Gynecologic Oncology : Withdrawal from familial ovarian cancer screening for surgery: Findings from a psychological evaluation study (PsyFOCS)

Highlights

► Previous negative experiences of OC screening might lead women to opt for surgery.
► OC screening may be an interim risk management strategy before opting for surgery.

Gynecologic Oncology : The association between endometriosis and ovarian cancer: A review of histological, genetic and molecular alterations

.... PTEN play a part in the malignant transformation of endometriosis, some studies have revealed TP53 mutations in endometriotic lesions, and mutation of ARID1A (clear cell)

Highlights
► Atypical endometriosis is a transition from benign endometriosis to carcinoma.
► Endometriosis is characterized by genetic instability.
► Oxidative stress, inflammation and hyperestrogenism link endometriosis with cancer.

Gynecologic Oncology : There is no decision to make: Experiences and attitudes toward treatment-focused genetic testing among women diagnosed with ovarian cancer

Highlights

► Women's views regarding genetic testing at diagnosis of ovarian cancer 
► This ‘treatment-focused’ genetic testing is highly acceptable 
► Advantages of genetic testing at diagnosis outweigh the disadvantages

Androgen receptor expression is a biological marker for androgen sensitivity in high grade serous epithelial ovarian cancer

Highlights

► Androgen receptor expression correlates with androgen sensitivity in ovarian cancer.
► Androgen receptor expression decreases with chemotherapy.
► Androgen receptor expression is a biomarker for androgen therapy in ovarian cancer.

Second Malignancies Among Elderly Survivors of Cancer

 Blogger's note: selected text referencing ovarian cancer:

 Ovarian Cancer Survivors

Most ovarian cancer patients present with relatively late stage disease, and thus the overall 5-year survival rate is only 46% [1]. However, in women who survive ≥5 years following ovarian cancer, the risk for developing a second malignancy is high, with a 31% higher risk than in the general population [54]. The cancers most often seen after ovarian cancer are breast, colorectal, and bladder cancer and leukemia [55]. Breast and colon cancer are most often seen after ovarian cancer in younger women, largely because of the prevalence of genetic syndromes, such as BRCA mutation and hereditary nonpolyposis colorectal cancer  (Lynch Syndrome),  that predispose to these tumors and ovarian cancer [27, 29, 55]. Some rare tumors have also been associated with ovarian cancer, including biliary tract cancer and both the ocular and skin variants of malignant melanoma, and are also thought to be a result of genetic syndromes such as BRCA-2 mutation [26, 54, 56].

However, an excess risk for second malignancies has been seen in women diagnosed with primary cancer of the ovary at age 50–69 years as well, and these second cancers appear more likely to be a result of treatment. In particular, the risks for bladder, soft tissue, and bone cancers are substantially higher in women who received radiation, and these risks become most apparent ≥10 years following the initial radiation therapy [54, 57].

The risk with chemotherapy in the development of second cancers is also apparent across all age groups. The risk for the subsequent development of both AML and acute lymphocytic leukemia have been shown to be significantly higher in women following a primary diagnosis of ovarian cancer, even in women aged ≥70 years at the time of their primary diagnosis and in women who did not receive radiation [54]. Historically, this greater risk was attributed to alkylating chemotherapeutic agents, such as melphalan and chlorambucil [32], but these agents have largely fallen out of use in the treatment of ovarian cancer. More recently, platinum-based chemotherapy, which is routinely used in ovarian cancer treatment, has also been associated with a higher late risk for leukemia. This was demonstrated in a large registry case–control study of women who developed leukemia after ovarian cancer. Of note, 71% of patients who developed leukemia were aged ≥60 years at the time of their ovarian cancer diagnosis, whereas 29% were aged ≥70 years [31]......

......Further evidence-based guidelines are needed for early detection and treatment of second malignancies in older adults, and physicians caring for this population should integrate age, health status, projected life expectancy, and patient preferences when deciding upon screening and prevention measures.  

Revisiting the Role of Antiandrogen Strategies in Ovarian Cancer

link to abstract

selected excerpts (in efforts to understand the issues):

Epidemiological Data on Androgens and the Risk for EOC

In women, androgens are mainly synthesized in the adrenal glands, the ovaries, and adipose tissue, and they have an important physiological significance for bone and muscle growth and maintenance as well as cognitive function [1, 5]. There is a growing body of evidence supporting the notion that androgens influence proliferation of the normal ovarian epithelium and are a risk factor for EOC......

First, most clinical trials evaluating the use of androgen blockade for the treatment of EOC have been small, nonrandomized studies involving patients with platinum-resistant disease......
 
Third, most clinical trials assessing anti-AR strategies in EOC have not measured AR expression. The trials that did measure it used IHC, the results of which may not always reflect AR activity in EOC.

Factors Associated with Altered Long-Term Well-Being After Prophylactic Salpingo-Oophorectomy Among Women at Increased Hereditary Risk for Breast and Ovarian Cancer

Blogger's note: full view may require $$$ (subscription)

link to abstract

Year in Review: Gene Patent Case May Head to Supreme Court - Myriad + Mayo/Prometheus Labs