Thursday, February 02, 2012
2012 Feb: Chemotherapy and Fingerprint Loss: Beyond Cosmetic (hand foot syndrome - chemotherapy induced/capecitabine) - case report
Hand–foot syndrome (HFS), or palmar–plantar erythrodysesthesia,
is a distinct localized skin reaction characterized by erythema,
numbness, tingling, and either dysesthesia or
paresthesia, especially on the palms or soles. Symptoms include
pain and swelling, and can progress to blistering, desquamation,
and ulceration .
A single report describes the loss of fingerprints as a manifestation
of HFS in a cancer patient who was detained several hours
by airport security as a result .
We present the case of a patient who lost his fingerprints during the course of treatment with a capecitabine-based protocol who also experienced stressful and inconvenient administrative delays because of his condition.......
Table 1. National Cancer Institute hand–foot
1 Skin changes or dermatitis (e.g., erythema)
without accompanying pain
2 Skin changes (e.g., peeling, blisters, bleeding,
edema) with accompanying pain not
interfering with activities of daily living
3 Ulcerative dermatitis or skin changes with
accompanying pain interfering with activities
of daily living
abstract: A hypofractionated radiotherapy regimen (0-7-21) for advanced gynaecological cancer patients.
AIMS:To evaluate the efficacy of a palliative three fraction radiation regimen delivered on days 0, 7 and 21 (0-7-21 regimen) for advanced stage gynaecological cancer patients.
MATERIALS AND METHODS:Fifty-one patients with advanced gynaecological cancer who were treated with the 0-7-21 regimen between 1998 and 2008 were identified. The median follow-up period was 1.4 months (range 0.2-33.4). Treatment completion data, symptomatic response, toxicity and survival were retrospectively analysed.
RESULTS:Forty-eight patients received at least two of the three planned fractions. Complete and partial responses of vaginal bleeding were seen in 92% of 26 evaluable patients. Complete and partial responses of pain were seen in 76% of 25 evaluable patients. Eighteen of the 33 evaluable patients experienced grade 1/2 acute toxicity. No patients experienced grade 3/4 toxicity. Grade 1/2 and grade 3 late toxicity occurred in four and one of 12 evaluable patients, respectively. Grade 5 toxicity was assigned in two patients. It was uncertain whether these deaths were radiation related or due to tumour progression. Eleven patients survived longer than 12 months.
CONCLUSIONS:The 0-7-21 regimen provided effective and rapid symptomatic relief with acceptable toxicity, and offered the advantage of convenience for most patients. It offers an alternate treatment option for carefully selected patients with incurable gynaecological malignancies.
in research:NIH study uncovers probable mechanism underlying resveratrol activity, February 2, 2012 News Release - National Institutes of Health (NIH)
"....Chung noted that because resveratrol in its natural form interacts with many proteins, not just PDEs, it may cause not-yet-known toxicities as a medicine, particularly with long-term use. He added that the levels of resveratrol found in wine or foods are likely not high enough to produce significant health benefits or problems. Convincing clinical studies in humans have used about 1 gm of resveratrol per day, roughly equal to the amount found in 667 bottles of red wine....."
With the exception of this blogger,
no public presentations were made on behalf of ovarian cancer by any professional organization nor charity (NP)
Commission on the Future of Health Care in Canada: The Romanow Commission
The Commission embarked on an ambitious effort to ensure that the final recommendations were evidence-based and reflected the values Canadians want in the health care system. Headed by Roy J. Romanow, Q.C., former Attorney General and Deputy Premier of Saskatchewan, the Commission carried out its work in two distinct phases:
The fact-finding phase included:
During the consultation and dialogue phase, the Commission worked collaboratively with a variety of partners to provide Canadians with opportunities to engage in an informed discussion about the future of health care in Canada. Tens of thousands of Canadians - from ordinary citizens to health experts, health ministers and premiers, researchers and health care workers - participated in the process, which included public hearings, workshops, policy dialogues and other consultations.
ReportsOn November 28, 2002, the Commission tabled its final report, Building on Values: The Future of Health Care in Canada, in the House of Commons. The report recommended sweeping changes to ensure the long-term sustainability of Canada's health care system.
Electronic and print copies are available from Government of Canada Publications.
Copies may also be available through associated bookstores and booksellers that carry Government of Canada publications or through Depository Libraries of Canadian government information.
What Information is Available
open access: Canada - Predictors of Home Care Expenditures and Death at Home for Cancer Patients in an Integrated Comprehensive Palliative Home Care Pilot Program Longwoods - Healthcare Policy
"....Care at home in the final weeks of life and an adequately supported home death is a goal expressed by most patients with a terminal illness (Higginson and Sen-Gupta 2000 (excerpt from abstract.......Respondents indicated preferences for home death (range 49%-100%), except one study of patients in the care of a continuing care team in London where only 25%-29% of patients wanted a home death, and inpatient hospice was the most favored option.........Only 2 of the studies provided longitudinal data, and 9 of the 18 had major deficits in design or reporting..........) ;
Teirnan et al. 2002 (Blogger's Note: this study was from Dublin and the abstract does not indicate whether cancer patients were included);
Townsend et al. 1990).
It is also a health system policy imperative (Romanow 2000) (Blogger's Note: no reference/link provided)............."
open access: Participatory Medicine: Must You Be Rich to Participate? | Journal of Participatory Medicine
Participatory Medicine: Must You Be Rich to Participate?
“Participatory Medicine is a movement in which networked patients shift from being mere passengers to responsible drivers of their health, and in which providers encourage and value them as full partners.”
Our lofty definition of participatory medicine requires patients who are both interested and capable of taking an active role in their health care as well as providers who have time to listen and work together in a partnership with patients.
We fear that this movement may be leaving too many people behind.........
Society for Participatory Medicine. Available at: http://participatorymedicine.org/.
A silver bullet to beat cancer?"The internet is awash with stories of how silver can be used to treat cancer.........."
"...........The research, still the first phase of drug development, involved exposing breast and colon cancer cells with different silver-based chemicals for six day periods. It has been shown that ligands which are co-ordinately bonded to the central silver atom through two sites are more effective than those coordinated through only one site. This may be due to the release of silver being much slower and make these compounds more effective over a longer period of time.
A major barrier to the continued development of these compounds is a lack of understanding of how they work. Over the next 12 months, research will focus on investigating how the compounds damage cancerous cells and what effects they have on healthy cells. This will establish whether these silver complexes are in fact less toxic to ordinary human tissue, and will help to design and develop the next-generation of chemotherapy drugs.
This work is been carried out in collaboration with Dr. Roger Phillips at the University of Bradford and is funded by Yorkshire Cancer Research."
open access: BioMed Central Blog : Connecting the evidence: an “ontology” (vocabulary) for Threaded Publications (unpublished research)
Clearly connecting trial-related publications is a way to help with this problem and is a major goal of BioMed Central’s Threaded Publications initiative. To achieve its fundamental aims of connecting all digital published content relating to the evidence about a particular trial, however, Threaded Publications must go beyond a single journal or publisher.
Through our partnership with CrossRef – an organisation founded by publishers, for publishers – and engagement with editors and publishers we hope to achieve interoperability across different publishing platforms.
The desired outcome is that articles reporting the protocol or the findings of a trial published in different journals or by different publishers will be linked in a thread, which should also include the trial’s entry in a research register......."
not yet recruiting - Phase 11 - Weekly Paclitaxel/Carboplatin With Neupogen in Gynaecological Cancers - Full Text View - ClinicalTrials.gov
Now accepting submissions
Please note that authors are not currently required to pay for publication of articles during the journal's first year of publication; this is due to the generous support of the BGI. For all enquires about the journal, please contact: firstname.lastname@example.org.
Wednesday, February 01, 2012
BackgroundThe consequences of defective homologous recombination (HR) are not understood in sporadic ovarian cancer, nor have the potential role of HR proteins other than BRCA1 and BRCA2 been clearly defined. However, it is clear that defects in HR and other DNA repair pathways are important to the effectiveness of current therapies. We hypothesize that a subset of sporadic ovarian carcinomas may harbor anomalies in HR pathways, and that a BRCAness profile (defects in HR or other DNA repair pathways) could influence response rate and survival after treatment with platinum drugs. Clinical availability of a BRCAness profile in patients and/or tumors should improve treatment outcomes.
ObjectiveTo define the BRCAness profile of sporadic ovarian carcinoma and determine whether BRCA1, PARP, FANCD2, PTEN, H2AX, ATM, and P53 protein expression correlates with response to treatment, disease recurrence, and recurrence-free survival.
ResultsHigh PARP, FANCD2 and BRCA1 expressions were significantly correlated with each other; however, elevated p53 expression was associated only with high PARP and FANCD2. Of all patients, 9% recurred within the first year. Among early recurring patients, 41% had high levels of PARP, FANCD2 and P53, compared to 19.5% of patients without early recurrence (p = 0.04). Women with high levels of PARP, FANCD2 and/or P53 had first year cumulative cancer incidence of 17% compared with 7% for the other groups (P = 0.03).
ConclusionsPatients with concomitantly high levels of PARP, FANCD2 and P53 protein expression are at increased risk of early ovarian cancer recurrence and platinum resistance.
abstract: Clinicopathologic Characteristics and Survival in BRCA1- and BRCA2-Related Adnexal Cancer: Are They Different?
open access: Identifying women with suspected ovarian cancer in primary care: derivation and validation of algorithm UK/Wales
audio: Pre-emptive surgery - ovarian/breast genetics/brca - ABC Queensland - Australian Broadcasting Corporation (ABC)
02 February 2012 , 1:34 PM by Christopher Welsh
Did you hear the story of a few women who are choosing to have Ovaries removed to avoid the risk of ovarian cancer.
It made me wonder what other surgical procedures are people choosing to avoid the possibility of serious illness or disease.
I have heard of pre-emptive mastectomies but are there similar procedures men are electing to have and does it work?
From the AMAQ Dr Gino Pecoraro explains.
After that talk we had a call from Sharn who is in this exact situation.
She is now confronted with the decision whether to wait and see if she develops breast cancer, or have a double mastectomy because her chances of getting the cancer are so high....
I spoke with Sharn and asked how many of her relatives had developed breast or ovarian cancer
Association des Patients du Canada, Patients' Association of Canada - conference notice/members' bios
The Patients’ Association of Canada (PAC) has been established to fill an important gap in the health field. Until now, there have been no national patient-led and patient-governed organizations that speak to the experience that people have as patients. In many public discussions about health care, the patient perspective is presented by health care professionals, disease-based organizations, researchers, or policy makers who have their own points of view that are not the same as those of patients....
conference notice: February 2, 2012
Clinical Practice Decisions in Ovarian Cancer
Roundtable Discussion - Optimal Care for Patients: Who Decides?
Clinical Practice Decisions in Treating the Adolescent and Young Adult with Cancer
Clinical Practice Decisions in CNS (central nervous system) Metastases
Sunday Brunch with the Experts (the patients??): Issues in Cancer Survivorship
"...So cancer is not under control. The problem is big; will get bigger; will affect nations unequally, prejudicing those with the least ability to respond; and will have enormous societal and economic consequences. However, this situation is not the problem, it is a reality. The real challenge is “What we are going to do about it,” because quite clearly, “more of the same” will be an inadequate, insufficient, and ineffective response....."
open access: 2011 Progression-free survival in advanced ovarian cancer: a Canadian review and expert panel perspective | Dr A. Oza | Current Oncology (topics: eg chronic disease, 1st line therapy...)
Blogger's Note: may require registration (free); note also list of useful (international) reference papers
Ovarian cancer is leading cause of gynecologic cancer mortality in Canada. To date, overall survival ( os ) has been the most-used endpoint in oncology trials because of its relevance and objectivity. However, as a result of various factors, including the pattern of sequential salvage (outdated term) therapies, measurement of os and collection of os data are becoming particularly challenging. Phase ii and iii trials have therefore adopted progression-free survival ( pfs ) as a more convenient surrogate endpoint; however, the clinical significance of pfs remains unclear. This position paper presents discussion topics and findings from a pan-Canadian meeting of experts that set out to
evaluate the relevance of pfs as a valid endpoint in ovarian cancer;
reach a Canadian consensus on the relevance of pfs in ovarian cancer; and
try to address how pfs translates into clinical benefit in ovarian cancer.~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Recommendations for future investigations include these:
Ensure that trials are designed to evaluate pfs , os , and other clinically relevant endpoints such as disease-related symptoms or qol .
Incorporate interim futility analyses intended to stop accrual early when the experimental regimen is not active.
Stop trials early to declare superiority only when compelling evidence suggests that a new treatment provides benefit for a pre-specified clinically relevant endpoint such as os or symptom relief.
Importantly, discourage early release of secondary endpoint results when such a release might increase the frequency of crossover to the experimental intervention.
Genome Research publishes special issue: Cancer GenomicsGenome Research (www.genome.org) publishes online and in print today a special issue entitled, "Cancer Genomics," highlighting insights gained form cutting-edge genomic and epigenomic analyses of cancer.
Included in this special issue are novel biological insights gained from genomic analyses of pancreatic cancer, ovarian cancer, and melanoma, including, functional genomic analyses of breast cancer genes, large scale colorectal and breast cancer epigenomics, advances in methodology identifying driver genes and networks in cancer, in genome-wide cancer association analyses, and using next-generation sequencing technology to detect driver mutations.
Additionally, the issue includes unique perspectives from leaders in the field on the translation of cancer genomics to improved outcomes in medicine. The following sections highlight several of the papers published in the issue:
1. Whole-genome and whole-exome sequencing: Searching for the drivers of cancer
2. Circulating free DNA holds clues to cancer diagnosis and risk of relapse
3. Epigenomic analyses shed new light on breast, colon, and prostate cancers
4. Cutting-edge methods to detect the genes and networks that drive cancer
Table B-9. Composite-Level Average Percent Positive Response by Interaction with Patients
Table B-10. Item-Level Average Percent Positive Response by Interaction with Patients
Table B-11. Average Percentage of Respondents Giving Their Work Area/Unit a Patient Safety Grade by Interaction with Patients
Table B-12. Average Percentage of Respondents Reporting Events in the Past 12 Months by Interaction with Patients
Pulitzer Prize-winning playwright focuses on lessons in ‘Wit’ (ovarian cancer) as work hits Broadway - The Washington Post
Blogger's Note: as background 'Wit' underwent both much criticism and many accolades when first introduced; great, if not short, interview
Hospital Survey on Patient Safety Culture
2012 User Comparative Database Report
Based on data from 1,128 U.S. hospitals, the Hospital Survey on Patient Safety Culture: 2012 User Comparative Database Report provides initial results that hospitals can use to compare their patient safety culture to other U.S. hospitals. In addition, the 2012 report presents results showing change over time for 650 hospitals that submitted data more than once. The report consists of a narrative description of the findings and four appendixes, presenting data by hospital characteristics and respondent characteristics for the database hospitals overall and separately for the 650 trending hospitals.
Select to download print version (Part 1, PDF File, 1.8 MB; Parts 2 and 3, PDF File, 1.6 MB). PDF Help.
The Agency for Healthcare Research and Quality (AHRQ) released the Hospital Survey on Patient Safety Culture, a tool to help hospitals evaluate how well they had established a culture of safety
BMC Cancer | open access - Chemotherapeutic errors in hospitalised cancer patients: attributable damage and extra costs
abstract: External Validation of Diagnostic Models to Estimate the Risk of Malignancy in Adnexal Masses (in research)
Purpose: To externally validate and compare the performance of previously published diagnostic models developed to predict malignancy in adnexal masses.
Results: Seven hundred and forty-two (74%) benign and 255 (26%) malignant masses were included. ........ The superior performance of the IOTA models was most pronounced in premenopausal patients but was also observed in postmenopausal patients. IOTA models were better able to detect stage I ovarian cancer.
Conclusion: External validation shows that the IOTA models outperform other models, including the current reference test RMI, for discriminating between benign and malignant adnexal masses
Experimental Design: We examined 45 matched primary/recurrent tumor pairs of high-grade ovarian adenocarcinomas for expression of CSC markers ALDH1A1, CD44, and CD133 using immunohistochemistry. Tumors collected immediately after completion of primary therapy were then laser capture microdissected and subjected to a quantitative PCR array examining stem cell biology pathways (Hedgehog, Notch, TGF-β, and Wnt). Select genes of interest were validated as important targets using siRNA-mediated downregulation.
Conclusions: These data indicate that ovarian tumors are enriched with CSCs and stem cell pathway mediators, especially at the completion of primary therapy. This suggests that stem cell subpopulations contribute to tumor chemoresistance and ultimately recurrent disease.
abstract: Health-related quality of life in recurrent platinum-sensitive ovarian cancer—results from the CALYPSO trial
Background: In the CALYPSO trial, carboplatin–pegylated liposomal doxorubicin (CD) demonstrated superior therapeutic index versus carboplatin–paclitaxel (CP) in patients with recurrent ovarian cancer. This paper reports the health-related quality of life (HRQoL) findings.
Conclusions: These patient-reported outcomes confirm the overall lower toxicity of CD versus CP. The improved disease-related outcomes achieved with CD were not at the expense of QoL.
abstract: Clinical Effects of Adjuvant Active Specific Immunotherapy Differ between Patients with Microsatellite-Stable and Microsatellite-Instable Colon Cancer
Blogger's Note: the abstract does not detail MSI-L/MSI-H (colon cancer in Lynch Syndrome)
Microsatellite status was assessed on archival tumor material from patients with stage II and III colon cancer. Microsatellite status was next associated with clinical outcome in control and ASI treatment groups using Kaplan–Meier analysis.
This retrospective study indicated that patients with MSI tumors did well, irrespective of treatment arm and tumor stage. The data also indicate that the clinical benefit, measured as recurrence-free survival, from adjuvant ASI treatment of patients with colon cancer was restricted to patients with MSS Dukes B tumors.
Blogger's Note: the full list of rare disorders is included in the article
7,000 Different Rare Diseases and Disorders Comprise 65 Page RARE List™, 95% of the Medical Conditions Included on RARE List™ Have No FDA Approved Treatments
DANA POINT, Calif., Feb. 1, 2012 /PRNewswire-USNewswire/ -- The R.A.R.E. Project (http://RAREproject.org), a leading patient advocacy organization representing the rare disease community, today issued the RARE List™, a stunning 65 page alphabetical listing of roughly 7,000 known rare diseases and disorders. The rare diseases and disorders that comprise the RARE List™ impact 30 million Americans (or 10% of the U.S. population) and an estimated 350 million people worldwide. The RARE List™ was released by the R.A.R.E. Project as part of month long public awareness campaign leading up to World Rare Disease Day on February 29, 2012.
Ovarian cancer, Ovarian cancer childhood, Ovarian carcinosarcoma, Ovarian epithelial cancer, Ovarian germ cell tumor, Ovarian insufficiency due to FSH resistance, Ovarian insufficiency familial, Ovarian low malignant potential tumor, Ovarian remnant syndrome, Ovarian small cell carcinoma
Tuesday, January 31, 2012
media report - ABC News
link to the website/questionnaire:
Why should I participate?
Is it confidential?
What does it involve?
Who can take part?
- Anyone can participate in our questionnaire and you don't have to know anything about genomics or genetics already.
- We are inviting the following groups: genomic researchers, health professionals, lay members of the public.
".....Nearly half the repeat operations were done in women whose pathology reports did not indicate that any stray cancer cells had been left behind, meaning that the operations probably did not help the patients. More disturbingly, 14 percent of patients who did have evidence of cancer left behind did not have another operation, for unknown reasons...."
Picture Your Life After Cancer - Interactive Feature - NYTimes.com - add your photo and story/discussion
Picture Your Life After Cancer
SLOCA's founders are shown here in 2002.
Back row, left to right: Nancy Larson-Vomund, Judy Parham, Grace Katzenberger, Joanne Guerrerio.
Front row, left to right: the late Christina Carr, Diane Harrison, JoAnn Carter.