Wednesday, February 24, 2010
2009 Safety of Bevacizumab in Advanced Ovarian and Müllerian Cancers: A Review: Bevacizumab (Avastin) and Ovarian Cancer
"To date, several investigators (Table 1) have explored bevacizumab as a single agent or in combination with metronomic chemotherapy in the management of advanced ovarian cancer. All studies to date with bevacizumab as a single agent or in combination with chemotherapy have shown promising responses...."
abstract: Combined oral cyclophosphamide and bevacizumab in heavily pre-treated ovarian cancer (Spain)
Conclusions: Combined bevacizumab and metronomic oral cyclophosphamide is a safe and effective regimen for heavily pre-treated ovarian cancer patients. Further research is needed on predictive factors to screen for those patients who will benefit from anti-angiogenic therapy.
2008 Phase II clinical trial of bevacizumab and low-dose metronomic oral cyclophosphamide in recurrent ovarian cancer: a trial of the California, Chic
Phase II clinical trial of bevacizumab and low-dose metronomic oral cyclophosphamide in recurrent ovarian cancer: a trial of the California, Chicago, and Princess Margaret Hospital phase II consortia.
Bevacizumab and Low-Dose Cyclophosphamide in Treating Patients With Recurrent Ovarian Epithelial or Primary Peritoneal Cancer - Full Text View - ClinicalTrials.gov
Bevacizumab and Low-Dose Cyclophosphamide in Treating Patients With Recurrent Ovarian Epithelial or Primary Peritoneal Cancer
This study has been completed.
First Received: November 4, 2003 Last Updated: February 6, 2009
Sponsor: California Cancer Consortium
Collaborator: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00072566
Cancer and the Family: The Silent Words of Truth -- JCO The Art of Oncology series
INCONCLUSIVE THOUGHTS: One of the aims of psycho-oncology is to explore, clarify, and accept different realities that are alluded to in the unspoken words of the family narrative, while also eliciting family stories of survival, adjustment, mutuality, belief, and hope. The psycho-oncologist is trained to understand the language of the patient and family members in their subjective appraisals of health and illness and then to encourage them to share their truths about being understood, heard, supported, and emboldened or discredited and stigmatized.
Ephraim McDowell - Wikipedia encyclopedia Ephraim McDowell (November 11, 1771 – June 25, 1830) was an American physician. He was the first to success
Ephraim McDowell (November 11, 1771 – June 25, 1830) was an American physician. He was the first to successfully remove an ovarian tumor.
Clinical Activity of Gemcitabine Plus Pertuzumab in Platinum-Resistant Ovarian Cancer, Fallopian Tube Cancer, or Primary Peritoneal Cancer - abstract
Conclusion: Pertuzumab may add activity to gemcitabine for the treatment of platinum-resistant ovarian cancer. Low HER3 mRNA expression may predict pertuzumab clinical benefit and be a valuable prognostic marker.
JCO - Relationship Between Plasma Estradiol Levels and Estrogen-Responsive Gene Expression in Estrogen Receptor-Positive Breast Cancer in Postmenopausal Women UK/US study
Purpose To determine whether plasma estradiol (E2) levels are related to gene expression in estrogen receptor (ER)–positive breast cancers in postmenopausal women.
Editorial: Whither HER2-Related Therapeutics? (breast cancer) -- Journal of Clinical Oncology
Note: references to solid tumours
"Evidence suggests that most solid tumors, regardless of their type, cannot grow beyond approximately 1 mm3 until they establish a blood supply by inducing new blood vessels from existing host capillaries, called tumor-induced angiogenesis......It follows then that tumor cells with low HER3 mRNA are more likely to respond to pertuzumab, given that these are the cells where the pathway is activated. We would conjecture that this signature does not apply exclusively in ovarian cancer, but may also be found in other solid tumors, such as non–HER2-positive breast, colorectal, and so on."
Prospective Multicenter Cohort Study to Refine Management Recommendations for Women at Elevated Familial Risk of Breast Cancer: The EVA Trial.
CONCLUSION: In women at elevated familial risk, quality-assured MRI screening shifts the distribution of screen-detected breast cancers toward the preinvasive stage. In women undergoing quality-assured MRI annually, neither mammography, nor annual or half-yearly ultrasound or CBE will add to the cancer yield achieved by MRI alone.
The Patient Factor: What Are Your Health Care Dollars Buying? | thepatientfactor.com
"Asking Canadians if they are getting value for their money when it comes to spending on health care is like asking a blind person if they can see better when the room light is turned on or off...."
The Patient Factor: (Canada) Blowing the Whistle on Patient Safety: Why Patients Need to Speak Out
"Patient safety is a hot topic in Canada and one that often leaves our politicians scrambling to maintain some semblance of action. They do so by creating more federal, provincial and territorial agencies and programs. Many of these government-funded initiatives are set-up as independent (arm’s length) non-profit organizations. Perhaps the biggest endeavour to date is the creation of the Canadian Patient Safety Institute (CPSI)...."
Long-term endometrial effects in postmenopausal women with early breast cancer participating in the Intergroup Exemestane Study (IES)—a randomised controlled trial of exemestane versus continued tamoxifen after 2–3 years tamoxifen
full access:
Conclusion: Switching from tamoxifen to exemestane significantly reverses endometrial thickening associated with continued tamoxifen.
free access: Impact of Medical Qigong on quality of life, fatigue, mood and inflammation in cancer patients: a randomized controlled trial - Australia
Unfortunately, most research evaluating Qigong has suffered from a lack of appropriate randomization and utilization of control groups. Studies have also tended to focus on limited numbers of biological and physical outcomes.
Drugmakers Join Forces to Improve Cancer Research - Press Release/news
INDIANAPOLIS, WHITEHOUSE STATION, N.J. & NEW YORK--Eli Lilly and Company, Merck (also known as Merck Sharp & Dohme (MSD) outside the USA and Canada), and Pfizer Inc. today announced the formation of the Asian Cancer Research Group, Inc., (ACRG), an independent, not-for-profit company established to accelerate research and ultimately improve treatment for patients affected with the most commonly-diagnosed cancers in Asia.
Intraperitoneal Paclitaxel as Consolidation Treatment in Ovarian Cancer Patients: A Case Control Study
Conclusion: Weekly IP consolidation chemotherapy with paclitaxel 60 mg/mq is well tolerated and, in this experience, a prolongation of progression-free survival was observed.
Tuesday, February 23, 2010
Financial news: HealthLinx Ltd launches ovarian cancer OvPlex™ test into UK market
HealthLinx (ASX: HTX) has reported that UK distribution partner Intus Healthcare is targeting a significant share of the potential 750,000 annual ovarian cancer diagnostic tests undertaken in the UK with the product launch of OvPlex™ on 25 February 2010.
The company obtained European Certification for OvPlex™ paving the way to market and sell the product within the European community.
Safety profile of new anticancer drugs; Expert Opinion on Drug Safety - abstract (solid tumors)
Take home message: The emergence of new targeted anticancer therapies promises more efficient and less toxic therapies. Generally, they are well tolerated, toxicities are commonly mild to moderate and can be handled rapidly. However, if most of these adverse events are manageable, life threatening and fatal complications can still occur.
Toxicity of sorafenib: clinical and molecular aspects; Expert Opinion on Drug Safety - abstract
Take home message: Although not life-threatening, toxicity of sorafenib can severely impact the physical, psychological and social well-being of patients. The management of this unusual toxicity highlights the particular need of new pluridisciplinarities linking oncologist, cardiologist and dermatologist
Drug interactions with antiretrovirals and warfarin; Expert Opinion on Drug Safety - abstract
Importance of the field: Antiretroviral therapy exhibits significant potential to alter the metabolism of other medications. Warfarin is widely used for the management of clotting disorders and is prone to drug–drug interactions that can result in subtherapeutic anticoagulation or over-anticoagulation. (warfarin, HIV, antiretroviral, drug interaction, protease inhibitor (PI), non-nucleoside reverse-transcriptase inhibitor (NNRTI), cytochrome P450 (CYP450), CYP2C9)
NCI Chemotherapy-induced Peripheral Neuropathy
"For preventing the onset of CIPN, the committee recommended further clinical testing of intravenous calcium and magnesium, which reduced CIPN symptoms by approximately half compared with a placebo in one trial
Avastin fails stomach-cancer trial - FiercePharma
"Data on Avastin use in ovarian cancer, expected sometime in the first half of this year."
Ovarian cancer diagnoses drop slightly
Note: prophylatic surgeries??
"Dr Zorbas said the figure had remained "fairly stable" for years and the lower level could represent the start of a new plateau, though the reason for the small drop was not yet clear......."The number of women diagnosed with ovarian cancer is expected to increase, and that's because the population is increasing and we have an increasingly ageing population," Dr Zorbas told AAP."
Coronary heart disease risk profile in women who underwent salpingo-oophorectomy to prevent hereditary breast ovarian cancer.
CONCLUSIONS: Self-selection of women seeking risk-reducing salpingo-oophorectomy, changes in lifestyle after surgery, and survival bias may explain that the women who underwent risk-reducing salpingo-oophorectomy had a more favorable coronary heart disease risk profile compared with the controls. Longitudinal studies are needed to further clarify the associations observed in this cross-sectional study.
Ovarian intestinal type mucinous borderline tumors: are we ready for a nomenclature change?
Note: mucinous is not specific to ovarian cancer but found in other tumour sites and without expert pathology can be confused with mucinous gastrointestinal tumours
"At a National Cancer Institute-sponsored workshop it was proposed that the borderline category of ovarian intestinal-type mucinous tumors (OInMTs) could be eliminated if the apparent benign behavior of these tumors could be confirmed..."
Randomized phase II trial of paclitaxel plus carboplatin therapy versus irinotecan plus cisplatin therapy as first-line chemotherapy for clear cell ad
Randomized phase II trial of paclitaxel plus carboplatin therapy versus irinotecan plus cisplatin therapy as first-line chemotherapy for clear cell adenocarcinoma of the ovary: a JGOG study CONCLUSIONS: A phase III randomized trial is required to elucidate the effectiveness of CPT-P combination chemotherapy for CCC
Final Agenda: Health 2.0 Europe conference (note: ACOR)
Patients and Online Communities - The advancement and popularity of patient communities online is an international phenomenon. We’ll be examining communities in different cultures, languages and context, and see what impact they have on care delivery in different countries–and what the internationalization of information means for patients and doctors.
The patient perspective from:
- Roberto Ascione, PagineMediche.it Italy
- Gilles Frydman, ACOR america
- Ben Heywood, PatientsLikeMe america
- Neil Bacon, iWantGreatCare UK
- Christian Angele, imedo Germany
Monday, February 22, 2010
Sunday, February 21, 2010
Clinical Presentation of Endometrioid Epithelial Ovarian Cancer with Concurrent Endometriosis: A Multicenter Retrospective Study — Cancer Epidemiology, Biomarkers & Prevention
Conclusions: In this large series of patients with EEOC, the main presenting symptoms were pelvic pain followed by gastrointestinal symptoms, palpable mass, abdominal distension, vaginal bleeding, and newly developed or exacerbated dysmenorrhea and dyspareunia. Dyspareunia and dysmenorrhea were more frequently detected in patients with endometriosis. Normal CA-125 levels cannot be applied as a marker to exclude EEOC, particularly at the early stages. Cancer Epidemiol Biomarkers Prev; 19(2); 398–404
Your Doc Is In: North American Menopause Society Issues Guidelines on Hormone Therapy
Note: The actual guidelines will be published in the March/April issue of the Journal of the North American Menopause Society
Saturday, February 20, 2010
full access 2008: Systematic Review and Meta-analysis of Ovarian Cancers: Estimation of Microsatellite-High Frequency and Characterization of Mismatch Repair Deficient Tumor Histology
Translational Relevance:
This systematic review and meta-analysis estimates the frequency of high-level microsatellite instability (MSI-H) in unselected ovarian cancers as 12%, suggesting that defects in the mismatch repair (MMR) pathway account for a relatively large proportion of ovarian cancers. In the era of personalized medicine, MSI-H status may provide valuable etiologic and diagnostic information, which may eventually be of prognostic and therapeutic utility, as seen in MSI-H colorectal cancers.
The results of this meta-analysis also reveal an overrepresentation of nonserous histologies in MMR-deficient tumors. The clinical relevance of these findings is that they may increase clinical awareness of MMR-deficient tumors; such awareness may aid in the identification of this subtype of tumors, having potential implications for medical management.
European Medicines Agency (EMA): the Agency takes a further step in its interaction with patients and consumers | A global voice for patients
REFLECTION PAPER ON THE FURTHER INVOLVEMENT OF PATIENTS AND CONSUMERS IN THE AGENCY’S ACTIVITIES
New Joint Outpatient Chemotherapy Administration Standards - Cancer Journal for Clinicians
The guidelines were created largely in response to recent studies that have examined reports of chemotherapy administration errors among outpatients, and to reports of an increased risk of errors with the administration of new oral chemotherapeutics.
Difficulty Accepting a Terminal Prognosis Linked with Depression, Anxiety, and Suffering - A Cancer Journal for Clinicians
Dissenting Opinion:
"Not all clinicians agree with the foregoing interpretations of these findings. "I've certainly seen people who denied dying up to their last breath and somehow never accepted it," Dr. Holland tells CA. "Were they more upset? I'm not sure."
She cautioned against allowing the findings by Dr. Thompson and colleagues to set a tone in which nonaccepting patients are viewed as dysfunctional."
Q&A: Harvard's Steven Skates Describes Using Clinical Assays for Longitudinal Proteomics Research | ProteoMonitor | Proteomics | GenomeWeb
"Skates is involved in a number of longitudinal studies honing in on early detection for ovarian cancer. In proteomics, such studies are still uncommon.
The three best-known studies that have incorporated proteomics are the Framingham Heart Study, the Busselton Health Study, and the UK Collaborative Trial of Ovarian Cancer Screening, of which Skates is a member."
Friday, February 19, 2010
PLoS Genetics: Use of DNA–Damaging Agents and RNA Pooling to Assess Expression Profiles Associated with BRCA1 and BRCA2 Mutation Status in Familial Breast Cancer Patients
definition: heterogeneous - the quality of being diverse and not comparable in kind
full access:
"A large number of rare sequence variants of unknown clinical significance have been identified in the breast cancer susceptibility genes, BRCA1 and BRCA2. Laboratory
methods to identify which of these variants are mutations would have utility for counseling and clinical decision making when identified in patients with a family history of
breast cancer."
clinical trial search - new trials 2/01/2010-2/19/2010 - solid tumors phase 11-111
Search terms: solid tumors | Adult | Phase II III IV | has safety issue outcome measures | received from 02/01/2010 to 02/19/2010 - 2
Search of: ovarian cancer | received from 02/01/2010 to 02/19/2010 - List Results - ClinicalTrials.gov
Search terms: ovarian cancer, received between the dates of 02/01/2010 to 02/19/2010 - 8 results
Thursday, February 18, 2010
Correspondence/Reply: Central Institutional Review Board–Facilitated Review Metrics Omit Critical Components
1) CORRESPONDENCE
Central Institutional Review Board–Facilitated Review Metrics Omit Critical Components
Michael S. Katz, Mary L. Smith
Patient Representative Committee, Eastern Cooperative Oncology Group, Philadelphia, PA
To the Editor:
"As cancer survivors and patient advocates, we must take issue with calculations of the impact of the central institutional review board (CIRB) on local institutional review board (IRB) protocol review times and societal costs by Wagner et al.1 The authors' definitions of these metrics omit critical components......Thus, the net impact on IRB review times, which determine how quickly a protocol can move from National Cancer Institute approval to putting patients on-study are actually slower by 66 to 76 days than a stand-alone local review. The suggestion, therefore, that there are "benefits of a more predictable and faster approval process" is not accurate.""
2) CORRESPONDENCE - Reply to M.S. Katz et al
"Recent internal data from National Cancer Institute show that these changes have decreased the length of CIRB review, defined as application receipt to approval, from a median of 95.5 days in 2008 to 45 days for the six trials using the new processes."Author's Reply to Correspondence: Endocrine Effects of Aromatase Inhibitors Journal of Clinical Oncology
" It is somehow astonishing that after approximately 15 years from the first clinical article on anastrozole, exemestane, and letrozole, we still have insufficient or weak knowledge of some of the consequences of their long-term use."
Patient Opinion - NHS (UK) website
Your story can change the NHS * Tell people what happened * See what others are saying * Find out how patients are changing the NHS
Quest, Vermillion 'On Track' to Launch OVA1 in March | GenomeWeb
"OVA1 generates a numerical score based on five immunoassays that is intended to help physicians determine the likelihood of malignancy in women with pelvic mass for whom surgery is planned."
HDAC Inhibitors in Cancer Care - Cancer Network
"What is more promising about this study was the utility in all of the cancers studied (ovarian, cervical, breast, testicular, and lung), demonstrating that combining HDAC inhibitors with other therapies may be clinically useful in multiple types of malignancies."
US Oncology picks up Cure magazine - Medical Marketing and Media
Cure magazine is located on the web at www.curetoday.com
Tumour Microenvironment The ‘low oxygen’ environment of solid tumours is leading to a new class of therapies and Measuring Tumour Hypoxia and Tumour Metabolism
Tumour Microenvironment The ‘low oxygen’ environment of solid tumours is leading to a new class of therapies and Measuring Tumour Hypoxia and Tumour Metabolism
Muslim women and medical students in the clinical encounter Medical Education
Medical Education 2010: 44 : 306–315
"Context Increasingly, male medical students report being refused by female patients, particularly in obstetrics and gynaecology, which is impacting on recruitment into the discipline. However, little has been documented in terms of Muslim patients and medical students in the clinical consultation."
Burnout and engagement among resident doctors in the Netherlands: a national study.
Conclusions: "As more than a fifth of the medical residents who responded could be diagnosed as suffering from burnout, we conclude that this problem needs addressing in the Dutch health care system, especially given that a relationship was proven between burnout and suboptimal patient care."
Variation at 8q24 and 9p24 and risk of epithelial ovarian cancer
"Abstract: The chromosome 8q24 region (specifically, 8q24.21.a) is known to harbor variants associated with risk of breast, colorectal, prostate, and bladder cancers. In 2008, variants rs10505477 and rs6983267 in this region were associated with increased risk of invasive ovarian cancer (p < 0.01); however, three subsequent ovarian cancer reports of 8q24 variants were null.........These results indicate that the SNPs studied here are not related to risk of this gynecologic malignancy and that the site-specific nature of 8q24.21.a associations may not include ovarian cancer."
Comment regarding Pelvic Exams while under Anesthesia
My comment: While Lynn's abstract is interesting, it is noteworthy again that these are not new issues as per the included references. I would disagree that further research is required. A root cause analysis is not going to add anything further to what has already been demonstrated. It is now a matter of policy.
“Come here. I want you to feel a normal rectum. Do it.”
Disposition of soy isoflavones in normal human breast tissue - American Journal of Clinical Nutrition
Background: Despite decades of research on the relation between soy and breast cancer, questions regarding the absorption, metabolism, and distribution of isoflavones in breast tissue largely remain unanswered.
Revisiting biographical disruption: Exploring individual embodied illness experience in people with terminal cancer
"Biographical accounts of illness offer useful insights into the social and adaptive processes of living with chronic illness. Yet there are concerns that the underlying theoretical assumptions of a reflexive self seeking to maintain meaning may not reflect the lived experience of individuals....We discuss the possibilities for new approaches to clinical assessment and management of need."
Wednesday, February 17, 2010
Research programs & studies - Cancer Prevention Institute of California
Research programs & studies
Studies of ovarian cancer
* Comorbidity and treatment for ovarian cancer / Survival following ovarian cancer
* Diet and risk of ovarian cancer
* Follow-up Care Us by Survivors (FOCUS study)
* Genetic epidemiology of ovarian cancer
The Most Outrageous Examples Of Health Insurers Denying Coverage - Huffington Post
"We compiled a list of some of the worst cases of insurance companies denying sick customers access to medical care. Check them out below -- and if you've been denied coverage, click "Participate" and tell us your story."
obituary/author: Karen Buhler-Wilkerson (ovarian cancer) nursing professor
"Karen Buhler-Wilkerson, 65, of Center City, who retired in 2006 as a professor of community health at the University of Pennsylvania School of Nursing, died Saturday at the university hospital of complications from ovarian cancer. The author of three books, Dr. Buhler-Wilkerson wrote her last paper, "Living With Cancer," with her life partner of 17 years, Dr. Neville Strumpf, for publication this summer in the quarterly journal Nursing Clinics of North America."
Disrupted lives and threats to identity: The experiences of people with colorectal cancer within the first year following diagnosis -- Hubbard et al. 14 (2): 131 -- Health:
Note: It's very unfortunate that this is not full access as it would apply across cancer domains.
"We conclude that universal application of the concept biographical disruption to the experience of cancer within the first year of diagnosis is not appropriate. This study has implications for cancer services, in particular, the findings call for the development of interventions to support those people who experience cancer as an assault on their identity."
Genome study shows what cancers have in common - news item
"The finding, based on a large-scale study of the genetic make-up of 26 different types of cancers, suggests cancer has less to do with where in the body it occurs, and more to do with the genetic changes that cause it to grow......What that means for treatment is that many treatments may be used across many different kinds of cancers."
Coherence and Completeness of Population-based Family Cancer Reports
Conclusions: These findings suggest that family history of cancer reports from the general population are generally complete and coherent.
Identification of Ovarian Cancer Symptoms in Health Insurance Claims Data
Conclusions:
"These results support previous findings that ovarian cancer symptoms were reported in health insurance claims and were more prevalent before diagnosis, but the symptoms may occur too close to the diagnosis date to provide useful diagnostic information. The passive screening approach should be reevaluated in the future using electronic medical records; if found to be effective, the method may be potentially useful for other incident diseases."
If only WHI was done well -- BMJ (Drug firm conflicting interests)
"Barrington claims that the women’s health initiative (WHI) trial had impeccable standards.1 We recently highlighted some of its shortcomings relating to hormone replacement therapy (HRT). The data and safety monitoring board used a global index of health which was modified on three occasions...."
Fluorescent probes light up cancerous tumors
In research:
"In a series of studies, working mainly in mice with implanted human tumors, the researchers showed that if tumors had spread to surrounding tissue, the ACCP-nanoparticle probes enabled them to visualize areas of tumors that they wouldn't ordinarily see -- either because the tissue was buried beneath other tissue or the tumor simply was difficult to distinguish from normal tissue."
Tuesday, February 16, 2010
WHI Study Data Confirm Short-Term Heart Disease Risks of Combination Hormone Therapy for Postmenopausal Women, February 15, 2010 News Release - National Institutes of Health (NIH)
Note: This is a re-analysis of the original study, however, between the time of the original publication and now, sub-analyses have been conducted. There continues to be wide debates on these issues.
"The NHLBI collaborates on the WHI with the National Cancer Institute, the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Institute on Aging, and the Office of Research on Women’s Health, all parts of the NIH. Wyeth-Ayerst Research provided the medication and placebo for the hormone study."
Hormone replacement after gynaecological cancer
"However, the majority of the most common gynaecological malignancies like squamous cell carcinomas of the cervix, serous papillary epithelial ovarian carcinomas and squamous cell carcinomas of the vulva are not oestrogen dependent."
Mismatch repair status and outcomes after adjuvant therapy in patients with surgically staged endometrial cancer (Lynch Syndrome mutations)
OBJECTIVES: "To determine whether DNA mismatch repair (MMR) modifies the response to chemotherapy or radiotherapy in patients with endometrial cancer...... METHODS: Immunohistochemistry (IHC) for the DNA MMR proteins MLH1, MSH2, MSH6, and PMS2 was performed on a tissue microarray of specimens of primary endometrial cancer."
BRCA1 gene mutations may explain more than 80% of excess number of ovarian cancer cases after breast cancer - a population based study from the Wester
BRCA1 gene mutations may explain more than 80% of excess number of ovarian cancer cases after breast cancer - a population based study from the Western Sweden Health Care region.
abstract: Surveillance for the detection of recurrent ovarian cancer: Survival impact or lead-time bias?
OBJECTIVE: "To compare the survival impact of diagnosing recurrent disease by routine surveillance testing versus clinical symptomatology in patients with recurrent epithelial ovarian cancer (EOC) who have achieved a complete response following primary therapy.....
abstract: Decreased severity of ovarian cancer and increased survival in hens fed a flaxseed-enriched diet for 1 year
OBJECTIVE: "With the exception of the laying hen, no other animal model of spontaneous ovarian surface epithelial cancer replicates the human disease."
Monday, February 15, 2010
Reduced levels of hydroxylated, polyunsaturated ultra long-chain fatty acids in the serum of colorectal cancer patients: implications for early screening and detection
"There are currently no accurate serum markers for detecting early risk of colorectal cancer (CRC)."
The impact of outcome reporting bias in randomised controlled trials on a cohort of systematic reviews -- Kirkham et al. 340: c365 -- BMJ
"Of the 42 meta-analyses with a statistically significant result only, eight (19%) became non-significant after adjustment for outcome reporting bias and 11 (26%) would have overestimated the treatment effect by 20% or more."
"Conclusions:
Outcome reporting bias is an under-recognised problem that affects the conclusions in a substantial proportion of Cochrane reviews. Individuals conducting systematic reviews need to address explicitly the issue of missing outcome data for their review to be considered a reliable source of evidence...."
Buchanan sees cancer fight as challenge - Martinsville Bulletin - stage 1C clear cell ovarian cancer (tumour rupture)
"Now, she knows that “unless you’ve truly been there and done that, you cannot truly understand what it is like,” she said. “I’m looking at this as a different phase in my life. If I turn that next corner, I will try to accept the things I cannot change and deal with it the best I know how. It will make me a stronger person.”
Confusing association with causation - common journalistic pitfall - Gary Schwitzer's HealthNewsReview Blog
"We've just posted a new guide on the importance of the language used to describe the results of observational studies. Day after day we see stories that use active powerful verbs like "prevent...boost...lower your risk...may cut death rate" to describe the results of these studies. That's misleading and inaccurate because such studies can't prove cause-and-effect. Read more about why in this detailed, thoughtful piece by Mark Zweig, MD, and Emily DeVoto, PhD. (It's actually a revision of a piece these two wrote for us two years ago. The new one fits nicely in our "Tips for Understanding Studies" section.)"
Switch that turns on the spread of cancer discovered - science news report
in research: "This is often the fatal process in breast, ovarian, pancreatic and colon-rectal cancers."
Quality of Healthcare in Canada : A Chartbook | CHSRF
Note: this rather large paper includes cancer and international comparisons
Social Science & Medicine : End of Life Care Policies: Do they make a difference in practice? (analysis - Saskatchewan, Canada)
"The findings of this study demonstrate a significant gap between institutional End of Life care policies and practice..."
table of contents - Surgical Oncology Clinics of North America focus on Pancreatic Cancer
Surgical Oncology Clinics of North America, Volume 19, Issue 2, Pages 235-462 (April 2010)
Pancreatic Cancer: Current Concepts in Treatment and Research
Posted Comments: Pelvic Exams Under Anaesthesia including abstract link
Sunday, February 14, 2010
2010 abstract Teaching Pelvic Examinations Under Anaesthesia: What Do Women Think? U of Calgary
Note:
This issue of pelvic exams while under anasethesia has been explored in the research in
the past (click on 'read
more' to see viewers comments)
Please take the poll and add your views on this issue.............................................
Conclusion: "The majority of patients wish to help medical students to learn but expect consent to be sought if medical students are to perform pelvic examinations on anaesthetized patients. Before introducing explicit consent in Canadian teaching centres, it will first be necessary to determine the feasibility of seeking consent specifically for this procedure."
Please take the poll and add your views on this issue.............................................
Conclusion: "The majority of patients wish to help medical students to learn but expect consent to be sought if medical students are to perform pelvic examinations on anaesthetized patients. Before introducing explicit consent in Canadian teaching centres, it will first be necessary to determine the feasibility of seeking consent specifically for this procedure."
February 15th, 2010: Results of (unscientific poll) Pelvic Exams while under Anaesethia
- I am happy to help with learning 24 (31%)
- I do not feel permission is need 0 (0%)
- Permission is needed sometimes 1 (1%)
- Permission is needed without except 71 (93%)
- I have no concerns with the ethics of this situation 1 (1%)
- I have great concerns with the ethics of this situation 68 (89%)
- Is this today common practice - pelvic exams while under anesthesia? 22 (28%)
- Yes (common practice) 6 (7%)
- No (common practice) 7 (9%)
- How would I know? (common practice) 29 (38%)
- Is this a trust issue? 17 (22%)
- I belong to the ACOR ovarian group 35 (46%)
- I am a medical professional 11 (14%)
- Yes, I read the article 47 (61%)
- No, I didn't read the article 15 (19%)
- Was this new information for patients? 15 (19%)
- Was this new information for healthcare professionals? 13 (17%)
The dark side of curcumin. International Journal of Cancer
a caution regarding Curcumin (partial abstract)
Sunday, February 14, 2010
Open Poll - Pelvic Exams While Under Anesthesia
please contribute your views (men & women)
Patients, Consumer and Health Care Professionals
2010 abstract Teaching Pelvic Examinations Under Anaesthesia: What Do Women Think? U of Calgary
Note: This issue of pelvic exams while under anasethesia has been explored in the research in the past (click on 'read more' to see viewers comments)
Please take the poll and add your views on this issue.............................................
media links to: Teaching Pelvic Examinations Under Anaesthesia
* research abstract: "Teaching Pelvic Examinations Under Anaesthesia: What do Women Think" by Sara Wainberg from the Journal of Obstetrics&Gynecology http://www.sogc.org/jogc/abstracts/2010
* "Time to end pelvic exams done without consent" The Globe&Mail http://www.theglobeandmail.com/life/health/time-to-end-pelvic-exams-done-without-consent/article1447337/
* "When unknowing, hardly implied" The Globe&Mail Editorials http://www.theglobeandmail.com/news/opinions/editorials/when-unknowing-hardly-implied/article1451312/
Saturday, February 13, 2010
news article: The popular test you don't need
"Does this mean you should avoid CT scans? No, don't swing from scan-a-mania to scan-a-phobia. These tests can be lifesavers, provided you and your doctor use them only when the benefits outweigh the risks....."
Powerpoint presentation: Opioid-Induced Constipation: Banishing a Barrier to Successful Pain Management
see the section: "Download the Slide Presentation"
Medical News: Gabapentin Studies for Off-Label Uses Cooked? - in Neurology, Pain Management from MedPage Today
"Because the outcomes we examined were fiddled with to some extent, we don't know what the outcome was for the primary outcome that was originally set," she said.
"If I were a physician, or a patient, I would be thinking, what is the true evidence base here?"
Friday, February 12, 2010
Maurie Markman, MD, explains his passion for gynecologic cancer research | HemOncToday
excerpts from article:
"What is the best advice you’ve ever received?
My earliest mentor was my family physician/internist, who,
unfortunately, died of pancreatic cancer many years ago. His advice
was to make
sure I approached the practice of medicine as a people’s doctor. There
is
nothing more rewarding than that. I took his advice very seriously and
I
certainly agree with it.
What would you consider one of your biggest
successes
in your specialty?
I’ve been involved in the development of a number of strategies,
including the development of intraperitoneal therapy in ovarian
cancer.
However, I would argue the most important thing, which I think and
hope
I’ve done and continue to do, is to insist upon — for myself and
others — viewing and thinking critically about everything we do as
physicians. It’s crucial that we absolutely strive for and base our
decisions on, as much as possible, solid, evidence-based medicine and
phase-3,
randomized trials. I believe to my core that the future of medicine
has to be
evidence-based?"
new Website - NCI - submit your ideas....
NCI is proud to announce an
“evolution” of our flagship Web site, Cancer.gov. We are
calling it an evolution rather than a site redesign because it is not a
one-time change. Instead of a massive overhaul, meaningful and significant Web
site enhancements will be rolled out in phases.
Using microRNAs to understand cancer biology : The Lancet Oncology
"Studies such as that by Ueda and colleagues offer hope to patients with cancer that in the future they will be offered truly tailored treatment, based on the unique biology of their tumour as defined by microRNAs."
"This type of study needs to be done for every cancer type."
MRI of Endometriotic Cysts in Association With Ovarian Carcinoma -- Tanaka et al. 194 (2): 355 -- American Journal of Roentgenology
CONCLUSION. Endometriotic cysts with enhanced mural nodules are not always complicated with malignancy. In elderly patients, the presence of large enhanced nodules on large endometriotic cysts is more likely to indicate malignancy.
Serum CA19.9 levels are commonly elevated in primary ovarian mucinous tumours but cannot be used to predict the histological subtype -- Journal of Clinical Pathology
Conclusion: Preoperative CA19.9 levels cannot be used to predict whether a suspected ovarian mucinous tumour is benign, borderline or malignant. Markedly elevated serum levels (>1000 U/ml) may be found in benign mucinous neoplasms as well as in borderline and malignant tumours.
Regional abdominal hyperthermia combined with systemic chemotherapy for the treatment of patients with ovarian cancer relapse: Results of a pilot stud
Note: warning on stats
"Results: Overall, 36 OCR patients were enrolled. The majority of the patients (>80%) were classified as platinum resistant.....
Prospective phase III trials are warranted to evaluate the benefit and efficacy in heavily pre-treated patients with OCR."
Adverse events experienced by homecare patients: a scoping review of the literature
CONCLUSION: A standardized definition of adverse events in the homecare setting is needed. Prospective cohort studies are needed to improve estimates and intervention studies should be undertaken to reduce the risk that homecare patients will experience adverse events.
PharmaLive press release: Clinical Science to publish manuscript on HTX005 ovarian cancer biomarker 'OvPlex' (plus HTX005/AGR2)
Note: the abstract included here did not indicate the number of patients involved in the studies (see prior research articles) but according to the press release showed results in stages 11/111.
"10 February 2010, Melbourne: HealthLinx Limited (ASX:HTX) has been notified by the journal Clinical Science that a manuscript submitted for review by HealthLinx scientists and collaborators at the University of Liverpool has been accepted for publication. The manuscript describes the identification of HTX005 (AGR2) as a novel biomarker released into the bloodstream of ovarian cancer patients.
The performance of the novel biomarker AGR2 will be further tested in an up-coming multi-centre, multi-national biomarker study planned by HealthLinx. Based on preliminary data it is expected that this biomarker will increase the performance of OvPlex™ to greater than 97 per cent."
Antibodies Against Abnormal Glycoproteins Identified as Possible Biomarkers for Cancer Detection, February 2, 2010 News Release - National Institutes of Health (NIH)
The team used this approach to screen blood specimens from breast, ovarian and prostate cancer patients.
Thursday, February 11, 2010
New ovarian cancer drug tested - 'Nanotax' news article Kansan
"The University of Kansas Cancer Center began running a Phase I clinical trial of the anti-ovarian cancer drug Nanotax. Nanotax is a breakthrough drug because, unlike other anti-cancer drugs, it is water-soluble....The clinical trial at the University comes nearly 15 year after Nanotax was first conceived. It is one of three active clinical trials for ovarian cancer treatment in Kansas, and it’s the only one still recruiting patients. The trial is classified as Phase I because it tests the drug in a small group.
Prevalence Rates of Pathogenic Mutations in the BRCA1 and BRCA2 Genes in Families with Different Disease Histories: Results from the German Consortium for Hereditary Breast and Ovarian Cancer
* From 1997-2009 more than 6,000 families were screened for pathogenic mutations in BRCA1/2.
Abstract Vitamin D: Panacea or a Pandora's box for prevention? CPR
"Among women, an increased rate of mortality was observed both for deficient concentrations and very high concentrations (>124nmol/L). Results suggest that caution should be exercised in using very high dose vitamin D supplementation in prevention trials that may result in high concentrations of vitamin D (>100nmol/L). Results suggest that caution should be exercised in using very high dose vitamin D supplementation in prevention trials that may result in high concentrations of vitamin D (>100nmol/L)."
Abstract - Cancer predisposition: I say genetics, you say genomics, but are we there yet? -- Cancer Prevention Research
"A few examples include Lynch syndrome, hereditary breast-ovarian cancer syndrome and Cowden syndrome."
Abstract: Risk factors for epithelial ovarian cancer by tumor dominance, a surrogate for cell of origin -Cancer Prevention Research
"Although limited by small case numbers, our results suggest that tubal ligation may be more strongly associated with tumors of ovarian origin, while family history of ovarian cancer primarily increases risk of tumors of tubal origin. Characterizing risk factor relationships by tumor dominance may elucidate how these exposures alter risk and help to improve prevention efforts."
short video: Participatory Medicine and Declaration
"Participatory Medicine is a cooperative model of health care that encourages and expects active involvement by all connected parties (patients, caregivers, healthcare professionals, etc.) as integral to the full continuum of care. The ‘participatory’ concept may also be applied to fitness, nutrition, mental health, end-of-life care, and all issues broadly related to an individual’s health."
Wednesday, February 10, 2010
news item - court case - Charleston woman names physician, practice in medical negligence case | West Virginia Record
Note: this article does not mention what type of cancer although it references gynecologic oncology
SGO Tumor Board Discussant presentation on Ovarian Cancer Neoadjuvant Chemotherapy by Ignace B. Vergote, MD, PhD, University Hospital Leuven, Leuven Belgium
Note: graphics/statistics
Clinical Presentation - 2/2009 (freely accessible) slide and subsequent discussion presentation on debulking procedures/neoadjuvant vs upfront surgery, maintenance therapies comparing outcomes in European/Central American/Canadian studies etc
Phase I Oncology Studies: Evidence That in the Era of Targeted Therapies Patients on Lower Doses Do Not Fare Worse — Dr Maurie Markman et al
abstract:
"Purpose: To safely assess new drugs, cancer patients in initial cohorts of phase I oncology studies receive low drug doses. Doses are successively increased until the maximum tolerated dose (MTD) is determined. Because traditional chemotherapy is often more effective near the MTD, ethical concerns have been raised about administration of low drug doses to phase I patients. However, a substantial portion of oncology trials now investigate targeted agents, which may have different dose-response relationships than cytotoxic chemotherapies.......
Finding the Right Dose for Cancer Therapeutics—Can We Do Better? — Clinical Cancer Research
Note: very short abstract as below, but good points (in the absence of the full paper)
Abstract:
"Unlike other diseases, dose-selection for cancer therapeutics is often based on the maximum-tolerated dose in phase 1 studies involving relatively few patients. In this issue of Clinical Cancer Research, Jain and colleagues provide evidence that lower doses may be as effective as maximum-tolerated doses in the treatment of cancer patients."
5th Canadian Conference on Ovarian Cancer Research (Toronto) 2010 + Survivor's Workshop
"This special session for survivors will provide updates on emerging research, as well as information about patient resources. Women and their families will have the opportunity to “Ask the Expert” as well as network with other individuals sharing the same experience. Please watch this space for detailed program updates."
Ovarian Cancer Canada - aka colour me stupid??
Editorial note (mine): colour me stupid, but at last check turquoise was not/is not teal
"With turquoise being the colour of the year, this provides us with the perfect opportunity to continue to create awareness about ovarian cancer, the deadliest of all gynecologic cancers. Celebrate our colour throughout 2010 – wear it often, tell your friends and paint your town teal!"
Endometriosis related to family history of malignancies in the Yale series
Conclusions:
"These data suggest a familial association of endometriosis with ovarian, colon and prostate cancers. This evidence could support the genetics and molecular similarities between endometriosis javascript:void(0)and cancer. Future studies will be important to determine a clear genetic link between endometriosis and cancer."
Abstract/full access: What physicians want to learn about sickness certification: analyses of questionnaire data from 4019 physicians
Conclusions:
"A majority of physicians in most types of clinics/practices, not only primary care, indicated the need for more knowledge and skills in handling sickness certification cases. Increased knowledge and skills are needed in order to protect both the health and equity of patients. However, few physicians stated that they needed more skills in filling out sickness certificates, which contradicts previous findings about such documents being of poor quality and suggests that factors other than mere knowledge and skills are involved."
Selective serotonin reuptake inhibitors and breast cancer mortality in women receiving tamoxifen: a population based cohort study (Paroxetine/Paxil/Seroxat)
CONCLUSION: Paroxetine use during tamoxifen treatment is associated with an increased risk of death from breast cancer, supporting the hypothesis that paroxetine can reduce or abolish the benefit of tamoxifen in women with breast cancer. (trade names Seroxat, Paxil)
Blog: What Reporters Missed at the NIH Colon CA Screening State-of-the-Science Conference By: Gary Schwitzer
(includes commentaries)
"....And it's difficult to understand why this didn't get news coverage. It sure sounded newsworthy to me."
Blog: Preempting End-of-Life Decisions
"I do not want my life to be prolonged if, to a reasonable degree of medical certainty, my situation is hopeless."
"I want my life to be prolonged as long as possible within the limits of generally accepted medical standards, even if this means that I might be kept alive on machines for years."
"Check one. That's one of the places where I'm stalled on making my advance medical directive."
Augmentation of Therapeutic Efficacy in Drug-Resistance - breast and ovarian cancers - C6 (CER) + Paclitaxel
"This study describes a novel mechanism to overcome MDR through a polymer-blend nanoparticle platform that delivers a combination therapy of C6-ceramide (CER), a synthetic analog of an endogenously occurring apoptotic modulator, together with the chemotherapeutic drug paclitaxel (PTX), in a single formulation. ( PTX/CER )
Survival in women with MMR mutations and ovarian cancer: a multicentre study in Lynch syndrome kindreds -- Grindedal et al. 47 (2): 99 -- Journal of Medical Genetics
Conclusions: In the series examined, infiltrating ovarian cancer in Lynch syndrome had a better prognosis than infiltrating ovarian cancer in BRCA1/2 mutation carriers or in the general population. Lifetime risk of ovarian cancer of about 10% and a risk of dying of ovarian cancer of 20% gave a lifetime risk of dying of ovarian cancer of about 2% in female MMR mutation carriers.
Tuesday, February 09, 2010
Assessment of clinical practices among cancer genetic counselors
Note: refers to time spent by genetic counselors in advising patients
Rate of severe ovarian damage following surgery for endometriomas
CONCLUSIONS: Severe ovarian damage, occurring in gonads operated on for ovarian endometriomas, is not a rare event.
news item: Paxil Blocks Tamoxifen Lowers Survival Odds Against Breast Cancer - Breast Cancer
"Patients taking Paxil and tamoxifen should talk with their doctors about changing their antidepressant, Juurlink said. But he advised against abruptly discontinuing Paxil.
"There is a very real danger to stopping Paxil suddenly. There is a well-described withdrawal syndrome and the risk of depression becoming more severe," he said.
In addition, any transition to another antidepressant should be done gradually over several weeks, he said."
Monday, February 08, 2010
Northwest Biotherapeutics Inc. - press release
"The Company is also conducting a Phase I/II trial with DCVax(R) for recurrent metastatic ovarian cancer."
Marshall Edwards, Inc. Announces Resignation of Christopher Naughton From Board of Directors
Note: the OVATURE ovarian cancer trial results are to be published later this year - Phenoxodiol
Do Canadian patients trust others like them?
"Trust in a “person like yourself” has decreased from 2008 to 2009 (as have most information sources listed in the report), and dropped again in 2010. From the global 2010 Edelman report, 44% of respondents aged between 25-64 years said they would find the information from a person like them to be either ‘very credible’ or ‘extremely credible’ (down from 47% in 2009, and 58% in 2008). That’s a huge drop over the past 3 years!......Another point to keep in mind is that a “person like yourself” is not the same as a “patient like yourself”. "
Sunday, February 07, 2010
2009 A Pan-Canadian Clinical Practice Guideline: Assessment of Psychosocial Health Care Needs of the Adult Cancer Patient
Note:
1) next update is 2014;
2) a quick search reveals that data was:
included for: breast,colorectal,lung,prostate
not included for: ovarian,brain,pancreatic,leukemia,lymphoma
CCAC_Research January 15, 2010 Section 10. ColoMarker
Note/Warning: very graphic images included in this newsletter
Section 10: ColoMarker Tests for Colon Cancer (Dec. 17/09)
Dec 2009: Colorectal Cancer Association of Canada - DNA stool tests for colorectal cancer
DNA stool test A DNA stool test screens stool for DNA mutations, indicating the presence of precancerous polyps or colon cancer"
* Pros: No dietary changes are required before the test. There’s no need to empty the colon ahead of time. Stool sample collection can be done at home.
* Cons: The test currently screens for a limited number of DNA mutations in stool. The test hasn’t been universally accepted as a screening tool for colon cancer. False-negative results are possible.
Search of: ovarian cancer | Adult | received from 01/01/2010 to 02/07/2010 - List Results - ClinicalTrials.gov
Search of: 'ovarian cancer' received from 01/01/2010 to 02/07/2010 - List Results = 11
Does risk-reducing bilateral salpingo-oophorectomy leaved behind residual tube?
Abstract
Objective
Risk-reducing bilateral salpingo-oophorectomy (RRSO) is an effective option for women with BRCA mutations however there is limited information as to how much tubal epithelium remains after RRSO.
Saturday, February 06, 2010
Serum tetranectin is a significant prognostic marker in ovarian cancer patients.
Conclusion. Preoperative serum TN is a useful prognostic indicator of advanced stage for patients with OvCa.
Mental health and occupational wellbeing of Australian gynaecologic oncologists
Conclusion:"Australian gynaecologic oncologists experience considerable occupational distress while possessing high levels of personal accomplishment and job satisfaction. To maintain a healthy workforce, it is important to build on existing supports while conducting further research to identify suitable evidence-based strategies for improving the mental health of these surgeons."
Radical hysterectomy during the transition period from traditional to nerve-sparing technique
Conclusions:"Although during the introductory period nerve-sparing technique brings about an improvement in voiding function, it prolongs the total operative time in comparison to traditional radical hysterectomy."
Evaluation of the risk of malignancy index in daily clinical management of adnexal masses
Conclusions
"In our study population, introduction of the RMI would improve the management of adnexal masses, with a higher percentage of ovarian cancer patients that are operated by a gynecologic oncologist. At the same time, referral of patients with non-invasive (benign and borderline) lesions would be reduced."
When ‘never-events’ occur despite adherence to clinical guidelines: The case of venous thromboembolism in clear cell cancer of the ovary compared with other epithelial histologic subtypes
Note: 'never-events' is a term used in patient safety (eg. language - near misses, etc)
Conclusions.
"Women with CCC-O have a 2.5-times greater risk of disease related VTE than women with other histologies of epithelial ovarian cancer despite adherence to prophylactic guidelines. Given the high rate of VTE postoperatively as well as with disease recurrence, one should consider indefinite therapeutic anticoagulation in women with CCC-O. The case of CCC-O is one example of the impracticality of payment denial for ‘never-events,’ as VTE arises despite best efforts at prevention."
Alternative intraperitoneal chemotherapy regimens for optimally debulked ovarian cancer
Conclusion: Intraperitoneal chemotherapy regimens using carboplatin or cisplatin and dropping day 8 IP paclitaxel have less toxicity and less discontinuation of therapy
Single agent carboplatin versus carboplatin plus pegylated liposomal doxorubicin in recurrent ovarian cancer: Final survival results of a SWOG (S0200) phase 3 randomized trial
Conclusion: "Despite a favorable impact of carboplatin and PLD on progression-free survival in this trial, the effect on overall survival is not statistically significant. For currently unknown reasons, administering PLD with carboplatin appears to substantially reduce the incidence of platinum-associated hypersensitivity reactions."
Quality of care in advanced ovarian cancer: The importance of provider specialty.
BACKGROUND: One of the cornerstones of ovarian cancer therapy is cytoreductive surgery, which can be performed by surgeons with different specialty training. We examined whether surgeon specialty impacts quality of life (as proxied by presence of ostomy) and overall survival for women with advanced ovarian cancer.
abstract: Pathway analysis of gene lists associated with platinum-based chemotherapy resistance in ovarian cancer: The big picture
"We propose that future international cooperation should aim at a uniform pooled analysis of the wealth of ovarian cancer array data already available. This will enhance the power of each separate ovarian cancer study and can lead to promising results."
Protein That Splices And Dices Genes Identified By Scientists
"A novel finding, described Feb. 4 on the Science Express Web site by teams from the National Cancer Institute, The University of Texas Health Science Center at San Antonio and the University of Toronto, offers a clue as to how genes can have what you might call multiple personalities...."
Association of pegylated liposomal doxorubicin and ifosfamide in early recurrent ovarian cancer patients: A Multicenter Phase II Trial
Conclusion
The combination of PLD and continuous IFO is a feasible and efficient treatment in patients with relapsed ovarian cancer, especially with TFI between 6 and 12 months. This regimen may represent an alternative to platinum reintroduction and should be evaluated in a randomized trial.Survival after recurrence in early-stage high-risk epithelial ovarian cancer: A Gynecologic Oncology Group study
Abstract
Objective
This study aimed to evaluate the clinical outcome of recurrent early-stage high-risk epithelial ovarian cancer patients.The potential benefit of 6 vs. 3 cycles of chemotherapy in subsets of women with early-stage high-risk epithelial ovarian cancer: An exploratory analysis of a Gynecologic Oncology Group study
Abstract Objectives A prior clinical trial on early-stage high risk ovarian cancer showed a lower recurrence rate in those treated with six vs. three cycles of chemotherapy. We proposed to identify subsets of patients who may benefit from more cycles of chemotherapy.
abstract: From randomized trial to practice: single institution experience using the GOG 172 i.p. chemotherapy regimen for ovarian cancer
Note: patients enrolled between January 2006 to December 2007 "Background: The objective of the study was to evaluate completion rates and toxic effects of an i.p. chemotherapy regimen in a cross-section of nonselected patients with ovarian cancer (OC). Conclusions: The i.p. chemotherapy regimen used in a consecutive cohort of patients carries could be completed in only a small percentage of patients. Less toxic regimens with higher acceptability should be considered."
Chemotherapy Resistance as a Predictor of Progression-Free Survival in Ovarian Cancer Patients Treated with Neoadjuvant Chemotherapy and Surgical Cytoreduction Followed by Intraperitoneal Chemotherapy: A Southwest Oncology Group Study
re: tumour assay testing
"Conclusions: While the small patient numbers in this trial do not permit definitive conclusions, these data fail to provide support for the argument that prospectively obtained in vitro data regarding platinum or paclitaxel resistance will be highly predictive of clinical outcome in advanced ovarian cancer."
Oncogene - Abstract (technical): Cadherin switching and activation of p120 catenin signaling are mediators of gonadotropin-releasing hormone to promote tumor cell migration and invasion in ovarian cancer
Definition: Cadherins - (Calcium dependant adhesion molecules) are a class of type-1 transmembrane proteins. They play important roles in cell adhesion.
Definition: Gonadotropin - hormone secreted by the anterior pituitary gland and placenta; stimulates the gonads and controls reproductive activity. A hormone that stimulates the ovaries (such as to produce estrogen).
"These results identify for the first time cadherin switching and p120ctn signaling as important targets of GnRH function and as novel mediators of invasiveness and tumor progression in ovarian cancer."
Menopausal Hormone Therapy Use and Risk of Invasive Colon Cancer: The California Teachers Study -- American Journal of Epidemiology
" ....perimenopausal or postmenopausal....
Dying at home: community nurses' views on the impact of informal carers on cancer patients' place of death European Journal of Cancer Care
Note: abstract; one of the few articles which challenges mainstream research discussing the issues of dying at home and the wishes of patients/caregiver.
HTML Full Text - Risk assessment model for first-cycle chemotherapy-induced neutropenia in patients with solid tumours
(included ovarian cancer patients in study)
Friday, February 05, 2010
Safe Work Hours, Safe Patients | WakeUpDoctor.org
"Other industries responsible for public safety (e.g., the transportation and nuclear power industries) have been subject to federal regulations that limit the number of hours their employees can work for decades."
Grants.gov - 2010 (research) Ovarian Cancer
Expected Number of Awards: 12
Estimated Total Program Funding: $4,100,000
Description:
NEW for FY10, the OCRP Translational Pilot Award mechanism supports innovative translational research addressing a critical problem or question in ovarian cancer that will accelerate the movement of promising ideas toward clinical applications.
IGRT, SBRT Guidelines Issued By ASTRO, ACR
"The American Society for Radiation Oncology (ASTRO) and the American College of Radiology (ACR) have released practice guidelines for image guided radiation therapy (IGRT) and stereotactic body radiation therapy (SBRT) in the February issue of the International Journal of Radiation Oncology*Biology*Physics, the official journal of ASTRO."
Surgical Mesh - Complications Associated with Transvaginal Implantation of Surgical Mesh for the Treatment of Stress Urinary Incontinence and Pelvic Organ Prolapse - Notice to Hospitals
Note: warnings on surgical mesh complications exist for other procedures as well (search adverse events reports)
Thursday, February 04, 2010
Cochrane Canada Symposium (includes consumers/patients)
Subject: Cochrane Canada Symposium Workshop: Cochrane Canada 8th Annual Symposium - Evidence in Uncertain Times: Meeting the Challenge Date: 19-20 May 2010, Presymposium: 17-18 May 2010 Location: Ottawa, Ontario, Canada Details: We invite researchers, health policy makers and managers, health professionals, and patients to join the Canadian Cochrane Centre as we discuss Evidence in Uncertain Times at our 8th annual symposium. Abstract submission for workshop, oral and poster presentations is open until 12 February 2010. Early Bird registration ends on 19 March 2010 Email: ccnc.symposium@uottawa.ca Website: www.ccncsymposium.com
Topics – Lack of Appetite and Loss of Weight – Canadian Virtual Hospice
Lack of Appetite and Loss of Weight
Rare ovarian tumours: therapeutic strategies in 2010, national website observatory for rare ovarian cancers and delineation of referent centers-France
Note: ignore the small spelling errors in the article as it was translated from French to English
Peritoneal-based Malignancies and Their Treatment. [Ann Acad Med Singapore. 2010] - PubMed result
Conclusion: It is important to recognise the role of and indications for CRS and HIPEC
MicroRNAs in ovarian carcinomas -- Dahiya and Morin 17 (1): F77 -- Endocrine-Related Cancer
(abstract) FOCUS REVIEW
MicroRNAs in ovarian carcinomas
Neetu Dahiya1 and Patrice J Morin1,2
1 Laboratory of Cellular and Molecular Biology, National Institute on Aging, NIH Biomedical Research Center, 251 Bayview Boulevard, Suite 100, Room 6C228, Baltimore, Maryland 21224, USA
2 Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA
Phase 1Trial Bi-shRNA-furin and Granulocyte Macrophage Colony Stimulating Factor (GMCSF) Augmented Autologous Tumor Cell Vaccine for Advanced Cancer
Trial of Bi-shRNA-furin and Granulocyte Macrophage Colony Stimulating Factor (GMCSF) Augmented Autologous Tumor Cell Vaccine for Advanced Cancer - Full Text View - ClinicalTrials.gov
In Research: Yale Makes Possible Breakthrough in Ovarian Cancer Treatment | NBC Connecticut
"Genetic researchers prevent genes from performing their function, "knocking down" the gene, by inserting small interfering RNA (siRNA) molecules into the cells. The next steps in the team's research will be to examine the effect of siRNA in ovarian cancer samples in the lab, and to test the technique on mice."
EPGM-Munich - Expert Practice in Gynecologic Oncology - free access
There are a number of slide presentations (free full access)
Muir-Torre syndrome-is it really a new syndrome? Am J Dermapathology
Note: that there is an overlap here with Lynch Syndrome
"This syndrome is defined as the coexistence of sebaceous adenomas, sebaceus carcinomas, keratoacanthomas, and pedunculated tumors, some with lobulated structure. The cutaneous involvement (sebaceous gland tumor) is associated with at least a single internal malignancy; mostly colonorectal or genitourinary malignancies."
Medical News: Hidden Dangers of Herbal Meds Reviewed - in Primary Care, Alternative Medicine from MedPage Today
discusses some of the negative interactions
Wednesday, February 03, 2010
Deadline February 28th: Nominations: Becoming a Member
Ideal Candidates for the NCI Director's Consumer Liaison Group:
Ideal candidates must:
1. have first-hand knowledge of the cancer experience;
2. be affiliated with a cancer-related constituency; and
3. possess relevant non-scientific skills and perspectives that will allow them to help improve research outcomes by identifying new approaches, promoting innovation, recognizing unforeseen risks or barriers, and identifying unintended consequences that could result from NCI decisions.
Wait Times For Medical Care: How The US Actually Measures Up - Better Health
Note: ACOR ovarian cancer members - the report will be in the archives - Commonwealth Fund
Immunohistochemical panel to identify the primary site of invasive micropapillary carcinoma
Note: technical/abstract
Journal of Chemotherapy 2009 full access: What is the Benefit of 'Avastin' Combined with Chemotherapy in Patients - recurrent Ovarian, Primary ....
Journal of Chemotherapy 2009 full access: What is the Benefit of 'Avastin' Combined with Chemotherapy in Patients - recurrent Ovarian, Primary Peritoneal, Fallopian Tube Cancers.
Note: 64 patients in study; descriptive (stage 1C+); stage 1/11=4 pts; clear cell (2);endometrioid (3); mucinous (2);platinum resistant; side effects....(paper takes time to download)
Cochrane Collaboration Review: Retroperitoneal drainage versus no drainage after pelvic lymphadenectomy for the prevention of lymphocyst formation in patients with gynaecological malignancies
Authors' conclusions:
Placement of retroperitoneal tube drains has no benefit in prevention of lymphocyst formation after pelvic lymphadenectomy in patients with gynaecological malignancies. When the pelvic peritoneum is left open, the tube drain placement is associated with a higher risk of short and long-term symptomatic lymphocyst formation.
Antibodies Against Abnormal Glycoproteins Identified as Possible Biomarkers for Cancer Detection press release - National Institutes of Health (NIH)
"The team used this approach to screen blood specimens from breast, ovarian and prostate cancer patients....They found distinct abnormal mucin-type O-glycopeptide epitopes (parts of molecules that antibodies will recognize and bind to) that were targeted by autoantibodies in cancer patients — but such antibodies were absent in healthy controls.....Although larger sets of specimens will have to be analyzed to fully appreciate the clinical value of this technology, the preliminary results are very promising.The study was an international collaboration that was funded in part by NCI through the trans-NIH Alliance of Glycobiologists for Detection of Cancer and Cancer Risk."
Stanford's Canary Center strives to find cancer sooner than every before - 2/01/10 - San Francisco News
"Scientists at the Canary Center say their first blood test, developed for ovarian cancer, is about to begin phase one clinical trials at Stanford. The first patient group will be women at high risk for ovarian cancer."
In Research: Magnetic Nanoparticles Latch On, Ferry Cancer Cells Out of Body
includes reference to ovarian cancer
End of LIfe Care in the 21st Century: Advanced Directives in Universal Rights Discourse
....legally binding international convention that would outlaw human rights violations in end-of-life decision-making.
Evidence-Based Medicine Requires Appropriate Clinical Context - re: Deep VeingThrombosis (excerpt)
"What if a patient—after diagnostic tests have been performed and there is no more certainty to obtain—still has a 1 in 100 chance of having venous thromboembolism (VTE)? Should the patient's physician engage the patient in a discussion of the harm and benefit of anticoagulation? What if the chance of VTE was 1 in 20? Or even 1 in 10?"
Effectiveness of a home care nursing program in the symptom management of patients with colorectal and breast cancer receiving oral chemotherapy
Note: includes professional commentaries; Implications for all patients ($$)
Searching for the roots of ovarian cancer | Health & Fitness News - OregonLive.com
"It's very frustrating for patients and for researchers that there hasn't been significant advances in ovarian cancer," says Dr. Tanja Pejovic, a gynecologic oncologist and associate professor at Oregon Health & Science University......Pejovic's group at OHSU is among those seeking to understand the basic biology as a means to zero in on likely markers of early disease. In a study reported in December, the group monitored the action of 69 genes in cells that make up the ovarian surface epithelium. They identified a set of genes that appear to become more active as cells progress from normal to cancerous......"We are still trying to understand early events," she says. But Pejovic remains optimistic."We have to understand early events to the point where it can lead us to markers that circulate in the blood."
Reuters Health Information (2010-02-02): Simple ovarian cysts not linked to cancer in postmenopausal women
"Women with and without simple cysts were at similar risk of invasive ovarian cancer after nearly 8 years of follow-up evaluation, the authors write. Furthermore, traditional ovarian cancer risk factors, such as increasing age, family history of breast or ovarian cancer, nulliparity, and infertility, were not associated with simple cysts. Finally, changes in average CA-125 were not correlated with increases in the number or progression of simple cysts.Thus, Dr. Greenlee and his group conclude, "Simple cysts are not likely cancer precursors or markers of increased risk and can be followed conservatively.""
full free access: A novel germline PALB2 deletion in Polish breast and ovarian cancer patients
Conclusions:
The c.509_510delGA is a novel PALB2 mutation that increases the risk of familial breast cancer. Occurrence of the same PALB2 alteration in seven unrelated women suggests that c.509_510delGA (p.R170fs) is a recurrent mutation for Polish population.
Tuesday, February 02, 2010
Cochrane Symposium - Ottawa May 2010
Upcoming Cochrane Collaboration conference includes seminars for consumers/patients
Fertility-sparing surgery in young women with invasive epithelial ovarian cancer.
Note: this study also discusses tumour rupture/survival; the abstract does not include specific cell types, however, clear cell can be possibly presumed given the research data on Japanese women with clear cell ovarian cancer.
Clinical Activity of Gemcitabine Plus Pertuzumab in Platinum-Resistant Ovarian Cancer, Fallopian Tube Cancer, or Primary Peritoneal Cancer
Note: The response rates in this study either alone or in combination were low. The side effects appear to be understated (abstract).
Monday, February 01, 2010
Drugs A-Z List - A on RxList
This is a useful website for finding a lot of information relating to drugs, including chemotherapies. It includes drug interactions, warnings, generic names, pill identifier, medical dictionary etc. The website has been around for many years.
full free access: from the series - the Art of Oncology : "Pessimism Is No Poison"
"....The fellow asked the oncologist why he was so pessimistic when talking with the patient. Why did he say things to make the patient and her husband cry? Shouldn't he have given the patient more hope? Would it not have been better for the patient to hear this dire news in chunks over the course of several clinic visits? After all, the patient was so young she may just beat the odds....."
PLoS ONE: Risk of Ovarian Cancer and Inherited Variants in Relapse-Associated Genes
"...We previously reported results of tumor mRNA expression studies which suggested that altered expression of a particular set of genes predicted response to chemotherapy among women with advanced-stage high-grade epithelial ovarian cancer.......Conclusions: "Tumor studies can reveal novel genes worthy of follow-up for cancer susceptibility. Here, we found that inherited markers in the gene encoding MSL1, part of a complex that modifies the histone H4, may decrease risk of invasive serous ovarian cancer."
full free access: Duration and magnitude of the postoperative risk of venous thromboembolism in middle aged women: prospective cohort study
Note: the full access to this publication is available for free; professional comments included CONCLUSION: The risk of deep vein thrombosis and pulmonary embolism after surgery is substantially increased in the first 12 postoperative weeks, and varies considerably by type of surgery.
Journal of Experimental & Clinical Cancer Research | Full text | Viscum album L. extracts in breast and gynaecological cancers: a systematic review of clinical and preclinical research
Note: there is a specific section on ovarian cancer
Background: Viscum album L. extracts (VAE, European mistletoe) are a widely used medicinal plant extract in gynaecological and breast-cancer treatment. Conclusion: VAE shows some positive effects in breast and gynaecological cancer. More research into clinical efficacy is warranted.
Use of CT Scans Linked to Cancer Risk, Studies Say | netReturns | e-Newsletter
"There is considerable disagreement in the scientific community about the validity of these models," notes Rosaleen Parsons, M.D., chair of the department of diagnostic imaging at Fox Chase Cancer Center. "And some scientists believe the radiation dose from these CT scans may not lead to any increased risk of cancer."
In the second study, conducted at the University of California-San Francisco, researchers compared CT scan use at four San Francisco Bay area facilities. They found that the amount of radiation from a CT scan may be up to four times greater than estimated in previous studies. In addition, they noted significant differences among different institutions and, in some instances, within the same institution, when looking at the radiation dose associated with CT scans.
Sunday, January 31, 2010
Editorial: The heterogeneity of epithelial ovarian cancer. Getting it right David M. Gershenson
Editorial
The heterogeneity of epithelial ovarian cancer
Getting it right
David M. Gershenson, MD *
Department of Gynecologic Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
email: David M. Gershenson (DGERSHEN@mdanderson.org)
Abstract
Epithelial ovarian cancer is heterogeneous and comprises 4 major rare subtypes - mucinous, clear cell, low-grade serous, and endometrioid - all distinct from the more common high-grade serous carcinoma. Women with uncommon histotypes should be triaged to separate clinical trials.
Search of: ovarian cancer | Open Studies | Adult - Results by Topic - ClinicalTrials.gov
Search results for Dietary Supplement - ovarian cancer:
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dg
Most patients aren't aware that they can be used as props in the operating room and I'm sure the hospitals and doctors want it that way. The operating room has always been known to medical students as a great place to "steal" their learning from the patient. I think what's unnerving is the vision of many students waiting their turn in line to practice on an unconscious patient.
How could this possibly be an issue or a problem? How could it NOT be feasible to require prior consent? Likely the feasibility question concerns the medical schools' fear that if they ask patients for consent, they'll get more refusals than they can abide.
I consider this practice to be extremely unethical and leaves women open to abuse.
Where are the ethics committees when it comes to issues like this?
If it is not ABSOLUTELY CLEAR to the patient that a specific exam is part of the process, AND that participation means a supervised student may do such an exam, then you don't have informed consent. Period.
And you sure don't get that by having the patient sign a pile of forms a few hours ahead of a procedure, or assuming they know what "participate" in operation means. Stand and watch? Help monitor? Hold a kidney? I don't object to being a learning tool, but I expect to be asked specifically, simply and clearly.
"is it common practice when women are undergoing any procedure to have pelvic exams while under anaesthesia?"
My heart sank when I read that question. I would love to know this too (while at the same time I dread the answer).
I'd also like to know, are men's bodies used in this experimental way? Do students practice examinations on men for testicular or prostate cancer while they are unconscious?
Sandi, I hope you'll keep us posted if you hear anything about this. Thank you.
My heart sank when I read that question. I would love to know this too (while at the same time I dread the answer).
I think from some of the poll responses and comments, it is common contrary to what may think. Surgical patients of any kind, male or female should be getting on the bandwagon on this issue. The best way to bring this issue forward is to blog,email,FB and Twitter the ethics of the issue in the public domain. I wonder what husbands/partners feel about this?
A lot of debates resulted from the expose, but the doctors and hospitals were defiant in their "right" to use patient bodies in the OR as teaching props with the reasoning that a doctor can't learn just by observing. And that the patient isn't harmed. In any debate, they were uniformly indignant at revealing anything that goes on in the OR to the public because of the fear "one foot in door, what next will they demand. And the threat that if there is interference, then patient care will suffer.
Here are a few news links addressing this issue.
http://www.washingtonpost.com/ac2/wp-dyn?pagename=article&node=&contentId=A36990-2003May9¬Found=true
http://papers.ssrn.com/sol3/papers.cfm?abstract_id=880120
(yes, men are used as props too)
http://www.menshealth.com/men/health/other-diseases-ailments/are-med-students-practicing-on-you/article/fb2a99edbbbd201099edbbbd2010cfe793cd
http://findarticles.com/p/articles/mi_m0CYD/is_13_38/ai_105514181/
http://jamwa.amwa-doc.org/index.cfm?objectid=C7EE5996-D567-0B25-50D3DA2B7834FEE5
1) http://upalumni.org/medschool/appendices/appendix-37.html
2) http://upalumni.org/medschool/appendices/appendix-49.html