abstract: How to follow-up patients with epithelial ovarian cancer : Current Opinion in Oncology

How to follow-up patients with epithelial ovarian cancer
Miller, Rowan E; Rustin, Gordon JS

Abstract

Purpose of review: Despite optimal primary treatment most patients with advanced epithelial ovarian cancer will relapse. This review discusses the controversy regarding surveillance and the timing of treatment for recurrent disease.

Recent findings: Routine physical examination has a limited role in the detection of recurrent ovarian cancer. PET/computed tomography (CT) has been shown to be useful in detecting small volume disease not apparent on traditional imaging in patients with suspected recurrence based on symptoms and/or rising CA125. The results of PET/CT can alter treatment plans and have particular use in guiding site-directed therapy. The benefits of early detection and systemic treatment of recurrence are now in doubt following the presentation of the MRC/EORTC CA125 surveillance trial. The impact on survival of secondary cytoreductive surgery requires more investigation.

Summary: Uncertainties remain in the surveillance and timing of treatment for relapsed disease. Patients should be informed of these uncertainties and become involved in decisions regarding their follow-up.

Canada playing in wrong health league - Michael Rachlis

Note: article relates to the  U.S.-based Commonwealth Fund report of June 25th, 2010 (see prior blog post); this was not the first Commonwealth Fund analysis which compared different countries on a variety of indices with Canada and the U.S. coming in dead last in overall rankings.

"The report compared Canada with other countries 18 times in the text. These included two favourable comparisons and 16 unfavourable ones, including indictments for long waits, the poor management of chronic conditions (like diabetes), the lack of electronic systems, poor care coordination and the failure to involve patients in decisions about their care."
Dr. Michael Rachlis is a health policy analyst and an associate professor at the University of Toronto.

Healthcare Events UK (London): Patient Involvement and Empowerment May 2010