Oncology Institute


Oncology Institute

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Yavuzsen T.,Oncology Institute | Cehreli R.,Oncology Institute | Dirioz M.,Dokuz Eylül University
Asian Pacific Journal of Cancer Prevention | Year: 2012

Purpose: The aim of this study was to evaluate the effects of the group therapy on psychological symptoms and quality of life of patients with early stage breast cancer. Methods: This study was performed on 16 breast cancer patients who completed treatments. The total group therapy program involved a weekly session of 2-3 hours, for 16 weeks. The group therapy sessions were given to women in the oncology department by a clinical psychologist and also given training sections by the different professional teams. All the required assessments for the study were performed after and before 16 week group therapy intervention. Results: Initially we had taken 21 women but 16 participated in all therapy programs and submitted questionnaires. The mean age was 47.8 years. There were significant differences between before and after group therapy program. Anxiety, depression, and distress showed significant improvements. Hopelessness scale was detected at the border of significance. There was no change in sleep problems and quality of life. According to the analysis of correlation, considering the age factor and year of diagnosis, there was found no statistically significant relationship between anxiety, distress, depression, hopelessness, sleeplessness, and quality of life. Conclusions: This pilot study demonstrated that brief, predominantly group therapy is feasible for patients with breast cancer and, also it may be helpful to cope with emotional and physical distress.

Kalich-Philosoph L.,Fertility Preservation Research Laboratory | Kalich-Philosoph L.,Bar - Ilan University | Roness H.,Fertility Preservation Research Laboratory | Carmely A.,Fertility Preservation Research Laboratory | And 12 more authors.
Science Translational Medicine | Year: 2013

Premature ovarian failure and infertility are major side effects of chemotherapy treatments in young cancer patients. A more thorough understanding of the mechanism behind chemotherapy-induced follicle loss is necessary to develop new methods to preserve fertility in these patients. We show that the alkylating agent cyclophosphamide (Cy) activates the growth of the quiescent primordial follicle population in mice, resulting in loss of ovarian reserve. Despite the initial massive apoptosis observed in growing, though not in resting, follicles of Cy-treated mice, differential follicle counts demonstrated both a decrease in primordial follicles and an increase in early growing follicles. Immunohistochemistry showed that granulosa cells were undergoing proliferation. Analysis of the phosphatidylinositol 3-kinase signaling pathway demonstrated that Cy increased phosphorylation of proteins that stimulate follicle activation in the oocytes and granulosa cells. Coadministration of an immunomodulator, AS101, reduced follicle activation, thereby increasing follicle reserve and rescuing fertility after Cy, and also increased the efficacy of Cy against breast cancer cell lines. These findings suggest that the mechanism in Cy-induced loss of ovarian reserve is accelerated primordial follicle activation, which results in a "burnout" effect and follicle depletion. By preventing this activation, AS101 shows potential as an ovarian-protective agent, which may be able to preserve fertility in female cancer patients.

Harel R.,Stereotactic Radiosurgery Unit | Harel R.,Spine Surgery Unit | Zach L.,Oncology Institute
Neurological Research | Year: 2014

Early diagnosis, better imaging, and advanced treatment of cancer patients extend survival and increase the incidence of symptomatic spine metastases. The treatment algorithm for spine metastases has shifted to a more aggressive approach in recent years. Spine stereotactic radiosurgery (SRS) is a relatively new tool utilizing advanced imaging systems, planning software, image-guided localization, and intensitymodulated dose delivery. Radiosurgery of spine metastases yields high rates of pain-and tumor control, and offers both the patients and the treating physicians an effective noninvasive alternative. This review presents the indications and outcomes for SRS and describes current techniques. © W. S. Maney & Son Ltd 2014.

Golan T.,Oncology Institute | Golan T.,Tel Aviv University | Urban D.,Oncology Institute | Urban D.,Peter MacCallum Cancer Center | And 4 more authors.
Cancer | Year: 2013

BACKGROUND Over the past 2 decades, significant progress has been made in the field of metastatic colorectal cancer (mCRC) regarding new imaging techniques, surgical interventions, and systemic therapy. It is not known whether the benefit from these interventions has extended overall survival (OS) within the general mCRC population. A population-based survival analysis of newly diagnosed patients who presented with mCRC was therefore performed. METHODS Survival statistics were extracted from the Surveillance, Epidemiology, and End Results (SEER) database for patients diagnosed with mCRC between 1988 and 2008. Demographic variables collected included age, race, and tumor grade. Survival was analyzed using the Kaplan-Meier method and extended Cox proportional hazard model as appropriate. RESULTS The study population consisted of 42,347 patients diagnosed with mCRC between 1988 and 2008 (52% women; mean age, 67 years). The 1- and 2-year estimated OS rates were 44% and 22%, respectively. Prognostic variables included race, sex, age, tumor location, and year of diagnosis. Median OS improved from 8 months to 14 months between 1988 and 2008. Significant improvements in OS were seen for all disease sites, but especially for descending colon cancers. Whereas the median OS increased by 13 months in patients ≤50 years of age and by 7 months in patients 51-70 years of age, the median OS of patients >70 years of age increased by only 1 month between 1988 and 2008. CONCLUSIONS There has been a continuous improvement in OS of patients diagnosed with mCRC between 1988 and 2008, especially for left-sided tumors. Little improvement has been seen in patients over 70 years of age. © 2013 American Cancer Society.

Cohen M.,Haifa University | Baziliansky S.,Rambam Health Care Campus | Beny A.,Oncology Institute
Journal of Geriatric Oncology | Year: 2014

Background: Studies generally report lower emotional distress in older patients with cancer than in younger patients with cancer. The personality construct of resilience was previously found to be higher with age, but has not been assessed in relation to emotional distress in older patients with cancer. Objective: To assess the mediating effect of resilience on the associations between age and emotional distress in patients with colorectal cancer (CRC). Patients and Methods: An exploratory cross-sectional study of 92 individuals, aged 27-87. years, diagnosed with CRC stage II-III, 1-5. years prior to enrollment in the study. They completed the Wagnild and Young's resilience scale and Brief Symptoms Inventory-18, cancer-related problem list, and demographic and disease-related details. Results: Older age, male gender, and less cancer-related problems were associated with higher resilience and lower emotional distress. A Structural Equation Modeling (SEM) analysis and mediation tests showed that, while controlling for cancer-related problems, resilience mediated the effects of age and gender on emotional distress. Conclusions: The study enlarges the explanation for the consistent previous findings on the better adjustment of older patients with cancer. Increased professional support should be provided for patients with low resilience levels. © 2013 Elsevier Inc.

Kushnir I.,Oncology Institute | Tzuk-Shina T.,Rambam Health Care Campus
Israel Medical Association Journal | Year: 2011

Background: Glioblastoma multiforme (GBM) is an ultimately fatal disease that affects patients of all ages. Elderly patients (65 years and older) constitute a special subgroup of patients characterized by a worse prognosis and frequent comorbidities. Objectives: To assess the efficacy of different treatment modalities in terms of survival in elderly patients with GBM. Methods: Using retrospective analysis, we extracted, anonymized and analyzed the files of 74 deceased patients (aged 65 or older) treated for GBM in a single institution. Results: Mean survival time was 8.97 months and median survival time 7.68 months. Patients who underwent tumor resection had a mean survival of 11.83 months, as compared to patients who underwent no surgical intervention or only biopsy and had a mean survival of 5.22 months (P < 0.0001). Patients who underwent full radiation treatment had a mean survival of 11.31 months, compared to patients who received only partial radiotherapy or none at all and had a mean survival of 4.09 months (P < 0.0001). Patients who underwent chemotherapy had a mean survival of 12.4 months, compared to patients who did not receive any chemotherapy and had a mean survival of 5.89 months (P < 0.001). Conclusions: Age alone should not be a factor in the decision on which treatment should be given. Treatment should be individualized to match the patient's overall condition and his or her wishes, while taking into consideration the better overall prognosis expected with aggressive treatment.

Shavit L.,Shaare Zedek Medical Center | Grenader T.,Oncology Institute | Lifschitz M.,Shaare Zedek Medical Center | Slotki I.,Shaare Zedek Medical Center
Journal of Pain and Symptom Management | Year: 2013

Context: Uremic pruritus (UP) affects many patients suffering from chronic kidney disease (CKD) and has a negative impact on quality of life and survival. It has become increasingly evident that central transmission and sensitization processes similar to those observed in chronic pain are important mechanisms of pruritus. Objectives: To test the potential role of pregabalin in reducing the intensity of UP in CKD patients. Methods: We prospectively collected data on CKD patients who suffered from severe intractable pruritus. Patients were asked to record the intensity of pruritus on a visual analogue scale. Results: Twelve patients were studied. The average pretreatment pruritus score was 9.7 ± 0.9 and decreased to 3.7 ± 2.35, 3.2 ± 1.75, and 3 ± 1.5 after one, four, and 24 weeks of treatment, respectively (P < 0.05). The positive effect of pregabalin was demonstrated during the first week of therapy in six patients. Most patients required 25 mg a day. Pregabalin was well tolerated, with somnolence and dizziness developing in two patients. Conclusion: We demonstrated dramatic improvement of long-standing UP after the initiation of pregabalin. We suggest that pregabalin can be used safely in CKD but careful titration of the dose is required to obtain an optimal response and minimize the possible adverse effects. © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Raiter A.,Tel Aviv University | Yerushalmi R.,Oncology Institute | Hardy B.,Tel Aviv University
Oncotarget | Year: 2014

Breast cancer tumor with triple-negative receptors (estrogen, progesterone and Her 2, receptors) is the most aggressive and deadly subtype, with high rates of disease recurrence and poor survival. Here, we show that induction in cell surface GRP78 by doxorubicin and tunicamycin was associated with CHOP/GADD153 upregulation and increase in apoptosis in triple negative breast cancer tumor cells. GRP78 is a major regulator of the stress induced unfolded protein response pathway and CHOP/GADD153 is a pro-apoptotic transcription factor associated exclusively with stress induced apoptosis. The blocking of cell surface GRP78 by anti-GRP78 antibody prevented apoptosis, suggesting that induction of cell surface GRP78 by doxorubicin and tunicamycin is required for apoptosis. A better understanding of stress induction of apoptotic signaling in triple negative breast cancer cells may help to define new therapeutic strategies.

Collins M.A.,Loyola University | Neafsey E.J.,Loyola University | Wang K.,University of Chicago | Achille N.J.,Oncology Institute | And 2 more authors.
Molecular Neurobiology | Year: 2010

There is no question that chronic alcohol (ethanol) abuse, a leading worldwide problem, causes neuronal dysfunction and brain damage. However, various epidemiologic studies in recent years have indicated that in comparisons with abstainers or neverdrinkers, light/moderate alcohol consumers have lower risks of age-dependent cognitive decline and/or dementia, including Alzheimer̄s disease (AD). Such reduced risks have been variously attributed to favorable circulatory and/or cerebrovascular effects of moderate ethanol intake, but they could also involve ethanol preconditioning phenomena in brain glia and neurons. Here we summarize our experimental studies showing that moderate ethanol preconditioning (MEP; 20̈C30 mM ethanol) of rat brain cultures prevents neurodegeneration due to β-amyloid, an important protein implicated in AD, and to other neuroinflammatory proteins such as gp120, the human immunodeficiency virus 1 envelope protein linked to AIDS dementia. The MEP neuroprotection is associated with suppression of neurotoxic proteinevoked initial increases in [Ca+2]i and proinflammatory mediators¡-e. g., superoxide anion, arachidonic acid, and glutamate. Applying a sensor → transducer → effector model to MEP, we find that onset of neuroprotection correlates temporally with elevations in effector heat shock proteins (HSP70, HSP27, and phospho-HSP27). The effector status of HSPs is supported by the fact that inhibiting HSP elevations due to MEP largely restores gp120-induced superoxide potentiation and subsequent neurotoxicity. As upstream mediators, synaptic N-methyld-aspartate receptors may be initial prosurvival sensors of ethanol, and protein kinase C epsilon and focal adhesion kinase are likely transducers during MEP that are essential for protective HSP elevations. Regarding human consumption, we speculate that moderate ethanol intake might counter incipient cognitive deterioration during advanced aging or AD by exerting preconditioning-like suppression of ongoing neuroinflammation related to amyloidogenic protein accumulation. © 2010 Springer Science+Business Media, LLC.

Zraly C.B.,Oncology Institute | Dingwall A.K.,Oncology Institute | Dingwall A.K.,Loyola University Chicago
Nucleic Acids Research | Year: 2012

Nucleosome remodeling catalyzed by the ATP-dependent SWI/SNF complex is essential for regulated gene expression. Transcriptome profiling studies in flies and mammals identified cell cycle and hormone responsive genes as important targets of remodeling complex activities. Loss of chromatin remodeling function has been linked to developmental abnormalities and aggressive cancers. The Drosophila Brahma (Brm) SWI/SNF complex assists in reprogramming and coordinating gene expression in response to ecdysone hormone signaling at critical points during development. We used RNAi knockdown in cultured cells and transgenic flies, and conditional mutant alleles to identify unique and important functions of two conserved Brm complex core subunits, SNR1/SNF5 and BRM/SNF2-SWI2, on target gene regulation. Unexpectedly, we found that incorporation of a loss of function SNR1 subunit led to alterations in RNA polymerase elongation, pre-mRNA splicing regulation and chromatin accessibility of ecdysone hormone regulated genes, revealing that SNR1 functions to restrict BRM-dependent nucleosome remodeling activities downstream of the promoter region. Our results reveal critically important roles of the SNR1/SNF5 subunit and the Brm chromatin remodeling complex in transcription regulation during elongation by RNA Polymerase II and completion of pre-mRNA transcripts that are dependent on hormone signaling in late development. © 2012 The Author(s).

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