Thursday, November 01, 2012
Gynecologic Oncology Case Reports - A case of small cell carcinoma of the ovary hypercalcemic variant in a teenager
Gynecologic Oncology Case Reports - A case of small cell carcinoma of the ovary hypercalcemic variant in a teenager
Highlights
►
Young women with hypercalcemic type small cell ovarian cancer face a
poor prognosis.
► Tumors respond to multi-agent chemotherapy, although rapid recurrence is typical.
► Using updated immunohistochemical staining patterns, this tumor can be identified.
► Tumors respond to multi-agent chemotherapy, although rapid recurrence is typical.
► Using updated immunohistochemical staining patterns, this tumor can be identified.
open access - Gynecologic Oncology Case Reports - Management of a skin metastasis in a patient with advanced ovarian cancer
Gynecologic Oncology Case Reports - Management of a skin metastasis in a patient with advanced ovarian cancer
Highlights
►
Skin metastasis of ovarian cancer is rare, often nodular in appearance,
and conveys a poor prognosis.
► This patient developed an unusual maculo-papular rash which was biopsy-proven to be metastatic endometrioid adenocarcinoma.
► Pruritic symptoms from skin metastases should be palliated; SSRIs, local radiation, and topical creams all may play a role.
► This patient developed an unusual maculo-papular rash which was biopsy-proven to be metastatic endometrioid adenocarcinoma.
► Pruritic symptoms from skin metastases should be palliated; SSRIs, local radiation, and topical creams all may play a role.
Gynecologic Oncology Case Reports - Destructive T10 Vertebral Lesion Leads to Diagnosis of Metastatic Ovarian Cancer
Gynecologic Oncology Case Reports - Destructive T10 Vertebral Lesion Leads to Diagnosis of Metastatic Ovarian Cancer
Highlights
►
Ovarian cancer presents as thoracic vertebral lesion in the absence of
gross abdominal disease
► Bilateral salpingo-oophorectomy with surgical resection of vertebral lesion leaves patient with no clinical evidence of disease
► Ovarian cancer can present as vertebral metastases in the absence of pelvic or abdominal metastatic disease
► Bilateral salpingo-oophorectomy with surgical resection of vertebral lesion leaves patient with no clinical evidence of disease
► Ovarian cancer can present as vertebral metastases in the absence of pelvic or abdominal metastatic disease
Mutant Tumor Suppressor Gene ID’d in Mucinous Ovarian Tumors
Mutant Tumor Suppressor Gene ID’d in Mucinous Ovarian Tumors
Mutant Tumor Suppressor Gene ID’d in Mucinous Ovarian Tumors
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NIH study uncovers new mechanism of action for class of chemotherapy drugs (PARP inhibitors) - pharma news
NIH study uncovers new mechanism of action for class of chemotherapy drugs | Pharmaceutical Processing
"...When the researchers tested three PARP inhibitors for their differential ability to trap PARP proteins on damaged DNA, they found that the trapping potency of the inhibitors varied widely. "Critical to our research is that, while PARP inhibitors had been assumed to be of equivalent potency based on the degree to which they elicit PARP inhibition, we now know that they are not equivalent with respect to their potency to trap PARP," .....
Azaya ramps up effort to produce generic cancer drug - San Antonio Business Journal (ATI-0918/doxil)
Azaya ramps up effort to produce generic cancer drug - San Antonio Business Journal
"Azaya Therapeutics is conducting a study of a generic version of a popular drug used to treat ovarian cancer. The company hopes that drug will fill a gap in the market next year.
Azaya’s drug is currently known as ATI-0918, but it is essentially a generic copy of the drug Doxil. The company that was producing Doxil recently shut down its manufacturing operation and this has led to a worldwide shortage of the drug for ovarian and breast cancer patients.....
Ontario, city of Toronto to help victims of superstorm Sandy
"Ontario, city of Toronto to help victims of superstorm Sandy ".
This article is on the Web at:
http://www.680news.mobi/article.aspx?content_id=417455
Privately owned genetic databases may hinder diagnosis and bar the way to the arrival of personalized medicine
Privately owned genetic databases may hinder diagnosis and bar the way to the arrival of personalized medicine
Public release date: 31-Oct-2012
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Contact: Mary Rice
mary.rice@riceconseil.eu
European Society of Human Genetics
Privately owned genetic databases may hinder diagnosis and bar the way to the arrival of personalized medicine
The European Society of Human Genetics reacts to today’s report in the European Journal of Human Genetics
In response to the on-line publication by the European Journal of Human Genetics today (Wednesday) of an article by US researchers led by Dr. Robert Cook-Degan, a former member of the US Office of Technology Assessment, showing that Myriad Genetics, providers of the BRCA1/2 genetic test in the US, has amassed vast quantities of clinical data without sharing it, Professor Martina Cornel, chair of the European Society of Human Genetics' Professional and Public Policy committee, said:"We are very concerned that such important data is being withheld from those who most need it. Interpreting the variants of unknown significance (VUS) that may be found on analysing the patient's genome plays an essential part in being able to provide proper counselling and if necessary, preventive or therapeutic guidance. By not sharing their data on the VUS obtained from individuals undergoing BRCA1/2 testing, where Myriad is the sole commercial provider of a test in the US, geneticists have been unable to develop the up-to-date algorithms that are necessary to best interpret the effects of genetic variants. While Myriad has access to public databases in order to help interpret their VUS results, this is currently not reciprocal.
"We know that, regrettably, medical geographic inequities are common, but what is particularly worrying about this situation is that it is the first time that such inequities have been based on a lack of access to clinical information, rather than lack of a product. Myriad's stated aim to enter the European market more vigorously may lead to unfair competition with academic institutions for predictive precision. It is vital that progress towards personalised medicine, which holds out so much promise, is not hindered by companies maintaining private genomic databases. Policymakers should take an urgent look at the regulatory and reimbursement issues involved in genomic testing in order for all the data that is essential to understanding the clinical significance of VUS to be made public, to the benefit of patients and healthcare providers alike."
Comparison Of Methods To Estimate Health State Utilities For Ovarian Cancer Using Quality of Life Data: A Gynecologic Oncology Group Study
Comparison Of Methods To Estimate Health State Utilities For Ovarian Cancer Using Quality of Life Data: A Gynecologic Oncology Group Study
Abstract
Highlights
►
Cost analyses of ovarian cancer treatment could be biased if estimation
methods are used to measure quality-adjusted life years.
► Comparisons of several utility-estimation methods found significant differences (p<0.001) between the utility values from these methods.
► There's a need to validate utility estimation methods before they can be recommended for cost analyses in ovarian cancer.
► Comparisons of several utility-estimation methods found significant differences (p<0.001) between the utility values from these methods.
► There's a need to validate utility estimation methods before they can be recommended for cost analyses in ovarian cancer.
Background
Cost-effectiveness/cost-utility
analyses are increasingly needed to inform decisions about care.
Algorithms have been developed using the Functional Assessment of Cancer
Therapy (FACT) quality of life instrument to estimate utility weights
for cost analyses. This study was designed to compare these algorithms
in the setting of ovarian cancer.
Methods
GOG-0152
was a 550-patient randomized phase III trial of interval cytoreduction,
and GOG-0172 was a 415-patient randomized phase III trial comparing
intravenous versus intraperitoneal therapy among women with advanced
ovarian cancer. QOL data were collected via the FACT at four time points
in each study. Two published mapping algorithms (Cheung and Dobrez) and
a linear transformation method were applied to these data. The
agreement between measures was assessed by the concordance correlation
coefficient (rCCC), and paired t-tests were used to compare means.
Results
While agreement between the estimation algorithms was good (ranged from 0.72 to 0.81), there were statistically significant (p< 0.001)
and clinically meaningful differences between the scores: mean scores
were higher with Dobrez than with Cheung or the linear transformation
method.. Scores were also statistically significantly different
(p<0.001) between studies.
Conclusions
In
the absence of prospectively collected utility data, the use of mapping
algorithms is feasible, however, the optimal algorithm is not clear.
There were significant differences between studies, which highlights the
need for validation of these algorithms in specific settings. If cost
analyses incorporate mapping algorithms to obtain utility estimates,
investigators should take the variability into account.
Wednesday, October 31, 2012
(2011) Oral contraceptive use and reproductive factors and risk of ovarian cancer in the European Prospective Investigation into Cancer and Nutrition
Oral contraceptive use and reproductive factors and riskof ovarian cancer in the European Prospective Investigationinto Cancer and Nutrition
Background:
It
is well established that parity and use of oral contraceptives reduce
the risk of ovarian cancer, but the associations with other reproductive
variables are less clear.
Methods:
We
examined the associations of oral contraceptive use and reproductive
factors with ovarian cancer risk in the European Prospective
Investigation into Cancer and Nutrition. Among 327
396
eligible women, 878 developed ovarian cancer over an average of 9
years. Hazard ratios (HRs) and 95% confidence intervals (CIs) were
estimated using Cox proportional hazard models stratified by centre and
age, and adjusted for smoking status, body mass index, unilateral
ovariectomy, simple hysterectomy, menopausal hormone therapy, and
mutually adjusted for age at menarche, age at menopause, number of
full-term pregnancies and duration of oral contraceptive use.....
396
eligible women, 878 developed ovarian cancer over an average of 9
years. Hazard ratios (HRs) and 95% confidence intervals (CIs) were
estimated using Cox proportional hazard models stratified by centre and
age, and adjusted for smoking status, body mass index, unilateral
ovariectomy, simple hysterectomy, menopausal hormone therapy, and
mutually adjusted for age at menarche, age at menopause, number of
full-term pregnancies and duration of oral contraceptive use.....J&J restoring cancer drug supply to EU patients - CBS News
J&J restoring cancer drug supply to EU patients - CBS News
J&J restoring cancer drug supply to EU patients
TRENTON, N.J. — Johnson & Johnson is making more headway in restoring supplies of a crucial cancer drug unavailable to many patients since the contract manufacturer producing it, Ben Venue Laboratories, shut down a year ago due to serious contamination and other quality problems at its Ohio factory.Access to Doxil, or Caelyx as it's called in the European Union and some other places, had been limited to existing patients since last fall amid dwindling supply. The drug treats advanced breast and ovarian cancers, the bone marrow cancer multiple myeloma and Kaposi's sarcoma, a blood vessel cancer. For many patients, it was the only effective option......
U.S. National Vital Statistics Report: Deaths: Preliminary Data for 2011 - open access
Introduction
This report presents preliminary mortality data for the United States based on vital records for a substantial proportion of deaths occurring in 2011. Statistics in preliminary reports are generally considered reliable; past analyses reveal that most statistics shown in preliminary reports were confirmed by the final statistics for each of those years (1-3).
Malignant neoplasm of ovary (C56)
2011 - 14,312
2010 - 14,572
The 15 leading causes of death in 2011 (Table B) were as follows:
1
Diseases of heart
2
Malignant neoplasms
3
Chronic lower respiratory diseases
4
Cerebrovascular diseases
5
Accidents (unintentional injuries)
6
Alzheimer’s disease
7
Diabetes mellitus
8
Influenza and pneumonia
9
Nephritis, nephrotic syndrome and nephrosis
10
Intentional self-harm (suicide)
11
Septicemia
12
Chronic liver disease and cirrhosis
13
Essential hypertension and hypertensive renal disease
14
Parkinson’s disease
15
Pneumonitis due to solids and liquids
The Massachusetts Health Care Reform Experiment: A Success « news@JAMA
The Massachusetts Health Care Reform Experiment: A Success « news@JAMA
To some extent, the Affordable Care Act (ACA) is based on the “Massachusetts experiment,” the health care legislation passed by the state in 2006, leading politicians on both sides of the political aisle to claim it as a success or failure. Supporters assert that the legislation resulted in nearly universal health insurance coverage in Massachusetts. Detractors point out that the quality of coverage may be suboptimal and its costs are exorbitant. Both sides have overstated their cases.....
press release: CANADIAN ORGANIZATION FOR RARE DISORDERS (CORD) | Canadian Organization for Rare Disorders Welcomes Announcement of Orphan Drug Framework
CANADIAN ORGANIZATION FOR RARE DISORDERS (CORD) | Canadian Organization for Rare Disorders Welcomes Announcement of Orphan Drug Framework
The announcement reverses a 16-year-old Health Canada policy denying the need for an Orphan Drug Policy in Canada and comes nearly 30 years after the USA passed the world's first Orphan Drug Act and 12 years after the European Union did the same for its 27 member countries....
A Guide to the Medicaid Appeals Process Prepared by: MaryBeth Musumeci Kaiser Commission on Medicaid and the Uninsured The Henry J. Kaiser Family Foundation
Table of Contents
Executive Summary ...................................................................................................................................... 1
Introduction .................................................................................................................................................. 5
Constitutional Requirements of the Medicaid Appeals Process: Notice and Hearing.............................. 5
Adequate Notice of State Agency Actions ................................................................................................... 7
Hearing Requests and Continuing Benefits Pending Appeal .................................................................... 10
State Agency Hearing Process and Decisions ............................................................................................ 11
Medicaid Managed Care Appeals Process ................................................................................................. 14
MCO Notices of Action ............................................................................................................................ 16
MCO Appeal Requests and Continued Benefits Pending Appeal ............................................................ 18
MCO Appeals Process and Decisions ....................................................................................................... 20
State Fair Hearing Requests by MCO Enrollees ....................................................................................... 21
Looking Ahead ............................................................................................................................................ 25
Monday, October 29, 2012
Another Fake Cancer Cure: Ukrain
Another Fake Cancer Cure: Ukrain:
Edzard Ernst, M.D., Ph.D.
Ukrain is based on two natural substances: alkaloids from the Greater Celandine and Thiotepa. It was developed by Dr Wassil Nowicky who allegedly cured his brother’s testicular cancer with his invention. Despite its high cost of about £50 per injection, Ukrain has become popular in the UK and elsewhere.
Ukrain has its name from the fact that the brothers Nowicky originate from the Ukraine, where also much of the research on this drug was conducted. When I say much, I should stress that I use this word in relative terms. In the realm of “alternative” cancer cures, we often find no clinical studies at all. For Ukrain, however, the situation is refreshingly different; there are a number of trials, and the question is, what do they really tell us?
In 2005, we decided to review all the clinical studies which had tested the efficacy of Ukrain. Somewhat to our surprise, we found 7 randomised clinical trials. Even more surprising, we thought, was the fact that all of them reported baffling cure rates. So, were we excited to have identified a cure for even the most incurable cancers? The short answer to this question is NO.
All of the trials were methodologically weak; but, as this is not uncommon in the area of alternative medicine, it did not irritate us all that much. Far more remarkable was the fact that these studies seemed to be odd in several other ways.
Their results seemed too good to be true; all but one trial came from the Ukraine where research governance might have been less than adequate. The authors of the studies seemed to overlap and often included Nowicky himself. They were published in only two different journals of little impact. The only non-Ukrainian trial came from Germany and was not much better: its lead author happened to be the editor of the journal where it was published; more importantly, the paper lacked crucial methodological details, which rendered the findings difficult to interpret, and the trial had a tiny sample size.
Collectively, these circumstances were enough for us to be very cautious. Consequently, we stated that “numerous caveats prevent a positive conclusion”.
Despite our caution, this article became much cited, and cancer centres around the world began to wonder whether they should take Ukrain more seriously; many integrative cancer clinics even started using the drug in their clinical routine. Dr Nowicky, who meanwhile had established his base in Vienna from where he marketed his drug, must have been delighted.
Soon, numerous websites sprang up praising Ukrain: “It is the first medicament in the world that accumulates in the cores of cancer cells very quickly after administration and kills only cancer cells while leaving healthy cells undamaged. Its inventor and patent holder Dr Wassil Nowicky was nominated for the Nobel Prize for this medicament in 2005…” .
Somehow, I doubt this thing with the Nobel Prize. What I do not question for a minute, however, is this press release by the Austrian police: since January, the Viennese police have been investigating Dr Nowicky. During a “major raid” on 4 September 2012, he and his accomplices were arrested under the suspicion of commercial fraud. Nowicky was accused of illegally producing and selling the unlicensed drug Ukrain. The financial damage was estimated to be in the region of 5 million Euros.
I fear, however, that the damage done on desperate cancer patients across the world might be much greater. Generally speaking, “alternative” cancer cures are not just a menace, they are a contradiction in terms: there is no such a thing and there will never be one. If tomorrow this or that alternative remedy shows some promise as a cancer cure, it will be investigated by mainstream oncology with some urgency; and if the findings turn out to be positive, the eventual result would be a new cancer treatment. To assume that oncologists might ignore a promising treatment simply because it originates from the realm of alternative medicine is idiotic and supposes that oncologists are mean bastards who do not care about their patients – and this, of course, is an accusation which one might rather direct towards the irresponsible purveyors of “alternative” cancer cures.
***
Dr. Ernst is a PM&R specialist and the author of 48 books and more than 1000 articles in the peer-reviewed medical literature. His most recent book, Trick or Treatment? Alternative Medicine on Trial is available from amazon. He blogs regularly at EdzardErnst.com and contributes occasionally to this blog.
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