OVARIAN CANCER and US

Tuesday, February 12, 2013

open access: CA-125--indicated asymptomatic relapse confers survival benefit to ovarian cancer patients who underwent secondary cytoreduction surgery Journal of Ovarian Research

Journal of Ovarian Research | open access - CA-125--indicated asymptomatic relapse confers survival benefit to ovarian cancer patients who underwent secondary cytoreduction surgery

Background

There is no consensus regarding the management of ovarian cancer patients, who have shown complete clinical response (CCR) to primary therapy and have rising cancer antigen CA-125 levels but have no symptoms of recurrent disease. The present study aims to determine whether follow-up CA-125 levels can be used to identify the need for imaging studies and secondary cytoreductive surgery (CRS).

Conclusions

The increase of serum CA-125 levels is an early warning of clinical relapse in ovarian cancer. Using CA-125 levels in guiding the treatment of patients with asymptomatic recurrent ovarian cancer, who have shown CCR to primary therapy, can facilitate optimal secondary CRS and extend the survival duration of the patients.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

The Evidence for Pharmacologic Treatment of Neuropathic Cancer Pain: Beneficial and Adverse Effects

Journal of Pain and Symptom Management - The Evidence for Pharmacologic Treatment of Neuropathic Cancer Pain: Beneficial and Adverse Effects

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Abstract

Context

The prevalence of neuropathic pain in patients with cancer pain has been estimated to be around 40%. Neuropathic pain may be caused by a tumor invasion and is considered as mixed nociceptive-neuropathic pain or caused by an anticancer treatment and considered as purely neuropathic pain. The use of adjuvant analgesics in patients with cancer is usually extrapolated from their efficacy in nononcological neuropathic pain syndromes.

Objectives

In this systematic review, we sought to evaluate the evidence for the beneficial and adverse effects of pharmacologic treatment of neuropathic cancer pain.

Methods

A systematic review of the literature in PubMed and EMBASE was performed. Primary outcome measures were absolute risk benefit (ARB), defined as the number of patients with a defined degree of pain relief divided by the total number of patients in the treatment group, and absolute risk harm (ARH), defined as the fraction of patients who dropped out as a result of adverse effects.

Results

We identified 30 articles that fulfilled our inclusion criteria. Overall, ARB of antidepressants, anticonvulsants, other adjuvant analgesics, or opioids greatly outweighed ARH. There were no significant differences in ARB or ARH between the four groups of medication or between patients with mixed vs. purely neuropathic pain. Because of the low methodological quality of the studies, we could not draw conclusions about the true treatment effect size of the four groups of medications.

Conclusion

Once a diagnosis of neuropathic pain has been established in patients with cancer, antidepressants, anticonvulsants, or other adjuvant analgesics should be considered in addition to or instead of opioids.

Hospital deaths and readmissions not linked: study | Reuters

Study Examines Hospital Readmission and Mortality Rates For Medicare Patients

Study Examines Hospital Readmission and Mortality Rates For Medicare Patients:

In a study that included data on nearly 3 million hospital admissions for Medicare beneficiaries with heart attack, pneumonia or heart failure, researchers failed to find evidence that a hospital's performance on the measure for 30-day mortality rates was strongly associated with performance on 30-day readmission rates, findings that may lessen concerns that hospitals with lower mortality rates will have higher readmission rates, according to a study appearing in the February 13 issue of JAMA.

AACR Hosts Congressional Briefing on Cancer Progress, NIH Funding « AACR News

Tumor Bank for Tissue Samples - Full Text View - ClinicalTrials.gov University of Vienna

Tumor Bank for Tissue Samples - Full Text View - ClinicalTrials.gov

Can a novel med school curriculum improve doctor-patient communication?

Can a novel med school curriculum improve doctor-patient communication?:

Anyone who has worked – or been a patient — in a large teaching hospital knows what a traditional third-year medical student clerkship can look like: Specialist sweeps in, accompanied by a gaggle of students; specialist has a few words with the patient; students nod and occasionally take notes; specialist leaves, accompanied by retinue. Students move on to next rotation and never see patient again.
A relatively new model, the longitudinal integrated clerkship (LIC), wants to change all that. It answers decades of increasing calls from the medical education community to revise the prevailing century-old current “block” model of clinical learning, which can present fragmented views of disease and allow only snips of caregiving in the current outpatient care-based healthcare system.

Researchers Highlight Warning Signs On Adult Stem Cell Treatments - Forbes

Researchers Highlight Warning Signs On Adult Stem Cell Treatments - Forbes

"One of the virtues of adult stem cell research, so the story goes, is that it does not suffer either the ethical concerns or scientific problems involved in embryonic stem cell research.

Adult stem cell experiments don’t require the destruction of human embryos–they can be derived from the patient’s own store of stem cells. Further, because they can be harvested from the patients themselves, there is no fear of any adverse immune response as there is with embryonic stem cells.
More and more clinics around the country are offering stem cell transplants using adult stem cells to treat an ever growing list of ailments.
But as Paul Knoepfler notes, recent research suggests adult stem cells should be viewed with more caution.
Three papers from the last year deal specifically with unexpected and adverse results of adult stem cell transplants......