Indian Journal of Cancer Education and Research

Background: Rajasthan, India, faces a rising burden of cancer. Real-time hospitalbased data offer insight where population-level registry coverage is incomplete. Objective: To analyze the cancer incidence, distribution, and patterns using ICDcoded data from a leading tertiary cancer center in Jaipur for the year 2024. Methods: All patients diagnosed with cancer at Bhagwan Mahaveer Cancer Hospital (BMCH), Jaipur, in 2024 were included. ICD-10 codes were analyzed for primary site distribution, patient demographics, geographic origin, and compared with Indian national estimates and registry data. Results: Among 10,363 cancer diagnoses (out of 14,911 hospital registrations, conversion 69.5%), the five most common cancers were of the lip, oral cavity and pharynx (26.89%), digestive organs (15.45%), respiratory and intrathoracic organs (10.02%), breast (11.38%), and female genital organs (8.41%). The estimated annual crude incidence rate for Rajasthan, extrapolated from BMCH data, is approximately 134.6 per 100,000, exceeding India’s 2025 estimate of 113. Geographic distribution reveals the highest incidence in Jaipur district (332/100,000). Unusually, in the polluted Sanganer region, female cancers predominated (65%). Conclusion: Cancer incidence in Rajasthan, extrapolated from comprehensive hospital ICD codes, exceeds the national average. The Sanganer anomaly warrants further study into environmental exposures and sex-specific risk.

Background: Breast cancer remains the most prevalent cancer among women, with a significant number of Indian patients being premenopausal and aged between 40–50 years. Radiotherapy plays a vital role in breast cancer treatment but may lead to pulmonary toxicity, including radiation pneumonitis (RP) and radiation fibrosis (RF), particularly in the lung tissue which is a critical organ at risk. Objective: This study aims to assess pulmonary toxicity following post-operative hypofractionated radiotherapy using conventional 2D techniques in breast cancer patients. It specifically evaluates the incidence of RP and RF, correlates clinical and radiological findings, and analyzes associations with treatment-related factors. Methods: A prospective observational study was conducted from March 2023 to March 2025 at the Department of Radiation Oncology, S.N. Medical College, Agra. Eligible post-mastectomy and breast conserving surgery patients receiving adjuvant hypofractionated radiotherapy (40 Gy in 15 fractions over 3 weeks) using conventional 2D techniques were enrolled. Baseline pulmonary function tests (PFTs), clinical assessments, chest radiographs, and simulation measurements (CLD, MLD, SLD, ILD) were recorded pre-treatment, and at 3 and 6 months posttreatment. CT imaging and PFTs (FEV1, FVC, TLC) will be used to assess RP and RF. Lung toxicity was graded using ATS criteria.

Background: Carcinoma of the esophagus, particularly middle one-third, presents unique treatment challenges. This study evaluates long-term survival outcomes and treatment-related toxicity in patients with medically inoperable esophageal carcinoma treated with induction chemotherapy followed by concurrent chemoradiation. Methods: A retrospective analysis was conducted at a tertiary care hospital on patients diagnosed with carcinoma esophagus (middle one-third) from 2015 to 2020. Patients were selected based on medical inoperability and received a standard regimen of induction chemotherapy followed by concurrent chemoradiotherapy. Data on demographics, tumor characteristics, treatment response, survival, and toxicities were analyzed. Results: Of the cohort (n=50), 74% were aged between 41 and 60 years with male pre dominance. Most tumors were moderately differentiated squamous cell carcinomas presenting with proliferative-ulcerative morphology and tumor length ranging from 5 to 10 cm. All patients received induction chemotherapy followed by 56 –60 Gy radiotherapy with concurrent cisplatin-based chemotherapy. Thirtytwo (64%) patients survived beyond two years, and six (12%) achieved a five-year survival. Acute toxicities included Grade II–III esophagitis in 36% of patients, while long-term toxicities such as strictures were observed in 10%. No Grade IV hematologic toxicities were reported. All patients had symptomatic relief in swallowing function during the second week of treatment. Conclusion: The treatment approach of induction chemotherapy followed by concurrent chemoradiation demonstrated early symptom relief and encouraging long-term survival in medically inoperable patients with middle-third esophageal carcinoma. Careful patient selection and supportive care can mitigate toxicity, making this regime a viable non-surgical alternative.

Amebiasis caused by Entamoeba histolytica is one of the most fatal parasitic diseases. The infection is acquired by ingestion of contaminated food and water and is endemic in developing countries with poor sanitation. It presents as asymptomatic infection or acute proctocolitis to acute fulminant colitis with high mortality rates. Both the clinical presentation and the endoscopic appearance of colonic amebiasis can mimic colon carcinoma. Colorectal cancer is an increasingly important public health problem worldwide. Colorectal cancers have the highest incidence among malignancies after lung cancer, breast cancer in women, and prostate cancer in men. Colon cancer is often sporadic and related to risk factors such as age, race, diet, and the presence of inflammatory bowel disease. Hereditary colon malignancies are most commonly associated with Lynch syndrome and genetic polyposis syndromes. Histological diagnosis is always essential for diagnosis of malignancy. However, it is essential to look beyond those malignant glands into surrounding tissue of tiny bits for better patient management. In this regard, amoebiasis may not only mimic carcinoma but, rarely, may coexist with carcinoma. Here, we present a rare case of coexisting adenocarcinoma and amoebiasis in the same patient diagnosed on biopsy.

Context: Adenoid cystic carcinoma (ACC) is a rare malignancy of secretory glands, characterized by an indolent yet relentless course with high rates of local recurrence and distant metastases. Case: We present a case of a 40-year-old male diagnosed in 2019 with nasal ACC, who developed widespread metastases to lungs, liver, bones, peritoneum, and lymph nodes despite multiple surgeries and targeted therapies. Progression continued on lenvatinib, lenalidomide, and axitinib. Patient received palliative radiotherapy for painful skeletal lesions. Conclusion: This case highlights the aggressive nature of ACC in advanced stages and underscores the role of palliation when systemic therapies fail.

Colon cancer represents a significant global health burden characterized by heterogeneous molecular profiles that influence disease progression and treatment outcomes. Tyrosine kinase receptors (TKRs), including epidermal growth factor receptor (EGFR) and vascular endothelial growth factor receptor (VEGFR), play a pivotal role in its pathogenesis by initiating oncogenic signaling pathways that are crucial for tumor growth, angiogenesis, and metastasis. The use of inhibitors, including monoclonal antibodies and tyrosine kinase inhibitors, to target TKRs has transformed the treatment of metastatic colorectal cancer (mCRC), leading to enhanced clinical outcomes, especially when used alongside conventional chemotherapy protocols. However, challenges like therapeutic resistance and adverse effects underscore the need for continued research into novel agents, biomarker development for patient stratification, and combination therapies integrating TKR inhibitors with immunotherapies. This review offers a detailed summary of existing treatment approaches that target TKRs in colon cancer, focusing on how they work their effectiveness in clinical settings, associated challenges, and future prospects for improving treatment outcomes and patient care.