugs.

A Rare Case of Breast Malignant Phyllodes Tumor With Metastases to the Kidney: Case Report.

Phyllodes tumors are rare breast neoplasms. Surgery is the treatment of choice. The role of postoperative radiotherapy and chemotherapy is still under dispute, as there are no equivocal prognostic factors. Treatment failure results in the occurrence of distant metastasis-mainly to the lungs, bones, liver, and brain. We have described the case of a woman with a malignant phyllodes tumor of the breast that was surgically treated. She did not receive adjuvant therapy because there is no consensus on the role of postoperative chemotherapy and radiotherapy. One year following the surgery, the patient had left-sided nephrectomy performed because of a rapidly growing tumor of the kidney. Renal cancer was suspected; however, a histopathological examination revealed that it was a metastatic phyllodes tumor. At the same time, the patient was diagnosed as having metastases in the other kidney, the lungs, liver, and bones.Our case report describes not only an unusual localization of the metastases (in the kidneys), but also failure of the chemotherapy and the aggressive course of malignant phyllodes tumor. Identification of patients with high risk for distant metastasis and the introduction of uniform rules for the management of adjuvant chemotherapy and radiotherapy would make planning treatment as efficacious as possible.

Hepatotoxicity of molecular targeted therapy.

A constant increase in occurrence of neoplasms is observed; hence new methods of therapy are being intensively researched. One of the methods of antineoplastic treatment is molecular targeted therapy, which aims to influence individual processes occurring in cells. Using this type of medications is associated with unwanted effects resulting from the treatment. Liver damage is a major adverse effect diagnosed during targeted therapy. Drug-induced liver damage can occur as necrosis of hepatocytes, cholestatic liver damage and cirrhosis. Hepatotoxicity is evaluated on the basis of International Consensus Criteria. Susceptibility of the liver to injury is connected not only with toxicity of the used medications but also with metastasis, coexistence of viral infections or other chronic diseases as well as the patient's age. It has been proven that in most cases the liver injury is caused by treatment with multikinase inhibitors, in particular tyrosine kinase inhibitors. The Food and Drug Administration (FDA) ordered the inclusion of additional labels - so-called "black box warnings" - indicating increased risk of liver injury when treating with pazopanib, sunitinib, lapatinib and regorafenib. A meta-analysis published in 2013 showed that treating neoplastic patients with tyrosine kinase inhibitors can increase the risk of drug-induced liver damage at least twofold. Below the mechanisms of drug-induced liver injury and hepatotoxic effects of molecular targeted therapy are described.

Prostate cancer incidence in Podkarpackie province in 2002-2011.

INTRODUCTION: Prostate cancer is an important epidemiological problem in Podkarpackie province. A significant rise in the number of new cases was reported. The values of crude and standardized rates, percentage share and cumulative risk also increased. OBJECTIVE: This article aims at analyzing incidence and mortality rates of prostate cancer in 2002-2011. MATERIAL AND METHODS: Analysis was based on data retrieved from the Podkarpackie Cancer Registry in Rzeszów. A total of 4 263 prostate cancer cases and 2 032 fatal cases were analyzed from the list of orderly arranged patients. Crude and standardized rates of incidence and mortality, cumulative risk and percentage share of prostate cancer out of all cancers were calculated. RESULTS: Compared to 2002, the number of cases increased by 150.5% in 2011. Cumulative risk rose from 1.8% in 2002 to 4.7% in 2011. Percentage of prostate cancer cases out of all registered cancers increased more than twofold in the analyzed decade. There was a 22.3% increase in the number of fatal cases due to prostate cancer, accompanied by a slight decrease of standardized mortality rate from 13.2/100 000 in 2002 to 12.6/100 000 in 2011. In the analyzed period, 41.8% of patients were diagnosed with locally adavanced prostate cancer.

Lung cancer in Podkarpackie region in the years 2002-2011.

INTRODUCTION: Lung cancer is one of the greatest challenges for modern medicine and in Poland the incidence and mortality rate are one of the highest. The aim of the study was to assess trends in the incidence and mortality rate lung cancer in the Podkarpackie province in the years 2002-2011. MATERIAL AND METHODS: 9993 cases (8018 men and 1975 women) and 8782 deaths (7211 men and 1571 women) of lung cancer were analyzed. Crude rate and standardized coefficients of incidence and mortality as well as stratum weight, and cumulative risk of incidence and mortality were calculated. RESULTS: In 2011, in Podkarpackie province a decrease number of lung cancer cases in men was observed compared to 2002 amounting to 195 case, but in women, an increase of 39 new cases was noted. Incidence rates in men were in the range of 65.8-93.1/100,000, while in women they ranged 9.6-35.2/100,000. Mortality rates for males ranged from 59.2 to 82.8/100,000, and in women from 6.1 to 29.0/100,000. Considerable diversity in incidence and mortality in different districts of the province of Podkarpackie was observed. CONCLUSIONS: In the years 2002-2011 the values of incidence and mortality rates for men in Podkarpackie province were lower than the rates for Poland, in case of women the same rates for Podkarpackie were almost two times lower than the rates for Poland. In the years 2002-2011 the highest value of incidence and mortality rate out of all districts of Podkarpackie Province was observed in the district Lubaczów for men and in Przemysl in case of women.

[Epidemiology, prevention and risk morbidity factors for lung cancer]. / Epidemiologia, profilaktyka i czynniki ryzyka zachorowania na raka pluca.

Lung cancer incidence kept increasing dynamically in male population until the late 90s and then there was a sudden drop in the cases and this tendency has been maintained up till now. What seems upsetting, however, is the fact that for female population there is a constant growth in the lung cancer morbidity. Needless to say, Poland still belongs to the countries with high lung cancer incidence and lung cancer mortality. In 2011 the standardized morbidity rate in Poland accounted for 50,0/100 000 in male population and 17,3/100 000 in female population. In Podkarpacie Voivodeship it was 43,6/100 000 for males and 11,8/100 000 for females respectively. Lung cancer incidence and lung cancer mortality seem to increase together with age, and for people 65 and more this type of cancer accounts for approximately 50% of all cancer cases and cancer caused deaths. In spite of various research conducted and great medical progress little can be done to cure lung cancer. The percentage of 5-year survivals increased for males from 10,8% in years 2000-2002 to 11,9% in years 2003-2005, and for females from 15,7% to 16,9%. The main cause of lung cancer is certainly active and passive smoking. It is highly possible that environmental factors are also responsible for lung cancer cases. Among the most devastating are such factors as asbestos, arsenic, aromatic hydrocarbons, individual lifestyle and nutrition, genetic predisposition and finally the pollution, particularly of the air.

[Hyponatremia in the course of small cell lung cancer--a case report]. / Hiponatremia w przebiegu drobnokomórkowego raka pluca--opis przypadku.

Hyponatremia is a common electrolyte disorder occurring in patients with malignancy. Typically, it runs in the form of the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Among malignant diseases it is often ascertained from small cell lung cancer. In the form of paraneoplastic syndrome it may precede clinical and radiological symptoms malignant disease. Hyponatremia requires special attention because of the neurological consequences and the risk of death. We present a case of a patient in whom the occurrence of hyponatremia preceded the appearance of clinical symptoms of lung cancer and has been the reason to start the diagnosis. The normalization of serum sodium was the first signal response to chemotherapy. In contrast, a statement confirmed the recurrence of hyponatremia progression of the disease in the form of metastases to the central nervous system. Speeches hyponatremia refractory symptomatic treatment should be a cause of further investigation into the neoplastic process. Recurrent hyponatremia during or after treatment may suggest its progression. Therefore, monitoring the sodium level is required not only during treatment, but also after the oncological treatment.

The influence of Kinesiology Taping on the reduction of lymphoedema among women after mastectomy - preliminary study.

INTRODUCTION: Kinesiology Taping is a method that assists healing processes and improves the physical efficiency. THE AIM OF THE STUDY: The aim of the study was to assess the influence of Kinesiology Taping on the lymphoedema reduction among women after mastectomy. MATERIAL AND METHODS: The subject of the research included 44 women underwent single mastectomy along with the removal of lymph nodes. The examination was carried out from the 4(th) of January to the 4(th) of February, 2013. The traditional taping method was implemented among 22 women, whereas the own taping method was used among the other 22 women. The therapy took 21 days, during which the tapes were applied three times every 7 days. The measurements were made before every application and at the end of the therapy. In the study, a questionnaire was used and it included questions concerning basic demographic, epidemiological data as well as the evaluation of the therapy effectiveness. The linear measurements of the upper limbs, the measurements of the range of joints' motion in the upper limb were taken as well as grip strength was made. RESULTS: The reduction of the volume of lymphoedema of 55% was reported in the study group, whereas the oedema reduced by 27% in the clinical control one. CONCLUSIONS: In the reduction of lymphoedema, the greater effectiveness of the own taping method in comparison to the traditional one was reported. Kinesiology Taping exerted an influence on the improvement of the upper limb's joints movability and the grip strength.

The quality of life of non-small cell lung cancer patients treated with chemotherapy.

INTRODUCTION: The aim of the study was to assess the influence of non-small cell lung cancer chemotherapy on patients' health status, the occurrence of adverse events and their effect on everyday activities, depending on the patients' sex and age. MATERIAL AND METHODS: The study group consisted of 62 non-small cell lung cancer patients, (21 women and 41 men), aged 51-84 years, hospitalised due to the chemotherapy. The survey included SF-20 test and a questionnaire prepared by the authors. RESULTS: The most frequent adverse events indicated by the patients were: weakness (79%), nausea and vomiting (77%), loss of appetite (56%) and diarrhoea (45%). It was found that the side-effects of chemotherapy were not dependent on age (p = 0.9882) or sex (p = 0.9968). The chemotherapy negatively influenced the quality of the patients' life (p < 0.000001). It was shown that there is a statistically significant correlation between age and limitations on social roles, professional life and performing housework (p < 0.0133), and also the inability to perform specific types of activities (p < 0.01). CONCLUSIONS: The results of the study show that chemotherapy of non-small cell lung cancer was connected with decreased quality of life, especially in patients over 65 years of age. The patients under 65 years of age could not deal with the disease in respect of psychological aspects, whereas people over 65 years of age had greater problems with physical, social and professional functioning.

[Hepatotoxicity of acetaminophen in a patient treated with capecitabine due to breast cancer]. / Hepatotoksycznosc paracetamolu u chorej leczonej kapecytabina z powodu raka piersi.

Toxic liver injury is among the major side effects of paracetamol. It is a direct effect of the drug metabolite on the liver cells and is dependent on the dose. Unintentional overdose is often the result of several days of taking excessive doses of the drug for medical use. It is fostered by patients' self-treatment, the availability of non-prescription drugs and lack of awareness of the actual composition of the medication taken. The authors of this study reported a case of hepatotoxicity in a patient treated with capecitabine for breast cancer. Capecitabine therapy was completed several days before the use of paracetamol. The detailed interview with the patient revealed that the cause of hepatic dysfunction was the fact that she took paracetamol for 3 days in a daily dose of 5.5 grams (the permissible safe dose is 4 grams) due to the viral infection. After symptomatic treatment over several days improved took place.