Online description of services provided in adult survivorship programs across U.S. accredited cancer centers.

PURPOSE: The American College of Surgeons Standard 4.8 requires an institution to implement a survivorship program to become a Commission on Cancer (CoC)-accredited cancer center. The online information offered by these cancer centers can help educate patients and their caregivers about available services. We assessed the content of survivorship program websites of CoC-accredited cancer centers in the United States. METHODS: Of the 1245 CoC-accredited centers for adults, we sampled 325 institutions (26%) based proportionately on the 2019 new cancer cases by state. Website pages of the institutions' survivorship programs were assessed for information and services offered using the COC Standard 4.8. We included programs for adult survivors of adult- and childhood-onset cancers. RESULTS: 54.5% of the cancer centers did not have a survivorship program website. Of the 189 included programs, most were aimed at adult survivors in general, rather than those with specific cancer types. On average, five essential CoC-recommended services were described, most commonly nutrition, care plans, and psychology services. The least mentioned services were genetic counseling, fertility, and smoking cessation. Most programs described services offered to patients who had completed treatment, while 7.4% of described services for those with metastatic disease. CONCLUSION: More than half of CoC-accredited programs did have information about cancer survivorship programs on their websites and when included, had variable and limited description of services. IMPLICATIONS FOR CANCER SURVIVORS: Our study provides an overview of online cancer survivorship services and offers a methodology that may be used by cancer centers to review, expand, and improve the information described on their websites.

Health Disparities Experienced by Hispanic Americans with Multiple Myeloma: A Systematic Review.

Health disparities in multiple myeloma (MM) disproportionately affect minorities. Characterization of health disparities encountered by Hispanic Americans with MM is necessary to identify gaps and inform future strategies to eliminate them. We performed a systematic review of publications that described health disparities relevant to Hispanic Americans with MM through December 2021. We included all original studies which compared incidence, treatment, and/or outcomes of Hispanic Americans with other ethnic groups. Eight hundred and sixty-eight articles were identified of which 22 original study articles were included in our systematic review. The number of publications varied over time with the highest number of studies (32%) published in 2021. Most of the published studies (59%) reported worse outcomes for Hispanic Americans with MM compared to other ethnic groups. There is growing evidence that Hispanic Americans with MM are facing a multitude of disparities that require immediate attention and solutions.

The Rise of the Expert Patient in Cancer: From Backseat Passenger to Co-navigator.

PURPOSE: Patients who have cancer have leveraged the Internet to gain a better understanding of their disease and connect across geographic boundaries with others facing the same challenges. Online cancer communities have developed into resources that highlight new research and evolving care pathways. Combined with increasing health literacy and social media, they have enabled some patients to become experts in their cancer. This combination of empowerment and expertise describes the new "e-patients." METHODS: We reviewed the literature to identify key areas where expert e-patients have directly participated in advancing cancer medicine, as well as opportunities available to those who wish to become more involved in research advocacy. RESULTS: E-patients are widely acknowledged as key stakeholders in oncology by clinicians, researchers, cancer centers, government agencies, and nonprofits. Their input is vital for informing cancer care delivery, developing and launching research initiatives, creating care guidelines and pathways, and formulating policy. CONCLUSION: Expert e-patients play an expanded role in their own care and in larger conversations regarding practice, research, and policy. Clinicians can engage e-patients as partners in cancer care as we work together towards improving health care access and outcomes for people with cancer.

ASCO-Sponsored Oncology Student Interest Groups in the World.

PURPOSE: In 2015, ASCO established a program designed to support medical interest in cancer-related careers: Oncology Student Interest Groups (OSIGs). The purpose of this study was to describe the characteristics of current student leaders of ASCO-sponsored OSIGs and their perceptions of cancer-related careers. METHODS: We reviewed the list of all ASCO-sponsored OSIGs between 2015 and 2021. For this study, we focused on OSIGs that were sponsored during the 2019-2020 academic year. All student leaders of the 89 OSIGs active in that academic year were invited to participate. RESULTS: The number of groups has more than tripled in the 6 years since the program's inception. The number of international groups has increased to become almost one fifth of all OSIGs; however, the range of countries represented remains limited. The majority of OSIG leaders were female. Eighty two percent of OSIGs were returning members, with most of their leaders being registered ASCO student members. Almost all participants reported an interest in pursuing a cancer-related specialty. Only a minority (14.8%) reported having a family member working in a cancer-related career. However, 85% reported having experience with a cancer diagnosis in their family. The majority of the respondents had a favorable perception of medical oncology as a specialty. Participants reported the highest levels of interest in medical oncology and pediatric oncology. CONCLUSION: The number of ASCO-sponsored OSIGs has steadily increased since the creation of the program. Most participants reported an interest in pursuing a cancer-related career. To our knowledge, this study is the first to provide insights into the makeup of this program around the world. Additional efforts are needed to increase the global reach of the program, particularly in low-income countries.

Cancer Survivorship in Latin America: Current Status and Opportunities.

PURPOSE: The number of cancer survivors is increasing globally although the status of cancer survivorship care provision and research in developing countries is limited. This study aimed to review published literature and available guidelines and/or recommendations to inform cancer survivorship care in Latin America. METHODS: Embase, Web of Science, Scopus, PubMed, and SciELO were systematically searched for articles and guidelines and/or recommendations published through December 31, 2020. Our search terms included cancer, survivors, neoplasm, cancer, survivorship, survivor, follow-up studies, and the name of the countries. We categorized the articles by country, year, cancer type(s), language, and domain of cancer survivorship care. We also searched governmental health agencies websites in all Latin American countries. RESULTS: Our literature review found 664 articles for inclusion. The number of publications increased over time. Brazil had most of the survivorship research (n = 483, 72.7%). The most common topics included surveillance and management of psychosocial effects (n = 237, 35.7%) and physical effects (n = 230, 34.6%). Prevention and surveillance for recurrences and health promotion and disease prevention were each addressed by about 10% (n = 71) of the publications. Although close to half of the publications included more than one cancer, 28.9% (n = 192) focused solely on breast cancer. We found no guidelines and/or recommendations explicitly focusing on Latin America in the reviews of the literature or the national governmental institutions' websites. CONCLUSION: We found a growing body of cancer survivorship publications, mainly focusing on psychosocial and physical effects, although no cancer survivorship guidance and/or recommendations focused on Latin America were identified. Expanding research across Latin American countries and covering a broader spectrum of cancer survivorship care is needed. Development of guidelines may further promote provision of quality care for this growing population of cancer survivors.

American Society of Clinical Oncology-Sponsored Oncology Student Interest Groups in Latin America.

PURPOSE: To describe the characteristics of the members of the ASCO-sponsored Oncology Student Interest Groups (OSIGs) in Latin America. METHODS: This was a multicenter cross-sectional study. We surveyed 97 OSIG members from three medical schools in Peru and Mexico. We administered a 60-question survey covering topics including personal background, oncology training experience, and professional practice expectations and preferences. RESULTS: A little more than one half of the surveyed OSIG members were female. More than one half had a visa to visit the United States and had an advanced level of English. One half of the OSIG members were also ASCO members. Most participants agreed or strongly agreed that participation in their OSIG increased their interest in cancer-related specialties (94%) and provided professional networking opportunities (94%) and that it was accessible to all students (91%). Most participants believed that their OSIG had sufficient resources to carry out its activities. Students were asked to rate their interest when they entered medical school versus at the time of the survey. Most of the members were strongly interested in pursuing surgical oncology. The majority of members were somewhat interested or very interested in palliative care and medical oncology. CONCLUSION: To our knowledge, this is the first study that provides data on medical student perceptions of the Latin American OSIGs sponsored by ASCO. Student perceptions of medical oncology and the impact of OSIGs were generally positive. Given the shortages of oncology specialists in Latin American and elsewhere, strategies to engage medical students in the pursuit of cancer-related careers are becoming increasingly essential.

Cancer cases detected in the prevention and control service of a private cancer clinic in Peru.

PURPOSE: Describe the characteristics of patients seen at the Cancer Prevention and Control Service at a Peruvian private cancer clinic in 2014. PATIENTS AND METHODS: This retrospective clinical study analyzed the prevalence of 10 cancers and characteristics of patients seen at a private cancer center located in Lima, Peru. The study sample included 7680 adults, and data were collected from de-identified medical records. RESULTS: The average age of the patients was 44.71 years and 98,82% of them had private insurance. The majority of patients were women (67.69%). Our gross incidence rate of cancer was 35.16 per 100,000 in the Cancer Prevention and Control Service in 2014. Only 0.35% had cancer, and most of those diagnosed with cancer (77.78%) were diagnosed in the early stages, stages I and II. The two most common cancers observed were breast and thyroid cancer. CONCLUSIONS: The high rates of early, rather than late-stage diagnoses at this clinic are dramatically different than national rates. This difference may be because we are analyzing data from a prevention service seeing mainly patients with private insurance as opposed to national data, which consists primarily of patients seen in oncologic services with national insurance.

Correction to: Cancer cases detected in the prevention and control service of a private cancer clinic in Peru.

[This corrects the article DOI: 10.1186/s13027-019-0259-0.].

Búsqueda de infección por Hepatitis B en familiares de portadores crónicos de la provincia de Huanta, Ayacucho -Perú / Search of Hepatitis-B infection in relatives of chronic carriers in the province of Huanta, Ayacucho, Peru

RESUMEN Un plan de eliminación del virus de hepatitis B (HBV) es factible porque la inmunización ha tenido buen impacto, tal como ha sucedido en la provincia de Huanta en Perú. El objetivo de nuestro estudio fue determinar la frecuencia de la infección por HBV en familiares de portadores del antígeno de superficie del virus de la hepatitis B (HBsAg). Este estudio transversal incluyó a 39 familiares de portadores crónicos, identificados en el Hospital de Apoyo de Huanta. Se recolectaron datos sociodemográficos y muestras de sangre. La frecuencia total de infección por HBV fue de 10,3 % y la mayoría correspondía a infección crónica (7,7 %). Una tercera parte tenía antecedentes de infección por HBV. Los miembros de la familia con infección por HBV fueron mayormente adultos alcohólicos y no vacunados. En conclusión, encontramos una alta frecuencia de HBV en familiares de portadores de HBsAg, esta estrategia ayudaría a identificar portadores crónicos que pueden ser tratados y contribuir a un plan de eliminación de HBV.

ABSTRACTS A plan of elimination of the virus of B hepatitis (HBV) is feasible because the immunization has had good impact, as it has been documented in the province of Huanta in Peru. The objective of our study was to determine the frequency of the infection by HBV in relatives of carriers of the surface antigen of the virus of hepatitis B (HBsAg). This cross-sectional study included 39 relatives of chronic carriers, identified at Hospital de Apoyo de Huanta. Sociodemographic data and blood samples were collected. The total frequency of infection by HBV was 10.3%, and the majority corresponded to chronic infection (7.7%). One third had a history of infection by HBV. The family members with HBV infection were mainly adult alcoholics who had not been vaccinated. In conclusion, we found a high frequency of HBV in relatives of carriers of HBsAg. This strategy would help identify chronic carriers that can be treated and to contribute to a plan for the elimination of HBV.

Prognostic factors in HIV-positive patients with non-Hodgkin lymphoma: a Peruvian experience.

BACKGROUND: Non-Hodgkin lymphoma (NHL) is the most common cancer in people with HIV. Although 95% of HIV patients are in developing countries like Peru, the majority of these studies have been conducted in developed countries. In this study we aim to evaluate prognostic factors associated with outcomes in HIV positive patients undergoing systemic therapy for treatment of NHL. METHODS: This retrospective study includes patients with NHL seen in the Instituto Nacional de Enfermedades Neoplasicas (INEN) between 2004 to 2014. Patients were divided into two groups: antiretroviral therapy (ART) -naïve (n = 34) and those previously treated, ART-exposed (n = 13), at the time of diagnosis. All patients received chemotherapy and ART. The medical records were reviewed. Data were analyzed using t-test and chi-square test. Survival curves were estimated by the Kaplan-Meier method and comparison was done by log-rank test. Multivariate analysis for overall survival (OS) was performed with the Cox proportional hazard regression model. RESULTS: All ART-exposed patients were from the capital city (p = 0.039); they had significantly lower hemoglobin levels compared to ART-naïve patients (p = 0.026). The median OS was 47.7 months with a 5-yr OS of 36.1%. The median OS for ART naïve patients was significantly higher than that for ART-exposed patients (57.05 and 21.09 months, respectively; p = 0.018). Advanced stage and low serum albumin were associated with lower OS in both groups. Age > 60 was associated with worse outcomes in the ART-naïve cohort. CONCLUSIONS: Advanced stage, low serum albumin and previous ART treatment were the primary prognostic factors associated with poorer outcomes in patients with NHL and HIV infection. In ART-naïve patients, age > 60 was associated with worse outcomes but in this cohort, older patients still had better overall outcomes than ART-exposed patients.

[Search of Hepatitis-B infection in relatives of chronic carriers in the province of Huanta, Ayacucho, Peru]. / Búsqueda de infección por Hepatitis B en familiares de portadores crónicos de la provincia de Huanta, Ayacucho -Perú.

A plan of elimination of the virus of B hepatitis (HBV) is feasible because the immunization has had good impact, as it has been documented in the province of Huanta in Peru. The objective of our study was to determine the frequency of the infection by HBV in relatives of carriers of the surface antigen of the virus of hepatitis B (HBsAg). This cross-sectional study included 39 relatives of chronic carriers, identified at Hospital de Apoyo de Huanta. Sociodemographic data and blood samples were collected. The total frequency of infection by HBV was 10.3%, and the majority corresponded to chronic infection (7.7%). One third had a history of infection by HBV. The family members with HBV infection were mainly adult alcoholics who had not been vaccinated. In conclusion, we found a high frequency of HBV in relatives of carriers of HBsAg. This strategy would help identify chronic carriers that can be treated and to contribute to a plan for the elimination of HBV.

Un plan de eliminación del virus de hepatitis B (HBV) es factible porque la inmunización ha tenido buen impacto, tal como ha sucedido en la provincia de Huanta en Perú. El objetivo de nuestro estudio fue determinar la frecuencia de la infección por HBV en familiares de portadores del antígeno de superficie del virus de la hepatitis B (HBsAg). Este estudio transversal incluyó a 39 familiares de portadores crónicos, identificados en el Hospital de Apoyo de Huanta. Se recolectaron datos sociodemográficos y muestras de sangre. La frecuencia total de infección por HBV fue de 10,3 % y la mayoría correspondía a infección crónica (7,7 %). Una tercera parte tenía antecedentes de infección por HBV. Los miembros de la familia con infección por HBV fueron mayormente adultos alcohólicos y no vacunados. En conclusión, encontramos una alta frecuencia de HBV en familiares de portadores de HBsAg, esta estrategia ayudaría a identificar portadores crónicos que pueden ser tratados y contribuir a un plan de eliminación de HBV.

Protective effect of Chuquiraga spinosa extract on N-methyl-nitrosourea (NMU) induced prostate cancer in rats.

BACKGROUND: The main objective was to evaluate the possible protective effect of Chuquiraga spinosa extract on N-methyl nitrosourea (NMU)-induced prostate cancer in rats and DU-145 cell line. MATERIALS AND METHODS: Prostate carcinogenesis was induced in 30 male Holtzman rats by providing cyproterone acetate, testosterone, and NMU. The tumors were monitored and hematological and biochemical parameters and frequency of micronucleated polychromatic erythrocytes were recorded. The cell line was assessed by a cytotoxicity assay. RESULTS: Oral administration of C. spinosa extract significantly lowered superoxide dismutase malondialdehyde, NO, C-reactive protein, and prostate-specific antigen levels (all P < 0.01 compared with Inductor Group). There was a significant decrease in the frequency of micronucleated polychromatic erythrocytes (P < 0.05). C. spinosa presented a selectivity index of 17.24 in the cytotoxicity assay. CONCLUSIONS: Considering its anti-inflammatory, antioxidant, and antigenotoxic effects, and important variations on biochemical and hematological parameters, including prostate-specific antigen of C. spinosa extract, we conclude that it has a protective effect on NMU-induced prostate cancer in rats and cytotoxicity in the DU-145 cell line.

Antiallergic effect of the atomized extract of rhizome of Curcuma longa, flowers of Cordia lutea and leaves of Annona muricata.

INTRODUCTION: Allergies are a problem that greatly affects the population, and hence the use of antiallergic medications is fairly widespread. However, these drugs have many adverse effects. The use of medicinal plants could be an option, but they need to be evaluated. OBJECTIVE: This study was designed to evaluate the antiallergic effect of the atomized extract of rhizome of Curcuma longa, flowers of Cordia lutea, and leaves of Annona muricata. MATERIALS AND METHODS: Twenty-four New Zealand white albino rabbits were randomized into 2 groups. Group A received the atomized extract diluted in physiological saline (APS) and group B received it diluted in Freund's adjuvant (FA). Then, the back of each rabbit was divided into 4 quadrants. The A-I quadrant received only physiological saline. The A-I quadrants of each rabbit conformed the PS group. The following 3 quadrants received the APS in 10 µg/mL, 100 µg/mL, and 1,000 µg/mL, respectively. The B-I quadrant received only FA. The B-I quadrants of each rabbit conformed the FA group. The following 3 quadrants received the AFA in 10 µg/mL, 100 µg/mL, and 1,000 µg/mL, respectively. The occurrence of erythema and edema was recorded according to the Draize scoring system and the primary irritation index. After 72 hours, biopsies were performed. RESULTS: The AFA group presented significantly less erythema and edema compared to the FA group (P<0.05). The histopathologic evaluation at 72 hours showed normal characteristics in the APS group. CONCLUSION: Considering the clinical and histopathological signs, we conclude that the administration of the atomized extract of rhizome of C. longa, flowers of C. lutea, and leaves of A. muricata lacks antigenic effect but could have an antiallergenic effect in a model of dermal irritation in rabbits.

Estudio de toxicidad a 28 días, del extracto atomizado de rizoma de Curcuma longa (A4R), flores de Cordia lutea (A4F) y hojas de Annona muricata (A4L) en un modelo murino / Study of toxicity to 28 days, of the atomized extract of the rhizome of Curcuma longa (A4R), Cordia lutea flowers (A4F) and leaves of Annona muricata (A4L) in a murine model

La asociación de las tres plantas ha sido aprobada por la Institución de Salud en Canadá, bajo la forma de extracto lioilizado, la cual ha demostrado poseer efectos terapéuticos. Objetivos: Determinar la seguridad de la asociación del extracto atomizado del rizoma de Curcuma longa (A4R); lores de Cordia lutea (A4F) y hojas de Annona muricata (A4L) a una dosis repetida durante 28 días por vía oral en ratas. Materiales y métodos: Diseño experimental, se utilizaron 40 ratas Holtzman (20 machos ­ 20 hembras); se siguió las directrices o normas de la Organization for Economic Cooperation and Development (OECD) Norma 407; se administró el extracto atomizado durante 28 días por vía oral, se realizaron las observaciones, registro de signos y evolución semanal del peso corporal de los animales; al final, se extrajo muestra de sangre para estudio hematológico y bioquímico; posteriormente, fueron sacrificados para estudio anatomopatológico de hígado, riñón, corazón, médula, cerebro, páncreas, y bazo; se aplicó el ANOVA, considerando el valor p<0,05 para la significancia. Resultados: Al administrar la asociación en forma de extracto atomizado, se observó una evolución temporal homogénea del peso corporal. No hubo variación significativa en los niveles de glucemia, urea, colesterol, triglicéridos, bilirrubina indirecta, transaminasas (GPT­ GOT), fosfatasa alcalina ni hemoglobina (p>0,05); Conclusiones: Los hallazgos demuestran que el extracto atomizado del rizoma de Curcuma longa (A4R), las flores de Cordia lutea (A4F) y las hojas de Annona muricata (A4L) no es toxico en ratas, al ser administrado por un periodo de 28 días.

Toxicidad a 90 días del extracto atomizado de rizoma de Curcuma longa (A4R), Flores de cordia lutea (A4F) y hojas de Annona muricata (A4L) en modelo murino / 90-day toxicity of the extract of rhizome of Curcuma longa (A4R), Flowers of Cordia lutea (A4F) and leaves of Annona muricata (A4L) in murine mode

Objetivos: Determinar la seguridad de la asociación del extracto atomizado del rizoma de Curcuma longa (A4R), flores de Cordia lutea (A4F) y hojas de Annona muricata (A4L) a una dosis repetida durante 90 días por vía oral en ratas. Material y métodos: Diseño experimental, se utilizaron 108 ratas Holtzman (54 machos ­ 54 hembras) y se administró el extracto atomizado durante 90 días por vía oral, se realizaron las observaciones, registro de signos y evolución cada 30 días del peso corporal de los animales; al final, se extrajo muestra de sangre para estudio hematológico, hepático, lipídico y antioxidante, se aplicó la prueba ANOVA, considerando el valor p<0,05 para la significancia. Resultados: La asociación de extracto atomizado (ALC) evidenció un incremento significativo del peso para el grupo ALC 200 mg/kg; en las ratas macho a partir de los 30 días (p<0,01) y en ratas hembra a partir de los 60 días (p<0,01) manteniendo dicho patrón a los 90 días. Todos los valores hematológicos y bioquímicos durante los 90 días se mantuvieron dentro de parámetros permitidos. Se observó un incremento en la actividad de la superoxido dismutasa (SOD) desde los primeros 30 días y manteniendo el mismo hasta el final, independientemente del género (p<0,05). Conclusión: Los hallazgos demuestran que el extracto atomizado del rizoma de Curcuma longa (A4R), flores de Cordia lutea (A4F) y hojas de Annona muricata (A4L) no produce toxicidad al ser administrado por un periodo de 90 días en ratas.

Sarcoma de Kaposi endémico en un paciente VIH negativo / Endemic Kaposi's sarcoma in a HIV-negative patient

El sarcoma de Kaposi (SK) es un cáncer angioproliferativo inflamatorio multifocal asociado a herpes virus 8 (VHH-8). Se han descrito cuatro variantes clínico-epidemiológicas: clásico, endémico, iatrogénico y epidémico o asociado a VIH. Clínicamente puede ser indolente o agresivo, afecta principalmente áreas mucocutáneas con eventual compromiso visceral y de ganglios linfáticos. Se presenta frecuentemente y de forma más agresiva en la población VIH positiva. Presentamos un caso de un paciente varón de 27 años VIH negativo con lesión tumoral sangrante en el anillo de Waldeyer, múltiples adenopatías y lesiones exofíticas en pie que remiten con quimioterapia de emergencia basada en antraciclinas. El SK VIH negativo es una condición poco frecuente. Es importante tener en cuenta al Perú como región endémica para el VHH-8. La afectación oral del SK es una manifestación rara y de mal pronóstico, sin embargo, el factor VIH negativo podría conferirle un buen pronóstico...

KaposiÆs sarcoma (KS) is a multicentric, inflammatory angioproliferative cancer associated with herpes virus 8 (HHV-8). It has four clinico-epidemiological types: classic, endemic, iatrogenic and epidemic, or HIV associated. Clinically it may be indolent or aggressive, mainly affecting mucocutaneous areas with eventual visceral and lymph node involvement. It is often present and in a more aggressive form in the HIV-positive population. We report a case of a 27-year-old HIV-negative male patient with a bleeding tumoral lesion in the Waldeyer ring, multiple lymphadenopathies and exophytic foot lesions that remit with anthracycline-based emergency chemotherapy. HIV-negative KS is a rare condition. It is important to consider Peru as an endemic region for HHV-8. The oral involvement of KS is a rare manifestation and of poor prognosis, however, the HIV-negative factor could confer a good prognosis...

[Endemic kaposi's sarcoma in a HIV-Negative patient]. / Sarcoma de kaposi endemico en un paciente VIH negativo.

Kaposi's sarcoma (KS) is a multicentric, inflammatory angioproliferative cancer associated with herpes virus 8 (HHV-8). It has four clinico-epidemiological types: classic, endemic, iatrogenic and epidemic, or HIV associated. Clinically it may be indolent or aggressive, mainly affecting mucocutaneous areas with eventual visceral and lymph node involvement. It is often present and in a more aggressive form in the HIV-positive population. We report a case of a 27-year-old HIV- negative male patient with a bleeding tumoral lesion in the Waldeyer ring, multiple lymphadenopathies and exophytic foot lesions that remit with anthracycline-based emergency chemotherapy. HIV-negative KS is a rare condition. It is important to consider Peru as an endemic region for HHV-8. The oral involvement of KS is a rare manifestation and of poor prognosis, however, the HIV-negative factor could confer a good prognosis.