Thursday, May 20, 2010
Giving Honest Information to Patients With Advanced Cancer Maintains Hope - Cancer Network
"Background: Oncologists often do not give honest prognostic and treatment-effect information to patients with advanced disease. One of the primary reasons stated for witholding this information is to “not take away hope.” We could find no study that tested if hope was influenced by honest clinical information...cont'd"
ORC Oncology report - fill out form to receive copy of the report
Note: once the form is filled out the paper uploads a pdf file of the report automatically
ORC’s Oncology Report examines three important Oncology issues: Assessing the Impact of Revised NSCLC Staging, Genetically Linked Breast Cancer and PARP-1 Inhibitors and Reactions to New Mammogram Recommendations. Submit the information below and download the full report.
What is Molecular Biology?
* ''Biochemistry'' is the study of the chemical substances and vital processes occurring in living organisms. Biochemists focus heavily on the role, function, and structure of biomolecules. The study of the chemistry behind biological processes and the synthesis of biologically active molecules are examples of biochemistry.
* ''Genetics'' is the study of the effect of genetic differences on organisms. Often this can be inferred by the absence of a normal component (e.g. one gene). The study of "mutants" – organisms which lack one or more functional components with respect to the so-called "wild type" or normal phenotype. Genetic interactions (epistasis) can often confound simple interpretations of such "knock-out" studies.
* ''Molecular biology'' is the study of molecular underpinnings of the process of replication, transcription and translation of the genetic material. The central dogma of molecular biology where genetic material is transcribed into RNA and then translated into protein, despite being an oversimplified picture of molecular biology, still provides a good starting point for understanding the field. This picture, however, is undergoing revision in light of emerging novel roles for RNA.
Wednesday, May 19, 2010
Validation of My Family Health Portrait for six co... [Genet Med. 2010] - PubMed result
CONCLUSIONS:
These data support the validity of My Family Health Portrait pedigrees for four common conditions-diabetes and colon, breast, and ovarian cancer.
Tuesday, May 18, 2010
Risk of Cancer Following Hospitalization for Type 2 Diabetes The Oncologist
ABSTRACT
Objectives. Cancer and type 2 diabetes (T2D) are two common diseases that may share risk factors. We aimed at determining subsequent cancer risks in patients hospitalized for T2D in Sweden.
Methods. T2D patients were obtained from the nationwide Hospital Discharge Register; cancers were recorded from the Swedish Cancer Registry. Standardized incidence ratios (SIRs) were calculated for cancer
following last hospitalization for T2D. The comparison group was the general Swedish population.
Results. The number of hospitalized T2D patients from 1964 to 2007 was 125,126, of whom 26,641 had an affected family member. Altogether 24 cancers showed an elevated risk when follow-up was started after the
last hospitalization. The highest SIRs were for pancreatic (6.08) and liver (4.25) cancers. The incidences of these cancers were even elevated when follow-up was started 5 years after the last hospitalization for T2D, with primary liver cancer showing the highest SIR of 4.66. Also increased were the incidences of upper aerodigestive tract, esophageal, colon, rectal, pancreatic, lung, cervical, endometrial, ovarian, and kidney cancers. Prostate cancer showed a lower risk. Familial T2D patients showed no exceptional elevated cancer risks but their prostate cancer and melanoma risks were lower.
Conclusions. This study, covering approximately one half of Swedish T2D patients, showed an elevated risk for several cancers after hospitalization for T2D, probably indicating the profound metabolic disturbances of the underlying disease. The highest risks were found for
liver and pancreatic cancers. No excess cancer risks were observed in familial diabetics. The lower risk for prostate cancer remains intriguing
(ovarian cancer incidence rates 15.61/per 100,000 population; risk 1.84 (>1.0 = increased risk)
CCR Clinical Trials at NIH: Health Care Professionals: Join Our Mailing List
Health care professionals who join the National Cancer Institute Clinical Trials at NIH mailing list receive: * Quarterly e-mail notifications about clinical trials * Information about the National Cancer Institute's programs and clinical opportunities
NCI: Talking About Trials: Overcoming Bottlenecks in Clinical Communication (enrolment)
".......“Patient refusal rates may be less of a problem than low rates of trial offers,” wrote the authors."
NCI Cancer Bulletin for May 18, 2010 - SPECIAL ISSUE
Additional Clinical Trials Resources
Cancer Clinical Trials at NIH
NCI supports cancer clinical trials across the country (U.S) through its extramural research program. Meanwhile, on NIH’s main campus, the Institute’s intramural researchers in the Center for Cancer Research (CCR) conduct hundreds of trials each year at the NIH Clinical Center in Bethesda, MD, and these trials often differ from those available elsewhere.While some cancer centers also offer early-stage clinical trials, the difference is that CCR focuses almost exclusively on early-stage trials, said Dr. Bill Dahut, CCR’s clinical director.
NCI’s intramural program is able to pay the transportation costs for patients who are enrolled in Clinical Center trials. This allows CCR to see many more patients with rare cancers, or rare subtypes of common cancers, than other research sites because CCR can fly in patients from around the country to be treated in investigational studies.
One commonly cited barrier to entering clinical trials is the worry among both patients and their physicians of losing control. “An important point about treatment at NCI is that everything we do here for patients is done in close collaboration with their local physicians back home,” Dr. Dahut explained. “Our physicians provide expert clinical care to patients while they are being treated on protocol at NCI, but our physicians can see patients only while they are at the Clinical Center. Thus, continued care by local physicians is incredibly important to allow patients to access standard treatments or other trials not available here. Local physicians must remain closely involved with patients on NCI studies because side effects, from the cancer or the therapy, may occur when the patient is home and far from Bethesda.”
Patients and physicians interested in exploring cancer clinical trials at NIH can visit CCR’s clinical trials Web site. The site includes detailed descriptions of clinical trials currently recruiting patients; information for the general public about clinical trials and participating in trials at NCI; and information for health professionals about referring patients, the Center’s clinical programs and investigators, and ways to keep up to date with CCR research and opportunities.
“We’d really like to encourage physicians to join our mailing list,” said Susan McMullen, patient outreach and recruitment coordinator for CCR’s Office of the Clinical Director. “One of the barriers to recruiting patients at NIH is that our doctors don’t have a patient base outside of clinical trials to draw from, so we rely on community doctors to refer patients to us.”
Family Cancer Registries
To determine what genetic factors may be at work and how environmental influences alter those genetic risks, researchers rely on those affected by familial cancer to participate in family cancer registries.
“Our major goal in studying these families is to identify what are called high-risk susceptibility genes,” explained Dr. Peggy Tucker, director of the Human Genetics Program and chief of the Genetic Epidemiology Branch in NCI’s Division of Cancer Epidemiology and Genetics (DCEG). “We then try to understand the function of those genes, how they confer risk, and what other factors within the family modify risk.
“Ultimately, we want to be able to alter the risk of cancer in these families either by identifying susceptibility factors we can modify—for example, avoiding sun exposure in melanoma families—or designing interventions that can affect risk—such as prophylactic oophorectomy for women in families with high risk of both breast and ovarian cancer,” she said.
Family cancer registry studies can also help inform researchers about cancer susceptibility risks in the general population. For example, researchers identified dysplastic nevi as a major risk factor for melanoma by studying families at high risk of melanoma.
Researchers at NCI first began conducting family registry studies in the mid-1960s. These long-term studies follow families through successive generations, and allow researchers to examine the role of inherited high-susceptibility genes and cancer. Today, DCEG researchers are studying families with a number of inherited cancers or cancer-susceptibility syndromes, and researchers in NCI’s Division of Cancer Control and Population Sciences (DCCPS) sponsor the Breast and Colon Cancer Family Registries.
Whereas DCEG’s family registries are conducted at the NIH Clinical Center, the family registries based in DCCPS are found throughout the United States, Australia, and Canada. “Currently, we have about 78,000 men and women from nearly 26,000 families participating in these registries,” said Dr. Sheri Schully, program officer for the DCCPS family registries program. “The main objective of these registries is to identify and characterize cancer susceptibility genes, but the investigators also look at gene–gene and gene–environment interactions as well.”
Although family registry studies do not provide treatment to participating families, investigators often provide test results that can help family members learn which of them may be at higher risk because of certain susceptibility genes, such as mutations in the BRCA1 and BRCA2 genes or those associated with Lynch syndrome, said Dr. Schully.
Additionally, the studies are an opportunity for people who are often desperate for answers to ask questions.
“We like to think it’s a positive experience for them because they have a whole day at NIH to meet with physicians and nurses who know a lot about the disease,” Dr. Tucker explained. “We try to keep them updated with new findings about the diagnosis and management of the cancer that affects their family, and they know they can always come to us for referrals for care of the disorders that we’re studying.”
Learn More About Clinical Trial Enrollment....
Breast Cancer Research | Full text | Familial relative risks for breast cancer by pathological subtype: a population-based cohort study
Conclusions
"We may conclude from our results that the FRR (familial relative risk) for breast cancer is significantly increased for each pathological subtype except TN tumours, although the numbers in the latter category were too small to draw definitive conclusions.
When analyzed by tumour subtype, a surprisingly high proportion of FRR (familial relative risk) for ER-negative disease is already explained.
We estimate that 32% of breast cancer FRR for ER-negative disease is explained by BRCA1 and BRCA2 mutations alone.
Patients carrying such mutations may be advised to undergo prophylactic therapies such as oophorectomy or mastectomy.
About 10% of the FRR for ER-positive disease is explained by 12 newly discovered SNPs, and the contributions of these SNPs to FRR are likely to be somewhat higher once the true causal variants are identified.
The construction of informative risk prediction models for ER-positive disease is particularly important as the risk of ER-positive disease can be reduced by chemoprevention such as tamoxifen.
It is possible that including novel (new) genetic variants associated with breast cancer susceptibility in models may improve risk prediction for subtype specific disease."
BSB4uD (Be Smart Before You Donate - see blog posting and income comparisons non-profit employees vs professional salaries) - note updated information on Canadian family physician salaries - average
Blogger Author's Opinion: based on these averages, most family physicians are underpaid
Family Physician salaries as per CMAJ April 9th 2010: $225,521. Cdn avg CMAJ
Update: May 18th, 2010
A separate, unpublished CIHI indice which weights all payments — whether fee-for-service, salary or other form of capitation — for all services, against a national median indicates that Newfoundland and Labrador doctors essentially earn 6.78% less than a national median of $224 875 earned by doctors in 2007–08. On that scale, doctors in Alberta (7.22% above the median) were the highest paid in the country, followed by those in British Columbia (5.84% above), New Brunswick (4.6% above), Saskatchewan (4.24% above), Nova Scotia (1.68% above), Ontario (1.68% below) and Manitoba (4.88% below). Only doctors in Prince Edward Island (18.28% below) and Quebec (28.66% below) earned less than those in Newfoundland and Labrador.
http://www.cmaj.ca/cgi/content/full/182/8/E339?etoc
EpCAM As a Target in Cancer Therapy -- Journal of Clinical Oncology
Function: (ref source WIKI) EpCAM is a pan-epithelial antigen that is expressed on almost all carcinomas. Its constitutional function is being elucidated.
Note: search blog for other references to EpCAM and in particular to Lynch Syndrome"...Like for every targeted therapy, the level of EpCAM target expression will have an impact on the outcome of a trial. This was evident for the human anti-EpCAM antibody adecatumumab in patients with metastatic breast cancer. Although a high level and frequency of EpCAM expression can be assumed for patients with colorectal cancer, none of the previous trials prospectively or retrospectively analyzed patients for levels of EpCAM expression on tumor tissue. Particularly for a low-affinity antibody, such as edrecolomab, it may be of importance that tumor cells express EpCAM at a high and not just at an intermediate level..... Future studies will certainly benefit from stratifying patients for their level of EpCAM target expression."
Warfarin diet: What foods should I avoid? - MayoClinic.com
Warfarin is a blood-thinning medication that helps treat and prevent blood clots. There is no specific warfarin (Coumadin) diet. However, certain foods and beverages can make it so warfarin doesn't effectively prevent blood clots. It's important to pay attention to what you eat while taking warfarin.
One nutrient that can lessen warfarin's effectiveness is vitamin K. It's important to be consistent in how much vitamin K you get daily. The average daily allowance of vitamin K for adult men is 120 micrograms (mcg). For adult women, it's 90 mcg. While eating small amounts of foods that are rich in vitamin K shouldn't cause a problem, avoid eating or drinking large amounts of:
- Kale
- Spinach
- Brussels sprouts
- Parsley
- Collard greens
- Mustard greens
- Chard
- Green tea
Stem cell transplant - MayoClinic.com (Overview)
Definition
By Mayo Clinic staff A stem cell transplant is the infusion of healthy stem cells into your body. A stem cell transplant may be necessary if your bone marrow stops working and doesn't produce enough healthy stem cells. A stem cell transplant can help your body make enough healthy white blood cells, red blood cells or platelets, and reduce your risk of life-threatening infections, anemia and bleeding.Although the procedure to replenish your body's supply of healthy blood-forming cells is generally called a stem cell transplant, it's also known as a bone marrow transplant or an umbilical cord blood transplant, depending on the source of the stem cells. Stem cell transplants can use cells from your own body (autologous stem cell transplant) or they can utilize stem cells from donors (allogenic stem cell transplant).
Retrospective comparison of patient outcomes after in-person and telephone results disclosure counseling for BRCA1/2 genetic testing.
"This study suggests that telephone results disclosure is clinically appropriate when counselors utilize their clinical judgment to determine which patients are appropriate candidates."
The predictive value of serum VEGF in multiresistant ovarian cancer patients treated with bevacizumab (Avastin)
CONCLUSIONS:
Single agent bevacizumab has activity in ovarian cancer patients. Pre-treatment serum VEGF seems to have predictive value.
A Comparison of Quality-of-Life Domains and Clinical Factors in Ovarian Cancer Patients: A Gynecologic Oncology Group Study
CONCLUSION:
Ovarian cancer patients have decreased QOL in physical, functional, and emotional domains; however, they may compensate with increased social support. At the time of diagnosis and treatment, patients' QOL is affected by inherent characteristics. Assessment of treatment outcomes should take into account the effect of these independent variables.
Comparison of a novel multiple marker assay vs the Risk of Malignancy Index for the prediction of epithelial ovarian cancer in patients with a pelvic
"CONCLUSION: The dual marker algorithm utilizing HE4 and CA125 to calculate a ROMA value achieves a significantly higher sensitivity for identifying women with EOC than does RMI."
abstract: Hormone prevention strategies for breast, endometrial and ovarian cancers
"The prevention of epithelial ovarian cancer (EOC) is of particular interest given its high mortality rate and the lack of a cost-effective screening program. OC (oral contraceptives) usage significantly diminishes the incidence of EOC, in both the general population, as well as in patients with BRCA 1 or 2 mutations. Risk reduction is greatest with prolonged usage and persists for more than 30 years after OC use, but diminishes over time. Prospective, randomized trials, designed to control for all known variables, are mandatory to fully assess the potential for hormonal chemoprevention in breast, endometrial and ovarian cancers."
Multicentric parallel phase II trial of the polo-like kinase 1 inhibitor BI 2536.....
Multicentric parallel phase II trial of the polo-like kinase 1 inhibitor BI 2536 in patients with advanced head and neck cancer, breast cancer, ovarian cancer, soft tissue sarcoma and melanoma. The first protocol of the European Organization for Research and Treatment of Cancer (EORTC) Network Of Core Institutes (NOCI)
CONCLUSIONS: BI 2536 showed limited antitumour activity according to the design of this trial in five different tumour types. Derivatives of BI 2536 with a more favourable pharmacological profile are currently explored further in prospective studies.
JCO -- Early Release CORRESPONDENCE Accrual Strategies for Cancer Genetics Research: Blurred Boundaries (ethics)
CORRESPONDENCE
Accrual Strategies for Cancer Genetics Research: Blurred Boundaries
Daniel Rayson and Karen A. Gelmon JCO published online May 17, 2010, DOI:10.1200/JCO.2010.29.0759 [PDF]
TO THE EDITOR:
Metcalfe et al1 describe the incidence of BRCA1 and BRCA2 founder mutations in an unselected group of Ashkenazi Jewish women, with an astounding 2,000 women enrolled within 14 days of an article appearing in one of Canada’s most respected newspapers. Given the overwhelming interest amongthe target population, one might ask exactly what information prompted such an overwhelming response. The article in question was published on the front page of the Toronto Globe and Mail (Saturday May 24, 2008) with a large-font headline reading: “Cancer test a genetic crystal ball for Jewish women.” The first line in the piece stated: “For the first time in Canada, Jewish women will be offered the chance to alter their genetic destiny by taking a test…” a patently untrue and sensationalistic statement, given that presymptomatic BRCA1 and BRCA2 mutation testing, including Ashkenazi Jewish founder mutations, have been available for many years through medical genetics services nationwide." "The study by Metcalfe et al has accentuated these concerns and should serve as a basis for additional discussion in the oncology and
medical genetics communities regarding appropriate methodologies or recruitment to clinical investigations in cancer genetics."
Response to D. Rayson et al - re: Correspondence - Accrual strategies for cancer genetics research: blurred boundaries (ethics)
Correspondence: Narod/Metcalfe:
"If Drs Rayson and Gelmon1 are under the impression that we
have influence over how the Globe and Mail2 chooses to present its
news items, they are mistaken—perhaps their comments should be
addressed to the Globe Editorial office. We too are frustrated by the
incessant optimism of the media when they enter into the realms of
genetics or oncology—each gene discovery ineluctably will lead to a
treatment of a devastating genetic disease, each new molecule is a
target for a new cancer drug—but we suppose that unfettered optimism
is good for the newspaper business and is included in the price
we pay for freedom of the press...."
If the opinions of Drs Rayson and Gelmon are representative of the medical communities of Nova Scotia and British Columbia, then it is unlikely that populationbased genetic screening for Jewish women will be introduced in those provinces any time soon."
REFERENCES
1. Rayson D, Gelmon KA: Accrual strategies for cancer genetics research:
blurred boundaries. J Clin Oncol doi: 10.1200/JCO.2010.29.0759
2. Cancer test a genetic crystal ball for Jewish women. Toronto Globe and
Mail, Saturday May 24, 2008
3. Metcalfe KA, Poll A, Royer R, et al: Screening for founder mutations in
BRCA1 and BRCA2 in unselected Jewish women. J Clin Oncol 28:387-391, 2010
DOI: 10.1200/JCO.2010.29.1146; published online ahead of print at
www.jco.org on May 17, 2010
OvPlex ovarian cancer screening now available in the UK
OvPlex website: OvPlex™ targets symptomatic women and has been designed as a simple blood test for earlier diagnosis of ovarian cancer and is statistically significantly better than CA125 alone (the current standard blood test) in the detection of ovarian cancer. OvPlex™ outperforms CA125 for the detection of ovarian cancer in all stages of the disease - particularly, early stage. As mentioned, if a woman is diagnosed with ovarian cancer at an early stage of the disease, five year survival rates are greatly increased.
Cancer Clinical Trial: E-health Intervention for Cancer Survivors
Brief Summary
Official Title: “E-health Intervention for Cancer Survivors”
Intervention(s):
* Behavioral: Project Onward website + social network
* Behavioral: Project Onward website + Coach
* Behavioral: Project Onward website
This study will develop and examine the effectiveness of an intervention that utilizes multiple telecommunications technologies to improve cancer survivors' access to mental health care and increase their ability to manage the high risk transition time from active cancer treatment to survivorship. The intervention, referred to as Project Onward, uses an interactive website, e-mail, telephone, and an online social network. The purpose of this study is to pilot a novel intervention that can reduce costs, examine methods to improve adherence to internet based treatment and overcome numerous barriers to treatment for mental health concerns.
Monday, May 17, 2010
Aeterna Zentaris Receives Positive Opinion for Orphan Medicinal Product Designation for AEZS-108 for the Treatment of Ovarian Cancer from the Committe
media: Aeterna Zentaris Receives Positive Opinion for Orphan Medicinal Product Designation for AEZS-108 for the Treatment of Ovarian Cancer from the Committee for Orphan Medicinal Products of the European Medicines Agency
Keeping the GINA in the bottle: asessing the current need for genetic non-discrimination legislation in Canada - full access
"The background to the adoption of the Genetic Information Nondiscrimination Act (GINA) in the United States has important lessons for Canada, especially in view of the increasing tread toward privatized services within the Canadian public health care system. When the US legislation was finally adopted in May 2008, observers rejoiced that “[a]t last, the United States has a federal law that protects consumers from discrimination by health insurers and employers on the basis of genetic information.”1 GINA is the culmination of a long process that began in 1995 when federal lawmakers first introduced the legislation. In the interim, more than 45 American states had passed their own genetic nondiscrimination laws.2
Such a high level of legislative activity indicates a deep and abiding public concern about the issue of genetic discrimination. Yet the same level of angst has yet to make its way north. Although a recent Canadian study reports on perceptions of genetic discrimination with regard to people at risk for Huntington’s disease,3 discussion of the general issue in Canada has been limited and is focused primarily on discrimination in the context of life insurance.4 More significantly, there is no legislation comparable to GINA at either the federal or the provincial/territorial level in Canada. Does the absence of such legislation mean that Canadians are at higher risk of genetic discrimination than Americans? Does Canada require similar legislation?"
Search of: ovarian cancer | Open Studies | received from 04/01/2010 to 05/17/2010 - List Results - ClinicalTrials.gov
Found 25 studies with search of: ovarian cancer - Open Studies - received from 04/01/2010 to 05/17/2010
amednews: Hospitals exchange of cost data clears antitrust hurdle :: May 17, 2010 ... American Medical News
"Quality-adjusted pricing also should be taken into account, he said. "From an antitrust perspective, when dealing with a service industry ... just looking at cost may say very little."
amednews: Informed consent: Hospitals explore personalizing risks :: May 17, 2010 ... American Medical News
"It is well-known from the medical literature that informed consent is neither informed nor consensual," said John Spertus, MD, MPH"
Man sold fake cancer drug over the internet - DCA media item
"The (web)site (now closed down)claimed the powder was the experimental cancer drug sodium dichloroacetate (DCA)
Sunday, May 16, 2010
Walking the Talk to Ensure Patient Safety on Medical News Corporate
"It has been 10 years since the Institute of Medicine released its damning report, To Err is Human, but it has been 24 centuries since Hippocrates admonished physicians to do no harm," said Dennis S. O'Leary, MD, president emeritus of The Joint Commission and a founding member of the Lucian Leape Institute. "Today, although some progress in improving patient safety continues to be made, healthcare remains fundamentally unsafe as up to one in 10 people admitted to hospitals continue to experience significant, preventable adverse events."
2010 ASCO Annual Meeting | Meeting Program
Note: to use the Online Meeting Program registration is required (free).
Online Meeting Program
Use the online Meeting Program to search the complete program listings of sessions and abstract titles. The online Meeting Program will be updated frequently, so use this tool for access to the most up to date information. Once you have found sessions you are interested in attending, you can also build an itinerary.
2010 ASCO Annual Meeting | Meeting Program | What Is New This Year 2010 annual meeting - Trials in Progress Poster Session
Note: the program is now online for the annual meeting June 2010 (searchable) (http://www.asco.org)
What's New This Year
Trials in Progress Poster Session
The new Trials in Progress Poster Session will facilitate awareness of and dialogue about open, ongoing clinical trials. It differs from other Poster Sessions in that
* outcomes data or results are not included
* the goal is to promote discussion among trial investigators, to encourage recruitment of new investigators or sites, and to stimulate discussion of successor or confirmatory trials
* the focus is on the background of the science behind the trial, and preclinical or earlier-phase data (preferably with references) is encouraged
The Trials in Progress Poster Session will be held Monday, June 7 from 8:00 AM to 12:00 PM. All Meeting attendees are welcome to attend this new session.
abstract: miR-20a promotes proliferation and invasion by targeting APP in human ovarian cancer cells.
define: microRNA - A short piece of single-stranded RNA that does not encode a protein and controls the expression of genes.
Abstract:
MicroRNAs (miRNAs) are emerging as a class of small regulated RNAs, and the alterations of miRNAs are implicated in the initiation and progression of human cancers. Our study shows that inhibition of miR-20a in OVCAR3 ovarian cancer cell line could suppress, whereas overexpression of miR-20a could enhance cell long-term proliferation and invasion. We also confirmed amyloid precursor protein (APP) as a direct target gene of miR- 20a. Furthermore, suppression of APP expression could also promote ovarian cancer cell proliferation and invasion, which is consistent with the results of miR-20a overexpression. Therefore, we concluded that the regulation of APP is an important mechanism for miR-20a to promote proliferation and invasion in ovarian cancer cells.
Saturday, May 15, 2010
Be Smart Before You Donate BSB4uD (Cancer) - Comparing Non-Profits before you donate (see chart)
Note: best viewed in Firefox browser
BSB4uD ( Be Smart Before You Donate )
So……. Always questions concerning donations?
When it comes to donations, how much do you really know?
Who do you believe, and why ?
How do you decide ?
Do you even care where you donate – if you donate?
Time or money or…..
Speaking of Trust:
Who gains?
What’s the priority?
Who loses?
Who leads?
Little, or nothing....... to gain /to lose?
Top down? Bottom up?
It’s…….Up to you to ask the right questions. Be smart, it’s your right to ask - your right to know.
Here’s a start – add your own
walk through this start of information - what you need or should know & think about but most likely don’t
Here’s the question: I donate because.....
Have a look at the charts below to compare ovarian cancer
.....click on 'read more'
.....click on 'read more'
Expert Reviews full access: On the advent of MSI testing of all colorectal cancers and a substantial part of other Lynch syndrome-related neoplasms
Worldwide, more than 1 million people present with colorectal cancer (CRC) annually. Of these, 2–5% occur in the context of Lynch syndrome (LS), the most common hereditary CRC predisposing syndrome (formerly designated as hereditary nonpolyposis CRC [HNPCC]). LS is characterized by a high lifetime risk for the development of CRC (20–70%), endometrial cancer (15–70%) and other extracolonic cancers (<15%). These extracolonic malignancies include carcinomas of the small intestine, stomach, pancreas and biliary tract, ovarium, brain, upper urinary tract and skin. .......germline mutation in one of the MMR genes MLH1, MSH2, MSH6 or PMS2.
Owing to the MMR deficiency in LS tumors, a microsatellite instability (MSI) phenotype is present. MSI, however, is also found in approximately 10–13% of sporadic CRCs (in total, MSI is present in approximately 15% of all CRCs). In addition to MSI, most LS tumors lack expression in the tumor cell nuclei of one of the four MMR proteins, MLH1, MSH2, MSH6 or PMS2.
Early detection of LS is of great importance, particularly in presymptomatic mutation carriers, since colonoscopic surveillance has proven to reduce CRC morbidity and mortality by 65–70% [6] and prophylactic surgery may prevent endometrial and ovarium carcinoma effectively.
Different models and strategies have been developed to identify patients with LS. In 1990, the Amsterdam criteria I were developed to provide a basis for uniformity in collaborative studies to find the disease-causing gene. These criteria were designed to be highly specific at the expense of sensitivity. They were criticized because extra-colonic tumors were not taken into account, thereby excluding classical LS families....Therefore, the Amsterdam criteria II were established in 1999"
Hyperthermic intra-peritoneal chemotherapy using Oxaliplatin as consolidation therapy for advanced epithelial ovarian carcinoma. Results of a phase II
CONCLUSION:
Using intra-peritoneal Oxaliplatin associated with hyperthermia as consolidation therapy for advanced ovarian cancer results in a high risk of grade 3 morbidities with only a small benefit on survival
Friday, May 14, 2010
Future Medicine - Link between personality and cancer
Note: also see prior blog post on Type D personality as per below (date):
Saturday, January 23, 2010
full free access: Type D personality in the general population: a systematic review of health status, mechanisms of disease, and work-related problems "Type D personality in the general population: a systematic review of health status, mechanisms of disease, and work-related problems."
2008 September CANO Survivors' Debate Presentation - authors Carolyn Benivegna & Sandi Pniauskas
primary authors: Carolyn Benivegna (in spirit) & Sandi Pniauskas
clicking above will bring you directly to the presentation,
or,
request a copy of the pdf presentation file via: sandipn@sympatico.ca
request a copy of the pdf presentation file via: sandipn@sympatico.ca
abstract and free full text: How old is this mutation? - a study of three Ashkenazi Jewish founder mutations
The three mutations analyzed were MSH2*1906 G->C, APC*I1307K, and BRCA2*6174delT.
"Mutation age estimates (averages):
16.8 generations for MSH2
106 generations for I1037K
90 generations for 6174delT
full access: Cancer Genomics: Conducting Exemplary Trials With Biospecimen and Biomarker Components
Note: long article regarding efforts in progress
One specific area of importance to patients:
"As clinical trials become more complex, so do the concerns researchers must address. Original correlative trials have now led to a new generation of clinical trials, some of which exclude patients who do not possess the specific biomarker being studied. When these biomarker tests must be completed before enrollment onto a clinical trial, it is important that the study budget provide reimbursement for testing of individuals who are afterward deemed ineligible. Additionally, because biomarker testing is generally completed at a central laboratory designated by the sponsor, it is important that physicians know how long it will take to receive the results. If the turnaround time is 3 to 4 weeks, it should be considered whether patients will agree to wait that long to begin treatment, especially if they may ultimately be excluded from the clinical trial on the basis of the test results. Considerations such as these should be discussed in advance with the sponsor, so efforts can be made to expedite testing. The research site should also be aware of all options that can be provided to patients who are excluded from the clinical trial. Sometimes sponsors will offer an expanded access option or suggest alternative trials using the medication, important factors when enrollment onto the clinical trial is the only remaining treatment option for a patient."
FDA Requires Doctors to Advise Patients about ESA Risks and Benefits | Anemia in the News | NAAC National Anemia Action Council (U.S.)
Note: see the website for additional links/information
FDA Requires Doctors to Advise Patients about ESA Risks and Benefits
Updated: February 18, 2010
The U.S. Food and Drug Administration (FDA) announced that they will soon require medical professionals prescribing erythropoiesis-stimulating agents (ESAs) to provide a Medication Guide to patients and to formally educate them about the drug’s risks and benefits.
The FDA will be implementing their new standards as part of a risk evaluation and mitigation strategy (REMS) intended to support informed decisions between patients and professionals, and mitigate the risks associated with the use of anemia drugs. As part of a the new standards, oncologists and professionals prescribing ESAs to treat anemic cancer patients will also be required to enroll in the ESA APPRISE Oncology program and complete a training module.
What Else Do You Need to Know?
Read more about these regulations in the feature article New Rules and APPRISE Program Regulate ESA Use in Oncology.
About the National Anemia Action Council (NAAC)
NAAC is an organization of anemia experts dedicated to raising the awareness of healthcare professionals and the public regarding the prevalence, symptoms, consequences, and treatment options of anemia. We aim to improve the lives of people with anemia by providing quality information to educate patients, consumers, medical professionals, writers and researchers.
Council of Experts
NAAC is an advisory council offering expert information about anemia of chronic disease to any interested person or organization. Because anemia is either a symptom or consequence of many diseases and conditions, the council is comprised of nationally recognized specialists from a broad variety of medical disciplines.
Meet Our Experts
Talk to our experts about anemia in the following areas:
Anesthesiology · Cardiology · Critical Care · Endocrinology · Gastroenterology · Geriatrics · Gynecology · Hematology · Nephrology · Pediatric Nephrology · Nursing · Oncology · Rheumatology · Surgery
2008/2009 Sponsors
Ortho Biotech Watson Affymax Takeda
Roche AMAG AMAG medgenics
Teal Toes: Women’s Health Week, Ovarian Cancer media/video - link between breast/ovarian cancers
Note: no mention of other genetic risks aside from the BRCA's
Index of Ovarian Cancer related articles: Future Medicine
Theme: Advances in therapy for ovarian cancer - Foreword
Ovarian cancer in 2010
Paul Sabbatini, Jacobus Pfisterer
Novel targeting strategies using recombinant antibodies for early diagnosis and therapy of ovarian cancer
Nathalie Scholler
Patient-specific tumor biology-based selection of ovarian cancer therapy
John P Fruehauf
Robotic-assisted minimally invasive surgery and ovarian cancer
Zvi Vaknin, Walter H Gotlieb
News & Views in ... Ovarian cancer
Research Highlights
David Robertson
Personalizing therapy for ovarian cancer
Chau Tran, Thomas McNally, Michael J Birrer
Oophorectomy as a preventative measure for ovarian cancer
Mary B Daly
Role of secondary cytoreduction in recurrent ovarian cancer
Joyce N Barlin, Robert E Bristow, Dennis S Chi
Fertility preservation in ovarian cancer
Rebecca Arend, Anne Holland, Caryn St Clair, Thomas J Herzog
Evidence-based chemotherapeutic management of potentially platinum-sensitive recurrent ovarian cancer
Maurie Markman
Antiangiogenic therapies in ovarian cancer
Carol Townsley, Amit Oza
full free access: Hope and Noncurative Chemotherapies: Which Affects the Other? Journal of Clinical Oncology
Note: references ovarian cancer, factors involved in treatment related decision making "We still do not fully understand the concept of hope and its effects, both positive and negative..."
abstract/free full access: A proposed systems approach to the evaluation of integrated palliative care
"The provision of palliative care that is client focused needs to be the grounding objective in service integration to help refocus some of the territoriality that arises as individual organizations try to protect their own interests."
Thursday, May 13, 2010
Cancer prevalence in 129 breast-ovarian cancer families tested for BRCA1 and BRCA2 mutations (South Africa)
Note: small study (Caucasian); stomach cancer link/BRCA2 (?)
"Stomach cancer prevalence was significantly elevated in the BRCA2-positive families compared with the general population."
(DCA) Simple, cheap drug holds cancer treatment promise - CTV News
Note: this is an issue discussed widely in the recent past (inexpensive/profit/lack of)
Discussing Complementary Therapy Use With Early-Stage Breast Cancer Patients: Exploring the Communication Gap
"These findings indicate that doctors require further education about CAM therapies and supplements as well as guidance in how to raise and effectively discuss CAM issues with concern for their safety while balancing respect for the patients’ beliefs."
RNA Interference Fact Sheet - National Institute of General Medical Sciences
What is RNA interference?
RNA interference (RNAi) is a natural process that cells use to turn down, or silence, the activity of specific genes.
Discovered in 1998, RNAi has taken the biomedical community by storm. Researchers quickly capitalized on the discovery and developed RNAi into a powerful research tool that is now used in thousands of labs worldwide.
How does RNAi work?
RNAi works by destroying the molecular messengers that carry information coded in genes to the cell’s protein factories. These messengers, called messenger RNAs (mRNAs), carry out a critical function, without which a gene is essentially inactive.
How can I find out more about RNAi?
See the RNAi section of our Extras on Newsmaking Research page at http://www.nigms.nih.gov/News/Extras/default.htm#rnai.
Epithelial Ovarian Cancer Clinical Trial: A Trial Using Novel Markers to Predict Malignancy in Elevated-Risk Women [Conditions: Epithelial Ovarian Cancer; Interventions
Epithelial Ovarian Cancer Clinical Trial:
Brief Summary
Official Title: “A
Randomized Controlled Trial Using Novel Markers to Predict Malignancy in
Elevated-Risk Women”
Condition Keyword(s):
Intervention(s):
The Novel Markers Trial will compare the safety, feasibility
and effectiveness of two different epithelial ovarian cancer screening
strategies that use CA125 and add HE4 as either a first or second line
screen. This study is the next step in a larger research effort to
develop a blood test that can be used as a screening method for the
early detection of epithelial ovarian cancer.
Wednesday, May 12, 2010
IN-CAM Outcomes Database (CAM)
About IN-CAM:
Purpose
We have developed a database of outcome measures of particular importance to Complementary and Alternative Medicine (CAM) research in order to facilitate and support the assessment of CAM interventions through high quality research, and thus, to improve clinical practice and inform policy.link- outcomes database/background:
http://www.outcomesdatabase.org/show/category/id/13
about the team:
http://www.outcomesdatabase.org/show/category/id/12
LISTSERV Choice Awards - Spread the Word - Nominate our ACOR listserv!
link - Nomination form:
http://www.lsoft.com/news/choiceform.asp
FAQ and link to FAQ:
http://www.lsoft.com/news/choicefaq.asp
What is the deadline for nominations to be submitted?
The 2009-10 contest is open for
nominations. Nominations must be received via the Web form by 6 p.m.
Central European Time, June 1, 2010. We highly encourage participants to
nominate their favorite lists as soon as possible so that the public
will have ample time to vote for the lists.
- Polls close July 1, 2010, at 6 p.m. Central European Time.
- You may vote once every 24 hours.
- After voting, you will be locked out from voting again (on the computer you voted from) for 24 hours.
- The voting consists of separate monthly contests. Counters will be reset at the beginning of each month.
- L-Soft reserves the right to close some or all polls earlier than the posted end date.
- The top three finalists will be announced Spring 2010.
Review Unmasking the complexities of mucinous ovarian carcinoma
Note: mucinous/KRAS is also prevalant in colorectal cancers
Conclusions
Primary mucinous ovarian cancer should be considered separate from the other epithelial ovarian cancers. Ongoing clinical trials in this disease will likely offer improvements in chemotherapeutic agents used to treat women with primary and recurrent mucinous ovarian cancer.Phase I clinical trials in 85 patients with gynecologic cancer: The M. D. Anderson Cancer Center experience
Note: the abstract does not detail outcomes/disease specific sites
Clinical relevance of rare germline sequence variants in cancer genes
Clinical relevance of rare germline sequence variants in cancer genes: evolution and application of classification models.
Abstract
Multifactorial models developed for BRCA1/2 variant classification have proved very useful for delineating BRCA1/2 variants associated with very high risk of cancer, or with little clinical significance. Recent linkage of this quantitative assessment of risk to clinical management guidelines has provided a basis to standardize variant reporting, variant classification and management of families with such variants, and can theoretically be applied to any disease gene. As proof of principle, the multifactorial approach already shows great promise for application to the evaluation of mismatch repair gene variants identified in families with suspected Lynch syndrome. However there is need to be cautious of the noted limitations and caveats of the current model, some of which may be exacerbated by differences in ascertainment and biological pathways to disease for different cancer syndromes.
abstract: The inherited genetics of ovarian and endometrial cancer
"Endometrial and epithelial ovarian cancers are the fourth and fifth most common cancers in women in developed countries, after breast, lung, and colorectal cancer. In the United States alone, in 2008 there were about 40000 new diagnoses of endometrial cancer and 7500 disease-related deaths. For ovarian cancer, there were about 22000 new diagnoses and 15000 deaths over the same period. The purpose of this article is to review the recent developments in the inherited genetics of ovarian and endometrial cancer, with particular attention to recent progress in identifying common low-penetrance susceptibility genes and their clinical implications."
Editorial: The cancer of bureaucracy: How it will destroy science, medicine, education; and eventually everything else
Editorial
The cancer of bureaucracy: How it will destroy science, medicine,
education; and eventually everything else
Summary
Everyone living in modernizing ‘Western’ societies will have noticed the long-term, progressive growth and spread of bureaucracy infiltrating all forms of social organization: nobody loves it, many loathe it, yet it keeps expanding. Such unrelenting growth implies that bureaucracy is parasitic and its growth uncontrollable – in other words it is a cancer that eludes the host immune system. Old-fashioned functional, ‘rational’ bureaucracy that incorporated individual decision-making is now all-but extinct, rendered obsolete by computerization. But modern bureaucracy evolved from it, the key ‘parasitic’ mutation being the introduction of committees for major decision-making or decision-ratification. Committees are a fundamentally irrational, incoherent, unpredictable decision-making procedure; which has the twin advantages that it cannot be formalized and replaced by computerization, and that it generates random variation or ‘noise’ which provides the basis for natural selection processes. Modern bureaucracies have simultaneously grown and spread in a positive feedback cycle; such that interlinking bureaucracies now constitute the major environmental feature of human society which affects organizational survival and reproduction. Individual bureaucracies must become useless parasites which ignore the ‘real-world’ in order to adapt to rapidly-changing ‘bureaucratic reality’. Within science, the major manifestation of bureaucracy is peer review, which – cancer-like – has expanded to obliterate individual authority and autonomy. There has been local elaboration of peer review and metastatic spread of peer review to include all major functions such as admissions, appointments, promotions, grant review, project management, research evaluation, journal and book refereeing and the award of prizes. Peer review eludes the immune system of science since it has now been accepted by other bureaucracies as intrinsically valid, such that any residual individual decision-making (no matter how effective in real-world terms) is regarded as intrinsically unreliable (self-interested and corrupt). Thus the endemic failures of peer review merely trigger demands for ever-more elaborate and widespread peer review. Just as peer review is killing science with its inefficiency and ineffectiveness, so parasitic bureaucracy is an un-containable phenomenon; dangerous to the extent that it cannot be allowed to exist unmolested, but must be utterly extirpated. Or else modernizing societies will themselves be destroyed by sclerosis, resource misallocation, incorrigibly-wrong decisions and the distortions of ‘bureaucratic reality’. However, unfortunately, social collapse is the more probable outcome, since parasites can evolve more rapidly than host immune systems.abstract - Jjournal of Medical Hypostheses: Determinants of geographic patterns of diseases: Interaction of lactose/lactase status and sunshine exposure. (vitamin D)
Note: in research
"Then in a preliminary fashion lactose digester and maldigester status are related to relative annual sunshine exposure. Further the relative national annual sunshine exposure is evaluated to outcomes of the same exemplary diseases. The patterns related to sunshine reflect that obtained with national lactase status proportions and also corroborate a literature review. However, correlations are weak to moderate and only ovarian cancer reached conventional statistical significance. Because these comparisons are based on modest number of national data firm conclusions cannot be made.....These could partly explain both north to south and west to east directional changes.
Tuesday, May 11, 2010
(2009) Turmeric and Curcumin: MedlinePlus Supplements
"Cancer:
Several early animal and laboratory studies report anti-cancer (colon, skin, breast) properties of curcumin. Many mechanisms have been considered, including antioxidant activity, anti-angiogenesis (prevention of new blood vessel growth), and direct effects on cancer cells. Currently it remains unclear if turmeric or curcumin has a role in preventing or treating human cancers. There are several ongoing studies in this area."
5 min podcast - Dr Ashworth - BRCA/PARPs
Podcast – A Breakthrough in BRCA-Mutated Cancers
11. May, 2010 in Podcast
Alan Ashworth, who helped discover the BRCA2 breast cancer gene in 1995, says understanding basic biology can help researchers find targeted cancer treatments. He shares about his research with PARP inhibitors to treat BRCA-mutated cancers.
ASCO - Endocyte Officials to Present Results from Four Clinical Trials at ASCO Annual Meeting - PRECEDENT = EC145/platinum resistant ovarian
"Interim results from the PRECEDENT study, a randomized phase II study of the combination of EC145 and Doxil for the treatment of patients with platinum-resistant ovarian cancer, will be provided during an oral presentation. EC145 is a folate-targeted conjugate of a very potent chemotherapy drug."
full access: Knowledge, attitudes, and clinical experience of physicians regarding preimplantation genetic diagnosis for hereditary cancer predisposit
Note: for full free access click on 'pdf'
Does surgical volume influence short-term outcomes of laparoscopic hysterectomy?
CONCLUSION: In laparoscopic hysterectomy, increasing the surgical volume can reduce the operating time and the risk for conversion to laparotomy but not the rate of serious complications
Public Perceptions of Ethical Issues Regarding Adult Predictive Genetic Testing
"Audience members emphasized public education and access to information regarding potential choices, which was different from the emphasis on informed consent and other ethical issues prominent in the literature. Members of the general public emphasized ethical issues that were different than those identified by experts and patients. It is essential that members of the public be included in complex and controversial public policy decisions."
Monday, May 10, 2010
medical news article: Versatility Of Amniotic Fluid Stem Cells
Versatility Of Amniotic Fluid Stem Cells
Main Category: Stem Cell ResearchAlso Included In: Diabetes; Urology / Nephrology; Genetics
Article Date: 25 Nov 2009
For the first time, scientists have demonstrated that stem cells found in amniotic fluid meet an important test of potential to become specialized cell types, which suggests they may be useful for treating a wider array of diseases and conditions than scientists originally thought.
Reporting in Oncogene, a publication of Nature Publishing Group, the research teams of Anthony Atala, M.D., director of the Wake Forest Institute for Regenerative Medicine, and Markus Hengstchläger, Ph.D., from the Medical University of Vienna, have shown that these amnion stem cells can form three-dimensional aggregates of cells known as embryoid bodies (EBs). It is believed that cells at this stage of development can be directed to become virtually any cell in the human body.
"This finding suggests that the amnion cells have greater potential than we originally thought and may be able to form many cell types," said Atala. "This could expand the number for diseases and conditions that they may be helpful for."
Atala's team is currently evaluating the cells for their potential to treat diabetes and kidney disease. They were the first to report success (Nature Biotechnology, Jan. 2007) in isolating stem cells from placenta and amniotic fluid, which surrounds the developing fetus. The current research is one of several projects designed to determine the potential of this new type of stem cell.
For the study, scientists generated two additional lines of stem cells from amniotic fluid using the same protocol developed by Atala's lab. They then investigated the incidence of EB formation in all three lines.
"Performing many independent experiments using different approaches, we demonstrate in the report that human amnion stem cells … can indeed form embryoid bodies," write the researchers in Oncogene. "Amnion cells are on the way to become an important source for both basic science and regenerative medicine."
In addition to the finding about EBs, the scientists identified a protein found inside cells (mTOR) as the regulator of EB formation. Hengstshläger, whose team was the first to provide evidence for the existence of stem cells in amniotic fluid, said that this finding may allow for new insights into the molecular mechanism of EB formation.
He said the cells may be a useful source for generating disease-specific stem cell lines for studying the differentiation process to determine what goes wrong in genetic diseases.
"These stem cells allow for studying the effects of mutations causing human genetic diseases on specific cell differentiation processes," he said.
Other potential advantages of the cells are that they can be grown in large quantities and are readily available during gestation and at the time of birth. "Whether these cells are as versatile as embryonic stem cells remains to be determined," said Atala, "but the current finding is certainly encouraging."
Atala stopped short of calling the cells pluripotent, which means the ability to form many cell types. He said while the cells meet some of the characteristics of pluripotency, such as versatility, they do not form tumors when implanted in animals, which is also considered a characteristic. The fact that the amnion cells are less likely to form tumors may be one advantage that they have over embryonic stem cells in their potential for clinical use.
Co-researchers were Alessandro Valli, Ph.D., Margit Rosner, student, Christiane Fuchs, MSc., Nicol Siegel, MSc., and Helmut Dolznig, Ph.D., from the Medical University of Vienna, Colin E. Bishop, Ph.D., from Wake Forest, and Ulrike Mädel, student, and Wilfried Feichtinger, M.D., from Wunschbaby Zentrum, in Vienna, Austria.
Source: Karen Richardson
Wake Forest University Baptist Medical Center
full access: PLoS ONE: Ovarian Cyst Fluid of Serous Ovarian Tumors Contains Large Quantities of the Brain Amino Acid N-acetylaspartate
Background
"In
humans, N-acetyl L-aspartate (NAA) has not been detected in other
tissues than the brain. The physiological function of NAA is yet
undefined. Recently, it has been suggested that NAA may function as a
molecular water pump, responsible for the removal of large amounts of
water from the human brain. Ovarian tumors typically present as large
cystic masses with considerable fluid accumulation....."
Arrayit Corporation Reports Strong Surge in Customer Demand for the Company's Leading Edge Life Sciences Microarray Instruments - financial news
Note: in prior new/press releases the Arrayit testing is still seeking FDA (U.S.) approval, this is not the same test as OVA1 which is the test for determining suspicion of ovarian cancer malignancy (search blog for further information on both)
"Arrayit microarrays and instruments offer richer content and greater sensitivity than competing platforms, and these attributes have allowed us to discover the world's only definitive pre-symptomatic biomarkers for ovarian cancer and Parkinson's Disease, as well as a new pharmaceutically important pathway in human biology that will be the subject of future announcements."
Cancer Diagnostics - Onko-Sure
Cancer Diagnostics
Our Onko-Sure™ in vitro diagnostic test enables physicians and their patients to effectively monitor and/or detect solid tumor cancers by measuring the accumulation of specific breakdown products in the blood called Fibrin and Fibrinogen Degradation Products (FDP). Onko-Sure™ is a simple, non‐invasive blood test used for the detection and/or monitoring of 14 different types of cancer including: lung (Oncologystat.com), breast, stomach, liver, colon, rectal, ovarian, esophageal, cervical, trophoblastic, thyroid, malignant lymphoma, and pancreatic. Onko-Sure™ can be a valuable diagnostic tool in the worldwide battle against cancer, the second leading cause of death worldwide. Onko-Sure™ serves the IVD cancer/oncology market which, according to Bio-Medicine.org is growing at an 11% compouned annual growth rate.
Onko-Sure™ is sold as a blood test for cancer in Europe (CE Mark certified), India, Taiwan, Korea, Vietnam, and in Chile (research use); approved in the U.S. for the monitoring of colorectal cancer (CRC); approved in Canada (by Health Canada) for lung cancer detection and lung cancer treatment monitoring; and in many key markets, has the significant potential to be used as a general cancer screening test.
MOHLTC - Nurse Practitioner-Led Clinics
Call for Applications – Wave 3
In announcing the Wave 3 Call for Applications, the Ministry is now accepting submissions to award the remaining 14 Nurse Practitioner-Led Clinics. The Ministry will receive applications until Friday, June 25, 2010. All applications must be received by 5:00 p.m. Friday, June 25, 2010. Late applications will not be considered...."
The role of cytoreductive surgery for non-genital tract metastatic tumors to the ovaries.
Abstract
OBJECTIVE: The aim of this study was to investigate prognostic factors of patients with metastases to the ovaries from non-genital organs.
STUDY DESIGN: From September 1994 to December 2006, 158 patients with pathologically confirmed metastatic tumors to the ovaries at Samsung Medical Center (SMC) were included in this study. The data were obtained from the patients' medical records and pathology reports.
RESULTS: The primary tumor origin was mostly stomach (73 cases) and colon (61 cases). Krukenberg tumor (pathologically proven signet ring cell carcinoma) was found in 34 cases: stomach (25), colon (2), appendix (1), and unknown (6). ....However, age, bilateral tumors, chronology of diagnosis and mass size did not affect survival.
CONCLUSION: Cytoreductive surgery and post-operative adjuvant chemotherapy had a beneficial effect on survival in selected patients.
amednews: Specialty societies set new policy on drug company influence :: May 10, 2010
Note: these policies address only drug company influences
Medical News: Cancer Costs Double in Less than 20 Years - in Public Health & Policy, General Professional Issues
Note: over the past many years, the cost factors (no matter the country/politics) have formed a large part of cancer research, the one part which is always missing is what if it's me....IMHO obviously
full free access: (breast cancer)Tailored targeted therapy for all: a realistic and worthwhile objective against
"Targeted therapy for breast cancer was actually used, albeit unwittingly, as early as the late 1800s. Beatson first surgically removed the ovaries of women to treat metastatic breast cancer in 1896......"
Sunday, May 09, 2010
Ontario doctor learning new lessons as a patient -media article
"...For Dr. Sutherland, becoming a patient has taught him new lessons as a doctor. "I have learned many things as a patient – some good things and some bad things.."
Saturday, May 08, 2010
Clinical Care Options Oncology - Research Update on PARP Inhibition: Emerging Data in Breast, Ovarian, and Other Cancers - Virtual Presentation
Note: free access/register
| Research Update on PARP Inhibition: Emerging Data in Breast, Ovarian, and Other Cancers | |||
|
In this Interactive Virtual Presentation, William J. Gradishar, MD, FACP,
reviews the mechanism of PARP inhibition and its rationale as a
therapeutic pathway and describes recent data using novel PARP
inhibitors.
To begin this Interactive Virtual Presentation, click here.
Downloadable Slideset
The slideset that accompanies this Interactive Virtual Presentation is available for use as a self-study resource or in your own noncommercial talks. To download, click here.
This CME-certified Interactive Virtual Presentation is located online at:
http://clinicaloptions.com/Oncology/Treatment%20Updates/PARP%20Inhibition.aspx | ||
full access: Tumor Angiogenesis: Insights and Innovations (not specific to ovarian cancer)
"These two ongoing theories showcase the current problems in the field of antiangiogenic research in cancer. After several years of clinical trials, it appears that targeting one angiogenic factor is not enough to permanently halt neovascularization in most tumors. Although these results were initially disheartening, they also opened up the possibility of other angiostatic therapies.
Many clinical trials now use existing chemotherapeutic drugs or radiation along with antiangiogenic drugs. This two-front attack has had more
success than antiangiogenic drugs or chemotherapy alone in a majority of patients."
Decreased severity of ovarian cancer and increased survival in hens fed a flaxseed-enriched diet for 1 year
ConclusionsThese findings show that 10% flaxseed supplementation for 1 year in the laying hen results in a significant reduction in the severity of ovarian cancer, but no change in the incidence of the disease. Hens fed flaxseed had overall better health and reduced mortality. These findings may provide the basis for a clinical trial that evaluates the efficacy of flaxseed as a chemosuppressant of ovarian cancer in women.
Study Finds Breast Cancer Metastasis Increases After Estrogen And Progestin Hormone Therapies
Note: a second study published in Menopause/postmenopausal women/preclinical study
"Although Hyder said that the study was independent of whether or not the ovaries were intact, it's still unclear whether progestins have the same effects in pre-menopausal women.
"Especially if there's a family history of breast cancer, it's advisable not to take progestins. It's a difficult call that must be made on an individual basis by a physician," Hyder said...."
Friday, May 07, 2010
PMH breast cancer researchers link ovarian hormone to breast stem cells growth
Note: easier to read Medscape article from previous blog post
"Cancer researchers at Princess Margaret Hospital (PMH) have discovered that the ovarian hormone progesterone plays a pivotal role in altering breast stem cells, a finding that has important implications for breast cancer risk.......The findings, published online today in Nature (10.1038/nature09091; http://dx.doi.org/), are significant because reproductive history is among the strongest risk factors for breast cancer, says principal investigator Rama Khokha, a molecular biologist at Ontario Cancer Institute and the Campbell Family Cancer Research Institute, PMH. Other major known risk factors are age, genetics and breast density."
Risk Tools Limited in Their Ability to Predict Development of Breast Cancer including Editorial Comment
Article:
....Major Limitations Exist
According to the researchers, these models each have major limitations. Most notable is that the models rely on known risk factors, given that up to 60% of breast cancers occur in the absence of known risk factors. In addition, with the exception of the Gail model, these tools have not been well validated, and they also do not include nonhereditary risk factors. However, even the Gail model has limited ability to discriminate between individuals at risk, especially those in higher-risk groups, according to the study authors.
To date, no existing model is "totally able to discriminate between families that do and do not have mutations or between women who will and will not develop breast cancer," they write. "Steady and incremental improvement in the models are being made, but these changes require revalidation."
Other risk factors, such as mammographic density, weight gain, and serum steroid hormone measurements, are being considered for inclusion in the existing models. Studies are underway to determine if these factors are feasible and will improve breast cancer risk prediction, according to the study authors.
Editorial: Models Differ in Details
"The authors have provided a useful survey of the literature and have presented an informative summary of the risk factors used in various models," write Mitchell Gail, MD, PhD, and Phuong Mai, MD, from the National Cancer Institute, in a related editorial. Drs. Gail and Phuong caution, however, that the various models differ in important details and that physicians need to be cognizant of these differences.
"Promising directions include incorporating mammographic density, information on genotype or regulation of gene expression ... and more refined use of pathology data and biomarker data from biopsy samples," the editorialists add.
Clinical Significance of Microsatellite Instability in Sporadic Epithelial Ovarian Tumors
Abstract: CONCLUSION: MSI was infrequent in ovarian tumors, including both borderline and malignant tumors. MSI was found to be uncommon in sporadic ovarian tumors, even by using additional MSI markers. The clinical significance of MSI is not strong in patients with sporadic ovarian tumors.
Link to full text (pdf file):
DISCUSSION
....MSI is caused by mutations in the mismatchrepair genes (MMR). MSI has been implicated in the pathogenesis of colon, endometrial, and gastric
carcinomas that occur in the setting of HNPCC (Lynch Syndrome), and also in a subset of sporadic cancers such as upper urinary tract, stomach, colon, andendometrial carcinomas.
In ovarian cancers, the reported incidence of MSI ranges from 0 to 37%, depending on the number and type of markers. Sood et al. first
reported the incidence of MSI in ovarian cancer using the NCI criteria.....Therefore, further study of molecular events that are correlated with ovarian tumors is needed."
JNCI podcast: re: recent frutis/vegetable/cancer risk study
Note: scroll down the page - the link as below will automatically start
"JNCI Interview: Dr. Regina Ziegler discusses a large study suggesting that fruits and vegetables are associated with only a modest reduction in cancer risk."
Thursday, May 06, 2010
Progesterone induces adult mammary stem cell expansion : Nature
Note: in research; defining the role of progesterones
"Reproductive history is the strongest risk factor for breast cancer after age, genetics and breast density. Increased breast cancer risk is entwined with a greater number of ovarian hormone-dependent reproductive cycles, yet the basis for this predisposition is unknown..........The emerging role of MaSCs (mammary stem cells) in cancer initiation warrants the study of ovarian hormones in MaSC homeostasis. Here we show that the MaSC pool increases 14-fold during maximal progesterone levels at the luteal dioestrus phase of the mouse."
Assessing Health-Related Quality of Life in Gyneco... [Int J Gynecol Cancer. 2010] - PubMed result
Int J Gynecol Cancer. 2010 May;20(4):664-684.
Assessing Health-Related Quality of Life in Gynecologic Oncology: A Systematic Review of Questionnaires and Their Ability to Detect Clinically Important Differences and Change.
Luckett T, King M, Butow P, Friedlander M, Paris T.
*Psycho-oncology Co-operative Research Group, School of Psychology, daggerCentre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), University of Sydney, Sydney, New South Wales, Australia; double daggerDepartment of Medical Oncology, Prince of Wales Hospital, Sydney, New South Wales, Australia; section signAustralia New Zealand Gynaecological Oncology Group (ANZGOG), Sydney, New South Wales, Australia; and parallelSchool of Psychology, University of Sydney, Sydney, New South Wales, Australia.
Abstract
OBJECTIVES:: Researchers wishing to assess the health-related quality of life (HRQoL) of women with gynecologic cancers have a range of questionnaires to choose from. In general, disease-, treatment-, or symptom-specific questionnaires are assumed to be better able to identify between-group differences (sensitivity) and changes over time (responsiveness) than are cancer-specific or generic questionnaires. However, little work has tested this assumption in oncology. We set out to (a) identify all multidimensional HRQoL questionnaires used in studies with women with gynecologic cancer and (b) evaluate their track records in identifying minimal clinically important differences (MCIDs), with a view to making recommendations. METHODS:: We searched MEDLINE using the term quality of life and each gynecologic cancer type, as well as the names of identified questionnaires. We used 10% of the scale range as the threshold for an MCID. RESULTS:: We identified 1 generic (SF-36/SF-12), 3 cancer-specific (European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire [EORTC QLQ] C30, Functional Assessment of Cancer Therapy-General [FACT-G], and short-form Cancer Rehabilitation Evaluation System [CARES-SF]), and 1 disease-specific (QOL-Ovarian Cancer Patient Version) HRQoL questionnaires and 5 disease-specific (QLQ-OV28, FACT-O for ovarian, QLQ-CX24, FACT-Cx for cervical and FACT-V for vulvar), 1 treatment-specific (FACT and Gynecologic Oncology Group-Ntx for neurotoxicity), and 2 symptom-specific (FACT-Anemia and Functional Assessment of Chronic Illness and Therapy [FACIT]-Fatigue) modules. Twenty-seven articles reported results from 26 studies in which an MCID had been identified. The FACIT's anemia and fatigue subscales were more sensitive, and the neurotoxicity subscale more sensitive and responsive than the FACT-G on at least 1 comparison. However, we found no evidence for superior performance by the FACT-G compared with the SF-36 or EORTC and FACIT disease-specific modules versus the QLQ-C30 and FACT-G. There was also little evidence to favor EORTC versus FACIT questionnaires or vice versa. CONCLUSIONS:: The evidence we reviewed offered little support for the hypothesis that disease-, symptom-, or treatment-specific instruments are more sensitive and responsive than cancer-specific or generic questionnaires. However, conclusions were limited by the small number of head-to-head comparisons available. We summarize the clinical contexts in which each instrument identified an MCID to inform choice of questionnaire(s), sample size calculations, and interpretation of results in future studies.
Atypical identification of Lynch syndrome by immunohistochemistry and microsatellite instability analysis on jejunal adenocarcinoma
Note: abstract/free full text (pdf)
*this case describes a patient with many different cancers in the family including breast cancer, MSH6 deficiency
"LS (Lynch Syndrome) has been traditionally described in terms of earlyonset colorectal and endometrial cancers. Although this remains a confirmed association, we are learning more about the variability of LS and the prevalence of other cancers associated with this condition. The majority of cases of LS are reported to be caused by MLH1 and MSH2 gene mutations, but as evaluation for this condition becomes more widespread and routine in cases beyond the classically reported presentation, it is likely that we will come to find that the prevalence of other mismatch gene mutations is much higher than previously suspected."
Surgical Staging and Treatment of Early Ovarian Cancer: Long-term Analysis From a Randomized Trial -- Trimbos et al., 10.1093/jnci/djq149 -- JNCI Journal of the National Cancer Institute
"Abstract:
A long-term follow-up analysis of the randomized clinical trial Adjuvant Chemotherapy in Ovarian Neoplasm (ACTION) from the European Organization for Research and Treatment of Cancer was undertaken to determine whether the original results with a median follow-up of 5.5 years could be verified after longer follow-up with more events........Thus, completeness of surgical staging in patients with early ovarian cancer was found to be statistically significantly associated with better outcomes, and the benefit from adjuvant chemotherapy appeared to be restricted to patients with nonoptimal surgical staging."
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Commentary:
CONTEXT AND CAVEATS
Prior knowledge
Surgical Staging and Treatment of Early Ovarian Cancer: Long-term Analysis From a Randomized Trial -- Trimbos et al., 10.1093/jnci/djq149 -- JNCI Journal of the National Cancer Institute
Brief Communication
Surgical Staging and Treatment of Early Ovarian Cancer: Long-term Analysis From a Randomized Trial
Affiliations of authors: Department of Gynecology, Leiden University Medical Center, Leiden, the Netherlands (BT); Medisch Centrum Rijnmond Zuid, Rotterdam, the Netherlands (PT); EORTC Data Centre, Brussels, Belgium (PT, CC, KV, AC); Department of Obstetrics and Gynaecology, University of Brescia, Brescia, Italy (SP); Department of Medical Oncology, Erasmus Medical Center, Rotterdam, the Netherlands (MvdB); Department of Medical Oncology, Hospital Universitario San Carlos, Madrid, Spain (AC)
Correspondence to: Baptist Trimbos, MD, PhD, Department of Gynecology, Leiden University Medical Center, POB 9600, 2300RC Leiden, the Netherlands (e-mail: j.b.m.z.trimbos@lumc.nl).
A long-term follow-up analysis of the randomized clinical trial Adjuvant Chemotherapy in Ovarian Neoplasm (ACTION) from the European Organization for Research and Treatment of Cancer was undertaken to determine whether the original results with a median follow-up of 5.5 years could be verified after longer follow-up with more events. In the ACTION trial, 448 patients with early ovarian cancer were randomly assigned, after surgery, to adjuvant chemotherapy or to observation (no further treatment). The original analysis found that adjuvant chemotherapy improved recurrence-free survival but not overall survival and found in a subgroup analysis that completeness of surgical staging was an independent prognostic factor, with better recurrence-free and overall survival among those with complete (optimal) surgical staging. After a median follow-up of 10.1 years, we analyzed the more mature data from the ACTION trial and found support for most of the main conclusions of the original analysis, except that overall survival after optimal surgical staging was improved, even among patients who received adjuvant chemotherapy (hazard ratio of death = 1.89, 95% confidence interval = 0.99 to 3.60; overall two-sided log-rank test P = .05). More cancer-specific deaths were observed among nonoptimally staged patients (40 [27%] of the 147 deaths in the observation arm and 11 [14%] of the 76 deaths in the adjuvant chemotherapy arm) than among optimally staged patients (seven [9%] of the 75 deaths in the observation arm and 11 [14%] of the 76 deaths in the adjuvant chemotherapy arm) (two-sided 
| CONTEXT AND CAVEATS Prior knowledge In the randomized clinical trial Adjuvant Chemotherapy in Ovarian Neoplasm, 448 patients with early ovarian cancer were randomly assigned, after surgery, to adjuvant chemotherapy or to observation. After a median follow-up of 5.5 years, adjuvant chemotherapy was associated with improved recurrence-free survival but not overall survival. In a subgroup analysis, better recurrence-free and overall survival were observed among those with nonoptimal surgical staging than those with optimal staging. Study design Long-term analysis of data from this trial after a median of 10.1 years of follow-up. Contribution The long-term analysis supported most conclusions from the original analysis, except that overall survival after optimal surgical staging was improved, even among patients who received adjuvant chemotherapy. More cancer-specific deaths were observed among nonoptimally staged patients than among optimally staged patients. Implications Completeness of surgical staging among patients with early ovarian cancer was statistically significantly associated with better outcomes, and the benefit from adjuvant chemotherapy was restricted to patients with nonoptimal surgical staging. Limitations The trial was not designed to compare different surgical staging procedures. Patients could not be prospectively stratified by surgical staging category. The study had a limited sample size. Quality of life was not studied. From the Editors |
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