Saturday, August 21, 2010
For ovarian cancer, in vitro chemotherapy sensitivity and resistance assays are cited as Category 3 recommendations (reflecting major disagreement among NCCN panel members) for the selection of chemotherapy when multiple appropriate chemotherapy choices exist. Such assays are used in a few NCCN Member Institutions but should not supplant standard of care chemotherapy choice due to the lack of evidence for clinical benefit.[100,101] The NCCN Guidelines™ also recommend that patients with ovarian cancer undergo measurement of serum carbohydrate antigen (CA)-125 levels and "other tumor markers as clinically indicated" at diagnosis, during treatment as markers of response, and as surveillance for disease recurrence.[102,103] Of note, the European Organization for Research and Treatment of Cancer (EORTC) 55955 trial showed no survival benefit when an elevation in CA-125 levels alone was used to prompt initiation of second-line treatment in 1442 patients with ovarian cancer in remission after first-line platinum-based chemotherapy, suggesting against a role for this marker in surveillance for recurrence. Other serum markers may include inhibin for sex cord-stromal tumors and HCG, AFP, and LDH for germ cell tumors of the ovary.[103,105]
National Guideline Clearinghouse | Initial evaluation and referral guidelines for management of pelvic/ovarian masses 2009
Initial evaluation and referral guidelines for management of pelvic/ovarian masses.
|Le T, Giede C, Society of Obstetricians and Gynaecologists of Canada (SOGC), Gynecologic Oncologists of Canada (GOC), Society of Canadian Colposcopists (SCC). Initial evaluation and referral guidelines for management of pelvic/ovarian masses. Practice guideline. J Obstet Gynaecol Can 2009 Jul 01;(230):668-73.|
This is the current release of the guideline.
U of Toronto researcher discovers key protein involved in DNA repair Discovery gives insight into the way cells protect their own genetic material
Note: in research
"In a groundbreaking study, U of T researchers including Professors Daniel Durocher, Anne‐Claude Gingras and Frank Sicheri have uncovered a protein called OTUB1 that blocks DNA damage in the cell—a discovery that may lead to the development of strategies to improve some cancer therapies.
Lead author Durocher, a senior investigator at Mount Sinai Hospital’s Samuel Lunenfeld Research Institute and the Thomas Kierans Research Chair in Mechanisms of Cancer Development, as well as colleagues at U of T, Mount Sinai Hospital and the Keio University in Japan, have revealed pivotal new information on how cells regulate their genetic material. In addition, the discovery improves understanding of familial breast and ovarian cancer, as the research shows that OTUB1 inhibits the action of BRCA1, a DNA repair protein often mutated in these cancers...."cont'd
"...Beginning in 2014, tax credits will be available for people under age 65 who purchase coverage on their own in a health insurance Exchange and are not covered through their employer, Medicare or Medicaid. The tool allows the user to examine the impact at different income levels, ages, family sizes, and regional costs....." see calculator/website for more information
Define: metachronous - multiple occurrences/multiple primary cancers
BACKGROUND: National guidelines for prophylactic oophorectomy in women with colorectal cancer are lacking. The aim of this population-based cohort study was to report on the prevalence, incidence and prognosis of ovarian metastases from colorectal cancer, providing information relevant to the discussion of prophylactic oophorectomy.
METHODS: All 4566 women with colorectal cancer in Stockholm County during 1995-2006 were included and followed until 2008. Prospectively collected data regarding clinical characteristics, treatment and outcome were obtained from the Regional Quality Registry.
RESULTS: The prevalence of ovarian metastases at the time of diagnosis of colorectal cancer was 1.1 per cent (34 of 3172) among women with colonic cancer and 0.6 per cent (8 of 1394) among those with rectal cancer (P = 0.105). After radical resection of stage I-III colorectal cancer, metachronous ovarian metastases were found during follow-up in 1.1 per cent (22 of 1971) with colonic cancer and 0.1 per cent (1 of 881) with rectal cancer (P = 0.006). Survival in patients with ovarian metastases was poor.
add your opinions cancer patients genetics breast colorectal ovarian health , metachronous , metastases