INTRODUCTION: Worldwide, one in eight deaths is due to cancer. Projections based on the GLOBOCAN 2012 estimates predict a substantive increase in new cancer cases per year by 2035 in developing countries if preventive measures are not widely applied. According to the World Health Organization (WHO), millions of lives could be saved each year if countries made use of existing knowledge and the best cost-effective methods to prevent and treat cancer. Therefore, this study aims to estimate a provisional budget against cancer in low and middle incomes countries, according to the GNI-PPP, the cancer incidence, and the population.

METHODS: Economically country classification is determined by the Gross national income (GNI), per capita, and Purchasing power parity (PPP), according to the administrations of the International Monetary Fund (IMF); the World Bank (WB), and the Central Intelligence Agency (CIA). Cancer incidence data presented are based on the most recent data available at IARC. However, population compares estimates from the US Bureau of the Census. The provisional budget is established among the guidelines developed by WHO for regional and national cancer control programs according to national economic development.

RESULTS:  A compilation of 91 articles representing 91 Programs against cancer in low and middle incomes countries are determined.

CONCLUSION: Provisional budget against cancer is estimated to be 51,477,422.00 (thousands of U.S $) for a population of 3,682,702.05 (thousands of people), in 91 low and middle incomes countries worldwide, according to the GNI-PPP, cancer incidence and the number of population.

The discovery of BRAF inhibitors has revolutionized therapy for the 50% of patients with BRAFV600 mutant melanoma however BRAFWT melanomas have few effective therapies. The oncogene NRAS is activated by mutation in 15-20% of melanomas and has limited therapeutic options. Among 24 hit compounds from our recent drug screen for small molecules that enhanced the cytopathic effects of histone deacetylase inhibitors, we identified compound 012 (C-12) which unexpectedly had significant single-agent activity on melanoma cell viability with limited toxicity against normal human fibroblasts. Importantly, when combined with the BRAFV600 inhibitor, vemurafenib, C-12 synergistically increased vemurafenib potency in 5 of 6 BRAFWT melanoma cell lines (Combination Index: CI<1) and dramatically reduced colony forming ability (P<0.0001). Mechanistically, the combination of vemurafenib+C-12 markedly increased a growth suppressor, tripartite motif (TRIM) 16 protein level and knockdown of TRIM16 in melanoma cells significantly reduced vemurafenib+C-12 induced growth inhibition suggesting that the combination exerted synergistic anti-cancer effects by inducing TRIM16 expression resulting in consequent growth arrest. Microarray analysis revealed an increase in cholesterol biosynthesis suggestive of a response to decreased intracellular cholesterol with combination treatment. Synergy studies between cholesterol inhibitors, lovastatin & U18666A, and vemurafenib revealed significant synergy preferentially targeting BRAFWT melanoma in like manner to C-12. Taken together, we have identified a novel compound that works synergistically with BRAF inhibitor as an anti-cholesterol drug and specifically targets BRAFWT melanoma cells. We have further shown that statins combined with vemurafenib have significant anti-tumor activity in BRAFWT melanomas, suggesting a novel therapeutic approach.

Objectives: After the introduction of non cytological tests like visual inspection after acetic acid (VIA) or Human Papillomavirus (HPV) test, there is a paradigm shift in screening for cervical cancer. Though ‘screen and treat’ strategy is being recommended in low resource settings, the low positive predictive values of both the tests will lead to lot of overtreatment. GynocularTM is a battery-operated, portable device with three-step magnification and green-filter. Present study was conducted in a community setting to evaluate GynocularTM in detection of cervical neoplasias.rnrnMethodology: Women between 30-60 years were screened using VIA and HPV test. Women positive on either test had evaluation by GynocularTM using IFCPC 2011 colposcopy classification and swede score. Punch biopsy was obtained from any lesion detected by GynocularTM. HPV positive women also had random punch biopsy from the cervix. The sensitivity, specificity and agreement between histology and gynocular diagnosis were estimated.rnrnResults: Total 6884 women were screened from April, 2014 to March, 2015. Total 684 women were examined by GynocularTM. A total of 28 cases of CIN2+ were detected. The sensitivity and specificity of Gynocular (IFCPC Grade-2 threshold) to detect CIN 2+ were 92.9% and 96.1% respectively. The exact agreement between Gynocular examination and histology to classify the cervical lesions was 55.5% with kappa value of 0.29 (95% C.I. 0.22–0.36) indicated ‘fair’ agreement. rnrnConclusion: There is a great need for an inexpensive colposcope to be used for programs in LMICs. The agreement of GynocularTM with histology was same as that of colposcopy reported in our earlier study conducted in the same setting. The logistic advantage of the device and ability to capture images using mobile phone are beneficial to use Gynocular TM for cervical cancer screening program.

Regardless of the fact that we often perform totally implantable venous-access ports (TIVAPs) for cancer chemotherapy, there have been several reports regarding complications. The objective of this study was to summarize the TIVAPs idiopathic complications of 400 devices in latest 6 years. The patients underwent TIVAPs in the internal jugular or sub-clavian vein via the Seldinger technique in our hospital. We used two different devices, which were the Bard X-Port™, used from 2009 to 2012, and the Power Port™ used from 2012 to 2015. These devices are composed of titanium and silicone rubber port (DomePort™, Bard Inc, Salt Lake City, UT, USA) connected to an 8Fr silastic Groshong™ catheter tube. 400 TIVAPs, total 89,568 days insertion, with a median follow up of 405 days. There were 30 idiopathic complications. The complications consisted of eleven complete occlusions (2.8%), eight pocket infections (2%), three of pneumothorax (0.8%), two pinch-offs and slip-offs due to pedunculated breast (0.5%), one catheter-related bacteremia, rubber port disconnection, rubber port rotation in pocket and wound dehiscence due to bevacizumab™(0.3%). Here, we focus to present the complete occlusion. Although, complete occlusion was most popular idiopathic complication of TIVAPs in this study, one patient has undergone complete occlusion with Trousseau syndrome. When we removed TIVAPs, we experimented 12 cm length red thrombus and elevated D-dimer which possibility triggered Trousseau syndrome in parallel. Finally, these complications were found by nurses, who are important in cancer nursing care.

Background:
Hyperthermia as complementary treatment is an important tool to improve the efficacy of chemotherapy and radiation in cancer. Hyperthermia treatment includes superficial hyperthermia, deep regional hyperthermia but also whole body hyperthermia. Beside a temperature dependent increase of the efficacy of cytostatic drugs or radiation there are also direct effects of hyperthermia on cancer cells at temperatures around 42 C° (107,6 F°).

Methods:
Hyperthermia is used together with radiation in locally recurrent disease or together with chemotherapy in patients with metastatic disease.
Superficial hyperthermia with water filtered infrared-A light (1200 nm, Hydrosun device)
1.Local regional hyperthermia is used for superficial disease, e.g. inflammatory skin involvement with short wave irradiation with 13,56 MHz (Oncotherm EHY 2000 device is used for the localized breast tumor or metastatic tissues e.g. liver metastases.
2.Whole body hyperthermia is performed by whole body radiation with water filtered infrared-A light (1200 nm) for patients with metastatic disease.
Chemotherapies are given to local hyperthermia session or to whole body hyperthermia.  

Results:
Early studies about simultaneously hyperthermia and radiation showed about doubled response rates compared to radiation alone. Even in pretreated patients with metastatic breast cancer using a combination of whole body hyperthermia and chemotherapy showed response rates between 70- 80%. Using cytostatic drugs in more moderate doses together with hyperthermia patients had only little side effects.

Conclusion:
Studies and own experiences show that hyperthermia in metastatic breast cancer shows promising results, in particular as breast cancer is a disease sensitive to different types of chemotherapy and radiation.