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   Table of Contents - Current issue
Coverpage
January-March 2021
Volume 58 | Issue 1
Page Nos. 1-153

Online since Wednesday, March 24, 2021

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LETTER FROM THE EDITOR  

Outgoing editor's thoughts – On Sisyphean tasks and the last refuge of scoundrels p. 1
Sanjay A Pai
DOI:10.4103/ijc.IJC_56_21  
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EDITORIAL Top

Epidermal growth factor receptor mutated lung cancers: Looking beyond adenocarcinomas p. 3
Saurabh Zanwar
DOI:10.4103/ijc.IJC_686_19  PMID:33402594
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REVIEW ARTICLES Top

Optimum patient selection for irinotecan-containing regimens in metastatic colorectal cancer: Literature review and lessons from clinical practice p. 5
Maheboob Basade, Akshata Mane
DOI:10.4103/ijc.IJC_507_19  PMID:33402591
Metastatic colorectal cancer (mCRC) accounts for over 20% of CRC cases and is associated with a poor prognosis. Irinotecan is an important first- and second-line chemotherapy option for mCRC. In this review, we summarize the clinical efficacy and safety of irinotecan-based regimens for the treatment of mCRC and discuss various tumor- and patient-related factors that affect the clinical response, survival, and toxicity associated with these regimens. Uridine diphosphate glucuronosyltransferase (UGT) gene polymorphisms such as UGT1A1*28/*6, age, performance status, serum lactate dehydrogenase levels, and bilirubin levels could be important considerations for predicting outcomes and tolerability with irinotecan-based regimens. The role of tumor location; chemotherapy backbone; and emerging evidence on the presence of microsatellite instability-high status, consensus molecular subtype 4 tumors, and signet-ring morphology in predicting response to irinotecan-based therapy have also been highlighted. Careful consideration of these factors will help guide clinicians in optimizing the selection of mCRC patients for irinotecan-based treatment.
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Grossing and reporting of a soft tissue tumor specimen in surgical pathology: Rationale, current evidence, and recommendations Highly accessed article p. 17
Bharat Rekhi, Jayasree Kattoor, Anne Jennifer, Nandini Govindarajan, Shantveer Uppin, Nirmala A Jambhekar, Annie Jojo, Uttara Chatterjee, Devmalya Banerjee, Pradyumn Singh
DOI:10.4103/ijc.IJC_738_20  PMID:33402595
Soft tissue tumors, including sarcomas are complex and diagnostically challenging tumors. This is as a result of their heterogeneity and overlapping clinicopathological, immunohistochemical and also molecular features, the latter to some extent. More than 80 types of sarcoma have been described. Current management, which is best offered at centers with active multidisciplinary care, is based on balancing oncologic and functional outcomes in such cases. This has transcended into the types of specimens received for grossing these rather uncommon tumors. Over the years, diagnostic specimens have reduced in their sizes from, open biopsies to core needle biopsies. These specimens need to be adequately and judiciously triaged for ancillary techniques, such as molecular testing. Conservative surgeries have led to resected specimens for marginal assessment. Lately, post neoadjuvant (chemotherapy or radiation therapy)-treated resection specimens of soft tissue sarcomas are being submitted for surgical pathology reporting. This article focuses on the grossing of soft tissue tumors, including sarcomas, in terms of types of specimens, grossing techniques including rationale, tissue triage, reporting, and recommendations from the surgical pathologists actively engaged in reporting musculoskeletal tumors, based on current evidence.
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SPECIAL ARTICLES Top

Advances in basic research in oncology in 2020: Bridging basic science and clinical care p. 28

DOI:10.4103/ijc.IJC_1358_20  
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Advances in community oncology in 2020: COVID-19 and beyond p. 30

DOI:10.4103/ijc.IJC_1362_20  
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Advances in pathology in 2020: Year's roundup p. 32

DOI:10.4103/ijc.IJC_1353_20  
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SPECIAL ARTICLES Top

Advances in breast cancer research in 2020: changes in clinical practice p. 35
GA Toshib, Suhani
DOI:10.4103/ijc.IJC_1396_20  
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SPECIAL ARTICLES Top

Advances in surgery in 2020: The impact of the COVID-19 pandemic on cancer surgeries and cancer care - a brief overview p. 38

DOI:10.4103/ijc.IJC_1271_20  
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Advances in radiotherapy in 2020: Hypofractionation - less is more in times of COVID-19 p. 41

DOI:10.4103/ijc.IJC_1345_20  
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Advances in palliative care in 2020: Palliative care and oncology in India - Looking ahead from 2020 p. 45

DOI:10.4103/ijc.IJC_1347_20  
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HISTORY OF MEDICINE Top

Cancer incidence in Madras Presidency in 1892–1901: William Niblock's commentary of 1902 p. 48
Ramya Raman, Anantanarayanan Raman
DOI:10.4103/ijc.IJC_302_20  PMID:32769292
William J. Niblock (WJN), an Assistant Surgeon at the Madras General Hospital (MGH), published a paper 'Cancer in India' (2 pages of text and 3 pages of tables) in the Indian Medical Gazette in 1902. He appears to have been a popular surgeon in Madras who surgically treated mouth cancers, testicular filariasis, and calcareous stones in the liver, gall bladder, and kidney. His 'Cancer in India' article is a compilation of numerical data of different cancers recorded in MGH from 1892 to 1901 mostly, and from 1896 to 1901 occasionally. In this article, WJN refers to cancers of different internal organs and external parts. He attributes the mouth cancers to constant chewing of 'betel' (the betel quid), which he explains as giving rise to leukoplakia, forerunner of buccal carcinoma. He supplies many, easily comparable, paired tables. These tables are made of raw numbers about the diverse human populations living in Madras, such as the Indians (Hindus and Muslims), Europeans, and Eurasians (Anglo-Indians) extracted from the 10-year records of MGH. None of the tables has been analyzed statistically. Nevertheless, he supplies the total numbers of admissions into MGH, which serve usefully as denominators in this study; occasionally, he presents data as percentages. Despite the lack of parametric statistical analysis, WJN's article, written in 1902, impresses as a useful contribution, because it provides a cross-sectional view of cancer incidence in Madras, particularly in defiance of Saldanha's supposition that cancers do not manifest in dark-skinned people, such as Indians.
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HEPATOBILIARY CANCER Top

Therapeutic efficacy of TACE 125I seed implantation and its combination with intra-tumor injection of cisplatin for the treatment of hepatocellular carcinoma p. 57
Zhaomin Song, Xiaoqing Guo, Chenghui Yin, Yongzheng Wang
DOI:10.4103/ijc.IJC_635_18  PMID:33402587
Background: This study aimed to compare the therapeutic efficacy of transcatheter arterial chemoembolization (TACE) combined with either 125I seed implantation or 125I seed implantation and intra-tumor injection of cisplatin in treating hepatocellular carcinoma (HCC). Methods: A total of 100 patients with HCC were analyzed. The control group (n = 50) received TACE combined with 125I seed implantation therapy. The therapy group (n = 50) was treated with an intra-tumor injection of cisplatin along with TACE and 125I seed implantation therapy. After treatment, routine blood, liver and kidney function, tumor volume, T lymphocyte subset count (CD3, CD4, and CD8), implanted metastases, and survival were studied. Results: The tumor volume decreased by 27.4% on average in the control group, and by 38.6% in the therapy group. Alpha fetoprotein (AFP) level decreased in all cases, and it was significantly lower in the therapy group than in the control group. Remote metastasis was observed in both groups (7 in the control group and 3 in the therapy group). No significant difference in routine blood, liver and kidney function, and T-lymphocyte subset counts were found between the two groups. Eight patients died of metastases in the control group and 2 in the therapy group at 1-year follow-up (P < 0.05). Conclusion: TACE combined with either 125I seed implantation or 125I seed implantation and intra-tumor injection of cisplatin was effective for the treatment of HCC. Of the 2 combination therapies, TACE combined with 125I seed implantation and intra-tumor injection of cisplatin was more effective for the treatment of HCC.
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HEAD AND NECK CANCER Top

Lower pretreatment hemoglobin status and treatment breaks in locally advanced head and neck squamous cell carcinoma during concurrent chemoradiation p. 62
Rajesh Kar Narayanasamy, RM Muthusekar, Sathiamoorthy Pattanam Nagalingam, Sendil Thyagarajan, Balasubramaniam Ramakrishnan, Karthikeyan Perumal
DOI:10.4103/ijc.IJC_656_18  PMID:33402593
Background: Treatment breaks during radiation for locally advanced Head and Neck Squamous Cell Carcinoma (HNSCC) is one of the important factors affecting the loco-regional control rate. We prospectively analysed the role lower pre-treatment hemoglobin (pre-T Hb) status and its influence on treatment breaks amongst patients undergoing concurrent chemoradiation (CRT). Methods: One hundred and twenty HNSCC (T3-T4a, N1-N2c) patients treated by CRT were prospectively analysed for influence of pre-T Hb on treatment breaks. Sub-sites included oral cavity, oropharynx, hypopharynx & larynx. All patients received radiation to a total dose of 66Gy to PTV along with weekly Inj. Cisplatin 40 mg/m2. All patients were evaluated weekly and at the end of 6 weeks by hemogram, physician and radiological examination. Results: Our study population had a mean age (±standard deviation) of 55 (± 10.7) years (range: 27 - 69 years), 85 men and 35 women with a performance status of the Eastern Cooperative Oncology Group (ECOG) 1-2. The mean pre-T Hb calculated (using receiver operating characteristic curve [ROC]) was 10.3 g/dL. Among 120 patients, in the pre-T Hb of ≤10.3 g/dL group, 44 (75.9%) patients had treatment breaks of ≥5 days and 11 (17.7%) patients had treatment breaks < 5 days; in the pre-T Hb of >10.3 g/dL group, 14 (24.1%) patients had treatment breaks of ≥5 days and 51 (82.3%) patients had treatment breaks < 5 days (P = 0.001). Conclusion: Lower pre-T Hb level of ≤ 10.3 g/dL is statistically significantly associated with higher treatment breaks of ≥ 5 days.
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Effect of corticosteroid ointment on radiation induced dermatitis in head and neck cancer patients: A prospective study p. 69
Rubu Sunku, Apurba K Kalita, Mouchumee Bhattacharyya, Partha P Medhi, Shashank Bansal, Luri Borah, Navin Nayan, Ghritashee Bora, Moumita Paul, Subhalakshmi Saikia, Amal C Kataki
DOI:10.4103/ijc.IJC_790_18  PMID:33402575
Background: Almost all the patients receiving curative radiotherapy for head and neck cancer develop radiation dermatitis, which many a times leads to treatment interruption and reduce patient compliance. In this study, we evaluated the effect of potent topical steroid (Betamethasone Valerate 0.1%) cream on acute radiation dermatitis in head and neck cancer patients receiving curative radiotherapy. Methods: A total 106 patients of head and neck cancers were randomly divided into arm A (52 patients) and arm B (54 patients). The patient in study arm A were treated with topical betamethasone 0.1% twice daily during radiotherapy/chemo-radiotherapy and arm B was kept as control. The radiation reaction in both the groups was monitored weekly according to Radiation Therapy Oncology Group (RTOG) acute radiation dermatitis grading. Results: Out of 106 patients, 85 (80.2%) patients completed treatment. Patient in control arm had earlier onset of grade 1 reaction (5.7% in arm A vs 16.7 % in arm B at 2nd week, P value 0.157 and 28.8% in arm A vs 50% in arm B at 3rd week, P value 0.028) and progression of radiation dermatitis. In 7th week patient in arm A had higher grade 1 reaction (17.3% in arm A vs 0% in arm B), while arm B had higher grade 2 reaction (66.7% arm B vs 55.8% in arm A). There was no difference in incidence of grade 3 and 4 reaction. No difference was observed in time taken for reaction to heal. Conclusion: Topical Betamethasone can delay the onset and progression of radiation dermatitis in head and neck cancer, without significant delay in wound healing.
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BREAST CANCER Top

Quality of life and its predictors in Iranian women with breast cancer undergoing chemotherapy and radiotherapy p. 76
Fatemeh Mirzaei, Azizeh Farshbaf-Khalili, Roghaiyeh Nourizadeh, Reza Eghdam Zamiri
DOI:10.4103/ijc.IJC_750_18  PMID:33402573
Background: Quality of life is an important indicator for quality of care. This study aimed to determine the quality of life (QOL) and its predictors in Iranian women with breast cancer who undergo chemotherapy and radiotherapy to design effective interventions in improving patients' QOL. Methods: The cross-sectional study was conducted on 190 women with breast cancer who were referred to oncology centers for chemotherapy and radiotherapy in Arak city, the central part of Iran. The participants were recruited utilizing convenience sampling method in a period from April to July 2018. Data were collected using demographic and disease characteristics questionnaires, QOL-Cancer30, QOL-Breast Cancer 23, Illness Perception Questionnaire, and Supportive Care Needs Survey – Short Form 34. Multivariate linear regression was used to analyze data. Results: The mean (standard deviation) score of cancer QOL was 57.1 (25.8). On the other hand, the mean (standard deviation) scores of the symptom and functional domains of breast cancer QOL were 43.3 (17.9) and 44.3 (21.7), respectively. Predictive variables for cancer QOL were spouse education, insurance coverage, type of surgery, type of treatment, supportive care needs, and illness perception. Predictive variables for the domain of symptoms of breast cancer QOL included spouse education, income, supportive care needs, and illness perception, while for the functional domain of breast cancer QOL, the predictive variables were the type of surgery, spouse age, supportive care needs, and illness perception. Conclusion: Fulfilling supportive care needs, helping to understand the curative nature of cancer, as well as empowering complementary health insurances are among intervenable variables to improve QOL among women with breast cancer.
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NEURO-ONCOLOGY Top

Triple intrathecal chemotherapy for leptomeningeal carcinomatosis in solid tumors: Treatment outcomes, response and their determinants p. 84
Vijay K Srinivasalu, Narayana Subramaniam, Arun Philip, Wesley Jose, Keechilat Pavithran
DOI:10.4103/ijc.IJC_730_18  PMID:33402572
Background: Leptomeningeal carcinomatosis (LC) is the metastatic infiltration of leptomeninges by malignant cells originating from an extrameningeal primary tumor site, either extraneural or intraneural. In the absence of treatment, survival is usually measured in weeks, however with treatment this may be extended to a few months. Our institutional protocol has been to offer intrathecal chemotherapy (ITC) to patients having solid tumors with cerebrospinal fluid (CSF) cytology positive leptomeningeal carcinomatosis. This study was performed to describe the oncological outcomes in this cohort and their determinants. Methods: A retrospective review of data of patients treated at Amrita Institute of Medical Sciences, Kochi, India was performed. Patients with CSF cytology positive solid tumors treated with triple ITC (methotrexate, cytosine arabinoside and hydrocortisone) were assessed for patient characteristics, treatment response, survival and the factors affecting them. Results: Twenty patients of LC treated with triple ITC were included in the study. The median age of the study group was 49 years with a slight female preponderance (55%). All patients had positive CSF cytology with mean CSF glucose of 60 mg/dL, mean CSF protein of 92 mg/dL and mean cell count of 5. Breast cancer was the most common primary tumor (45%), followed by lung (35%) and stomach (5%). Symptomatic improvement was reported in 70% of patients after initiating ITC. Median overall survival (OS) at 6 and 12 months was 38% and 14%, respectively. Median progression-free survival (PFS) was 2 months. Patients with brain parenchymal metastasis had poor 6 month OS (25% vs 50%, P = 0.013) and 6 month PFS (0% vs 20%, P = 0.023). Conclusion: A triple drug combination of methotrexate, cytosine arabinoside and hydrocortisone when given intrathecally for patients with LC showed good control of symptoms and reasonable survival. It may be beneficial in patients with no brain parenchymal involvement.
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Reoperation does not provide a survival advantage in patients with recurrent Glioblastoma treated with irinotecan/bevacizumab treatment p. 91
Ozlem Nuray Sever, Kadir Oktay, Ebru Güzel, Vildan Kaya, Aslan Güzel, Mustafa Yıldırım
DOI:10.4103/ijc.IJC_758_18  PMID:33402574
Background: Treatment options for recurrent glioblastoma (GBM) have limited efficacy. Although reoperation is useful for both the confirmation of the diagnosis of recurring disease and the relief of the symptoms, its effect on survival is unknown. The aim of this study was to evaulate the impact of second surgery in recurrent GBM. Methods: Patients with GBM followed in our center between January 2015 and April 2018 were analyzed retrospectively based on the treatment options. Results: 25 patients diagnosed with recurrent GBM were analyzed. Ten patients (40%) were treated with chemotherapy following reoperation, and 15 patients (60%) were treated with only chemotherapy. No benefits of reoperation were observed in the univariate analysis. Conclusion: The second surgery in recurrent GBM has limited effect in clinical course.
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MCQS Top

MCQs on “Reoperation does not provide a survival advantage in patients with recurrent Glioblastoma treated with irinotecan/bevacizumab treatment” p. 96
HS Darling, Pradeep Jaiswal, Nishant Lohia, Nishant R Tiwari
DOI:10.4103/ijc.IJC_89_21  
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CASE REPORTS Top

A rare RET mutation in an Indian pedigree with familial medullary thyroid carcinoma p. 98
Roopa Vijayan, Vasantha Nair, Usha Menon, Harish Kumar
DOI:10.4103/ijc.IJC_639_19  PMID:33402557
Familial medullary thyroid carcinoma (FMTC) is a variant of multiple endocrine neoplasia type 2 (MEN2) associated with the RET gene mutation. We report a rare RET mutation of c.2671T>G; p.Ser891Ala in Exon 15 of the RET gene in an Indian pedigree where seven family members out of 14 screened were found to be positive for the same. RET genetic analysis should be considered as an early approach in the diagnosis of medullary thyroid carcinoma (MTC) since it improves the prognosis and permits surveillance of other family members.
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Perineum and penile invasion of recurrent prostate carcinoma shown by Ga-68 PSMA PET/CT p. 101
Zehra Pinar Koc, Pınar Pelin Özcan, Vehbi Erçolak
DOI:10.4103/ijc.IJC_660_19  PMID:33402554
Imaging of prostate cancer has recently had new modalities. Ga-68 Prostate Specific Membrane Antigen (PSMA) Positron Emission Tomography/Computed Tomography (PET/CT) has gained important diagnostic role in the management of the patients with prostate cancer. Patients with progressively elevated serum prostate specific antigen (PSA) level may be evaluated by Ga-68 PSMA PET/CT imaging. This case report presents a seventy five year old man with diagnosis of prostate cancer and progressive serum PSA increase. Local recurrence of the tumor as well as spread to the penis, perineum and skeleton was determined by Ga-68 PSMA imaging. This case illustrates that Ga-68 PSMA imaging may show unexpected sites of disease spread.
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Mediastinal small cell carcinoma with a metastasis to the orbit: A rare carcinoma with an unusual metastatic progression p. 104
Meltem Kirli Bolukbas, Fatma Yalcin Musri, Sibel Karaca
DOI:10.4103/ijc.IJC_820_19  PMID:33402555
Extraocular muscle (EOM) is a rare site for orbital metastasis. We presented a case of solitary EOM metastasis from mediastinal small cell cancer (MSCC) for the first time. A 49-year-old man presented with hoarseness. Thorax computed tomography (CT) revealed a mediastinal mass. A fine-needle aspiration biopsy (FNAB) confirmed the diagnosis of MSCC. The patient staged as limited-stage MSCC with a positron emission computed tomography (PET-CT). The patient received radical chemo-radiotherapy (CRT). PET-CT showed a complete response after CRT. Afterward, the patient presented with double vision and a headache. Brain magnetic resonance imaging (MRI) demonstrated a 2 cm metastatic lesion at the left inferior rectus muscle. A 30 Gy palliative RT was applied. The full regression of the mass was achieved 3 months after the palliative RT. Although solitary EOM metastasis is rare, the timing of accurate diagnosis and appropriate treatment can help to preserve the patient's vision and relieve complaints related to the mass.
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Successful combination of crizotinib and hematopoietic stem cell transplantation in relapsed ALK-positive ALCL Highly accessed article p. 108
Xue Sun, Xiaosheng Fang, Yujie Jiang
DOI:10.4103/ijc.IJC_961_19  PMID:33402581
We report a case wherein a combination of crizotinib and hematopoietic stem cell transplantation (HSCT) cured a 20-year-old woman with relapsed and refractory anaplastic lymphoma kinase-positive anaplastic large cell lymphoma (ALK-positive ALCL). Although she received cyclophosphamide, doxorubicin, vincristine, prednisone, and etoposide (CHOPE) as the first-line chemotherapy from the beginning, the disease progressed rapidly with the emergence of bone marrow invasion and hemophagocytic syndrome. Vincristine, idarubicin, l-asparaginase, and prednisone (VILP) chemotherapy was not effective. Therefore, the patient received off-label use of crizotinib (an ALK inhibitor) and her condition improved rapidly. Subsequently, she received allogeneic hematopoietic stem cell transplantation (allo-HSCT) and achieved complete remission (CR) a month later. Later, crizotinib was used as a maintenance treatment for 3 months and discontinued because of adverse reactions. Our patient has been in CR for 3 years.
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COMMENTARY Top

Challenging role of new agents in the treatment of ALCL p. 112
Carolina V Mahuad
DOI:10.4103/ijc.IJC_240_20  PMID:33402578
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VIEW POINTS Top

Accelerated drug approvals in oncology: Pros and cons p. 114
Sayanta Thakur, Sandeep Lahiry
DOI:10.4103/ijc.IJC_793_19  PMID:33402558
The inevitable surge of the accelerated approval process, especially for oncology drugs, has been a success story. However, the use of surrogate end-points and its validation has been debatable over the years. Over the years, US Food and Drug Administration has been rigorously working for the validation of these end-points to capture the real clinical benefit and appropriateness of clinical study designs. However, the high cost imposed by the manufacturer attributed to the faster drug access can be prohibitive and well undermine the whole process. We discuss issues that must be addressed and solved accordingly for managed care in oncology.
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Psycho-oncology: My chosen journey Highly accessed article p. 119
Sravannthi Maya
DOI:10.4103/ijc.IJC_949_19  PMID:32594078
Before choosing psycho-oncology, there was a juncture in my life when I had to select my specialization for further education. It was overwhelming to choose one from all the areas available at that time and be solely responsible for this decision as it had a bearing on not just me, but also on my family. In 2013 (when I decided on my area of specialization), psycho-oncology was a new field. With just a belief to hold onto, that one day psycho-oncology would be widespread and welcomed in Indian cancer care, I pursued this field with dedication and passion. Despite knowing the risk of choosing a career of a barely trodden path, I took the plunge because I believed in its need and that I could contribute to this field meaningfully. Persistent efforts to integrate psycho-oncology into mainstream oncology are being made by psychologists, policymakers, oncologists, social workers and palliative care professionals and I will continuously strive to add my bit to this field. Cancer, as is commonly known, is an illness of the patient, as well as the family. Cancer impacts patients, caretakers, and oncologists. I observed that factors such as culture, age, caretakers beliefs, their perceptions about the illness, society, and the stigma associated with the illness are some of the barriers to truthful disclosure. This is an area within psycho-oncology that interests me and I have dedicated the past few years of my research to knowing it in depth. In this narration, I share with you an encounter with a patient which propelled me certainly and went deeply into psycho-oncology.
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PERSPECTIVE Top

Psychosocial counseling of patients planned for hematopoietic stem-cell transplantation for malignant conditions—practical challenges and solutions from India p. 122
Vishnu Gopal, Smita Kayal, Biswajit Dubashi, Vikas Menon, Surendran Veeraiah, C Sivakumar, R Jayalakshmi, Bhanu Prakash Bandlamudi, Arnab Bhattacharjee, Sindhu Dahagama, D Kalpana, Divya Annadurai, Prasanth Ganesan
DOI:10.4103/ijc.IJC_81_20  
Hematopoietic stem-cell transplantation (HSCT) is a life-saving procedure often performed to cure relapsed and difficult-to-treat malignancies. Only a handful of centers in India were initially involved in the delivery of these services. However, in the last decade, more than 100 centers in the private and public domain have started offering transplant services in the country. Moreover, there are funding options, which has opened up this expensive treatment options for economically backward patients. Costs apart, there are multiple social, familial, and emotional challenges faced by these patients. A multidisciplinary support team involving social workers, psychologists, and transplant nurses, besides the treating hematologist/oncologist, is required for the optimum care of these patients. These challenges, in the Indian context, are often unique. Unfortunately, there is limited information and resource available to guide counseling of patients planned for HSCT in India. We conducted a workshop at our center where a panel of experts with experience in dealing with patients undergoing HSCT discussed issues faced by them. These discussions constitute a valuable resource for counseling patients planned for HSCT. They were transcribed by a postgraduate doctor and are summarised here in a case-based format.
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LETTERS TO THE EDITOR Top

Linking of National Health Protection Mission with cancer screening in eligible population of India p. 129
Manigreeva Krishnatreya
DOI:10.4103/ijc.IJC_630_19  PMID:33402556
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Therapy-related acute promyelocytic leukemia in a patient with testicular mixed germ cell tumor p. 131
Manveen Kaur, Ranjeev Bhagat, Sanjay Gupta, Kislay Dimri
DOI:10.4103/ijc.IJC_853_19  PMID:33402559
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Chennai tobacco vendors compliance to India's cigarette and other tobacco products Act (COTPA) 2003— A descriptive evaluation p. 133
V Anu, B Soundharyasri, Preman Srisruthi, KG Madhumithra, H Sreemadhumitha, A Sornambiga
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Denosumab in breast cancer patients receiving aromatase inhibitors: A single-center observational study of effectiveness in adjuvant setting Highly accessed article p. 136
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Radiotherapy practice during the COVID-19 pandemic and nation-wide lockdown: The Indian scenario p. 140
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DOI:10.4103/ijc.IJC_603_20  
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Time to modify informed consent in the COVID-19 era! p. 143
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IMAGES IN ONCOLOGY Top

A young boy with stridor and bilateral Bell's palsy p. 145

DOI:10.4103/ijc.IJC_385_20  
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NEWS Top

News from the world of oncology p. 147

DOI:10.4103/ijc.IJC_282_21  
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REVIEWERS FOR 2020 Top

. p. 149
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