Day 2 :
Keynote Forum
Denise Johnson Miller
Memorial Sloan Kettering Cancer Center, USA
Keynote: Update on genetics of breast and gynecologic cancers
Time : 10:00-10:40
Biography:
Denise Johnson Miller was accepted in a six year Bachelor of Science/MD program after graduating high school in Chicago Illinois. She has completed her MD at Washingon University Medical School, St. Louis Mo. She has completed her General Surgery Residency at University of Illinois in Chicago. She has completed two fellowships, the first in Tumor Immunology at University of Texas, Southwestern in Dallas, TX during her surgical residency. She has completed her Surgical Oncology Fellowship at City of Hope Medical Center in Duarte, CA. She was recruited to VA in Palo Alto and she has served as a Chief of General Surgery and Acting Chief of Surgery, she was then promoted to Assistant than Associate Professor of Surgery at Stanford University Medical School where she served as a Advising Dean and Director of Melanoma Surgery. She is currently a Medical Director of Breast Surgical Oncology for the MSK Hackensack Meridian Health System in New Jersey and Clinical Associate Professor of Surgery Rutgers Medical Center and Clinical Professor of Surgery Seton Hall University.
Abstract:
The keynote address will provide evidence based information to guide clinicians in evaluation and treatment of high risk for genetic breast and gynecologic cancers. A review of BRCA gene function, incidence of genetic mutations related to BRCA and other high risk genes will be provided. The use of next gene sequencing and multi-gene panels and discussion of new genes that are high, moderate and low penetrance pathologic mutations that impact risk of developing breast/gynecologic cancers will be noted. Clinical management of carriers, of pathogenic gene variants will be reviewed with incidence of primary and secondary cancers. Impact of high risk for breast/gynecologic cancers pathologic genetic mutations on patient’s wellbeing, economics of surveillance vs. prophylactic surgery or chemo prevention will be addressed.
Keynote Forum
Homer S Black
Baylor College of Medicine, USA
Keynote: Omega-3 fatty acids and cancer prevention
Time : 11:00-11:40
Biography:
Homer S Black received a BSc fromTexas A & M University, a MEd from Sam Houston State University, a M.S.Admin. (business/health science management) from the University of Houston and a PhD from LSU in Plant Biochemistry in 1964. He joined the Faculty at Baylor College of Medicine and the Houston Veterans Affairs Hospital as a Physiologist in 1968. His research interests have centered around UVR-induced skin cancer and antioxidant and dietary lipid modulation of this most common of cancers. He became Professor Emeritus in 2003.
Abstract:
The evidence for omega-3 fatty acid (FA) involvement in cancer has generally been equivocal. However, considerable circumstantial evidence has accrued from both experimental animal and human clinical studies that support a role for omega-3 FA in the prevention of non-melanoma skin cancer (NMSC). Direct evidence from animal studies has shown that omega-3 FA inhibit ultraviolet radiation (UVR) induced carcinogenic expression. In contrast, increasing levels of dietary omega-6 FA exacerbate NMSC. Both omega-3 and omega-6 FA are essential and exhibit only minor structural differences. Nevertheless, these differences lead to differential metabolites, as these FA are metabolized through the lipoxygenase (LOX) and cyclooxygenase (COX) pathways. These metabolites are influential in inflammatory and immune responses involved in carcinogenesis. Clinical studies have shown that omega-3 FA ingestion protects against UVR-induced genotoxicity, raises the UVR-mediated erythema threshold, reduces the level of pro-inflammatory and immunosuppressive prostaglandin E2 (PGE2) in UVR-irradiated human skin and appears to protect human skin from UVR-induced immune suppression. Thus, there is considerable evidence, albeit circumstantial, that omega-3 FA supplementation might be beneficial in reducing the occurrence of NMSC, especially in those individuals who are at highest risk.
- Gynecologic Oncology | Breast Cancer | Preventive Oncology
Session Introduction
Arpita Kulshrestha
Rosalind Franklin University of Medicine and Science, USA
Title: Vacuolar ATPase 'a2' subunit is a tumor associated antigen candidate for diagnosis and treatment of ovarian cancer
Time : 12:00- 12:25
Biography:
Arpita Kulshrestha has completed her PhD in 2012 from National Institute of Pathology, New Delhi, India. Presently, she is pursuing her Post-doctoral Training from Rosalind Franklin University of Medicine and Science. She has published more than 20 papers in peer reviewed journals along with several book chapters.
Abstract:
The identification of novel targets for early diagnosis and development of alternate therapies is vital to patient outcome in ovarian cancer (OVCA). Tumor associated vacuolar-H+-ATPases (V-ATPases) are multi-subunit proton-pumps that acidify the tumor microenvironment, thereby promoting tumor invasion, metastasis and drug-resistance. The subunit ‘a’ of its V0 domain is the major pH-sensing unit. Specifically, its ‘a2’ isoform (V0a2) is critical in metastasis through tumor-acidification and immuno-modulation. Initial evidence suggests that this is an ideal molecule for early diagnosis/treatment of OVCA. We investigated the expression of V0a2 in the clinical tissues from low-grade, high-grade and endometrioid OVCA. Immuno-histochemistry revealed that V0a2 was expressed in both low and high-grade serous-adenocarcinoma with weak staining in normal ovarian tissues. Among different pathological grades, V0a2 expression was significantly higher (p<0.05) in high-grade compared to low-grade serous-adenocarcinoma. The V0a2 expression correlated with Ki67 and CA-125 cancer cell antigen staining, confirming its expression on cancer cells. In these tissues, immuno-fluorescence analysis showed V0a2 localization on the plasma-membrane of cancer cells with no surface expression on normal ovary. V0a2 DNA/RNA-seq studies are ongoing to identify its underlying gene expression and regulation in OVCA. We also examined the presence of V0a2 in infiltrated immune cells in these OVCA tissues. V0a2 was expressed on CD68-positive tumor-associated macrophages (TAMs). In TAMs, V0a2 is known to regulate IL-1β expression leading to angiogenesis. Therefore, we conclude that V0a2 isoform is the plasma-membrane form of V-ATPase-‘a’subunit and is a potential tumor associated antigen candidate to target for diagnosis and treatment of ovarian cancer.
Qing Jiang
Purdue University, USA
Title: Vitamin E gamma-tocotrienol induces death of cancer cells by altering sphingolipids via inhibition of dihydroceramide desaturase
Time : 12:25-12:45
Biography:
Dr. Jiang is a Professor in the Department of Nutrition Science at Purdue University. Her research has focused on different forms of vitamin E and novel vitamin E metabolites, long-chain carboxychromanols, with respect to their anti-inflammatory and anticancer activities. Her lab has identified new vitamin E metabolites and novel bioactivities, and developed various analytical methods for quantifying vitamin E metabolites. Dr. Jiang has authored in 48 publications and obtained three patents. She is a member of the editorial board of Journal of Nutritional Biochemistry. She has served as a reviewer in study sections of NIH and USDA as well as numerous scientific journals. She is a recipient of E.L.R. Stokstad Award for outstanding fundamental research in nutrition from American Society for Nutrition and University Faculty Scholar Award from Purdue University
Abstract:
Gamma-tocotrienol (γTE) is a vitamin E form rich in palm oil. Gamma-tocotrienol has been shown to be stronger than vitamin E tocopherols in inducing death of cancer cells, and therefore proposed to be a potentially useful chemopreventive agent. However, mechanisms underlying these actions are not clear. Here using liquid chromatography tandem mass spectrometry, we show that γTE induced marked changes of sphingolipids including rapid elevation of dihydrosphingosine and dihydroceramides (dhCers) in various types of cancer cells. The elevation of dihydrosphingolipids coincided with increased cellular stress, as indicated by JNK phosphorylation, and was prior to any sign of induction of apoptosis. Chemically blocking de novo synthesis of sphingolipids partially counteracted gTE-induced apoptosis and autophagy. Experiments using 13C3, 15N-labeled l-serine together with enzyme assays indicate that γTE inhibited cellular dihydroceramide desaturase (DEGS) activity without affecting its protein expression or de novo synthesis of sphingolipids. Unlike the effect on dhCers, γTE decreased ceramides (Cers) after 8 h treatment, but increased C18:0-Cer and C16:0-Cer after 16 and 24 h, respectively. The increase of Cers coincides with gTE-induced apoptosis and autophagy. Since gTE inhibits DEGS and decreases de novo Cer synthesis, elevation of Cers during prolonged gTE treatment is likely caused by sphingomeylinase-mediated hydrolysis of sphingomyelin. This idea is supported by the observation that an acid sphingomeylinase inhibitor partially reversed gTE-induced cell death. Our study demonstrates that γTE altered sphingolipid metabolism by inhibiting DEGS activity and possibly by activating SM hydrolysis during prolonged treatment in cancer cells.
Nick Kostovic
Kostovic Acupuncture by bio Electron’s Laser, Corp., USA
Title: Cancer cured by bio electron's laser acupuncture
Time : 14:00- 14:25
Biography:
Abstract:
Bio-electric current is converted from standard electricity, by using a bio-electron-laser. This energy format can deeply penetrate into any physical organ, including the brain, heart, lungs, etc., with no risk. It is absolutely safe, non-lethal and does not cause any electrical shocks. This revolutionary technology using 120 voltages of AC knowing the human body's resistance to ground could be 1,000 Ohms/wet/produces the effect of approximately 12 micro amperes. By utilizing my newly discovered RC reverse current we can cancel magnetic from electricity and thereby prevent electromagnetic shock. My K-BTE device produces 10,000 times less speed-strength/frequencies of electrons than today's most developed technology. We are the only center in the world, who has successfully canceled magnetic from electro-magnetic, enabling us to perform at the unrivaled gentle frequency of micro amperes and nano amperes. The Kostovic Bio-Technology Energetic Device has the ability to extract bio-electron’s photons from H2O electric fluid, creating 1A=1,000,000 micro amperes. Using the power of standard 120 voltages yet creating such an extremely low frequency of micro amperes we do not create any electric shock, it is not at all lethal. We can also bring the frequency down even smaller to the nano amperes level which is 1A=1,000,000,000 billionth nano amperes, while controlling them like little tame sheep. Bio electrons at the micro amperes and nano amperes level can gently, precisely and efficiently burn off oxidized proteins and dead cells while energizing the hibernating healthy cells within the vascular system and the targeted injured organ while safely energizing weakened and hibernating healthy cells. World’s science and today official medicine is far behind this new developed advanced technology!
Gunjan Bhardwaj
EBS University of Business and Law, Germany
Title: Access to health–Breast cancer awareness and screening camps in rural India
Time : 14:25-14:50
Biography:
Dr. Gunjan Bhardwaj, Innoplexus AG, CEO and Founder, a consulting-led product and technology firm focused on big data and advanced analytics. Previously he served Boston Consulting Group and Ernst & Young where he led the Global Business Performance think tank.Additionally, Dr. Gunjan Bhardwaj was also an honorary representative of the state of Baden Württemberg to India.He has been publishing in several scientific and business journals such as the Harvard Business Review, MIT Sloan Review, International Journal of Innovation Management and Journal of Service Research. Dr. Gunjan Bhardwaj has studied at Indian Institute of Technology Bombay, Pforzheim Business School,MIT Sloan and European Business School.
Abstract:
Breast cancer is the most common cancer of urban Indian women and the second most common in rural women. Owing to lack of awareness of the disease in India and in absence of breast cancer screening programs, majority of breast cancers are diagnosed at a relatively advanced stage. Government agencies, NGOs and charity organizations have put great emphasis on improved breast cancer awareness among masses for promotion of early detection, providing comprehensive treatment module, providing support for breast cancer management and for screening and rehabilitation. The efforts have resulted in an improved survival and quality of life of Indian breast cancer patients but the improvement is more pronounced in urban population. In rural areas, there is still a lack of good health care and awareness among masses regarding the importance of early breast cancer screening and thus cases of late diagnosis are more prevalent. In addition, there is still an identified lack of breast cancer screening programs in rural areas which further causes late diagnosis. The other common factors that lead to late diagnosis include delays on the part of womenfolk of rural areas to seek advice for a recognized health problem which is mainly due to financial reasons, social/cultural reasons such as general inhibition of women to see the doctor for breast ailments, general scare of people towards cancer like disorders and a general indifference of women towards their health. In rural areas illiteracy is widespread and also people are inhibited and not motivated to come to the hospitals for screening/check-up. Considering various factors of cancer incidence rate, to address the most common barriers such as lower cancer literacy, lesser availability and accessibility of proper medical facilities, three Indian states were shortlisted to initiate the project ECHO by organizing breast cancer awareness and screening programs for rural and semi-urban Indian population. In addition to being a CSR approach, project ECHO also increased the cancer literacy amongst the rural population and emphasized on health education, early diagnosis of breast cancers and more public facilities for breast cancer treatments.
Homer S. Black
Baylor College of Medicine, Houston, USA
Title: Pro-Carcinogenic Action of Beta-carotene
Time : 14:50-15:10
Biography:
Homer S. Black, Ph.D. was born in Port Arthur, Texas in 1935. He completed high school at Nederland, Texas in 1952. he entered Texas A & M University and completed a B.Sc. in animal science. He attended Sam Houston State University where he received a M.Ed and then attended LSU where he earned a Ph.D. in Plant Biochemistry. He later received a M.S.A. in business/health science management from the University of Houston.. He joined the Baylor Faculty and Veterans Medical Center in 1968..His research has centered around UVR-induced skin cancer and antioxidant and dietary lipid modulation of this cancer. He retired in 2003 and became Professor Emeritus at Baylor College of Medicine.
Abstract:
Over 600 carotenoids have thus far been identified. About 100 are found in foods consumed by humans. Beta-carotene, as a pre-cursor of vitamin A, can have a profound influence on human health. An epidemiological study in 1981 found that those persons, who consumed foods rich in carotenoids such as green leafy and yellow vegetables, were at lower risk for cancer.. Beginning in the late 70s, a series of experimental UV-carcinogenesis studies found beta-carotene to be photoprotective. The role of beta-carotene as an anti-cancer agent began to be questioned as a result of intervention studies in which the incidence of non-melanoma skin cancer was unchanged in patients receiving beta-carotene supplements (1990) and in beta-carotene supplemented smokers who suffered a significant increase in lung cancer occurrence (1996). This was followed by an experimental study (1998) in which beta-carotene supplementation was shown to exacerbate UV-carcinogenic expression. The differences in response to beta-carotene supplementation were ascribed to type of diet, either closed-formula or semi-defined. A controlled dietary study was conducted in which varying levels of vitamin C and E were fed to animals receiving control and beta-carotene supplemented semi-defined diets. Vitamin C level had no effect on repair of the presumed caroteinoid radical cation. Beta-carotene supplementation resulted in a three-fold increase in tumor multiplicity. However, when the dietary level of vitamin E was reduced, a nearly six-fold increase in tumor multiplicity, compared to control, occurred. The mechanism of beta-carotene exacerbation of UV-carcinogenesis remains speculative, but beta-carotene supplementation should not be recommended as a cancer prevention strategy for the general population
Azita Haddadi
College of Pharmacy and Nutrition, University of Saskatchewan, SK, Canada
Title: Novel Immuno Oncology approches for cancer therapy
Time : 15:10-15:35
Biography:
Dr. Azita Haddadi is currently an Associate Professor at the Division of Pharmacy, University of Saskatchewan. She received her Pharm.D. in 1997 and Ph.D. in Pharmaceutical Sciences in 2005. She also completed a 3-year postdoctoral fellowship followed by a Research Associate position at the University of Alberta and a Senior Scientist position at the Quest PharmaTech inc. Dr. Haddadi’s research program focuses on overcoming the ongoing challenges in cancer therapy. The main emphasis of her research is to develop new biomedical and pharmaceutical nanotechnology strategies for cancer chemo-immunotherapy. Her research attracted considerable funding from a number of national organizations in Canada.
Abstract:
In spite of significant advances in recent years towards the development of new therapies, cancer is still a largely unmet medical need and the leading cause of death in industrialised countries. The main challenge in cancer therapy is the patients’ immune suppression leading to tumor relapse and therapeutic failure. Chemotherapy agents are often accompanied by various side effects and poor pharmacokinetics profile. Advancements in nanoparticles as novel drug carriers are rapidly progressing and offer exciting promises. Polymeric nanoparticles for immuno oncology purposes were developed, characterized and applied to improve the efficacy of the immunotherapy and chemotherapy of cancer. The nanoparticles showed significantly superior efficacy compared to conventional treatments. The drawbacks and challenges of the current cancer treatments and different strategies to overcome the issues will be presented and discussed.
Rajagopal Chattopadhyaya
Department of Biochemistry, Bose Institute, India
Title: Why extracts of five Indian plants may prevent cancer: enhanced protection of DNA but destruction of nucleotides through the endogenous Fenton reaction, inhibition of human topoisomerases
Time : 16:00-16:25
Biography:
Rajagopal Chattopadhyaya completed his PhD (UCLA,1987) under Richard Dickerson,who as a postdoc solved the 2Å structure of myoglobin under John Kendrew. Rajagopal did his postdoctoral work at UC Berkeley and Baylor College of Medicine. He has been a faculty member at Bose Institute since 1993, professor since 2006. His work at Bose Institute is mentioned in the Encycl. Britannica. Book of the Year, 1996 and LexA model in Burton E. Tropp’s Molecular Biology : Genes to Proteins, 3rd edn, a continuation of David Freifelder’s classic undergraduate textbook. Structural Biologist, biochemist, religious historian & author (as a hobby)
Abstract:
The influence of substoichiometric amounts of seven plant extracts in the Fenton reaction-mediated damage to deoxynucleosides, deoxynucleoside monophosphates, deoxynucleoside triphosphates and supercoiled plasmid DNA were studied to rationalize anticancer properties reported in the extracts Acacia catechu, Emblica officinalis, Spondias dulcis, Terminalia belerica, Terminalia chebula. Extracts from these five plants, as well as gallic acid, epicatechin, chebulagic acid and chebulinic acid enhance the extent of damage in Fenton reactions with all monomeric substrates but protect supercoiled plasmid DNA, compared to standard Fenton reactions [1]. However, Dolichos biflorus and Hemidesmus indicus extracts generally do not show this enhancement for the monomeric substrates though they protect plasmid DNA. Compared to standard Fenton reactions for deoxynucleosides with ethanol, the presence of these five plant extracts render ethanol scavenging less effective as the radical is generated in the vicinity of the target [1]. Since substoichiometric amounts of these extracts and the four compounds produce this effect, a catalytic mechanism involving the presence of a ternary complex of the nucleoside / nucleotide substrate, a plant compound and the hydroxyl radical was proposed [1]. Such a mechanism cannot operate for plasmid DNA as the planar rings in the extract compounds cannot stack with the duplex DNA bases. These plant extracts, by enhancing Fenton reaction-mediated damage to deoxynucleoside triphosphates, slow down DNA replication in rapidly dividing cancer cells. In another set of experiments, extracts of Acacia catechu, Emblica officinalis, Terminalia belerica, Terminalia chebula, Spondias dulcis, completely inhibit human topoisomerase I at 40 μg/ml concentration while Hemidesmus indicus and Dolichos biflorus extracts inhibit partially at the same concentration when included in standard assays [2]. Extracts of the same five plants which inhibit human topoisomerase I strongly are known to possess anticancer activity, while the other two are antioxidant only. Extracts of Acacia catechu, Terminalia chebula and Spondias dulcis show 20 to 80% inhibition of human topoisomerase I at even 9 μg/ml concentration [2]. All seven plant extracts partially inhibit human topoisomerase II at 120 μg/ml concentration in the decatenation assay. Chebulagic and chebulinic acids purified from Terminalia chebula extract inhibited human topoisomerase I at around 2 μM and 3 μM respectively [2]. The nuclear fragmentation leading to apoptosis observed earlier in cancerous cell lines in the presence of such plant extracts may thus be explained by the inhibition of topoisomerases in addition to modulation of Fenton reaction-mediated damage to DNA constituents.
Debarshi Jana
Institute of Post Graduate Medical Education & Research, India
Title: Prognostic significance of miR-34a in respect of NF-κB, p53 expression in different stage/grade of female genital and gonadal cancer
Time : 16:25-16:50
Biography:
Debarshi Jana is presently pursuing Young Scientist (DST, New Delhi) at Department of G & O, Institute of Post Graduate Medical Education & Research and Seth Sukhlal Karnani Memorial Hospital, under Calcutta University, Kolkata, India and has completed his PhD in October 2014. He has published more than 14 papers in reputed journals. He has presented more than 26 papers in oral/poster presentations in various conferences.
Abstract:
Female genital and gonadal cancer is first becoming commonest malignancy in female in urban population in India. Till now, most of the treatments are guided by the tumor parameters and many occasions the results of treatment have been unpredictable. This work aims to study various molecular factors and will try to link them with the tumor factors. This study has evaluated prognostic significance of miR-34a in female genital and gonadal cancer and correlated them with NF-κB and p53 expression in cancer patients. In this hospital based study, female genital and gonadal cancer patients attend at OPD in our institute of Eastern India. miR-34a, NF-κB and p53 protein expression was measured from cancer tissue sample by both Western Blot and RT-PCR techniques. Statistical significant risk of NF-κB and p53 positive tumor was found in advance stage. It was concluded that miR-34a is an independent prognostic and predictive marker of Indian female genital and gonadal cancer. Thus, the study can result in a pioneering work in establishing new risk stratification system which will be of importance in selecting appropriate adjuvant therapy following surgery. No such host-tumor integrating study has come out from this subcontinent and therefore is of importance in establishing female genital and gonadal cancer guideline for general Indian population.
Ashutosh Gupta
Dr. B R Ambedkar Hospital Medical College Raipur, India
Title: Laparoscopic radical hysterectomy and pelvic lymphadenectomy for uterine and cervical cancer: Our institutional experience
Time : 16:50-17:15
Biography:
Ashutosh Gupta has done his MCh in Surgical Oncology from Gujarat Cancer Research Institute, Ahmadabad, completed in the year 2007. He is Associate Professor and Head of surgical oncology Regional Cancer Center Dr. B R Ambedkar Hospital Medical College Raipur, India. He has expertise and special interest in minimal invasive oncosurgery. He has more than 12 publications in various national and international reputed journals.
Abstract:
Aim: To study retrospectively the outcome, feasibility, morbidity and safety of total radical hysterectomy and lymphadenectomy at our institution.
Materials & Method: A total of 20 patients of carcinoma cervix and endometrium according to International Federation of Gynecology and Obstetrics (FIGO) stage were studied. Various patients parameters i.e. age, weight, BMI and stage of the disease were noted. Intra-operatively mean operative time and mean blood loss were recorded. Post-operative parameters noted in the present study included lymph node yield, surgical margin and hospital stay. Patients were followed up for a period of 6 months.
Results: Mean age of the patients was 54.2 years (range 45–67 years). Sixteen (16) patients had carcinoma cervix (12 patients had stage IB1 and 4 patients had stage IA2) and four patients were diagnosed to have endometrial carcinoma. Mean operative time recorded was 166 minutes (range 120-210 minutes) and average blood loss calculated was 212 ml (range 150–320 ml). These patients neither required intra operative blood transfusion nor had any intra operative complications. Surgical margins of the specimen were clear for all patients and average lymph node yield was 15.35 per patient. Mean hospital stay was 3 days. All the patients were followed up for a period of 6 months and all of them were locally controlled till last follow up.
Conclusion: Total laparoscopic radical hysterectomy and lymphadenectomy can be performed safely with shorter hospital stay and no morbidity and patients can be started on the post-operative adjuvant therapy early.
- Gynecologic Oncology | Breast Cancer | Preventive Oncology
Session Introduction
Aaron H. Chevinsky
Aurora Health Care, Milwaukee, USA
Title: Nanoknife Irreversible Electroporation (IRE) for Pancreatic and Liver Tumors
Time : 11:40-12:05
Biography:
Aaron H Chevinsky is the Director of Surgical Oncology at Aurora Health Care in Wisconsin. He has lectured nationally and internationally and has published on many aspects of cancer care. He attended medical school and completed his surgical residency in New York, and completed a surgical oncology fellowship at Ohio State. He has been named to the Top Docs list and has won awards for the development of multidisciplinary cancer care programs. He also appeared on TV and radio to raise awareness and promote cancer screening he remains committed to providing the best cancer care to the patients he treats.
Abstract:
Nanoknife Irreversible Electroporation is a locally based treatment for unresectable cancers, particularly those close to major vascular structures. Using DC electrical current, small pores are created in the cellular membrane allowing extracellular fluid to enter and rupture the cell. This is accomplished without damage to the underlying vessels and ducts in the vicinity. In contradistinction to heat based ablative therapies such as radiofrequency and microwave ablation, there is no heat-sink effect which increases the rate of recurrence near major vascular structure. This procedure has been primarily used for locally advanced tumors of the pancreas involving the superior mesenteric artery and/or vein or the celiac artery, and tumors of the liver near the major hepatic veins, inferior vena cava or portal veins. It has also been successfully used in tumors of the head and neck, lung, retroperitoneum, kidney and prostate. Martin et al (1) documented a doubling in survival in patients with locally unresectable pancreatic cancers from under 12 months (historical controls) to 24.9 months. This procedure can be done both as an open surgical procedure and percutaneously by interventional radiology. Nanoknife therapy provides a safe alternative therapy for patients with previously unresectable disease in the liver and pancreas. With a short follow up, we have demonstrated effective local control. Longer follow up and larger series are needed.
Aurora Health Care system has become the first site in Wisconsin to offer this new technology. The procedural details, indications, patient selection and precautions will be presented along with case studies of patients undergoing this procedure.
Joseph O Nwankwo
Federal University, Nigeria
Title: Anticancer potentials of phytochemicals from indigenous west African plants
Time : 12:05-12:30
Biography:
Joseph O Nwankwo obtained his DPhil from Oxford University and Post-doctoral/Research fellowships at University of Southern California and University of Iowa. He was also an Associate Scientist at the University of Wisconsin, Madison Department of Surgery and the Cancer Centre. He was the pioneer Director of the Centre for Molecular Biosciences and Biotechnology, Michael Okpara University of Agriculture, Umudike, Nigeria and currently, the Head of Department of Medical Biochemistry at the Federal University, Ndufu-Alike, Ikwo, Nigeria. He has published more than 25 papers in reputed journals.
Abstract:
Many indigenous west African plants have been employed as local remedies for various human ailments in the traditional medicine of the region and as nutritional sources for countless generations. Isolation and characterization of the chemical structures for phytochemicals from useful indigenous plants have however been undertaken only for a minimal fraction largely, because the modern techniques of chromatography and mass spectroscopy have been exploited by African scientists relatively, recently. The significance of the latter development has been to greatly enhance an understanding of the molecular mechanisms of action for these isolated compounds as pharmacological agents. In particular, such knowledge has been applied in the present discussion to identify indigenous west African phytochemicals with potential anticancer activities based on their structure-activity relationships to known active compounds – an outcome totally unanticipated by the organic chemists who merely isolated and characterized these phytochemicals. The compounds are grouped as potential “Cancer Chemopreventive” and “Cancer Chemotherapeutic” agents and cover most of the known phytochemical classes of alkaloids, flavonoids, lignans, quinones, terpenoids and ‘miscellaneous’, the latter class comprising compounds considered chemically inappropriate for the previous classes. Such identified compounds still await relevant biological activity tests before confirmation of suggested anticancer potentials.
Biography:
Zaid Al-Wahab has completed his Medical Degree from Al-Nahrain University. He has completed his residency in Obstetrics and Gynecology from Wayne State University/Detroit Medical Center. He then did a Fellowship in Gynecologic Oncology from Karmanos Cancer Institute/Wayne State University. His interest lies in minimally invasive surgery including Robotic Surgery and Sentinel lymph node mapping.
Abstract:
Cancer is an important cause of death in women of childbearing age. Cancer incidence in pregnancy has increased in the last 50 years due to higher rates of cancer and delay in childbearing. There are more than 800,000 women receive cancer diagnosis every year and 4 million women who will become pregnant in the US each year. The most common cancers in pregnancy are Breast and Cervical cancers. Symptoms of cancer can be confounded with pregnancy symptoms. The diagnosis and treatment require a balance of risks and benefits for both maternal and fetal wellbeing. This requires a multidisciplinary approach of different specialties. Management of cancer with surgery, chemotherapy, radiation and hormonal therapy depend on the gestational age, stage of disease and the specific type of treatment. As advancements in cancer treatments continue to improve survival, increased focus has been given to improvement in quality of life for survivor. Onco-fertility is a fast growing field that focuses on fertility preservation for the patients after cancer treatment. Options for women to have children after cancer have increased significantly in recent years.
Shaila Anwar
Ghurki Trust Teaching Hospital, Pakistan
Title: Correlation of lymph node metastases with stage and grade of the disease in carcinoma of the cervix
Time : 12:55-13:20
Biography:
Shaila Anwar working in the Department of Obstetrics and Gynecology of Ghurki Trust Teaching Hospital, Pakistan. She has published many papers in reputed journals
Abstract:
Objectives: To find out pelvic and paraaortic lymph node enlargement with clinical stage of carcinoma of cervix; and also to see the histopathological correlation with lymph node enlargement.
Duration: June 2004 to May 2016.
Place of Study: Department of Obstetrics & Gynecology, Department of Radiotherapy and Department of Radiology Ghurki Trust Teaching Hospital and Mayo Hospital, Lahore.
Method: 115 patients were clinically staged and evaluated by CT. Treatment record of radiotherapy was available.
Results: Paraaortic and pelvic lymph node involvement was seen to be increasing with advancing stage of carcinoma of cervix. Highest lymphatic involvement was seen with SCK type of histopathology.
Conclusion: With SCK tumor and advanced stage of disease, radiation fields may need to be modified to include lymph nodes in para aortic region. More studies need to be conducted in this area
Nabeela Shami
Lahore Medical & Dental College, Pakistan
Title: Early secondary cytoreduction may be associated with better surgical outcomes in recurrent epithelial ovarian cancer
Time : 14:10-14:35
Biography:
Nabeela Shami working in the Department of Obstetrics and Gynecology of Lahore Medical & Dental College, Pakistan. She has published many papers in reputed journals.
Abstract:
Background: Secondary cytoreductive surgery should be considered in all patients with recurrent epithelial ovarian cancer as optimal secondary cytoreduction has been associated with improved survival, irrespective of duration of disease free interval (DFI). A good performance status, initial optimal cytoreduction and absence of ascities are suggestive of increased odds of optimal secondary cytoreduction. Extent of disease is also a major determinant as patients with smaller disease burden are more likely to achieve optimal cytoreduction. Consequently, delay in secondary cytoreduction may reduce the number of patients who can undergo optimal cytoreduction. As yet, there is no consensus in literature regarding the optimum timing of secondary cytoreduction in patients with recurrent disease. The present series aims to document the success rate of optimal secondary cytoreduction in patients based on their DFI.
Methods: Patients who had undergone primary cytoreductive surgery, had received chemotherapy and showed a complete response, but subsequently presented with disease recurrence, were included. Evidence of measurable disease on imaging study was required. Abdomen was opened with a vertical incision, ascitic fluid/washings were removed, maximal cytoreduction was performed with a goal to reduce the tumor to <1 cm diameter. All patients were given gemcitabine 1250 mg/m2 on day 1 and 8 and cisplatin 70 mg/m2on day 1 only. Cycles were repeated every three weeks. RECIST was used for response evaluation.
Result: One hundred and eight patients were enrolled from December 1998 to December 2013. Median age was 52 years (range 40-68). Seventy two patients had previously received cyclophosphamide and cisplatin while 36 had received paclitaxel and carboplatin. The disease free interval was less than 6 months in 32 patients, more than 6 months in 50 patients and more than 12 months in 26 patients. Optimal cytoreduction was achieved in 42 (38.8%) patient only and included 15, 20 and 7 patients with DFI of <6 months, >6 months and >12 months, respectively. Gut injury was seen in 8 (7.4%) and bladder perforation in 8 (7.4%). Among 42 patients with optimal cytoreduction, 20 had a CR while 22 showed a PR with chemotherapy whereas in patients with sub-optimal surgery CR was seen in 14 patients, PR in 20 and less than PR in 32 patients.
Conclusion: Secondary cytoreduction and postoperative second line chemotherapy with gemcitabine and cisplatin is a reasonable treatment option for patients with recurrent epithelial ovarian cancer. Early cytoreduction seems to confer a favorable surgical outcome. The present data suggests that early detection and surgical intervention of recurrent disease may result in increased response rates. Further studies are needed to validate our findings in larger patient cohorts.
Marta Recio Rodriguez
Complutense University of Madrid, Spain
Title: Sexual dysfunction in the gynecologic oncology patient
Time : 14:35-15:00
Biography:
Marta Recio Rodríguez has completed her Medical studies in Universidad Complutense de Madrid (Spain) and continued her foundation for 4 more years with the National Medical Residency System to specialize in Gynecology and Obstetrics. She also has 2 Master degrees, the first one in Sexology and couples therapy, and the second one in Urogynecology and pelvic floor dysfunctions. She is the Coordinator Manager of the Gynaecological and Obstetrics team in Policlinica Nuestra Señora del Rosario in Ibiza and also a Member of the Breast Pathology Unit.
Abstract:
Being diagnosed with gynecological or breast cancer implies confronting the organic and psychological consequences of an illness that affects parts of the body which are full of sexual significance. Together with the actual process of the cancer, the medical and surgical treatments received can cause severe consequences on the patients’ sexuality, including body image and self-esteem. It is the duty of the medical professionals to include a sexual assessment of oncology patients as an integral part of the medical evaluation. The aim of this talk is to deal with the different physical and psychological issues in oncological patients’ sexuality and their correct management.
Roya Dolatkhah
Tabriz University of Medical Sciences, Iran
Title: Are dietary, life style and socio-economic factors associated with the risk of mutations in colorectal cancer?
Time : 15:00-15:25
Biography:
Abstract:
Muhammad Ibrar Khan Afridi
Near East University, Turkey
Title: Role of adiponectin in menopausal women
Time : 15:25-15:50
Biography:
Muhammad Ibrar Khan Afridi is currently working Near East University, Turkey. He has published many papers in reputed journals.
Abstract:
Adipogenesis refers to the differentiation of pre-adipocytes into mature fat cells, i.e., the development of adipose tissue, which varies according to sex and age. Adipocytes differentiate from stellate or fusiform precursor cells of mesenchymal origin. Adiponectin has been postulated to act an important role in the modulation of glucose and lipid metabolism in insulinsensitive tissue in both humans and animals. The transition from pre to post menopause is associated with the emergency of many features of metabolic state. The intraabdominal body fat increases, low density lipoprotein and triglyceride levels increase while high density lipoprotein decreases, as the results to date are conflicting. In this study, we aimed to study the changes in adiponectin and anthropometric parameters after menopause. For the purpose, the ELISA method was used in the study to evaluate the values of adiponectin. A total of 70 female in menopause and 90 control subjects were included in this study. The results showed that adiponectin, BMI and blood pressure increased with menopause. It is recommended that further work must be carried out in the near future in order to investigate the effect of menopause on these parameters.
Aaron H. Chevinsky
Aurora Health Care, Milwaukee, USA
Title: Nanoknife Irreversible Electroporation (IRE) for Pancreatic and Liver Tumors
Biography:
Aaron H Chevinsky is the Director of Surgical Oncology at Aurora Health Care in Wisconsin. He has lectured nationally and internationally and has published on many aspects of cancer care. He attended medical school and completed his surgical residency in New York, and completed a surgical oncology fellowship at Ohio State. He has been named to the Top Docs list and has won awards for the development of multidisciplinary cancer care programs. He also appeared on TV and radio to raise awareness and promote cancer screening he remains committed to providing the best cancer care to the patients he treats.
Abstract:
Nanoknife Irreversible Electroporation is a locally based treatment for unresectable cancers, particularly those close to major vascular structures. Using DC electrical current, small pores are created in the cellular membrane allowing extracellular fluid to enter and rupture the cell. This is accomplished without damage to the underlying vessels and ducts in the vicinity. In contradistinction to heat based ablative therapies such as radiofrequency and microwave ablation, there is no heat-sink effect which increases the rate of recurrence near major vascular structure. This procedure has been primarily used for locally advanced tumors of the pancreas involving the superior mesenteric artery and/or vein or the celiac artery, and tumors of the liver near the major hepatic veins, inferior vena cava or portal veins. It has also been successfully used in tumors of the head and neck, lung, retroperitoneum, kidney and prostate. Martin et al (1) documented a doubling in survival in patients with locally unresectable pancreatic cancers from under 12 months (historical controls) to 24.9 months. This procedure can be done both as an open surgical procedure and percutaneously by interventional radiology. Nanoknife therapy provides a safe alternative therapy for patients with previously unresectable disease in the liver and pancreas. With a short follow up, we have demonstrated effective local control. Longer follow up and larger series are needed.
Aurora Health Care system has become the first site in Wisconsin to offer this new technology. The procedural details, indications, patient selection and precautions will be presented along with case studies of patients undergoing this procedure.
Birtukan Derso Endalew
Bahir Dar University, Ethiopia
Title: A case of tuberculoma in a neonate with associated umbilical vein aneurism
Biography:
Birtukan Derso is BSC mid wife working in felegehiwot Referral hospital as a midwife for the last 5 year and currently doing her second degree in public health in Bahir Dar university .She has been a sole participant in many research activities undertaken in the region , especially in maternal and child health
Abstract:
Background: Intracranial tuberculoma in new born is a rare occurrence. We report a 7-month-old male infant presenting to our tertiary care referral center with complaints of global developmental delay and right hemiparesis for 3 months. Radiologic imaging was suggestive of large left frontoinsular space–occupying lesion with initial differential of primitive neuroectodermal tumor or desmoplastic infantile ganglioma. Considering the clinicoradiologic findings and no history suggestive of immunodeficiency or contact with tuberculosis, surgical decompression was done. Final histopathology revealed multiple epithelioid granulomas suggestive of tubercular etiology or intracranial Langerhans cell histiocytosis. He was started on antitubercular therapy after ruling out Langerhans cell histiocytosis using CD1a and Langerin immunohistochemistry staining. Interpretation of tuberculous etiology in infants can be challenging for clinicians, radiologists, and pathologists. A high index of suspicion is necessary to diagnose such lesions, predominantly in endemic regions.
Case Presentation: A 2500 gm neonate is born from a para-ii mother at a gestational age of 35weeks. The mother had only two antenatal follow up. In the last two months before delivery she had productive cough, shortness of breath, easy fatigability. Obstetric ultrasound showed normal pregnancy. Labor started in a week. She delivered 2800gm male with APGAR of 5 and 6in the 1st and 5th minutes. With widened anterior fontanel, increased tones of lower extremity of the right side and progressively fails to suck. With investigation the problem is found to be tuberculoma. The diagnosis, treatment and outcome of the case will be discussed in the presentation
Sajid Iqbal
Emirates College of Technology, Abu Dhabi, UAE
Title: An Investigation of BC Risk Factors In Pakistani Population
Biography:
Sajid Iqbal have completed his predoctoral program in Biomedical Sciences from department of human genetics, KU Leuven University, Belgium. Currently working as Institution Research Manager with Emirates College of Technology, Abu Dhabi, U.A.E, Few of his publications are in international journals already.
Abstract:
Brest cancer (BC) is the second most widespread and the utmost common cancer among females population in the world. It has foremost influence on women health. Deaths from BC account for 1.6% of female deaths every year. The aim of this study was to determine the prevalence of BC, also to determine and quantify the associated risk factors for BC among Pakistani females. We carried out an observational case-control study for the present research. The study includes 105 BC patients and a group of 105 controls (healthy women). Univariate and multivariate logistic regression analysis along with Pearson’s Chi-square was applied to determine and quantify the association between risk factor and BC risk. In multivariate models, Environmental area and exposure to X-Ray radiations were found to be significantly associated with BC risk (p = 0.012, 0.03). Female with a positive family history of BC/ were at higher risk for developing BC. An early age at menarche was a strong risk factor for developing BC. Age less than 12 years increased the risk 2.551 times and an older age at menarche was associated with a significant reduction in the risk of BC. Menopausal status and age at last pregnancy were also risk factor of BC. We may conclude that the breast cancer is highly prevalent in the local population and its risk increases with X-ray radiation exposure, living area and habits, family history, early age of monarch and menopausal status.