Vol 10 No 3 (2018)

Original Articles

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    Background: Breast cancer is a serious concern for women health. Providing enough information to these patients will increase awareness, level of participation and improve quality of care. To provide information through the internet, identifying information needs is essential. The purpose of this study was to identify information needs that can be available through Internet for women with breast cancer based on their perspectives. Method: 120 women with breast cancer, who were familiar with the internet, entered to the study with convenient sampling method from Cancer Institute of Imam Khomeini hospital located in Tehran. The questionnaire was designed in seven areas: disease, treatment, daily activities, sexual health, and impact of disease on the family and private life, disease acceptance and self-image as well as other educational content based on a literature review and six sample portals. Descriptive statistics (frequency, mean and standard deviation) were used to analyze data by SPSS software. Result: The information content needed by patients on the internet, was in seven areas: Treatment (mean= 4.62 out of 5), daily activity (mean= 4.51 out of 5), disease (mean= 4.42 out of 5), disease acceptance and self-image (mean= 4.37 out of 5), the effect of disease on private life (mean= 4.21 out of 5) ,sexual health (mean= 4.2 out of 5) and other educational content( mean=4/55 out of 5).   Conclusion: The need for information in the field of treatment is the most important needs of patients. They are interested in accessing through the online medium that provides them with information about cancer, decision making and treatment management. The care team can improve quality of care by providing information through the internet and portals. 
  • XML | PDF | downloads: 321 | views: 367 | pages: 12-21
    Background: In recent years, financial coverage and availability of new and expensive cancer drugs have changed into one of the challenges of the health system, especially in low-income and middle-income countries,. We studied the availability ofanticancer drugs, insurance coverage and the financial burden of these drugs in Iran.Methods: In this cross-sectional descriptive study, first, we listed effective cancer drugs according to the World Health Organization’s Model List of Essential Medicinesand previous studies. Then, we evaluated financial burden of these drugs byusing the available data in Iran pharmaceutical Pharmacopoeia, the national pharmaceuticalsales statistics database (pharmaceutical Amarnameh), and inquiry of theinsurance organizations, the availability, insurance coverage in Iran. Excel softwarewas used for data analysis.Results: All of the medicines incorporated into the latest version of the WHO Model List of Essential Medicines were available in Iran, and, except for Bendamustine and Anastrazole all medicines were covered by insurance. In addition, of the 19 drugs,those were not on the WHO Model List of Essential Medicines, there were sevendrugs in Iran, insurance covered that six drugs. The total Dollar sales of the studiedcancer drugs amounted to US$350.85 million in 2015 and US$384.96 million in 2016.Conclusion: It seems that the status of access to effective cancer drugs in Iran is better than many low and middle-income countries. However, since the cost of cancerdrugs is rising, health policy makers inevitably need to prioritize cancer drugs by using the results of health technology assessment methods and provide patients withaccess to drugs that are cost-effective in order to the optimal allocation of limitedresources and provide maximum access to cancer drugs throughout the country.
  • XML | PDF | downloads: 196 | views: 337 | pages: 22-29
    Background: About one-third of the total breast cancer occurs in women over 65 years of age. Elderly breast cancer management is one of the worldwide oncology challenges. Unlike radical treatment of younger women’s mammary tumors, the type of treatment in elderly breast cancer is based on life expectancy. The present study aimed to determine the clinical and pathological characteristics of elderly breast cancer in Iranian patients and to identify modal treatment differences with developed countries. Methods: A total of 239 cases of breast cancer patients over 65 years referred the Cancer Institute of Iran between 2000 and 2014 was studied and the demographic, pathologic, surgical, and adjuvant therapy data were recorded. In addition, two parameters of recurrence and disease free survival (DFS) were analyzed statistically. Results: The mean age of patients was 71.8±6.15 and invasive ductal carcinoma (IDC) was the most abundant tumor. In terms of tumor size, T2 was 52.5% and in terms of axillary lymph node involvement, N1 was 53.2%. Stage II has the highest rate and metastasis was occurred in 16% of patients in follow up. Hormone receptors were positive in 74.2% and HER-2 in 33.1%. In terms of treatment, 64.6% of patients underwent modified radical mastectomy (MRM), 76.8% chemotherapy, 75.1% radiotherapy, and 54% hormone therapy. In 54-month follow-ups, local and systemic recurrence occurred in 27 patients, in most of the cases in the first 4 years; 79 patients died of cancer during the same period. Conclusion: Our results showed that tumors stage was higher than similar studies, and despite the radical regimen strategies in Iran, the risk of recurrence and mortality was higher. Therefore, it is suggested to repeat the study in other major treatment centers in Iran. We suggest perform the treatment of elderly breast cancer based on a multidisciplinary team, and to develop national guidelines for these patients.

Case Reports

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    The role of comparative oncology has been highlighted in recent years. It refers to a discipline in which pets’ cancers are studied in terms of etiology, biology and therapeutic approaches. This part of translational research finds evidences needed to compare pets’ cancers with similar human cancers to generalize obtained results to the medical oncology. As with humans, the prevalence of cancers is increasing in pet animals. Comparative oncology pay particular attention to malignancies in dogs due to the similarities of this animal with human in terms of etiology, morphology, biology, clinical course, prognostic factors and therapeutic methods. Some believe that comparative oncology will find a place in clinical trials of medical oncology in the near future. This is because dogs with cancers can well replace human patients in clinical trials phase I and II. The National Cancer Institute (NCI) has launched the Comparative Oncology Trials Consortium (COTC) to provide evidence to replace humans with dogs in clinical trials phase I and II. The increasing interest of Iranians in pet animals has led to an increase in the number of academic medical centers and private veterinary hospitals in recent years. It seems that the incidence of malignancies has been rising increasingly in recent years in dogs due to the sudden increase in pet population, using advanced imaging systems in pet animal treatment centers and development of laboratory centers. The increasing incidence of cancer in pets can prepare the ground for Iranian researchers to enter the arena of comparative oncology program. Authorities are recommended to establish comparative oncology infrastructures in collaboration with cancer research centers and academic veterinary clinics and to conduct studies on etiology, molecular epidemiology and common risk factors; this can facilitate Iran's accession to networks such as the COTC.