Introduction: Cancer now affects more than one in three people in their lifetime. Cancer remains the leading cause of death in many countries. Anthracycline-based chemotherapy has played an important part in the current age of cancer treatment, with earlier diagnosis and novel medicines. Objective: To find out the frequency of cardiac-toxicity (cardiomyopathy) in patient treated with anthracycline Methodology: This Descriptive Study was carried out at the Oncology department of Hayatabad Medical Complex, Peshawar for duration of six months from 20 Dec, 2019 to 20 Jun, 2020. Patients attending the medical oncology department of Hayatabad Medical Complex, Peshawar were included in the study. Demographic data like age, sex was collected in the pre-designed Performa. The patients were sent for echocardiography which was done by cardiologist and ejection fraction was noted. The patients suitable for treatment on anthracycline were started with standard doses for his/her carcinoma which were for leukemia 25mg/m2 weekly for 1 months, for lymphoma (NHL) 50mg/m2 after every 21 days for 4.2 months, for breast carcinoma 60mg/m2 after every 21 days for 2.8 months. Results: As per frequencies and percentages for anthracycline induced cardiomyopathy, 31 (15.0%) patients had anthracycline induced cardiomyopathy. Conclusion: Our research shows that although preventing chronic cardiotoxicity may be challenging, prolong infusion methods for anthracyclines offer a reduced risk, and novel liposomal formulations of doxorubicin may provide less cardiotoxicity as compared to conventional doxorubicin. Key words: Anthracyclines; Cardiotoxicity; Treatment

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Background: Malignant disease diagnosis brings great psychological suffering to the patient, and the sickness might have catastrophic ramifications for the relatives. Objective: To assess influence of cancer news on quality of life of patient’s families Methodology: This study was prospective cohort study conducted at the oncology department of tertiary care Hospitals of Peshawar for duration of one year. The quality of life was assessed as per pre defined questionnaire both from two first degree relatives at each clinical visit during treatment every week and every month for six months after completion of treatment. Data analysis was done by employing SPSS version 21. Results: A total of 180 family members were included. In the current study, the quality of life of family members was 1.54±0.57 in view of usual activities (p=0.001). Anxiety/depression score of the family members was 1.67±0.64 while in control group it was 1.50±0.64 (p=0.031). The EQ VAS score in control group was 66.5±16.7 whereas in caregivers group, it was 71.3±18.8 (P=0.023). Based on mental health, stress was observed in 98 (54.44%) participants in caregivers group. Moderate-severe depression was observed in 45 (25%) participants in caregiveres group whereas in contorl group moderate to severe depression was observed in 21 (11.67%) subjects. (p=0.041) Conclusion: Our findings reveal that family caregivers of cancer patients face mental health issues and a decline in health-related quality of life. To reduce the effect of caring on the mental health and health related quality of life of family caregivers in Pakistan, culturally suitable caregiver support programs are required. Key words: Cancer news; Quality of life; Stress; Depression

Background: Methotrexate was first used in 1947 as a chemotherapeutic drug in the treatment of acute lymphoblastic leukemia (ALL). Methotrexate has been extensively explored as an anticancer drug since that time. High dose methotrexate is a term used for doses above 1000mg/m2. Objective: To determine efficacy of Furosemide in methotrexate clearance in patients treated with high dose methotrexate Methodology: The current study was prospective cohort study carried out at the Oncology department of tertiary care hospitals of Peshawar for a period of one year from January 2020 to January 2021. A total of 80 patients were enrolled in the study. All patients received daily hydration of at least 5 liters along with urine alkalization with sodium bicarbonate and on calcium rescue as per protocol. All patients were given Furosemide 40 mg three times a day. Methotrexate levels were monitored every 24 hours to follow its clearance. All the Data analysis was done by using IBM SPSS version 24. Results: The mean (SD) hospital stay in the current study was 4 (±1) days. Frequency of delayed methotrexate clearance was observed in 16 (20%) patients. The mean (SD) time of methotrexate clearance was 4 (±1) days. Renal injury was observed in 8 (10%) subjects, electrolyte imbalance in 12 (15%) subjects, transaminitis in 11 (13.75%) subjects while mucositis was observed in 8 (10%) subjects. Conclusion: Our study concludes that furosemide is highly effective in methotrexate clearance in patients treated with high dose methotrexate. The use of furosemide reduces the cost and hospital stay. As furosemide is cheaper and easily available so it can be used easily in the methotrexate clearance. Key words: Furosemide; Methotrexate clearance; High dose methotrexate; Cancer