Saturday, May 19, 2012
paywalled: Visit Duration for Outpatient Physician Office Visits Among Patients With Cancer
Visit Duration for Outpatient Physician Office Visits Among Patients With Cancer
Conclusion:
Higher use of performance-based payment mechanisms and capitated arrangements are associated with a decrease in the amount of time physicians spend with their patients with cancer. It is unclear whether shorter visit times impact the quality of medical care provided or whether physicians in these settings have become more proficient in caring for their patients.
paywalled: Meat and fish consumption and risk of pancreatic cancer – results from the european prospective investigation into cancer and nutrition - International Journal of Cancer
Blogger's Note: implications for all cancers/research
Meat and fish consumption and risk of pancreatic cancer – results from the european prospective investigation into cancer and nutrition - Rohrmann - International Journal of Cancer
Conclusion:
Our
results do not support the conclusion of the World Cancer Research Fund
that red or processed meat consumption may possibly increase the risk
of pancreatic cancer. The positive association of poultry consumption
with pancreatic cancer might be a chance finding as it contradicts most
previous findings.
UPDATE: New Website Selling Miracle Mineral Solution Sodium Chlorite Solution Not Authorized for Oral Consumption by Humans
Blogger's Note: the website is still active as of the date of this positing
UPDATE: New Website Selling Miracle Mineral Solution Sodium Chlorite Solution Not Authorized for Oral Consumption by Humans
Information Update
2012-74
May 18, 2012
For immediate release
OTTAWA - Further to our previous communications, Health Canada is advising Canadians that a new website has been identified selling "MMS", also known as Miracle Mineral Solution or Miracle Mineral Supplement. The website is http://www.buymms.biz
When new websites or retailers are identified, Health Canada will continue to update our current list of MMS products. Canadians are advised to monitor this list of affected products for any possible updates.
Health Canada continues to remind Canadians that there are no therapeutic products containing sodium chlorite authorized for oral consumption by humans. MMS may cause serious health problems that include poisoning, kidney failure and harm to red blood cells that reduces the ability of the blood to carry oxygen. Additional health problems may also include abdominal pain, nausea, vomiting, and diarrhoea.
Consumers should consult their health care practitioner if they have used or are using MMS products and report any adverse reaction to Health Canada.
Health Canada has notified distributors identified to date that the sale of sodium chlorite for human consumption is in contravention of the Food and Drugs Act. We have also requested that identified distributors remove product from the Canadian market. As such, this website (http://www.buymms.biz) may or may not be operational. (Blogger's Note: is active)
May 21 Webinar: Steps to Addressing Health Disparities
May 21 Webinar: Steps to Addressing Health Disparities:
Michelle Yeboah of FDA's Office of Minority Health tells how the agency is addressing health disparities among minority populations in America.
Google goes cancer: Researchers use search engine algorithm to find cancer biomarkers
Google goes cancer: Researchers use search engine algorithm to find cancer biomarkers:
The strategy used by Google to decide which pages are relevant for a search query can also be used to determine which proteins in a patient's cancer are relevant for the disease progression. Researchers from Dresden University of Technology, Germany, have used a modified version of Google's PageRank algorithm to rank about 20,000 proteins by their genetic relevance to the progression of pancreatic cancer. In their study, published in PLoS Computational Biology, they found seven proteins that can help to assess how aggressive a patient's tumor is and guide the clinician to decide if that patient should receive chemotherapy or not.
read more
Cancerworld.org: GrandRound - A second opinion, because there’s no second chance
A second opinion, because there’s no second chance
Patients want the option of consulting a second doctor, and the evidence shows that, for a minority of them, treatment decisions have altered significantly as a result. But could granting every patient the legal right to a second opinion tie up precious resources as each one ‘shops around’ in search of the opinion they want to hear?.....
"The fear that many have about ‘upsetting’ their doctor should not be underestimated"
IN SHORT
- Women, especially breast cancer patients, are among the most likely to seek second opinions, probably because of the many different treatment options for breast cancer and its high visibility in the media.
- Computers networks are obvious second opinion enablers. The European Union’s e-Health
- action plan predicts that by 2008 the majority of European health organisations should have the technical capability to provide online teleconsultation services for second opinions and other needs.
- More than a quarter (29%) of US adults reported that they or a member of their family received a second medical opinion from a doctor in the past five years, according to a 2005 Harris Interactive survey. In 30% of these, the diagnosis differed from the original. Another Harris poll in 2006 found that 36% of US adults never get a second opinion and nearly one in ten (9%) ‘rarely or never understand’ their diagnosis.
- Australian researchers have found that ‘Googling’ symptoms on the Internet came up with the right diagnosis in 15 out of 26 cases (reported in the New England Journal of Medicine). At Duke University in the US, medical physicists are using a Google-like approach to compare mammograms with the most highly ranked images returned from a database.
Patient-Centered Outcomes Research Institute PCORI: What Is It? How Does It Work? The Director Explains
PCORI: What Is It? How Does It Work? The Director Explains
In this segment of Medscape One-on-One, Joseph Selby, MD, talks with Eli Adashi, MD, about his new role as head of the Patient-Centered Outcomes Research Institute, its mission, and how physicians might benefit from this institute created under the Affordable Care Act.
excerpt:
"How Does PCORI Differ From the Cochrane Collaboration?
Dr. Adashi: A question you almost certainly have heard before and that some of our viewers almost certainly contemplated has to do with the distinction between PCORI and other undertakings, such as the Cochrane Collaboration and programs that engage in systematic reviews or meta-analysis of data. In what way does PCORI stand out to other efforts? Where is it unique and distinct?
Dr. Selby: I think the most striking difference is that we are a research funding institution. The Cochrane Collaboration collects, disseminates, and guides the creation of evidence syntheses. We will fund some evidence syntheses, but we'll also fund a lot of empirical research, including observational research and randomized comparisons. So, we are a funding institute of substantial size in distinction to, as you mentioned, the Cochrane Collaboration and several European organizations that synthesize data and go beyond synthesis to supporting policymaking.
The other distinguishing characteristic is that we don't make policy; we generate information....
Friday, May 18, 2012
Experts Report Little Certainty in Vitamin D’s Potential Benefits « news@JAMA
Experts Report Little Certainty in Vitamin D’s Potential Benefits « news@JAMA
Conclusions in the statement include the following:
• Topical or oral vitamin D may help treat psoriasis, but more evidence is needed to determine its efficacy in treating other skin disorders or preventing skin cancer.
• No strong evidence exists to support the theory that vitamin D supplements reduce the risk of type 2 diabetes or the metabolic syndrome.
• Clinical trial evidence does not support taking vitamin D supplements to lower cardiovascular disease risk.
• Observational studies linking vitamin D with reduced cancer incidence are strongest for colorectal cancer but weak or inconsistent for breast, prostate, and all cancers combined.
The statement will be published in the June issue of the Endocrine Society’s Endocrine Reviews.
The Disparity of Motivational Drivers in International Health Care Systems
OMICS Publishing Group | Full-text | The Disparity of Motivational Drivers in International Health Care Systems
".......Undeniably, some industrialized countries, particularly in Europe, are far closer to attaining sustainable, universal (timely) healthcare access than others and yet no country can claim perfection.....
An alternative approach to identify women at risk for colorectal cancer. | 2012 ASCO Annual Meeting Abstracts
An alternative approach to identify women at risk for colorectal cancer. | 2012 ASCO Annual Meeting Abstracts
Abstract:
Background:
Hereditary colorectal cancer (CRC) is preventable; however, identification of individuals at sufficiently high risk to warrant heightened surveillance is difficult. Lynch Syndrome (LS) is an inherited cancer syndrome due to germline mutation in a DNA mismatch repair gene. For women with LS, the lifetime risk of endometrial cancer (EC) is 64% and CRC is 54%. Fifty percent of women with LS will present with EC or ovarian cancer prior to CRC. Therefore, women with LS associated EC represent an ideal group for CRC prevention. The optimal method to identify women with LS associated EC is not known. The purpose of this study was to determine the utility of Amsterdam II and Society of Gynecologic Oncology (SGO) Criteria (modified Bethesda criteria that use EC as the sentinel cancer) in identifying women with LS associated EC. Our ultimate goal is to identify women at increased risk of CRC.
Our data suggest that classic clinical screening criteria are inadequate to detect patients with LS who present with EC, potentially missing up to 25% of these patients.
| Gene | MLH1 | MSH2 | MSH6 | PMS2 | Total |
|---|---|---|---|---|---|
| Total number | 14 | 27 | 11 | 7 | 59 |
| Median age at diagnosis (range) | 52 (42-79) |
44 (33-81) |
56 (31-76) |
66 (45-87) |
50 (31-87) |
| Diagnosis at greater than 50 years | 7 | 8 | 9 | 6 | 30 |
| FH CRC | 3 | 16 | 4 | 3 | 26 |
| Amsterdam criteria | 3 | 13 | 0 | 1 | 17 |
| SGO criteria | 11 | 22 | 7 | 4 | 44 |
2012 ASCO Annual Meeting Abstracts (searchable)
2012 ASCO Annual Meeting Abstracts
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paywalled: Lipid Profiles and Risk of Breast and Ovarian Cancer in the Swedish AMORIS Study
WIKI: Lipid metabolism refers to the processes that involve the intercourse and degradation of lipids.
The types of lipids involved include:
- Bile salts
- Cholesterols
- Eicosanoids
- Glycolipids
- Ketone bodies
- Fatty acids - see also fatty acid metabolism
- Phospholipids
- Sphingolipids
- Steroid - see also steroidogenesis
- Triacylglycerols (fats) - see also lipolysis and lipogenesis
Lipid Profiles and Risk of Breast and Ovarian Cancer in the Swedish AMORIS Study
Background:
Obesity is a risk factor for
breast (BCa) and ovarian cancer (OCa); the mechanisms of action are not
completely
understood. Perturbed lipid metabolism often
accompanies obesity; we therefore ascertained the associations between
lipid
components and BCa and OCa risk in a
prospective cohort study.
Methods:
234,494 women with baseline measurements
of triglycerides (TG) and total cholesterol(TC) and glucose were
selected
from the AMORIS database. 27,394 had measurements
of HDL,LDL, apolipoprotein (Apo) B and A-I. Associations between quartiles
and dichotomized values of lipid components and BCa
and OCa risk were analysed using Cox proportional hazard models.
Results:
We identified 6,105 women diagnosed with
BCa and 808 women diagnosed with OCa. A weak trend was observed between
TG and BCa (HR: 1.01 (CI95% 0.94-1.09), 0.93
(0.86-1.00) 0.91
(0.84-0.99) 2nd 3rd and 4th quartiles; P = 0.01).
No other associations between lipid components and risk of BCa or OCa
showed
statistical significance.
Conclusions:
A weak protective association was
found between levels of TG and risk of BCa.
Impact: An analysis including information on tumour
characteristics of OCa and BCa may provide more insight in possible
links
between lipid metabolism and the risk of these
cancers.
paywalled: CT diagnosis of intrasplenic metastasis from ovarian carcinoma
CT diagnosis of intrasplenic metastasis from ovarian carcinoma
We concluded that CT can demonstrate intraparenchymal and infiltrative splenic metastasis in patients with ovarian cancer even in the absence of increased CA 125 levels.
Thursday, May 17, 2012
2012 CDC/NCI report - United States Cancer Statistics (USCS)
Cancer - NPCR - USCS - View Data Online
| The 1999–2008 United States Cancer Statistics (USCS): Incidence and Mortality Web-based Report
marks the tenth time that the Centers for Disease Control and
Prevention (CDC) and the National Cancer Institute (NCI) have jointly
produced official federal cancer incidence statistics for each state
having high-quality cancer data. The report is produced in collaboration
with the North American Association of Central Cancer Registries. This year's report features information on more than one million invasive cancer cases diagnosed during 2008 among residents of all 50 states, six metropolitan areas, and the District of Columbia. Incidence data are from CDC's National Program of Cancer Registries (NPCR) and NCI's Surveillance, Epidemiology and End Results (SEER) Program. Data from population-based central cancer registries in these states and metropolitan areas meet the selected criteria for inclusion in this report. The report also provides cancer mortality data collected and processed by CDC's National Center for Health Statistics (NCHS). Mortality statistics, based on records of deaths that occurred during 2008, are available for all 50 states and the District of Columbia. Report Highlights
United States Cancer Statistics (USCS)View Data Online1999–2008 Cancer Incidence and Mortality DataThis Web-based report includes the official federal statistics on cancer incidence from registries that have high-quality data and cancer mortality statistics for each year and 2004–2008 combined. It is produced by the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute (NCI), in collaboration with the North American Association of Central Cancer Registries (NAACCR). |
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Cancer Data by Statepaywalled: Presence of a sarcomatous component outside the ovary is an adverse prognostic factor for primary ovarian malignant mixed mesodermal/mullerian tumors: a clinicopathologic study of 47 cases
Blogger's Note: also known by short form MMMT
Abstract
Primary ovarian malignant mixed mesodermal tumors are uncommon. There exist few data in the literature on the significance of the sarcomatous (sarcoma) component (SC) in these tumors. Here we investigated this aspect in 47 such tumors, with particular interest in whether the presence of SC outside the ovary confers a worse prognosis. .......................We advocate listing the specific extraovarian tumor component (SC and/or CC) in the pathology report for primary ovarian malignant mixed mesodermal tumors.Gamma knife surgery for brain metastases from ovarian cancer.
numerous tables including:
Table 1 Patient characteristics of 16 patients with 119 brain metastases
Conclusions
Brain metastases from ovarian cancer are
rare, but their incidence is increasing as patient survival has been
extended by
successful platinum-based chemotherapy and improved
imaging techniques have enabled the identification of smaller lesions.
In our study, the median survival from brain metastases
was 12.5 months, and the local control rate was 86.4 %. The KPS and
total volume of brain metastases were important factors
predictive of survival. Our results suggest that GKS is an acceptable
therapy for brain metastases from ovarian cancer.
Conflicts of interest
None.
Open Access
update March 15th Grants.gov - Find Grant Opportunities - Opportunity Synopsis
Grants.gov - Find Grant Opportunities - Opportunity Synopsis
The synopsis for this grant opportunity is detailed below, following this paragraph. This synopsis contains all of the updates to this document that have been posted as of 03/15/2012 . If updates have been made to the opportunity synopsis, update information is provided below the synopsis.....
News : Many Primary Care Docs Don't Know Long-Term Effects of Chemo: Survey
Blogger's Note: general/non-ovarian cancer specific
HON - News : Many Primary Care Docs Don't Know Long-Term Effects of Chemo: Survey
"....The findings highlight the need for more communication between the different doctors involved in a patient's care, one expert stressed.
The burden of that communication lies not only with doctors (oncologists and primary care physicians) but also with patients, said Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City.....
paywalled- Gynecologic Oncology - Response to: “Management of ovarian cancer has changed”
ScienceDirect.com - Gynecologic Oncology - Response to: “Management of ovarian cancer has changed”
In Press, Accepted Manuscript, Available online 15 May 2012
Joyce N. Barlin, Dennis S. Chi
Close preview |
Related articles | Related reference work articles Abstract - No abstract is available for this article.
paywalled - Gynecologic Oncology - Comparison of ERCC1/XPF genetic variation, mRNA and protein levels in women with advanced stage ovarian cancer treated with intraperitoneal platinum
ScienceDirect.com - Gynecologic Oncology - Comparison of ERCC1/XPF genetic variation, mRNA and protein levels in women with advanced stage ovarian cancer treated with intraperitoneal platinum
Abstract
Objective
Approximately 20% of patients receiving platinum-based chemotherapy for epithelial ovarian cancer (EOC) are refractory or develop early recurrence. Identifying these patients early could reduce treatment-associated morbidity and allow quicker transfer to more effective therapies. Much attention has focused on ERCC1 as a potential predictor of response to therapy because of its essential role in the repair of platinum-induced DNA damage. The purpose of this study was to accurately measure protein levels of ERCC1 and its essential binding partner XPF from patients with EOC treated with platinum-based therapy and determine if protein levels correlate with mRNA levels, patient genotypes or clinical outcomes.Methods
ERCC1 and XPF mRNA and protein levels were measured in frozen EOC specimens from 41 patients receiving intraperitoneal platinum-based chemotherapy using reverse transcription polymerase chain reaction and western blots. Genotypes of common nucleotide polymorphisms were also analyzed. Patient outcomes included progression free (PFS) and overall survival (OS).Results
Expression of ERCC1 and XPF were tightly correlated with one another at both the mRNA and protein level. However, the mRNA and protein levels of ERCC1 were not positively correlated. Likewise, none of the SNPs analyzed correlated with ERCC1 or XPF protein levels. There was an inverse correlation between mRNA levels and patient outcomes.Conclusion
Neither genotype nor mRNA levels are predictive of protein expression. Despite this, low ERCC1 mRNA significantly correlated with improved PFS and OS.
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