abstract: A hypofractionated radiotherapy regimen (0-7-21) for advanced gynaecological cancer patients.

Abstract

AIMS:

To evaluate the efficacy of a palliative three fraction radiation regimen delivered on days 0, 7 and 21 (0-7-21 regimen) for advanced stage gynaecological cancer patients.

MATERIALS AND METHODS:

Fifty-one patients with advanced gynaecological cancer who were treated with the 0-7-21 regimen between 1998 and 2008 were identified. The median follow-up period was 1.4 months (range 0.2-33.4). Treatment completion data, symptomatic response, toxicity and survival were retrospectively analysed.

RESULTS:

Forty-eight patients received at least two of the three planned fractions. Complete and partial responses of vaginal bleeding were seen in 92% of 26 evaluable patients. Complete and partial responses of pain were seen in 76% of 25 evaluable patients. Eighteen of the 33 evaluable patients experienced grade 1/2 acute toxicity. No patients experienced grade 3/4 toxicity. Grade 1/2 and grade 3 late toxicity occurred in four and one of 12 evaluable patients, respectively. Grade 5 toxicity was assigned in two patients. It was uncertain whether these deaths were radiation related or due to tumour progression. Eleven patients survived longer than 12 months.

CONCLUSIONS:

The 0-7-21 regimen provided effective and rapid symptomatic relief with acceptable toxicity, and offered the advantage of convenience for most patients. It offers an alternate treatment option for carefully selected patients with incurable gynaecological malignancies.

CDC (U.S.) - Gynecologic Cancers - Inside Knowledge Campaign update Sept 2010

Inside Knowledge Campaign

CDC, in collaboration with the Department of Health and Human Services' Office on Women's Health, established the Inside Knowledge: Get the Facts About Gynecologic Cancer campaign to raise awareness of the five main types of gynecologic cancer: cervical, ovarian, uterine, vaginal, and vulvar. (A sixth type of gynecologic cancer is the very rare fallopian tube cancer.) When gynecologic cancers are found early, treatment is most effective. It is important for women to pay attention to their bodies and know what is normal for them so they can recognize the warning signs of gynecologic cancers.

Strategies for Survival - Gynecologic Cancer Conference - Regina, Saskatchewan Sept 24th

click: Registration

September 24th: Gynecologic Cancer Conference: Strategies for Survival - Conference Information | Online Registration by Cvent

Menopause, hormone replacement and gynaecological cancers -- Menopause International

Note: abstract, full access via subscription ($$$)

Reviews

Menopause, hormone replacement and gynaecological cancers

Lynsey Hinds and John Price
Belfast City Hospital, Northern Ireland
Correspondence: Dr Lynsey Hinds, 1 Strawhill Manor, Donaghcloney, Belfast BT66 7GH Northern Ireland. Email: hindslynsey@hotmail.co.uk
 
Approximately 18,000 women are diagnosed with a gynaecological cancer in the UK each year. Predisposing risk factors for some of these gynaecological cancers include an early menarche/late menopause and hormone replacement therapy (HRT). Furthermore, treatment of gynaecological malignancies often induces an iatrogenic menopause, which may be more severe than a natural onset. HRT is an extremely effective treatment that may dramatically improve physical and psychological symptoms and ultimately quality of life in patients with cancer. However, the safety of using HRT in patients with gynaecological cancer is a controversial issue and not entirely clear. The main concern is the theoretical risk of the stimulation of residual cancer cells by estrogen replacement. The review of the evidence in this article found that for most gynaecological cancers this hypothesis was not proven. No study to date has found HRT to have a detrimental effect on survival in patients with early stage endometrial cancer, epithelial ovarian cancer, cervical cancer and vulval tumours. HRT is only an absolute contraindication in low-grade endometrial stromal sarcomas and is best avoided in granulosa cell ovarian tumours. Therefore, HRT should not be withheld in the majority of patients with gynaecological cancer. If quality of life is being adversely affected by symptoms of the menopause, then patients with cancer should be counselled regarding the known risks and benefits of HRT to enable them to make an informed decision on their treatment.

Partners of long-term gynaecologic cancer survivors: Psychiatric morbidity, psychosexual outcomes and supportive care needs (abstract)

Objective

To describe long-term psychological morbidity, unmet supportive care needs, positive changes, sexual outcomes and relationship satisfaction in partners of gynaecologic cancer survivors, as compared with respective survivors.

Method

Self-report measures were administered to a cross-sectional sample of 68 partners recruited via patient survivors.

Conclusion

The majority of partners reported excellent sexual outcomes and little perceived change since the survivors' diagnosis. The association between unmet needs and psychological morbidity suggests a useful target for further intervention. Despite methodological limitations, these data are novel and present a starting point for further investigation to improve outcomes for survivors and partners.

OvaGene Oncology Opens New Innovative Gynecologic Cancer Laboratory and Research Facility (California) financial news

website: www.ovagene.com

(molecular diagnostics)

CHUM (Montreal) turns cancer patients away

"The crisis at Notre Dame Hospital, a renowned cancer treatment centre, has reached such acute proportions that hospital officials are sending letters to women diagnosed with gynecological cancer to seek treatment elsewhere – in hospitals in Quebec City and Trois Rivières....."

"In fit of anger, (Dr.) Sauthier penned an open letter to his colleagues accusing the Quebec Health Department, the Quebec College of Physicians and his hospital of ignoring best practices in favour of balancing the books.

"Ovarian cancer survivor Suzanne Poulet read Sauthier’s letter aloud after Health Minister Yves Bolduc lauded his department’s successes inbreast and colon cancer screening programs as well as anti-smoking legislation. “What about problems operating on women with gynecological cancer?” Poulet demanded. Such delays are “intolerable” and “unacceptable,” Bolduc responded. “It’s an emergency and we are in the process of fixing it.”

Read more: http://www.montrealgazette.com/health/CHUM+turms+cancer+patients+away/2945070/story.html#ixzz0lzEiOwCF

Strength in Numbers | Canadian Women's Health Network

Strength in Numbers

Project plans to unite support services for women with breast and reproductive cancers
By Jane Shulman

Cancer support networks in different parts of the country are looking at grouping women’s gynaecological cancers with breast cancer for the purpose of offering more support to women who have had a cervical, ovarian or uterine cancer diagnosis. Manitoba has been working on this for some time, explains Barbara Clow, director of the Atlantic Centre of Excellence for Women’s Health, and now New Brunswick and Newfoundland and Labrador are looking at their own models for delivering programming under the same umbrella.

In a 2008 report for Canadian Partnership Against Cancer, called “Where Do We Go From Here? Support services for women with breast, cervical, ovarian and uterine cancer in Atlantic Canada,” Clow and co-authors looked at the idea of merging services to meet the needs of the underserved gynaecological cancer population.

The idea is not without its detractors. Some have expressed concern that breast cancer groups might jeopardize their funding or lose their identity if they expand their mandate, or stretch their already overextended resources.

But the focus on breast cancer over the past several years, with fundraisers and awareness campaigns popping up all over the country, means that the disease has a lot of attention, and Clow notes that it’s the kind of attention that gynaecological cancers desperately need. While she says that fewer women are diagnosed with cervical, ovarian and uterine cancers combined than breast cancer in Canada each year, with the exception of cervical cancer, their prognosis is not as good. And the psychosocial support specific to their kind of cancer just does not exist.

Clow cites the work of volunteer-based Ovarian Cancer Canada as the only national gynaecologically-based cancer group. There are no national groups for people with cervical or uterine cancer. The needs are different, but there’s overlap, which is why a program that pools resources for cancers that affect women is so appealing.

The report recommendations included:
Foster new research on the needs of women from vulnerable and disadvantaged communities who are faced with a diagnosis of cancer;

Explore the possibility of adopting and adapting the processes and products developed by breast cancer support networks in Atlantic Canada to meet the needs of those with other women’s cancers;

Promote the creation of publicly funded cancer patient navigator programs throughout Atlantic Canada.

Clow says the next step is to look at how feasible this idea is, and where the desire lies. So far, nurses and service providers involved with the planning and delivering of programming are most passionate about it because they see the possibilities that lie in making the most of the services they can offer.

Jane Shulman is a the Director of Knowledge Exchange at the Canadian Women’s Health Network and a former staff member of Breast Cancer Action Montreal

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.