Wednesday, May 05, 2010
Note: with thanks to Helen Palmquist - http://www.ovariancancer.org/2010/04/12/Jean-Strauss/ along with the many Mom's profiled
Arch Environ Occup Health. 2010 Apr-Jun;65(2):101-5.
"Epidemiologic studies have found inverse associations between allergy and the development of certain tumors. The authors sought to determine if there was an association between asthma and ovarian cancer......The results of this statewide (Florida) exploratory study suggest that individuals with asthma may have a lower risk of developing ovarian cancer than nonasthmatics.
Assessing Health-Related Quality of Life in Gynecologic Oncology: A Systematic Review of Questionnaires and Their Ability to Detect Clinically....
Assessing Health-Related Quality of Life in Gynecologic Oncology: A Systematic Review of Questionnaires and Their Ability to Detect Clinically Important Differences and Change
Methods: We searched MEDLINE using the term quality of life and each gynecologic cancer type, as well as the names of identified questionnaires.
Conclusions: The evidence we reviewed offered little support for the hypothesis that disease-, symptom-, or treatment-specific instruments are more sensitive and responsive than cancer-specific or generic questionnaires. However, conclusions were limited by the small number of head-to-head comparisons available. We summarize the clinical contexts in which each instrument identified an MCID to inform choice of questionnaire(s), sample size calculations, and interpretation of results in future studies.
Postoperative Pulmonary Embolism Including Asymptomatic Case... : International Journal of Gynecological Cancer
Conclusions: A substantial number of postoperative PEs were occult, and identification of high-risk patients and routine SpO2 level monitoring would reduce the diagnostic delay of PE after gynecologic surgery. Increasing age, longer operation time, and obesity were risks. The use of a perioperative intermittent pneumatic compression device in multimodal conditions might thus prevent PE. (pulmonary embolism/blood clot)
Increasing the Effectiveness of Referral of Ovarian Masses From Cancer Unit to Cancer Center by Using a Higher Referral Value of the Risk of Malig.........
Increasing the Effectiveness of Referral of Ovarian Masses From Cancer Unit to Cancer Center by Using a Higher Referral Value of the Risk of Malignancy Index
Higher risk of malignancy index (RMI) with multidisciplinary approach will reduce the number of referrals of ovarian masses, thus reducing the stress for patients and workload at the cancer center.
Conclusions: A higher RMI with multidisciplinary approach to refer patients with pelvic masses has the potential to reduce the numbers of benign cases, thus reducing stress for patients and reducing workload at centers.
Note: also see post of Dr Maurie Markman (blogger dat May 4th) for Editorial on this particular subject matter
Conclusions: These findings suggest the possibility that SL can improve OS in advanced-stage EOC. However, the efficacy of SL on OS is still unknown because of the lack of RCTs, which requires more relevant studies for investigating the role of SL in EOC
Survivin Small Interfering RNA Transfected With a Microbubbl... : International Journal of Gynecological Cancer
Conclusions: Delivery of survivin siRNA using a microbubble contrast agent combined with ultrasound exposure can effectively inhibit survivin expression and induce apoptosis, providing a new promising approach for siRNA delivery in vivo.
Cervical, Uterine Corpus, and Ovarian Cancer Mortality in Greece During 1980 to 2005: A Trend Analysis
"The increasing trend of uterine corpus and ovarian cancer mortality in older women suggests that development of well-organized tertiary centers for the implementation of modern therapeutic modalities is urgently needed."
The James Lind Alliance announces the launch of online Guidebook for priority setting in research | The Cochrane Collaboration
"Sir Iain Chalmers, co-founder of the JLA says: “It is surprising how difficult it is to find out how research funders decide what research to fund. What is clear is that patients, carers and ordinary ‘jobbing’ clinicians are only very rarely involved in these processes. That is probably one of the reasons that the little evidence there is reveals mismatches between the questions that interest researchers and the questions that interest patients and clinicians. The James Lind Alliance Guidebook will help people who want to try to bridge those gaps.”...cont'd
2010: Collateral damage: toxic effects of targeted antiangiogenic therapies in ovarian cancer : The Lancet Oncology (abstract only)
Note: abstract/full access is by subscription/$$
add your opinions antiangiogenic , collateral damage , ovarian primary peritoneal cancer risk side effects , toxicity
"We found that women who experienced non-natural menopause are at almost twice the risk of developing lung cancer compared to women who experienced natural menopause," Anita Koushik, a researcher at the Universite de Montreal's Department of Social and Preventive Medicine, said in announcing her team's findings Tuesday.
"This increased risk of lung cancer was particularly observed among women who had non-natural menopause by having had both their ovaries surgically removed."
It's the second study this year to associate bilateral oophorectomy — removal of both ovaries — with higher odds of developing lung cancer...."
Abstract/full access; TIMP-1 and VEGF-165 serum concentration during first-line therapy of ovarian cancer patients
Angiogenesis appears to play an important role in ovarian cancer. Vascular endothelial growth factor (VEGF) has recently been implicated as a therapeutic target in ovarian cancer. The tissue inhibitor of metalloproteinase 1 (TIMP-1) is involved in tissue invasion and angiogenesis. The application of serum TIMP-1 and VEGF to monitor primary therapy and predict clinical outcome of patients with ovarian cancer is unclear.
The role of initial maximal surgical cytoreduction in ovarian cancer still debated Dr Maurie Markman Editorial
"Although the world of surgery is not necessarily characterized by the utility of innovative clinical hypotheses being formally evaluated through the conduct of randomized phase-3 clinical trials, it will hopefully be the case that the gynecologic cancer surgical community will see the wisdom of further exploration of these important concepts in prospective well-designed and evidence-based clinical trials.
Our current and future patients deserve no less."
Note: full access is available/click on 'pdf' "For the majority of citizens worldwide, effective, nontoxic, culturally appropriate, and attainable care for cancer has not yet been defined."
"It’s in the interests of public health to try our best to measure what should guide our health decisions – and to measure what actually does."
"The zoster vaccine has demonstrated benefit in reducing the frequency and severity of zoster in elderly patients. It’s an attenuated vaccine, so should be used with caution in patients who have immunosuppression."
Initial Assessment, Surveillance, and Management of Blood Pressure in Patients Receiving Vascular Endothelial Growth Factor Signaling Pathway Inhibitors -- Maitland et al. 102 (9): 596 -- JNCI Journal of the National Cancer Institute
Box 1. Summary recommendations
- Conduct and document a formal risk assessment for potential cardiovascular complications before vascular endothelial growth factor signaling pathway (VSP) inhibitor treatment. The assessment should include standardized blood pressure measurements (two separate sessions are suggested) and thorough history and examination to assess specific cardiovascular risk factors, and directed laboratory studies as indicated. (Table 2 summarizes the risk factors.) The purpose of this evaluation is to guide the physician and patient in determining the appropriate intensity of monitoring and control of blood pressure elevations. This provides an important opportunity to address comorbidities that through more attentive management could help prolong the patient's life and support more aggressive anticancer therapy.
- Recognize that preexisting hypertension will be common in cancer patients and should be identified and addressed before initiation of VSP inhibitor therapy. Given the suspected importance of pretreatment intervention in the management of VSP inhibitor–induced blood pressure elevations, properly collected, objective, office measurements or more thorough evaluations for isolated office hypertension (also known as "white coat hypertension") should guide the risk assessment rather than patient and/or physician speculation and dismissal.
- Actively monitor blood pressure throughout treatment with more frequent assessments during the first cycle of treatment. The first cycle is typically when the bulk of the blood pressure elevation is expected to occur and when most patients unexpectedly present with elevations warranting treatment even in the absence of preexisting cardiovascular risk factors.
- The goal for hypertension control in patients receiving VSP inhibitor therapy is a maximum blood pressure of 140/90 mmHg, and efforts to reach this goal should begin before initiation of VSP inhibitor therapy. The recommendation for a goal of maintaining blood pressure less than 140/90 mmHg is based on prudence and consistency with general guidelines. As per the risk stratification considerations, targets should be adjusted lower for patients with multiple preexisting risk factors for adverse consequences of high blood pressure. For example, for patients with diabetes and/or chronic kidney disease, a goal blood pressure of less than 130/80 mmHg is the current public health recommendation.
- Manage blood pressure elevations aggressively to avoid the development of complications associated with excessive/prolonged elevations. Management requires attention to proper agent selection, dosing, and scheduling of follow-up to ensure efficacy and to control adverse effects of the antihypertensive agent. The panel suggests that at any time, if the oncologist or responsible medical team member has any difficulty in helping the patient progress to the goal blood pressure of 140/90 mmHg, consultation with the local hypertension specialist (cardiologist, nephrologist, endocrinologist, or certified hypertension specialist) should be obtained promptly.
FDA Finalizes REMS Program for ESAs,; Amgen Continues to Study Risks -- limited information in text/article
Note: extract of article - limited information (requires subscription/$$)
".......The fact that Dahm et al. could not correct the fiber consumption odds ratios for these types of systematic biases casts a shadow over the interpretation of their reported inverse association.
Unfortunately, this shadow extends to virtually the entire body of the existing nutritional epidemiology literature and may well contribute to the fact that few associations between diet and cancer are regarded as established or probable (8).
The explicit use of biomarkers to correct nutritional epidemiology associations for systematic and random measurement error in dietary assessment seems a logical next step in the nutritional epidemiology research agenda..." cont'd
Magnitude of Overdiagnosis in Cancer Indicates Need for Strategies to Address the Problem -- 102 (9): NP -- JNCI Journal of the National Cancer Institute
Note: in general, not specific to ovarian cancer
Note: still recruiting as of Jan 2010 Official Title: Use of the CA 125 Algorithm for the Early Detection of Ovarian Cancer in Low Risk Women
Note: requires registration/free to view
".........She also said that more education should be directed at cancer survivors so that they know where to go when they have a problem when they are not routinely managed by the cancer care team.
“It may not be their oncology pharmacist, it may be their primary care physician or their community pharmacy, but we must tell them that these symptoms can occur and that they should be addressed. Our role as educators shouldn’t simply be to tell them that their chemotherapy can cause nausea and vomiting; rather, I think it should be to tell them that they may experience symptoms..."cont'd