Many cancer institution websites lack nutritional guidance, others give mixed messages

media

Radiation oncologists at Thomas Jefferson University Hospital are stressing the need for evidence-based, standardized guidelines on dietary recommendations for cancer patients—and with good reason. A new analysis revealed that online dietary recommendations for cancer patients, if even present on an institution's website, appear to be consistently inconsistent.

Read more at: http://medicalxpress.com/news/2013-03-cancer-websites-lack-nutritional-guidance.html#jCp

A review of all 21 of the National Comprehensive Cancer Network (NCCN) member institutions found that only four provided nutritional guidelines, with seven linking to external sites. What's more, many of the sites with recommendations contradicted each other. The results were published online March 26 in Nutrition and Cancer: An International Journal. Given that recent data reveals that dietary factors may influence outcomes in patients undergoing cancer treatment, and that over 60 percent of patients head to the Internet for guidance on diet, it's imperative that information is as accurate and uniform as possible, says senior author Colin Champ, M.D., a resident in the Department of Radiation Oncology at Jefferson . "More and more patients are coming to their doctors and asking for nutritional recommendations before and after treatment, but there is really no standard direction to send them," said Dr. Champ. "So we started looking at sources where people may go to see what information they were digesting." There were discrepancies. Half the information presented or linked to on NCCN sites contradicted the other half.

Read more at: http://medicalxpress.com/news/2013-03-cancer-websites-lack-nutritional-guidance.html#jCp

A review of all 21 of the National Comprehensive Cancer Network (NCCN) member institutions found that only four provided nutritional guidelines, with seven linking to external sites. What's more, many of the sites with recommendations contradicted each other. The results were published online March 26 in Nutrition and Cancer: An International Journal. Given that recent data reveals that dietary factors may influence outcomes in patients undergoing cancer treatment, and that over 60 percent of patients head to the Internet for guidance on diet, it's imperative that information is as accurate and uniform as possible, says senior author Colin Champ, M.D., a resident in the Department of Radiation Oncology at Jefferson . "More and more patients are coming to their doctors and asking for nutritional recommendations before and after treatment, but there is really no standard direction to send them," said Dr. Champ. "So we started looking at sources where people may go to see what information they were digesting." There were discrepancies. Half the information presented or linked to on NCCN sites contradicted the other half.

Read more at: http://medicalxpress.com/news/2013-03-cancer-websites-lack-nutritional-guidance.html#jCp

A review of all 21 of the National Comprehensive Cancer Network (NCCN) member institutions found that only four provided nutritional guidelines, with seven linking to external sites. What's more, many of the sites with recommendations contradicted each other. The results were published online March 26 in Nutrition and Cancer: An International Journal. Given that recent data reveals that dietary factors may influence outcomes in patients undergoing cancer treatment, and that over 60 percent of patients head to the Internet for guidance on diet, it's imperative that information is as accurate and uniform as possible, says senior author Colin Champ, M.D., a resident in the Department of Radiation Oncology at Jefferson . "More and more patients are coming to their doctors and asking for nutritional recommendations before and after treatment, but there is really no standard direction to send them," said Dr. Champ. "So we started looking at sources where people may go to see what information they were digesting." There were discrepancies. Half the information presented or linked to on NCCN sites contradicted the other half.

Read more at: http://medicalxpress.com/news/2013-03-cancer-websites-lack-nutritional-guidance.html#jCp

A review of all 21 of the National Comprehensive Cancer Network (NCCN) member institutions found that only four provided nutritional guidelines, with seven linking to external sites. What's more, many of the sites with recommendations contradicted each other. The results were published online March 26 in Nutrition and Cancer: An International Journal. Given that recent data reveals that dietary factors may influence outcomes in patients undergoing cancer treatment, and that over 60 percent of patients head to the Internet for guidance on diet, it's imperative that information is as accurate and uniform as possible, says senior author Colin Champ, M.D., a resident in the Department of Radiation Oncology at Jefferson . "More and more patients are coming to their doctors and asking for nutritional recommendations before and after treatment, but there is really no standard direction to send them," said Dr. Champ. "So we started looking at sources where people may go to see what information they were digesting." There were discrepancies. Half the information presented or linked to on NCCN sites contradicted the other half.

Read more at: http://medicalxpress.com/news/2013-03-cancer-websites-lack-nutritional-guidance.html#jCp

A review of all 21 of the National Comprehensive Cancer Network (NCCN) member institutions found that only four provided nutritional guidelines, with seven linking to external sites. What's more, many of the sites with recommendations contradicted each other. The results were published online March 26 in Nutrition and Cancer: An International Journal. Given that recent data reveals that dietary factors may influence outcomes in patients undergoing cancer treatment, and that over 60 percent of patients head to the Internet for guidance on diet, it's imperative that information is as accurate and uniform as possible, says senior author Colin Champ, M.D., a resident in the Department of Radiation Oncology at Jefferson . "More and more patients are coming to their doctors and asking for nutritional recommendations before and after treatment, but there is really no standard direction to send them," said Dr. Champ. "So we started looking at sources where people may go to see what information they were digesting." There were discrepancies. Half the information presented or linked to on NCCN sites contradicted the other half.

Read more at: http://medicalxpress.com/news/2013-03-cancer-websites-lack-nutritional-guidance.html#jCp

Physician Assistant - Gynecologic Oncology Peoria Job

 Job
One of the largest multi-specialty oncology practices in Arizona has an opportunity for a Physician Assistant to join its dynamic Division of Gynecologic Oncology. This truly unique opportunity will afford the selected candidate significant growth and development within a flourishing, team-oriented organization that specializes in gynecologic oncology, radiation oncology, medical oncology, and urology. New graduates as well as experienced practitioners are encouraged to apply.

Skills / Requirements

Responsibilities and duties include assisting in surgery (robotic and open cases), patient management in the office (Scottsdale and Peoria), managing inpatients, seeing patients post-operatively, performing history and physicals, reviewing diagnostic tests, preparing discharge summaries, hospital rounding, monitoring the effectiveness of therapeutic interventions, prescription of pharmacological agents and treatments, and offering counseling and education to meet patient needs.....

Gene patenting – a Genome Medicine twitter chat - March 27th UK/EST

Gene patenting

The biotechnology company Myriad Genetics holds US and European patents on the breast cancer risk genes BRCA1 and BRCA2 and sells a diagnostic test based on these. The ethics, legality and scientific validity of these patents have been extensively debated, from the courts to the blogosphere, and on April 15th 2013, this topic is back in the limelight as the Supreme Court considers a legal challenge on the case. Many other companies also hold gene patents, and the implications and controversies are wide-ranging......  

With this in mind, it seems like a good time to discuss this topic further. So, what are your views on gene patenting? For a chance to have your say, join Genome Medicine, author Christopher Mason, and others for a one-hour twitter chat on Wednesday 27 March at 2pm UK time (10am EST).  The twitter chat will use the hashtag #GMpatents, and be moderated from the @GenomeMedicine account.
The questions we’ll be discussing during the chat are:

1. What is an ‘isolated DNA’? How scientifically valid is this definition?
2. Should genes be patented at all, and if so under what conditions?
3. Does gene patenting drive scientific impact, or impede research?
4. What is the impact of DNA patenting on other areas of orthogonal research, like epigenomics or transcriptomics?
5. What are the medical and clinical implications if the Supreme Court ruling is successfully challenged ?
6. Would you start testing BRCA1 or other patented genes in your lab if the patents are invalidated?

Educating Physicians About Genomics: Are We Doing Enough?

Medscape

"Patients are clamoring to know whether sequencing their DNA can shed light on their condition. Every physician of the future will have to know how to respond to this, and it is essential that they receive some training in this area," added Michael Snyder, PhD, Chair of the Department of Genetics at Stanford University School of Medicine, Stanford, California, and Director of the Stanford Center for Genomics and Personalized Medicine.....

The experience of chemotherapy-induced alopecia for Australian women with ovarian cancer

Abstract

This article describes the experience of chemotherapy-induced alopecia. Data resulted from an ongoing study, which sought to explore the experience of Australian women with a primary diagnosis of ovarian cancer. Phenomenological analysis of written accounts or interviews with 15 Australian women resulted in 13 of these 15 women giving priority to describing their experience of alopecia. The women described alopecia as the most distressing corporeal feature of the ovarian cancer experience. Factors which contributed to women's distress included: loss of sense of self and altered body image; reminder of their illness and potential for an early death; public statement about their private life, practical issues and re-growth. No literature was located, worldwide, which specifically explores the experience of alopecia for women with ovarian cancer. This article presents the first in-depth exploration of the experience of alopecia for Australian women with ovarian cancer. Insight gained from this study will inform understanding of the issues associated with alopecia for women with ovarian cancer and may facilitate the provision of optimal supportive care provided by health care professionals for female cancer patients with chemotherapy-induced alopecia.

open access: A critical exploration of the International Classification of Function

open access

 Background: In 2001, the World Health Organization developed the International Classification of Functioning, Disability, and Health (ICF) framework in an effort to attend to the multidimensional health-related concerns of individuals. Historically, although the ICF has frequently been used in a rehabilitation-based context, the World Health Organization has positioned it as a universal framework of health and its related states. Consequently, the ICF has been utilized for a diverse array of purposes in the field of oncology, including: evaluating functioning in individuals with cancer, guiding assessment in oncology rehabilitation, assessing the comprehensiveness of outcome measures utilized in oncology research, assisting in health-related quality of life instrument selection, and comparing the primary concerns of health professionals with those of their patients......

Physician preferences and attitudes regarding different models of cancer survivorship care: a comparison of primary care providers and oncologists (Canada)

Abstract

PURPOSE:

New strategies for delivering cancer follow-up care are needed. We surveyed primary care providers (PCPs) and oncologists to assess how physician attitudes toward and self-efficacy with cancer follow-up affect preferences for different cancer survivorship models.

METHODS:

The survey of physician attitudes regarding the care of cancer survivors was mailed to a randomly selected national sample of PCPs and oncologists to evaluate their perspectives regarding physician roles, knowledge about survivorship care processes, and views on cancer surveillance. Multinomial logistic regression models were constructed to examine how physician attitudes towards, and self-efficacy with, their own skills affected preferences for different cancer survivorship care models.

RESULTS:

Of 3,434 physicians identified, a total of 2,026 participants provided eligible responses: 938 PCPs and 1,088 oncologists. Most PCPs (51 %) supported a PCP/shared care model; whereas, the majority of specialists (59 %) strongly endorsed an oncologist-based model (p < 0.001). Less than a quarter of PCPs and oncologists preferred specialized survivor clinics. A significant proportion of oncologists (87 %) did not feel that PCPs should take on the primary role of cancer follow-up. Most PCPs believed that they were better able to perform breast and colorectal cancer follow-up (57 %), detect recurrent cancers (74 %), and offer psychosocial support (50 %), but only a minority (32 %) was willing to assume primary responsibility. PCPs already involved with cancer surveillance (43 %) were more likely to prefer a PCP/shared care than oncologist-based survivorship model (OR, 2.08; 95 % CI, 1.34-3.23).

CONCLUSIONS AND IMPLICATIONS FOR CANCER SURVIVORS:

PCPs and oncologists have different preferences for models of cancer survivorship care. Prior involvement with cancer surveillance was one of the strongest predictors of PCPs' willingness to assume this responsibility.

open access: Vitamin D: Pharmacokinetics and Safety When Used in Conjunction with the Pharmaceutical Drugs Used in Cancer Patients: A Systematic Review

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Abstract:
Vitamin D has reported anti-cancer and anti-inflammatory properties modulated through gene transcription and non-genomic signaling cascades. The purpose of this review was to summarize the available research on interactions and pharmacokinetics between vitamin D and the pharmaceutical drugs used in patients with cancer. Hypercalcemia was the most frequently reported side effect that occurred in high dose calcitriol. The half-life of 25(OH)D₃ and/or 1,25(OH)₂D₃ was found to be impacted by cimetidine; rosuvastatin; prednisone and possibly some chemotherapy drugs. No unusual adverse effects in cancer patients; beyond what is expected from high dose 1,25(OH)₂D₃ supplementation, were revealed through this review. While sufficient evidence is lacking, supplementation with 1,25(OH)₂D₃ during chemotherapy appears to have a low risk of interaction. Further interactions with vitamin D₃ have not been studied.

Cancer Articles in Weekly Magazines: Useful Media to Deliver Cancer Information to the Public?

jco

Conclusions Cancer articles in weekly magazines are common paper media for providing cancer information to the public. However, the information provided might place emphasis on unestablished treatments or biased opinions. 

Elevated Risk of Prostate Cancer Among Men With Lynch Syndrome

abstract

Conclusion The cumulative lifetime risk of prostate cancer in individuals with LS is two-fold higher than in the general population and is slightly higher in carriers diagnosed before age 60 years (HR, 2.48; 95% CI, 1.34 to 4.59). These estimates are clinically valuable to quantify risk for both patients and providers.

Footnotes (not available unless paid subscriber)

• See accompanying article doi: 10.1200/JCO.2012.48.4667

NeLM integration into NHS Evidence (NICE/UK info services)

NeLM integration into NHS Evidence

Summary

by: Hina Radia

From April 2013, evidence currently available through the National electronic Library for Medicines (NeLM) will only be accessible via NHS Evidence provided by NICE, and NeLM will cease to exist.

NICE is working with the UK Medicines Information service (UKMi) to bring medicines information together into one place – NHS Evidence - making it simpler for those with medicines and prescribing responsibilities to view, search and filter high quality evidence-based information......

paywalled: Effect of various forms of postmenopausal hormone therapy on the risk of ovarian cancer - a population based case control study from Finland

abstract

Postmenopausal hormone therapy (HT) associates with an increased risk of ovarian cancer, but its' influence on tumor histology is not as well known. Therefore, we evaluated the effect of various types of HT on the risk of epithelial ovarian cancer by histological subtype. All Finnish women diagnosed with ovarian cancer (n= 3,958) aged over 50 during 1995-2007 were identified from the Finnish Cancer Registry. For each case, three controls, matched for age and place of residence, were recruited from the Finnish National Population Register, which also provided data on parity and ages at deliveries. After exclusion of controls with oophorectomy, 11,325 controls remained. The Prescription Register provided HT use from age 50. Odds ratios (OR) for different HTs were estimated by conditional logistic regression: adjusted for parity, ages at deliveries, and hysterectomy. Estradiol-only therapy use for 5 years or more associated with an increased risk (OR 1.45; 95% confidence interval 1.20-1.75) of a serous subtype, but with a decreased risk of mucinous subtype (0.35; 0.19-0.67). Use of sequential estradiol-progestin therapy (EPT) for 5 years or more associated with an increase in overall ovarian cancer risk (1.35; 1.20-1.63) and with an increase in the endometrioid subtype (1.88; 1.24-2.86) particularly. Continuous EPT, estradiol+levonorgestrel-releasing intrauterine system or tibolone had no effect on overall ovarian cancer risk. In conclusion, only sequential EPT use for 5 years or more associates with an increased risk of overall ovarian cancer. Furthermore, HT regimens differ significantly in their association with various histological types of ovarian cancer.

(Mexico) Endometriosis as a risk factor for ovarian cancer

Abstract

A history of endometriosis is a risk factor for some subtypes of epithelial ovarian cancer. Endometriosis is associated with increased risk of ovarian clear cell, serous low-grade endometrioid cancer, but it is unclear what the role of endometriosis is in the development of other histopathological subtypes of ovarian cancer, such as high-grade serous borderline tumors subtypes or borderline serous and mucinous cancers. An understanding of the mechanisms leading to malignant transformation of endometriosis will be needed to identify subgroups of women at increased risk of ovarian cancer. This is important because of their high prevalence and cause of infertility in Mexico and the world. All factors must be considered during the decision-making process for the treatment of endometriosis, including the rare malignant transformation.

(Spain) Evaluating the Effect of Unclassified Variants Identified in MMR Genes Using Phenotypic Features, Bioinformatics Prediction, and RNA Assays

Abstract

Familial Cancer - 3 abstract articles regarding Lynch Syndrome (paywalled)

Familial Cancer 

Latest Articles

1. 
   Original Article

   Gene variants of unknown clinical significance in Lynch syndrome. An introduction for clinicians

   Rolf H. Sijmons, Marc S. Greenblatt, Maurizio Genuardi (March 2013)
2. 
   Original Article

   Colorectal surveillance in Lynch syndrome families

   Wouter H. de Vos tot Nederveen Cappel, Heikki J. Järvinen… (March 2013)
3. 
   Original Article

   Psychosocial consequences of predictive genetic testing for lynch syndrome and associations to surveillance behaviour in a 7-year follow-up study

   Katja Aktan-Collan, Helena Kääriäinen, Heikki Järvinen, Päivi Peltomäki… (March 2013)

Schedule: e-Health conference May 26-29th Ottawa (abstracts now online)

Schedule

 

Blogger's Note: search term 'cancer' resulted in the following:

Showing Records 1 - 6 of 6

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Ref.	Date	Time	Room	Name
CS4	Mon, May 27	13:30 - 15:00	212	M-Health for Clinicians
CS14	Mon, May 27	15:30 - 17:00	213	Wait Times
CS15	Mon, May 27	15:30 - 17:00	202	Patient Access
CS9	Mon, May 27	15:30 - 17:00	201	EMR Ontario
CS45	Wed, May 29	10:30 - 12:00	211	Consumer Health Solutions to Drive Clinical Outcomes
CS47	Wed, May 29	10:30 - 12:00	214	Engaging Patients and Improving Outcomes with Health Coaching

UK's NICE draft guidance says "no" to Roche's Avastin for ovarian cancer - Pharmaceutical and Biotechnology News - Pharma Letter

 Pharma Letter

Lynch Syndrome - Statewide Screening Initiative Launched By Ohio State Has Life-Saving Potential

Statewide Screening 

COLUMBUS, Ohio – The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Institute (OSUCCC – James) has launched a statewide initiative to screen newly diagnosed colorectal cancer patients and their biological relatives for Lynch Syndrome, the most common form of inherited colorectal, ovarian and uterine cancer. The effort – made possible through money raised by Pelotonia – will identify family members who may be at risk of developing these cancers so they can take precautionary measures.....

Emerging Biomarkers: How Reliable Is The Evidence? - Forbes

Reuters

"Novel biomarkers are the subject of intense controversy, with a bewildering variety of factions and perspectives seeking to elevate or dismiss any of a large number of proposed new measures. Now a new examination of the literature published online in JAMA Internal Medicine suggests that the evidence base used to evaluate novel biomarkers may be seriously compromised by selective reporting bias......

UJ - Making research available to all: open access panel discussion at the Cambridge Science Festival - BioMed Central blog

article

abstract: Early Surgical Menopause Is Associated with a Spectrum of Cognitive Decline

Abstract

AAN: Surgical Menopause Tied to Brain Deficits

AAN conference coverage

SAN DIEGO -- Women who had surgically induced menopause at an early age saw a decline in cognitive function and possible signs of Alzheimer's disease pathology, researchers reported here.
Among women who had surgically induced menopause, younger age was significantly tied to declines in episodic memory (P=0.0003), semantic memory (P=0.0022), and global cognition (P=0.0007) compared with women who had natural menopause, according to Riley Bove, MD, of Harvard Medical School in Boston, and colleagues......

What patients want

Abstract

Purchase $31.50

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Objective

Although most health care professionals im- or explicitly will assume that they tend to use patient-centered communication strategies, there are reasons to believe that this might not always be a valid assumption. In everyday practice, professionals’ own value system is often the dominant steering guide. This Special Issue aims to bring together ongoing research and reflections about the quality of health care communication from the patients’ own perspective. In short: what do patients want?

Methods

This introduction presents a comprehensive overview of the papers in the special issue of Patient Education and Counseling within a framework that describes the collected papers according to the six functions of medical consultations, taking account of the studies’ applied methodologies: quantitative versus qualitative.

Results

Two functions of the medical consultation are strongly represented in the collected papers on the quality of communication from the patients’ perspective: ‘fostering the relationship’ and ‘information giving’. There is a remarkable difference between the qualiative and quantitative studies, showing that if patients are not limited to prestructured questionnaires but completely free to express themselves, they tend to focus on ‘fostering the relationship’ with an emphasis on personal attention, warmth and empathy.

Conclusions

Patients’ needs and preferences for personalized and humane medical care cannot be overestimated. For the rest, patient diversity is striking, showing the limited usefulness of general communication guidelines for the other five functions of the medical consultation. Researchers should be aware that patients’ views might be different dependent on the applied methodologies.

Re-operation outcome in patients referred to a gynecologic oncology center with presumed ovarian cancer FIGO I-IIIA after sub-standard initial surger

Abstract

BACKGROUND:

Surgery is the mainstay of treatment for early ovarian cancer both as therapeutic and comprehensive staging. Only the latter allows appropriate tailoring of systemic treatment. However, the compliance with guidelines for comprehensive staging has been reported to be only moderate and, therefore, re-staging procedures are commonly indicated to avoid undertreatment. The purpose of our study was to evaluate re-operation in a tertiary gynecologic oncology unit after primary operation for presumably ovarian cancer FIGO I-IIIA in general gynecology departments.

MATERIAL AND METHODS:

Forty consecutive patients after primary surgery in the outside institutions for presumed early ovarian cancer with assumed tumor spread limited to the pelvis (FIGO I-IIIA) admitted to our department between 1999 and 2007 were included. In 35 cases re-staging surgery in our unit was indicated. The intra- and post-operative results were compared with initial diagnosis and sites of undetected disease were evaluated. Reasons for re-staging and referral pattern were studied.

RESULTS:

40 patients were enrolled of whom 53% came by self-referral. Only 18% were referred by the primary surgeon and the remaining patients were referred by their home gynecologist. Only 5 patients (13%) were classified as having had a comprehensive staging by surgical records and pathology reports and 35 patients underwent comprehensive re-staging laparotomy after which 20 patients (50%) experienced an upstaging including 13 patients with final diagnosis of FIGO stage IIIC. Most frequent sites of primarily undetected tumor were peritoneum (pelvic 34%, diaphragm 13%, paracolic 8%), lymph nodes (para aortic 32%, pelvic 11%), intestines 24%, and residual omental tissue 18%. The indication for post-operative chemotherapy was modified in 53% of patients.

CONCLUSION:

Comprehensive staging of presumed early ovarian cancer has been described as major problem especially outside gynecologic oncology units. Re-staging results in our department confirmed this deficiency by showing a considerable proportion of upstaging associated with alterations of recommendations for systemic treatment. However, series like this may even underestimate the problem, because incomplete staging is unfortunately accompanied by non-systematic referral practices not reflecting staging quality.

Breast and ovarian cancer: the forgotten paternal contribution

Abstract

Five to 10% of all cases of breast and ovarian cancer are attributed to a heritable genetic predisposition. Transmission of BRCA1 and BRCA2 mutations is equally likely through maternal or paternal lineage; however, fewer referrals to cancer genetics clinics appear to be made for a paternal, than maternal, family history of breast and/or ovarian cancer. To examine this potential bias, a retrospective review of 315 patient and family charts was conducted by one familial cancer clinic in Toronto, Canada. Referral letters, risk estimates, and family histories were analyzed to identify significant differences between patients referred with maternal and paternal family histories. It was determined that patients are approximately five times more likely to be referred with a maternal family history of breast and/or ovarian cancer as compared to those with a paternal family history (p = <.0001). Individuals with a paternal family history were found to have a different, and higher, pattern of risk estimates (p = .00064). No significant difference was seen between the type of referrals sent by general practitioners, oncologists, and gynecologists. Recommendations to increase the awareness of paternal family history in assessing cancer risk are provided.