A Pilot Cancer-Phenome Biobanking System in a Low-Resource Southeast Asian Setting: The Philippine General Hospital Biobank Experience.

Biobanking has become an indispensable tool for translational research and health innovations. While the field of biobanking has progressed and evolved globally, biobanking in developing Association of Southeast Asian Nations (ASEAN) countries such as the Philippines remains underrepresented because of several challenges often encountered in these low- and middle-income countries. Recently, the Philippine government has undertaken enormous efforts to advancing research and development in the country, and one of the current research pursuits is the establishment of biobanks, with the hope of attaining more discoveries and innovations in the future. Given that cancer remains a leading cause of death in the Philippines, the Philippine government supported the establishment of a cancer biobank at the Philippine General Hospital (PGH). In this study, we present a specific use case of biobanking activity at the PGH Biobank, to build a cohort of biospecimens from Filipino patients with breast, endometrial, and ovarian cancer. This initiative is part of a biomonitoring study (1) to assess environmental exposures and possible risk factors in the Philippine population and (2) to develop a system of culturing human cells from Filipino patients for subsequent in vitro studies. We discuss issues faced and the solutions developed during the implementation of the biobank. Strong research collaboration, a funding source, basic infrastructure, and appropriate technology helped initiate this pilot biobank in the Philippines. Overall, the experiences of establishing the PGH Biobank may help other institutions in low-resource countries to set up cancer biobanks.

Epidemiology, prevention and treatment of cervical cancer in the Philippines.

Cervical cancer remains to be one of the leading malignancies among Filipino women. High-risk human papillomavirus (HPV) types, such as 16 and 18, are consistently identified in Filipino women with cervical cancer. Factors identified to increase the likelihood of HPV infection and subsequent development of cervical cancer include young age at first intercourse, low socioeconomic status, high parity, smoking, use of oral contraception and risky sexual behaviors. Cancer screening programs presently available in the Philippines include Pap smears, single visit approach utilizing visual inspection with acetic acid followed by cryotherapy, as well as colposcopy. However, the uptake of screening remains low and is further compounded by the lack of basic knowledge women have regarding screening as an opportunity for prevention of cervical cancer. Prophylactic HPV vaccination of both quadrivalent and bivalent vaccines has already been approved in the Philippines and is gaining popularity among the Filipinos. However, there has been no national or government vaccination policy implemented as of yet. The standard of treatment of cervical cancer is radiotherapy concurrent with chemotherapy. Current researches are directed towards improving availability of both preventive and curative measures of cervical cancer management.

The role of solifenacin succinate in the management of bladder dysfunction in radical hysterectomy patients / Philippine Journal of Obstetrics and Gynecology

Prolonged bladder catheterization, the conventional management of urinary bladder dysfunction secondary to radical hysterectomy for gynecologic malignancies, is associated with patient discomfort, higher incidence of urinary tract infection, delayed ambulation and moderate cost.OBJECTIVE: This study aimed to determine the efficacy and safety of solifenacin succinate in the decreasing mean duration of indwelling catheterization after radical hysterectomy.METHODS: In this non-blinded, no placebo, randomized controlled trial, patients 19 years old and above, diagnosed with early stage cervical cancer and stage II endometrial cancer were randomized to 2 arms: control arm and treatment arm (given solifenacin succinate 5 mg once a day after radical hysterectomy). Bladder function testing on the 3rd postoperative day and weekly thereafter was done on all patients. The primary endpoint was the mean duration of indwelling catheterization until bladder function recovery was obtained. Patients were monitored for adverse drug reactions and development of urinary tract infection.RESULTS: Each arm had 18 patients. The clinicopathologic profiles of the patients in the 2 arms were comparable. The mean duration of indwelling catheterization was significantly shorter in the treatment arm (13.33 days ± 10.50 SO) than in the control arm (21.33 days ± 11.66 SO) (P = 0.046). No adverse drug reactions were noted.CONCLUSION: Solifenacin succinate effectively and safely reduced mean duration of indwelling catheterization among patients who underwent radical hysterectomy.

Outcomes of patients undergoing fertility-sparing surgery for ovarian cancers: 5- year review in a tertiary hospital

A five-year retrospective study was conducted to determine the fertility and clinical outcomes of ovarian cancer patients undergoing fertility-sparing surgery (FSS). Medical records were evaluated. Menstrual, fertility and clinical outcomes were measured. Of the 44 cases evaluated, 41 (93.18%) were stage I, while 3 (6.82%) had advanced stages. Complete surgical staging was done in 19 (43.18%) patients. All had restoration of menses 1-2 months after surgery with no significant amenorrhea among those given platinum-based chemotherapy. There were 15 successful pregnancies (83.33%). There were only 5 patients (27.78%) with infertility, and 8 (18.18%) cases of tumor persistence/recurrence, all of malignant germ cell tumors without adjuvant chemotherapy. This study confirms FSS as a safe and acceptable treatment for reproductive-age women < 30 years old with no history of infertility, with either stage I epithelial tumors (low malignant potential and frank carcinoma) or malignant germ cell tumors with assured adjuvant chemotherapy.