Oncology

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    Admission Pattern and Treatment of Solid Tumors at Tikur Anbessa Specialized Hospital Radiotherapy Center from July 2020 to February 2021.
    (Addis Ababa University, 2022-02) Hagos, Gebrekirstos; Dr.Assefa, Mathewos(Consultant Clinical Oncologist, Internist, Associate Professor of Medicine)
    Background: The incidence of cancer has increased dramatically worldwide in the last two decade. Cancer in sub-Saharan Africa (SSA) is on the rise caused by a rapid population growth, increased life expectancy and adoption of unhealthy lifestyles. In Ethiopia the incidence of cancer is increasing over years with an estimated 67, 573 new cases and over 46, 373 deaths in 2018. At TASH RT center there was no study that tried to evaluate admission pattern and intent of therapy of solid tumors. So this study was conducted to determine admission pattern and treatment intent of solid tumor in TASH radiotherapy (RT) center. Objective: To assess the admission pattern and treatment intent of Solid Tumors at TASH RT center from July 2020 to February 2021. Method: A cross sectional study was conducted to assess admission pattern and treatment of solid tumors among patients admitted for chemotherapy in TASH RT wards from July 2020 to February 2021 who fulfilled the inclusion criteria. Data was extracted from the Oncology Patient Registration System, then it was checked for completeness. Descriptive statistic was conducted using SPSS version 23. Association of patient address with cancer stage and intent of therapy was evaluated. Result: A total of 434 patients were admitted during the study period. Median age was 43.0 years, ranging from 18 years to 80 years. Almost half (50.5%) of the patients were females and most patients (87.6%) had no any known comorbidity and 7.4% had HIV infection. Most of the patients came from Addis Ababa City (44.5%), followed by Oromia region (30%) and Amhara region (11.8%). The most common anatomic sites of the cancers were GIT (37.1%), head and neck (25.6) and genito-urinary (15.0%). Based on histology, adenocarcinoma and SCC accounted for about 38.5% and 36.9% respectively. Most patients were admitted with stage IV (72.1%) and stage III accounts 21%. The treatment intent was palliative in 59.4%, neo-adjuvant in 23.3%, adjuvant in 14.3% and radical in 3%. Conclusion: Most patients presented with advanced stage and more than half of all the patients were treated with palliative intent.
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    Assessment of Caregiver Strain and Associated Factors Among Family Caregivers of Children with Cancer Attending Tikur Anbessa Specialized Hospital in 2020
    (Addis Ababa University, 2020-06) Lemessa, Kalkidan; Deribe, Leul(Assistant Professor, PhD student ); Getahun, Negalign(MSC)
    Background: High levels of strain are potential contributors to develop a sign and symptoms of depression, anxiety, poor marital satisfaction and increase risk mortality. Caregivers with strain have limited capacity to provide the care that the patient needs. The aim of this study was to assess caregiver strain and associated factors among family caregivers of childhood cancer patients in TASH Addis Ababa, Ethiopia, 2020. Methods: a cross sectional study design was carried out among 153 family caregivers of children with cancer attending Tikur Anbessa specialized hospital using interviewer administrated. Multidimensional scale of perceived social support and modified caregiver strain was used to assess perceived social support and caregiver strain respectively. the data collection period was from April 15 to May 15 2020. The collected data was entered and cleaned using Epi-data 4.6 and then analyzed using SPSS version 25. Multiple linear regression was conducted to identify variables at P<0.05. Result: From 153 family caregivers 81(52.9%) were male and 72(47.1%) were between age group 35-49. Seventy-two (47.1%) of them had moderate level of perceived social support. The multiple linear regressions show a significant and association between caregiver strain and caregiver‟s age, duration of caregiving and perceived social support with P-value of 0.007, 0.006, and 0.003 respectively. Conclusion: The mean score of caregiver strain was 20.915 with standard deviation of 3.6417, One hundred forty (91.5%) of family caregivers report financial strain. Caregiver‟s age, duration of caregiving and perceived social support were significantly associated with caregiver strain. Recommendation: Focus must be given on family caregivers and make caregiver strain a routine nursing activity along with improving the socioeconomic status of the family caregivers.
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    Assessment of Nurses Knowledge and Associated Factors Towards Prevention and Management of Cytotoxic Extravasation in Selected Public Hospitals Oncology Units Addis Ababa, Ethiopia, 2021.
    (Addis Ababa University, 2021-06) Adugna, Girma; Argaw, Zeleke( BSC, MSC, Ass. Professor); S/r.Berhane, Emebet(BSC, MSC (PhD fellow)
    Background: Cytotoxic extravasation is the major adverse effect than the combinations of sepsis, neutropenia, mucositis and gastrointestinal disorders. Pain, immobility, irreversible damage of nerve, tissues and tendon, skin grafting and loss of extremity are the significant morbidities secondary to extravasation. Objective: The aim of this study was to assess nurse’s knowledge and associated factors towards prevention and management of cytotoxic extravasation in selected public hospitals, Addis Ababa, Ethiopia, 2021. Methods: A descriptive cross-sectional study design was conducted at Tikur Anbessa Specialized Hospital and Saint Paul Hospital Millennium Medical College that was selected purposely. A convenient sampling technique was employed for the selection of study participants. The data was collected by using a structured self-administered questionnaire. The data entry and cleaning was done by using Epi-data version 4.6 and SPSS version 25. Logistic regression analysis technique was employed to evaluate the effect of independent variables on the dependent variable. Statistical significance was declared with the p
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    Awareness of Colorectal Cancer and its Associated Factors Among Adult Patients Attending Jimma University Medical Center South-West, Ethiopia, 2020.
    (Addis Ababa University, 2020-06) Hamza, Abdulmenan; Argaw, Zeleke (MSc, Assi’t professor); Gela, Debela(MSc)
    Background: Colorectal cancer (CRC) is the first commonest diagnosed cancer in men and the fourth commonest in women in Ethiopia. The most significant factors that may increase the risk of having CRC were modifiable. These factors were prevented by increasing awareness of the population. Objective: This study aimed to assess the awareness of CRC and its associated factors among adult patients attending Jimma University Medical Center, South-West Ethiopia, 2020. Methods: The institution-based quantitative cross-sectional study design was conducted among 422 patients at Jimma University Medical Center from March 8 to April 30, 2020. The study participants were recruited by a systematic random sampling method and data was collected semi-structured interviewer-administered questionnaires. The collected data were entered into Epi data version 4.6.0 and transferred to SPSS version 25. Descriptive, Bivariate and multivariate logistic regression were implemented. The strength of association was determined by using AOR, 95% CI. The statistical level of significance was stated at P<0.05. Result: A 100% response rate in this study was recorded. More than half (57.6%) of the study participants had low awareness of CRC. The first common and least common risk factors that were known by participants were smoking (78.2%) and aging (32.5%) whereas the most common and least common symptoms were blood in the stool (49.3%) and abdomen lump (33.9%). There is significant association between awareness of colorectal cancer and gender [AOR=1.86; 95% CI (1.26, 2.75)], residency [AOR= 0.45; 95% CI (0.30, 0.67)], monthly income [AOR=4.72; 95% CI (3.11, 7.15)], level of education [AOR=2.83; 95% CI (1.49, 5.37)], information sources [AOR=2.51; 95% CI (1.18,5.37)], and heard about CRC [AOR=4.48; 95%CI (2.90,6.93)]. Conclusion and recommendation: Results showed that awareness of patients towards CRC was inadequate. However, the majority of patients had better awareness of colorectal cancer risk factors. Similarly, participants with high levels of education and females had better awareness of CRC than the reverse. Therefore, there is a need for campaigns and educational programs, from health care authorities, a higher educational institution for the general public and patients.
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    Awareness of Prostate Cancer and its Associated Factors Among Male Patients Attending in Urology unit at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2021.
    (Addis Ababa University, 2021-06) Gebru, Tilaye; Dr.Mekonnen, Hussen(MPH,PhD.); Getahun, Negalign(MSc. Lecturer)
    Prostate cancer is a common type of cancer in men Globally. It is the world's second most diagnosed disease and the fifth major cause of cancer-related deaths. In Ethiopia, it is the 3rd most common type of cancer. Having awareness of Prostate cancer is the key to early detection and prevention. The major risk factors for prostate cancer were controllable by increasing public awareness. The study aimed to assess the status of awareness about prostate cancer and its associated factors among male patients attending a Urology unit at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2021. A facility-based crosssectional study was done. Among 241 male patients using a pretest and intervieweradministered questionnaire. The study was done at theTikur Anbessa Specialized Hospital from February to April 2021. Epidata version 4.6.0 and SPSS 26 version were used to enter and analyze the data. Descriptive statistics and linear regressions were used for the analysis. Simple and multiple linear regression analysis was used to identify factors associated with awareness of prostate cancer. The strength of the association between independent and dependant variables was described using unstandardized β with 95% CI. A total of 250 patients were approached with a response rate of 241(96.4%), with a mean score of prostate cancer awareness (12.6+10.4) and a proportion of 45%. Families average monthly income >8900ETB (β=2.6, 95%CI:1.1-4.1, P=0.001), heard about prostate cancer (β=5.6, 95%CI:1.5-9.6, P=0.011), having a regular source of care with every six months and above (β=4.3, 95%CI: 2.5-6.1, P<0.001), three times, admission history (β=5.4, 95%CI:1.3-9.5, P=0.009), and health care providers (β=10.7, 95%CI 6.6-14.8, P<0.001) as the major source of information followed by the media (β=9.6, 95%CI 5.4-13.8, P<0.001) were significantly associated with awareness of prostate cancer. Prostate cancer is one of the important health-related problems among men in the world. Therefore, a wellplanned health education program should be implemented to address the observed knowledge gaps and raise awareness with a focus on the role of prevention and screening. Additional studies are also, required to investigate the awareness of prostate cancer among men and the Federal Ministry of Health may take preventive methods to increase the level of awareness of prostate cancer among the people.
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    Clinico-pathology and Treatment Patterns of Urinary Bladder Cancer at Tikur Anbessa Specialized Hospital.
    (Addis Ababa University, 2022-02) Yeshitla, Amare; Tigeneh, Wondmagegnehu(MD, Consultant Clinical Oncologist)
    Back ground: Bladder Cancer is the sixth most common cancer in the world, the seventh most common cancer in men, and the seventeenth most common cancer in women. Although the incidence of malignant tumors of the bladder is increasing in developing countries, like Ethiopia, there is a lack of evidence regarding the overall profile of bladder cancer in Ethiopia. Objective: To asses the demography, clinicopathology and treatment patterns of urinary bladder cancer attending at oncology department and Urology unit of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia during the study period. Methods: An institution based descriptive cross-sectional study was conducted in TASH, department of Oncology and Urology unit, Addis Ababa, Ethiopia, and comprised medical records related to urinary bladder tumors between September 2018 and August 2021. Results: Of 158 cases, 81% were of males while 19% were of females making a male to female ratio of 6.74:1. The mean age was 57.41±13.662 years (ranged from 22 to 88years). Hematuria was the most common presenting symptom occurring in 143 (90.5%). Transitional cell carcinoma (urothelial carcinoma) was the most common histology which accounted 87.4% followed by Squamous cell carcinoma (6.3%), adenocarcinoma (1.9%), sarcoma (1.3%) and mixed histology variants (1.3%). Overall, 45.6% was non-muscle invasive, 37.3% was muscle invasive and the remaining 17.1%was metastatic at presentation. Majority of patients were treated with radical intent. TURBT was the most commonly practiced type of treatment. Intravesical chemotherapy, perioperative chemotherapy and cystectomy were rarely practiced as compared with standard guidelines and text books. Conclusion: The most common type of bladder cancer in TASH is TCC. Bladder tumor is more frequent in men than in women. Hematuria was the most common presenting symptom. The commonest procedure for bladder tumors was TURBT which is the golden standard for nonmuscle invasive tumors.
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    Clinicopathology and Treatment Patterns of Head and Neck Cancer at Tikur Anbessa Specialized Hospital, Radiotherapy Center, Addis Ababa, Ethiopia.
    (Addis Ababa University, 2019-09) Wondwossen, Nahom; Dr.Assefa, Mathewoss; Dr. Kantelhardt, Eva Johanna; Dr. Jemal, Ahmedin
    Background: Breast cancer is a major public health problem with significant morbidity and mortality in women worldwide. Studies in Sub-Saharan Africa (SSA) have shown that the estimated 5-year survival in women with breast cancer is below 50%, which is significantly lower than those from developed countries. There is limited data on survival of patients treated for breast cancer in Ethiopia. Objective: The aim of this study is to asses the five-year survival of breast cancer patients treated at Oncology Department of Tikur Anbessa Specialized Hospital (TASH). Methods: This is a retrospective cohort study that asses the survival of and contributing factors of patients that were evaluated and treated at TASH between September 2014 and August 2015 G.C. Data was extracted from patient file by data collectors under the supervision of the primary investigator using structured questionnaire. Patients and/or their relatives were contacted through phone call and for those patients who were not available over the phone, the last date of follow up was used to calculate overall survival (OS). The data was analyzed using SPSS 22 software. Results: Out of a total of 249 patient charts collected based on HMIS data, 216 cases were found eligible for our study. On further evaluation of the 216 cases, only 181 patients were eligible for the final analysis as 35 patients had some data missing (error of date entry on excel) or were lost from follow up by more than 6 months and couldn’t be contacted over the phone. The mean age of presentation was 43 (SD) years. Most patients (38.1%) had a stage III disease at presentation followed by stage IV disease 31.5%. Only 4.4% of our patients were stage I. The median survival was 27 months where the 5-year OS was 44.2%. Stage at diagnosis, duration before the initiation of Adjuvant chemotherapy, number of chemotherapy cycles, the use of hormonal therapy and its duration were significantly associated with survival. Conclusion/recommendation: The outcome of stage III & IV patients in our study is very low by the western standards. We should devise a policy to increase public awareness, so that we can get these patients at an earlier stage. In addition, we have to increase access to recent treatment modalities and expand the available cancer centers.
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    Clinicopathology and treatment patterns of head and neck cancers at Tikur anbessa specialized hospital, radiotherapy center, Addis Abeba, Ethiopia.
    (Addis Ababa University, 2019-09) Fekadu, Adugna; Tigeneh, Wondimagegnehu(MD, MMsc (RT) FCR oncology)
    Background: Head and neck cancer (HNC) is one of the most common cancers worldwide and its incidence is reported to be increasing both in developed and developing countries. There is lack of published data on clinicopathology and treatment patterns of head and neck cancers in Ethiopia. Objective: To assess clinicopathology and treatment patterns of head and neck cancers at Tikur Anbessa Specialized Hospital, Radiotherapy Center, Ethiopia Methodology: A retrospective cross-sectional study design and simple random sampling technique was used to select the required sample size. Descriptive statistics (mean, SD, frequency, percentage, graph and table) and chi-square results were generated by using SPSS version 21. The level of significance was obtained at 0.05. Results: Four hundred twenty two (422) histopathologically confirmed head and neck cancers that were treated at TASH from 2014 to 2017 G.C were analyzed in this study. The male to female ratio (M: F) was 1.98: 1. The most common primary site of head and neck cancers was pharynx 156 (37%) and the major histologic type was carcinoma which accounted 358 (84.81%). From carcinomas, squamous cell histologies were 330 (92.12%). Majority of the cases had advanced disease at diagnosis (89.29%). There was unacceptable delay between diagnosis and initiation of treatment. Conclusion/recommendation: This study showed that head and neck cancers treated at this hospital presented at advanced stage of the disease. Only small proportion of patients took concurrent chemo radiotherapy and there was long duration between diagnosis and initiations of treatments. These all might have reduced the curability of the disease. Majority of cases were males and relatively young at diagnosis. The awareness of the society on head and neck cancers should be increased as it helps to diagnose at early stages of the disease. The government and other stakeholders should expand cancer centers to reduce the treatment delay and increase quality of care of these cancers. Further studies are very important on head and neck cancers to optimize treatment out come
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    The Clinicopathology, Treatment Pattern and Survival of Nasopharyngeal Carcinoma Patients at Tikur Anbessa Specialized Hospital, Oncology Department, Addis Ababa, Ethiopia.
    (Addis Ababa University, 2021-04) Shimeles, Ruth; Dr. Woldemariam, Aynalem Abraha(Internist, Consultant Oncologist, Department of Oncology, School of Medicine, CHS, AAU); Dr. Jemal, Ahmedin(American Cancer Society, Atlanta, GA); Dr. Kantelhardt, Eva Johanna(Department of Gynecology, Martin Luther University, Halle an derSaale, Germany.)
    Background: Nasopharyngeal carcinoma is one of the most common head and neck cancers worldwide and its incidence is reported to be increasing both in developed and developing countries. There is, however, lack of published data on nasopharyngeal carcinoma in Ethiopia. Objective: To assess the clinicopathology, treatment patterns and median survival of patients diagnosed with nasopharyngeal carcinoma at Tikur Anbessa Specialized Hospital (TASH), Oncology Department, Ethiopia Methodology: A retrospective cohort study design of histopathologic proven nasopharyngeal carcinoma patients seen at the Oncology Department of TASH from September 11, 2014 and September 10, 2017 and followed for vital status up until October 2020. Descriptive statistics (mean, SD, frequency, percentage) were calculated and chi-square tests were performed using SPSS version 26, with P<05 for level of statistical significance. Survival curves were analyzed using the Kaplan-Meier method, and survival curves between groups of patients were compared using a log-rank test. A multivariable Cox proportional hazard model was used to identify prognostic factors. Results: A total of 170 patients with histopathological confirmed nasopharyngeal cancer were seen in the Oncology Department during the study period. The mean age of the patients was 37.73 ±17.7 SD years, with 2:1 male to female ratio. Majority 77 (56.6%) of the histology types were taken from Lymphnode with 36 (26.5%) showing secondary carcinoma from nasopharynx. Generally 113 (83.31%) of the patients presented with stage III-IV. 23.5 % of the patients did not take any form of treatment. Of those who received treatment, the most common form of treatment was induction chemotherapy (19.1%), followed by concurrent chemo radiotherapy (16.9%). Patients had to wait on average 3.24 months to get any types of treatment. The median waiting periods were 8.4 months for any form of radiation and 3.3 months for chemotherapy. The median followup period was 23.3 months, and the median survival was 33 months. Survival was statistically significantly associated with advancing age, keratinizing histologic type, lack of receipt of treatment, suboptimal dose of RT and nodal disease. However, Sex, Tumor stage, metastasis, group stage, waiting time to treatment and performance status were not significantly affecting the survival time of patients. Conclusion: Majority of patients with nasopharyngeal cancer seen at TASH in Addis Ababa are presented at advanced stage of the disease, and with exceedingly long waiting period for receipt of radiotherapy and poor survival outcomes. These findings underscore the need for development of public health plans for early diagnosis and treatment of nasopharyngeal cancer and for expansion of radiotherapy services in the country.
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    Clinocopathologic Features, Treatment Pattern and Overall Survival of Patients with Osteosarcoma Treated at Radiotherapy Center of Tikur Anbessa Specialized Hospital, Ethiopia: Cross-sectional Study.
    (Addis Ababa University, 2021-03) Worku, Yasin; Dr.Abreha, Aynalem(Internist,consultant clinical oncologist, assistant professor of medicine, AAU, CHS); Dr.Seife, Edom(Consultant clinical oncologist, assistant professor, AAU, CHS)
    Background: Primary malignant tumors of bone are extremely rare neoplasms accounting for <0.2% of all cancers, although the true incidence is difficult to determine due to the rarity of those tumors. Bones Sarcomas occur throughout the musculoskeletal system. Osteosarcoma is the most common malignant bone tumor. Osteosarcomas are more common in the appendicular skeleton. Most patients with osteosarcoma have an advanced disease at presentation and the survival is generally poor in low income countries despite the 5-year survival rate of about 80% in the developed countries. Objective: The objective of this study is to describe the clinical features, treatment pattern, and two year overall survival of patients with osteosar coma admitted at TikurAnbessa Specialized Hospital oncology ward. Methodology: A cross-sectional study design was used and all patients with a diagnosis of osteosarcoma admitted to oncology ward were included. A descriptive analysis and frequency were used to analyze mean, median, standard deviation and range. Kaplan Meier was used to analyze the survival pattern of patients. Bivariate and multivariate Cox regression was used to analyze association between dependent and independent variables. Multicolinearity test was done on independent variables found to have association with the outcome variable (VIF>10). STATA software version 16.0 was used for statistical analysis. Result: From 80 patients included in our study, the age ranged between 11 and 58 years with a median age of 19.5 years. Ostoesarcoma peaks between 15-19 years of age. From all patients, 93.75% came after 3 months of the onset of symptoms. Thirty-four patients (42.5%) had documented distant metastasis at presentation. Of all patients with extremity tumors that had surgery, 43 patients (95.5%) had an amputation. Seventy-one patients received chemotherapy, 37 patients (52.11%) received a palliative intent, 18 patients (25.35%) got adjuvant intent, and 16 patients (22.4%) neoadjuvant intent. The median overall survival of osteosarcoma was 20.8  2.96 months (95% CI, 14-50-33.63) and 2-year overall survival was 45%. Conclusion/recommendation: Most patients are delayed at presentation and have an advanced disease. Patients with osteosarcoma were under investigated and received suboptimal care. Patients with osteosarcoma had low median and two-year overall survival. Overall survival was found to be significantly associated with curative surgery (p=0.001), distant metastasis at presentation (p=0.004) and not taking chemotherapy (p=0.05) on bivariate Cox regression but the intent of chemotherapy was the only significantly associated factor for overall survival (p=0.005) on multivariate Cox regression.
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    Coping Strategies of Stress in Breast Cancer Patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2020: a cross-sectional study.
    (Addis Ababa University, 2020-06) Assefa, Bethlehem; Tadele, Niguse (MSc, Assistant Professor); Getahun, Negalign (BSC, MSN)
    Background-Diagnosis of breast cancer can be stressful, impacting on multiple domain of life, affecting physical status, emotional and spiritual well-being and personal relationships for the patient and mostly affects woman’s body image, sexuality leads to stress. In order to adapt, the patient used different coping methods. Variations may occur from one person to another person due to individual coping strategies, personality factors, and the level of social support available to them. In Ethiopia studies conducted so far are very limited. Objectives-To identify Coping Strategies of Stress in Breast Cancer Patienst at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2020 Methods-Institution based cross-sectional study design was conducted from February to April 2020 at Tikur Anbessa Specialized Hospital. Quantitative approach convenient sampling technique was used and sample sizes of 264 are participated in the study. The data was collected using structured and semi structured questionnaire and analyzed using SPSS version 25. The statistical analysis was done at 95% confidence and p-value of <0.05 was considered to declare statically significance. Descriptive statistics, Bivariate and multivariable binary logistic regression analysis was employed for data analysis and tables, figures and pie charts are used to present data results. Result- The mean of practicing positive coping strategies for breast cancer stress is 25.48 +3. And therefore, is negative coping stress. Around 64% of the participants solve their problems by confrontive stress coping strategy. More than 73% participants solve their problems by distancing stress coping strategy. In the self- controlling coping mechanisms of stress, the higher participants do most of the activities for positive coping strategy. Conclusion- Being uneducated, working in governmental organizations, 1-3 times of diagnosis for breast cancer, being taking combination chemotherapy and having social support have been associated with outcome of stress coping strategies. Recommendation- Better to take special attention on the accessibility of cancer treatment and social support in order to address the use different coping strategies.
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    Demographic, Clinical, and Treatment Patterns of Non-small Cell Lung Cancer Patients seen in Tikur Anbessa Specialized Referral Hospital, Radiotherapy Center; Addis Ababa, Ethiopia, 2017-2020
    (Addis Ababa University, 2021-03) Asefa, Amanuel; Dr.Tigeneh, Wondimagegnehu(Associate Prof MD, M MSC(RT), FC Rad Onc (SA)); Dr. Jemal, Ahmedin(American Cancer Society, Atlanta, GA); Dr. Kantelhardt, Eva Johanna(Department of Gynecology, Martin Luther University, Halle an der Saale, Germany)
    Background: Lung cancer is the most commonly diagnosed cancer and the leading cause of cancer death worldwide. There are two main types of lung cancer, non–small cell lung cancer (NSCLC) and small-cell lung cancer (SCLC). Non–small cell lung cancer (NSCLC) accounts for 80% to 85% of lung cancer. Even though lung carcinoma is the 6th most frequent malignancy in male based on data from Addis Ababa city-based cancer registry, there is lack of published data on demographic, clinical, and treatment patterns of non small cell lung cancers in Ethiopia. Objective: To determine the demographic, clinical, and treatment patterns of non-small cell lung cancer patients seen in Tikur Anbessa Specialized Referral Hospital, Radiotherapy Center, Addis Ababa, Ethiopia, 2017-2020 Methodology: A retrospective cross-sectional study design on histo pathologically confirmed non small cell lung cancer patients treated from September 2017 to September 2020. Descriptive statistics (mean, SD, frequency, percentage, graph and table) and chi-square results were generated by using SPSS version 25. P-value of <0.05 was considered as significant. Result: 126 patients were enrolled in the study. There were 67 (53.2%) males and 59 (46.8%) females giving a male to female ratio of 1.14:1. The mean age at presentation was 52 years, ranged from 24 to 90 years. The majority of the patients presented with cough (103, 81.7%), followed by chest pain (40, 31.7%), haemoptysis (21, 16.7%), shortness of breath (18, 14.3%). According to AJCC staging of lung cancer 43.7% (55) and 32.5% (41) of the patients were diagnosed with stage IVb and IVa diseases, respectively. Ever cigarette smoking was reported in 20 (15.9%) patients. 20(15.9%) patients had associated co-morbid medical illnesses. Mostly the primary lesion was located peripherally in 73% of patients and centrally in 23.8%. The most common histology type was adenocarcinoma in 81(64.3%) patients, followed by squamous cell carcinoma in 34(27%). Metastasis at the time of diagnosis was recorded in 96(76.2%) of cases. Common sites of metastasis were pleura (27.8%) and bone (24.6%), followed by lung, liver, brain and adrenal in 15.9%, 14.3%, 9.5% and 5.6% of patients respectively. Chemotherapy was given in 87.3% of patients. The intent of chemotherapy was palliative in 93.6% patients, neoadjuvant in 3.6% patients and adjuvant in 2.7% patients. Radiotherapy was given in 23.2% of patients with the intent of palliative treatment. Conclusion and Recommendation: The majority of patients with NSCLC seen at TASH are presented at advanced stage of disease, with adenocarcinoma as the most common histology type and history of smoking in only 16% of the cases. Future studies should examine the causes of lung cancer in the country.
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    Demographic, Clinical, Pathologic and Treatment Pattern of Soft Tissue Sarcoma at Tikur Anbessa Specialized Hospital,Ethiopia.
    (Addis Ababa University, 2022-02) Abeje, Melsew; Dandena, Yonas (MD, clinical oncologist, assistant professor)
    Abstract Soft tissue sarcomas are an uncommon group of neoplasm that could be fatal, especially in the metastatic setting. Late presentation, Missed Diagnosis and inadequate treatment may worsen clinical outcomes. There is lack of evidence on the demographic, pathological, Clinical and treatment pattern of soft tissue sarcoma in developing countries like Ethiopia Thus, this study is aimed to assess the demographic, pathological, Clinical and treatment patterns of soft tissue sarcoma in a single tertiary health institution in Ethiopia. Objective: The aim of this study is to assess demographic, pathologic, clinical and treatment pattern of soft tissue sarcoma at Tikur Anbesa Specialized hospital at four years duration. Methods :This is a retrospective cross-sectional study that asses demographic, clinical,pathologic and treatment pattern of soft tissue sarcoma at the TASH between august 2017 and August 2021 G.C. This period was selected because most patient data before this are not available according to my pilot study. Result: A total of 320 patients were registered from August 2017 to August 2021 and 190 patients card were available for this study and 80 of patients were excluded according to exclusion criteria and 50 of patients’ card were lost. The median age was 32 years of age and Male sex was commonly affected accounting 61.6% and female sex accounts 38.4%. The commonest sites were extremities accounting for 48.9 % of cases. The Commonest presenting symptoms were mass and pain accounting for 93.2% and 77.9% of cases respectively. The commonest histology subtypes were, un differentiated sarcoma, rhabdomyosarcoma and synovial sarcoma accounting 50%, 15.8% and 6.3 % cases respectively. The grade of the lesions was described in 67.3 % of patients. Of those lesions whose grade was described 56.8 % were high grade lesions. From all cases 58.3% of the patients underwent surgery as a primary treatment modality. Only 50.5% of cases were started treatment with curative intent and 49.5% of the case started their treatment with palliative intent. Conclusion: The pattern of soft tissue sarcoma in this cross sectional study has shown different distribution in terms of demography, clinical presentation, treatment and pathological subtypes when compared to other studies. Advanced stage of initial clinical presentation and substandard work up according to standard text books and therapy makes it unique from cases reported from other parts of the world
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    Demography and Clinico-pathologic Pattern of Laryngeal Cancer at Tikur Anbessa Specialized Hospital: A Retrospective Cross Sectional Study
    (Addis Ababa University, 2021-04) Eshetu, Natenael; Abreha, Ayenalem (MD, Internist, Consultant clinical oncologist); Jemal, Ahmedin(DVM, PHD); Dr. Kantelhardt, Eva Johanna
    Background: Malignant laryngeal tumors are uncommon, yet invariably fatal neoplasms of the larynx. Late presentation of the disease may worsen management outcomes. Although the incidence of malignant tumors of the larynx is increasing in developing countries, like Ethiopia, there is a lack of evidence regarding the overall profile of laryngeal cancers in Ethiopia. Objectives: To assess the epidemiologic, clinico-histo-pathologic characteristics of laryngeal patients attending at oncology department of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods: A 3-year retrospective cross-sectional review of medical records of patients managed for malignant laryngeal tumors at the oncology department of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, was performed. The demographic, clinical & histopathologic characteristics of participants were computed by using descriptive statistics (mean, percentage, frequencies, and standard deviation). Finally, the study finding was presented using diagrams, tables, and figures. Results: Most of the laryngeal cancer patients who attended the oncology unit of Tikur Anbessa Specialized Hospital are elderly males, with a male to female ratio of 5.1:1, and the sixth decade being the most affected age stratum. The most common presenting symptom was dysphonia. The majority (88.8%) of patients presented with late stage of the disease and squamous cell carcinoma is by far the most common histopathology, occurring in 98.8% of the patients. Conclusion: Elderly men are the most affected age group of laryngeal neoplasms. Late disease presentation observed in the patients can lead to poor management outcomes and limited management options. Health education of the community on early features of laryngeal cancer, early symptom detection by clinicians, and policies targeted at reducing cigarette smoking and alcohol consumption is recommended.
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    Disease Control After Delayed Adjuvant Radio Therapy Among Locally Advanced Breast Cancer Patients Treated After One Year Mastectomy at Tikur Anbessa Specialized Hospital in 2016 G.C.
    (Addis Ababa University, 2020-09) Tafesse, Ephrem; Dr.Seife, Edom(consultant oncologist, Assistance Professor of Medicine, AAU); Dr. Kantelhardt, Eva Johanna
    Introduction – Nearly more than half of post mastectomy patient needs adjuvant radiotherapy. Adjuvant radiotherapy should be given according to clinical recommended indication, dose and time to reduce risk of loco-regional tumor recurrence. Most post mastectomy patients do not get adjuvant radiotherapy due to long radiotherapy waiting time at the centers. Delayed initiation of adjuvant radiotherapy associated with increased risk of tumor recurrence. Radiotherapy waiting time at TASH oncology center is unknown and expected to be more than a year. All high risk post mastectomypatients will be registered and wait for adjuvant radiotherapy. Benefit of giving delayed adjuvant chest wall irradiation is unknown. Despite our routine clinical practice, such treatment delay should be evaluated. Objective – The main objective of study was to assess the clinical benefit of delayed adjuvant radiotherapy delivery after 1 year of post mastectomy. Methods – Institutional based retrospective cross-sectional used to assess tumor control rate among post mastectomy breast cancer patients registered at TASH radiotherapy center for the indication of adjuvant chest wall irradiation. Result- In 2016 at TASH radiotherapy center, total of 274 high risk post mastectomy patients had registered for adjuvant chest wall irradiation. At 1year of post mastectomy, among radiotherapy registered 67.5%(185) patients had stable disease. Nearly 38.6% (106)patients did not take adjuvant radiotherapy and 28.8% (79) patients had took sequentially adjuvant chemotherapy and radiotherapy. The mean radiotherapy waiting time was 8.8±1.4months .Among those who took delayed adjuvant radiotherapy, the mean post mastectomy adjuvant radiotherapy delivery time was 10.4 ±1.9 months. At 4 years follow up,62.7%(116) patients are alive, 27.6%(52) had died and 9.7%(17) had unknown status. Tumor recurrenceconfirmed in 28.6% (53) patients. Among sub-groups, 34.1% (27) and 24.5% (26) patients had tumor recurrence among those who took and did not tookdelayed adjuvant radiotherapy respectively. Adjuvant radiotherapy was not found to be association with tumor control (COR=1.5, 95% CI=0.83-3.03, P-0.16). On multivariate analysis only advanced nodal tumor showed statically significant for tumor recurrence. N2 and N3 stage patients were found to be 3.8 and 4.3 times morelikely to develop recurrence as compared to Nx& N1 patients respectively (AOR, 3.86, CI 1.72-8.65, AOR 4.34, CI 1.54-12.26) Conclusion- Delayed adjuvant radiotherapy after median 10.4 months of post mastectomy did not associate with improved tumor control. According to our finding, most unnecessary delivery of delayed adjuvant radiotherapy can be omitted and delayed adjuvant chest wall irradiation should be given among patients having one of those poor prognostic factors age less than 55 years or advanced nodal tumor disease (N2 and N3). Recommendations– Radiotherapy waiting time at TASH oncology center can be improved through avoiding unnecessary delayed radiotherapy delivery among breast cancer patients. since TASH oncology center is the only center having single cobalt-60 machines for the whole country, the available energy source should be used effectively and efficiently without compromising treatment quality.
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    Disparities in Receipt of Radiotherapy and Outcomes Among Cervical Cancer Patients Seen in Tikur Anbessa Hospital, Ethiopia
    (Addis Ababa University, 2018-05) Deressa, Biniyam Tefera; Dr.Assefa, Mathewos( MD, FC Rad Onc (SA), Internist); Dr. Jemal, Ahmedin(DVM, PHD); Dr. Kantelhardt, Eva Johanna
    Introduction: Ethiopia is among countries with the highest burden of cervical cancer worldwide. Up to 6,000 new cervical cancer patients are diagnosed each year. The primary objective of this study was to evaluate the survival of cervical cancer patients in general and compare the difference in survival, waiting time and stage migration among patients treated with radiotherapy in Tikur Anbessa Hospital on private wing and regular sides. Methodology: Women with histologically verified cervical cancer, who received radiotherapy in 2014, were included. All patient characteristics, tumor characteristics, and information concerning therapy and outcome were extracted from the patients’ medical record files. Vital status was obtained through telephone contact or patient cards. Result: Out of 249 patients treated in 2014, the patient file of 242 could be retrieved. 152 (63%) were treated on the regular service side and 90 (37%) were treated on Private wing side. The median age at diagnosis was 45 years and 48 years for patients with private wing side and regular service side. After first oncologist consultation private wing patients waited more (92 days) than regular side patients (39 days) to receive radiotherapy. During this time, stage migration was seen more in private wing (20%) than regular side (8.6%) patients. In general, the estimated of 52 months overall survival probabilities were 21.5% (14.6% in worst-case scenario). The median overall survival time was 21 months (18 months in worst-case scenario). The median survival was 23 months (19 months in worst-case) and 19 months (17 months in worst-case) between private wing and regular side patients, respectively. The FIGO stage, intension of radiotherapy, one-year tumor control rate, comorbidity and concurrent chemotherapy were the factors, which has found to be significant association with survival. Conclusion: The survival of cervical cancer patients remains low in Ethiopia, despite the higher cure rate of the disease. The reason for poor survival were advanced stage at presentation, very long waiting time for treatment and as a result stage migration, the old treatment machine and technique and absence of brachytherapy are some of the reason. Therefore, the parallel oriented efforts in all direction such as prevention, early detection and improving access to standardized care are required.
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    The Effect of COVID-19 on Cancer Patients Taking Chemotherapy at Tikur Anbessa Specialized Hospital Oncology Department.
    (Addis Ababa University, 2021-03) Welekidan, Hailemichael; Dr.Assefa, Mathewos(Consultant Oncologist, Associate Professor of Medicine, AAU, CHS ); Dr.Seife, Edom(MD, Clinical Oncologist); Dr. Jemal, Ahmedin(American Cancer Society, Atlanta, GA); Dr. Kantelhardt, Eva Johanna(Department of Gynecology, Martin Luther University, Halle an der Saale, Germany)
    Background: Coronavirus disease 2019 (COVID-19) pandemic have caused hundreds of thousands deaths worldwide, with the first case in Ethiopia reported on March 13, 2020. Knowledge and awareness of mode of disease transmission, basic hygiene principles and measures in public health crisis are important for developing effective control measure. This pandemic and actions taken to prevent its spread is affecting the world population including cancer patients. In Ethiopia the COVID-19 awareness as well as its effect on cancer patients is not known. Objective: To evaluate awareness, experiences and effect of COVID 19 on cancer patients in receipt of chemotherapy from April 01 to June 30, 2020 in Ethiopia. Methods: Phone based cross-sectional survey was conducted among cancer patients attending day care or inpatient chemotherapy treatment from April 01 to June 30, 2020 at TASH, at the Department of Clinical Oncology. All patients taking chemotherapy in day care or ward admissions during the study period whose age was greater than 18 years, and who agreed to participate was included in the study. Descriptive statistics and further analysis for association was conducted using STATA version 16. The level of significance was obtained at P<0.05. Results: A total of 212 patients completed the questionnaire, with median age of 40 years (range 20-82), and 67.9% were females. 44.3% of participants were patients diagnosed with breast cancer and 41% of the participants were on palliative intent treatments. Delay, cancellation, or change in scheduling for receipt of treatment occurred in 78 patients (36.79%). Service interruption by providers accounted for the majority of the impacts (45 patients, 57.7%), followed by transportation difficulties (16, 20.5%), fear of virus exposure (14, 18.0%). Patients on palliative intent of treatment had more effect on treatment compared to adjuvant (P<0.001), and likelihood of not having enough medications to last for a month, not having a place to stay in nearby vicinity were associated with effect on treatment (P=0.009, and P=0.03 respectively). Patients’ knowledge and practice regarding COVID-19 and its prevention methods is good. Conclusion: The coronavirus outbreak or restrictions made in response to the outbreak impacted receipt of chemotherapy for a considerable proportion of patients at TASH.
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    Glycemic Control Level and Its Associated Factors Among Adult Cancer Patients with Comorbid Type II Diabetes in Public Cancer Care Centers in Addis Ababa, Ethiopia, 2023.
    (Addis Ababa University, 2023) Getachew,Addisalem; Aga,Fikadu(PhD, Associate professor),Getahun,Negalign (Assistant professor)
    Background: The two main causes of fatalities worldwide are cancer and DM they are more common and dramatically increasing. Currently, those with cancer co-morbid with DM have higher rates of morbidity and early death than cancer patients without DM. However the most and essential means to control complications of Diabetes Mellitus is controlling serum glucose level, to the best of our knowledge there is no study conducted in Ethiopia to identify aspects of the problem. Objectives: The purpose of the study is to determine the glycemic control level and its associated factors among adult cancer patients with comorbid type II diabetes in public cancer care centers in Addis Ababa, 2023. Methods: Methods: In Tikur Anbesa Hospital and St. Paul's Hospital Millennium Medical College (SPHMMC), a cross-sectional study design was used. Each study area, participants were selected by convenient sampling technique. Data was filled kobo toolbox and exported to SPSS program version 26.0 for analysis. The degree of association between dependent and independent variables were assessed using binary logistic regression analysis. The odds ratio (OR) with a 95% confidence interval (CI) and a P-value of 0.05 was used to evaluate statistical significance. Finally, result of the study presented in the form of text, tables and figures. Result - This study included 120 participants in total. The majority 75(62.0 %) of them were female patients. Most 30(25%) study participants were diagnosed and treated for Hematologic cancer, followed by gynaecological cancer 26(21.7%). Regarding fasting blood glucose level, more than half 68 (56.7%) of the study participants were hyperglycaemic (FBG >130mg/dl) and only 38(31.7%) study participants checked their HgA1C values in the last 6 months. Treatments of DM, Forget to include fruits in the dietary plan and Educational status (illiterate) was related to good glycemic control practice. Patients who were illiterate were 3.1 times more likely to have a good glycemic control practice than patients who were educational status was below diploma (AOR = 3.68, 95% CI: 1.24-10.94, P=0.02) and patients who forgot to include fruits in their dietary plan were 64% less likely to be good glycemic control practice (AOR= 0.36, 95% CI: 0.12-1.06, p=0.03). Conclusion- The glycemic control level in adult cancer patients was poor even if most of the study participants got dietary education for the management of diabetic mellitus. Education level and forgetting to include fruits in their diet were factors linked to good glycemic control levels.
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    Health Related Quality Life (HRQoL) Among Patients with Childhood Leukemia in Tikur Anbessa Specialized Hospital,Addis Ababa,Ethiopia,2023.
    (Adiss Ababa University, 2023) Kelbessa, Megertu; Ayalew, Yohannes(Ass. Prof.); Dugassa, Boka
    Background:There has been a paradigm shift in health service delivery to a more holistic approach, which considers Health Related Quality of Life (HRQoL) and overall functioning. HRQoL is a multidimensional construct that encompasses physical functioning as well as psychosocial aspects of emotional and social functioning. Childhood Leukemia is among threats to HRQoL to the patients and parents of the children, which trigger extensive studies on the subject. Objective:The study objectives were twofold. Primarily, the statuses of HRQoL of childhood leukemia patients in TASH were assessed. Secondly, factors affecting HRQoL among childhood leukemia patients in TASH were examined. Method:The study employed mixed research approach where descriptive design and explanatory research design concurrently utilized. Questionnaire distributed to sample of 422 respondents with 100% response rate. Data were analyzed through descriptive analysis, regression analysis and correlation analysis. Result:The study revealed that, f 422 patients (57% males) with leukemia; their ages ranged from 5 to 14 year (Mean = 8.58, Standard Deviation = 2.56). Age and gender had a significant and positive relationship with HRQoL of childhood leukemia in TASH. Male children were found to be more exposed to the disease, while an increase image improves physical functioning aspect HRQoL. Addiction free habit of parents had a positive relationship with HRQoL and school functioning at p < 0.05. Chemotherapy morbidity however worsens physical wellbeing of the patients. All other correlations were statistically non-significant. The current findings added to HRQoL research, and provided an impetus for more research in the area of HRQoL for children with leukemia in Ethiopia
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    Incidence and determinant factors of Neutropenia among cancer patients receiving chemotherapy at Public Hospitals, Addis Ababa, Ethiopia, 2023
    (Addis Ababa Uinversity, 2023) Mebrie,Degayehu; Boka,Abdissa(Ass. Prof.),Alemu, Tsion( MSc)
    Background: Cancer is one of the most common causes of morbidity and mortality in the world. Around the globe, 19.3 million new cases of cancer were diagnosed in 2020, while about ten million people died from cancer. Patients receiving myelosuppressive chemotherapy for cancer face the risk of developing chemotherapy-induced neutropenia, which puts them at risk for serious consequences like febrile neutropenia. Objectives: This study aimed to assess the incidence and determinant factors of neutropenia among cancer patients receiving chemotherapy at public Hospitals, in Addis Ababa, Ethiopia. Methods; This retrospective follow-up cohort study was carried out at Saint Paul Hospital Millennium Medical college and Tikur Anbessa Specialized Hospital. All eligible cancer patients’ medical records from January 1st, 2020 to December 31st, 2022 were a source population. Computer generated simple random sampling technique was employed to select study participants. Data was collected by using Kobo toolbox software. SPSS version 26 was used for data analysis. Bi-variable logistic regression analysis was carried out to select variables with P-value <0.25. In multivariate analyses the significance of the association was interpreted using an Adjusted Odds Ratio (AOR) by considering a P-value <0.05 with 95% confidence interval. The results were summarized using text, tables and graphs. Result; A response rate of 98.8% was achieved with 348 of the total 352 enrolled participants. The overall incidence of chemotherapy-induced neutropenia was 58.6% [53.6-63.9]. cervical cancer (AOR=0.31(95%CI: 0.096-0.997), normal baseline WBC (AOR =0.492 (95% CI: 0.279- 0.867), and bone metastases (AOR= 2.536(95% CI:1.121-5.737) were significantly associated factors of chemotherapy-induced neutropenia. Conclusion; the overall incidence of neutropenia was high. Baseline WBC, cervical cancer, and bone metastases were significantly associated determinant factors of neutropenia. Throughout the course of chemotherapy, it is critical to make every effort to limit the risk of neutropenia. Determinant factors of neutropenia are multifaceted, and healthcare providers should be familiar with these factors as much as possible