Oral health-related quality of life in breast cancer survivors.

OBJECTIVE: The aim of the present study was to evaluate oral health-related quality of life (OHRQoL) among breast cancer survivors and identify possible factors associated with the outcome. METHODS: A cross-sectional study was conducted with 151 women in follow-up at a hospital after treatment for breast cancer. Data were collected on socio-demographic characteristics, general health, and breast cancer. Clinical examinations were performed to determine caries experience using the decayed, missing, and filled teeth (DMFT) index. The Oral Health Impact Profile (OHIP-14) questionnaire was administered for the assessment of OHRQoL. Logistic regression analysis was performed to identify associated factors after adjustments for confounding variables. RESULTS: The mean OHIP-14 score was 12.8 (SD 10.92). The prevalence of negative impact was 58.9%. A negative impact was associated with depression, the diagnosis of breast cancer, chemotherapy, number of restored teeth, and xerostomia (p < 0.05). In the adjusted analysis, only the oral variables remained significantly associated with the outcome. CONCLUSION: A greater number of restored teeth and xerostomia exert a negative impact on the OHRQoL of women who have survived breast cancer, which suggests the need for special attention to the oral health of this population.

Ectoenzymes and cholinesterase activity and biomarkers of oxidative stress in patients with lung cancer.

We aimed to examine the nucleoside triphosphate diphosphohydrolases (NTPDase) in lymphocytes; adenosine deaminase (ADA) and butyrylcholinesterase (BChE) in serum; and acetylcholinesterase (AChE), superoxide dismutase (SOD), and catalase (CAT) activity in whole blood; since these enzymes are involved in inflammation responses as well as in oxidative stress conditions. We also checked the levels of total thiols (T-SH), non-protein thiols (NPSH), and thiobarbituric acid reactive substances (TBARS) in serum of patients with lung cancer. We collected blood samples from patients (n = 31) previously treated for lung cancer with chemotherapy. Patients were classified as stage IIIb and IV according to the Union for International Cancer Control (UICC). The results showed a significant increase in the hydrolysis of ATP, ADP, and adenosine in patients when compared with the control group. The activity of AChE, SOD, and CAT as well as the T-SH and NPSH levels were higher in patients group and TBARS levels were lower in patients compared with the control group. These findings demonstrated that the enzymes activity involved in the control of inflammatory and immune processes as well as the oxidative stress parameters are altered in patients with lung cancer.

Uncaria tomentosa-Adjuvant Treatment for Breast Cancer: Clinical Trial.

Breast cancer is the most frequent neoplasm affecting women worldwide. Some of the recommended treatments involve chemotherapy whose toxic effects include leukopenia and neutropenia. This study assessed the effectiveness of Uncaria tomentosa (Ut) in reducing the adverse effects of chemotherapy through a randomized clinical trial. Patients with Invasive Ductal Carcinoma-Stage II, who underwent a treatment regimen known as FAC (Fluorouracil, Doxorubicin, Cyclophosphamide), were divided into two groups: the UtCa received chemotherapy plus 300 mg dry Ut extract per day and the Ca group that only received chemotherapy and served as the control experiment. Blood samples were collected before each one of the six chemotherapy cycles and blood counts, immunological parameters, antioxidant enzymes, and oxidative stress were analyzed. Uncaria tomentosa reduced the neutropenia caused by chemotherapy and was also able to restore cellular DNA damage. We concluded that Ut is an effective adjuvant treatment for breast cancer.

Gastric cancer patients treated by a general or gastric cancer surgical team: a comparative study.

BACKGROUND: Although gastric cancer has been decreasing in incidence in many countries, it is still the second most common cause of cancer deaths worldwide. Its prognosis is poor and depends, among other factors, on early diagnosis as well as on surgeon expertise. AIM: To compare the outcomes of gastric cancer patients treated at a university hospital by a general surgical team and later on by a gastric cancer surgical team. METHODS: Gastric cancer patients were separated into two groups according to whether they were treated by a general surgical team (group 1, n = 136; 1984 to 1993) or by gastric cancer team (group 2, n = 149; 1994 to 2003). Clinical and pathologic features and survival rates were assessed. RESULTS: During a 20-year period, a decreased number of patients underwent surgical resection in the second period (94% vs 86%), a greater number of upper gastrointestinal endoscopies were performed resulting in an increased number of tumors diagnosed as stage I (5% vs 22%). Also, D2 gastrectomies were more frequently performed instead of D0 gastrectomies and negative surgical margins were adequate. Mortality decreased from 9% to 6% in group 1 and 2, respectively and adjuvant therapy has been considered. CONCLUSION: Surgical specialized units for gastric cancer are necessary if better results are to be expected since this approach definitely provides better patient care.

δ-Aminolevulinate dehydratase activity in lung cancer patients and its relationship with oxidative stress.

This study investigated the δ-aminolevulinate dehydratase (δ-ALA-D) activity in whole blood as well as the parameters of oxidative stress, such as reactive species (RS) levels in serum, thiobarbituric acid reactive substances (TBARS) levels, the superoxide dismutase (SOD) and catalase (CAT) activities, as well as total thiols (T-SH) and non-protein thiols (NPSH) levels in platelets. Moreover, the content of vitamin C and E in plasma and serum, respectively, in lung cancer patients was also investigated. We collected blood samples from patients (n=28) previously treated for lung cancer with chemotherapy. Patients were classified as stage IIIb and IV according to the Union for International Cancer Control (UICC). Results showed a decrease of 37% in δ-ALA-D activity in patients with lung cancer when compared to the control group. RS and TBARS levels were 8% and 99% higher in the patient group, respectively. The activity of SOD and CAT as well as the vitamin C content were 41%, 35% and 127% lower in patients when compared with controls, respectively. However, T-SH and vitamin E levels were 27% and 44% higher in lung cancer patients, respectively. Results show that the overproduction of reactive species in patients with lung cancer may be interfering with the activity of δ-ALA-D. Likewise, the decrease in the activity of this enzyme may be contributing for the oxidative stress.

Lung cancer alters the hydrolysis of nucleotides and nucleosides in platelets.

BACKGROUND: The nucleotides and nucleosides of adenine are signaling molecules related to thromboregulation and modulation of immune responses in patients with malignancies. Thus, this study aims to determine NTPDase, 5'-nucleotidase, ectonucleotide pyrophosphatase/phosphodiesterase (E-NPP) and adenosine deaminase (ADA) activities in the platelets of patients with lung cancer. METHODS: We collected blood samples from patients (n=33) previously treated for lung cancer with chemotherapy. Patients were classified as stage IIIb and IV according to the Union for International Cancer Control (UICC). RESULTS: Patients showed a significant decrease in the hydrolysis of adenosine diphosphate (ADP) and adenosine, whereas the adenosine monophosphate (AMP) hydrolysis and platelet aggregation were significantly increased in this group. Adenosine triphosphate (ATP) hydrolysis did not show significant results between the group of patients and the control group. CONCLUSIONS: We may suggest that ectonucleotidases as well as ADA are enzymes involved in thromboembolic events but especially here we may see that they are also directly involved in the generation of adenosine formation in the cancer patient circulation.

Cholinesterase activities and biochemical determinations in patients with prostate cancer: influence of Gleason score, treatment and bone metastasis.

Prostate cancer (PCa) is the sixth most common type of cancer worldwide. Cholinesterase is well known as having non-cholinergic functions such as cellular proliferation and differentiation, suggesting a possible influence of cholinesterase in tumorogenesis. Thus, the aim of this study was to investigate the whole blood acetylcholinesterase (AChE) and plasma butyrylcholinesterase (BChE) activities and some biochemical parameters in PCa patients. This study was performed in 66 PCa patients and 40 control subjects. AChE and BChE activities were determined in PCa patients and the influence of the Gleason score; bone metastasis and treatment in the enzyme activities were also verified. Furthermore, we also analyzed possible biochemical alterations in these patients. AChE and BChE activities decreased in PCa patients in relation to the control group and various biochemical changes were observed in these patients. Moreover, Gleason score, metastasis and treatment influenced cholinesterase activities and biochemical determinations. Our results suggest that cholinesterases activities and biochemical parameters are altered in PCa. These facts support the idea that the drop in the cholinesterase activity and the consequent increased amount of acetylcholine could lead to a cholinergic overstimulation and increase the cell proliferation in PCa.

Correlation between TBARS levels and glycolytic enzymes: the importance to the initial evaluation of clinical outcome of colorectal cancer patients.

Colorectal cancer (CRC) has been associated with high levels of lipid peroxidation, probably due to neoplasic tissue metabolism. Our objectives were to relate lipid peroxidation with the evolution of CRC and with various biomarkers (GGT, ALP, LDH, CEA) to assess its prognostic value. A longitudinal study was conducted with CRC patients (n=43), using FOLFOX4. At the end of the treatment, patients were grouped into two groups: poor outcome (PO) for those patients whose computed tomography showed signs of metastasis, not reduced or increased in the previous implants, and not reduced or increased in CEA levels and good outcome (GO) for the opposite trends. PO patients had a significant increase in TBARS levels, being different from other group in cycles 4, 5, and 6 of chemotherapy. After cycle 6 of chemotherapy, GO patients had higher SOD (27%) and catalase (33%) activity. TBARS levels showed a positive correlation with biomarkers at the beginning of the treatment, which disappeared after six cycles of chemotherapy, when TBARS levels of the PO group started to increase; the other parameters increased at a later time. Because the serum TBARS levels in GO patients did not increase after the beginning of chemotherapy, it is expected that the increase is not a result of the effects of chemotherapy but of sickness evolution. It is possible that the systemic assessment of lipid peroxidation might become an additional marker because it occurs earlier than other biomarkers and could therefore be useful in the prognosis of CRC patients.

Oxidative stress and antioxidant status in prostate cancer patients: relation to Gleason score, treatment and bone metastasis.

Over the last decade, epidemiological, experimental and clinical studies have implicated oxidative stress in the development and progression of prostate cancer. In the present study, we evaluated the oxidative status and antioxidant defense in patients with prostate cancer (PCa) taking into consideration: treatment, Gleason score and bone metastasis. For this, we measured concentrations of plasmatic thiobarbituric acid reactive substances (TBARS), serum protein carbonylation, whole blood catalase (CAT) and superoxide dismutase (SOD) activities, as well as the plasma and erythrocyte thiol levels and serum vitamin C and E concentration. This study was performed on 55 patients with PCa and 55 healthy men. TBARS levels and serum protein carbonylation were higher in PCa patients than in controls and altered levels of antioxidants were found in these patients. CAT activity was decreased and SOD activity was higher in PCa patients when compared with controls. Non-protein thiol levels were increased, however, serum vitamin C and vitamin E content were reduced in PCa patients when compared with controls. In addition, different parameters analyzed in PCa patients based on metastasis, treatment and Gleason score showed changes in oxidative stress biomarkers and antioxidant defenses. These findings may indicate an imbalance in the oxidant/antioxidant status, supporting the idea that oxidative stress plays a role in PCa, moreover, the oxidative profile appear to be modified by bone metastasis, treatment and Gleason score.

Gastric cancer patients treated by a general or gastric cancer surgical team: a comparative study

BACKGROUND: Although gastric cancer has been decreasing in incidence in many countries, it is still the second most common cause of cancer deaths worldwide. Its prognosis is poor and depends, among other factors, on early diagnosis as well as on surgeon expertise. AIM: To compare the outcomes of gastric cancer patients treated at a university hospital by a general surgical team and later on by a gastric cancer surgical team. METHODS: Gastric cancer patients were separated into two groups according to whether they were treated by a general surgical team (group 1, n = 136; 1984 to 1993) or by gastric cancer team (group 2, n = 149; 1994 to 2003). Clinical and pathologic features and survival rates were assessed. RESULTS: During a 20-year period, a decreased number of patients underwent surgical resection in the second period (94 percent vs 86 percent), a greater number of upper gastrointestinal endoscopies were performed resulting in an increased number of tumors diagnosed as stage I (5 percent vs 22 percent). Also, D2 gastrectomies were more frequently performed instead of D0 gastrectomies and negative surgical margins were adequate. Mortality decreased from 9 percent to 6 percent in group 1 and 2, respectively and adjuvant therapy has been considered. CONCLUSION: Surgical specialized units for gastric cancer are necessary if better results are to be expected since this approach definitely provides better patient care.

RACIONAL: Embora a incidência de câncer gástrico esteja diminuindo em muitos países, ainda é a segunda causa de morte por câncer mundialmente. O prognóstico desta doença é reservado e depende, entre outros fatores, do diagnóstico precoce e da experiência da equipe cirúrgica. OBJETIVO: Comparar os resultados obtidos no tratamento de pacientes com câncer gástrico em um hospital universitário, inicialmente por uma equipe de cirurgia geral e posteriormente por outra especializada no tratamento dessa doença. MÉTODOS: Os pacientes foram cronologicamente divididos em dois grupos: o primeiro tratado pela cirurgia geral (grupo 1, n = 136, 1984-1993) e o segundo pela equipe de cirurgia gástrica (grupo 2, n = 149, 1994-2003). As características clínicas e patológicas e as taxas de sobrevida foram avaliadas. RESULTADOS: Durante um período de 20 anos de tratamento, menor número de pacientes foi submetido a cirurgia no segundo período (94 por cento vs 86 por cento), foram realizadas mais endoscopias digestivas altas no segundo período, resultando em maior número de tumores em estágio I (5 por cento vs 22 por cento). Também as gastrectomias D2 foram mais realizadas e as margens de segurança cirúrgicas respeitadas. A mortalidade cirúrgica diminuiu de 9 por cento para 6 por cento, e tratamentos complementares como radio e quimioterapia adjuvantes foram realizados no segundo período. CONCLUSÃO: Equipes cirúrgicas especializadas são necessárias para a obtenção de melhores resultados no tratamento de pacientes com câncer gástrico.