Harvard Professor Re-Identifies Anonymous Volunteers In DNA Study - Forbes

Forbes

"....Misha Angrist, an assistant professor of the practice at the Duke Institute for Genome Sciences & Policy and one of the original ten to participate in the Personal Genome Project, praises the re-identification experiments by researchers such as Sweeney and Erlich. “It is a nuisance to scientists who are trying to operate under the status quo and to tell their participants with a straight face, you know, it’s very unlikely that you will be identified,” he says. “It is useful for pointing out that the emperor has no clothes, that absolute privacy and confidentiality are illusory.”"

Cancer Doctors Raise Pressure On Pharma Industry To Cut Drug Prices - Forbes

 Forbes

"In the latest flap over the high cost of cancer medicines, nearly 120 physicians from 15 countries have authored a commentary in a medical journal in which they call for drugmakers to lower their prices. The move reflects ongoing concern that rising price tags — a growing number of such drugs cost $100,000 or more annually — will eventually force some patients to forgo treatment.....

Encouraging Moves From Medscape - Forbes

Forbes

Patient-Oncologist Alliance, Psychosocial Well-Being, and Treatment Adherence Among Young Adults With Advanced Cancer

Abstract

Purpose Patients who develop a strong alliance with their health care providers have been shown to have higher levels of psychosocial well-being and rates of treatment adherence. Young adults with cancer have lower levels of psychosocial well-being and treatment adherence relative to patients with cancer in other age groups. This study sought to evaluate the relationships between the patient-oncologist alliance, psychosocial well-being, and treatment adherence in young adults with advanced cancer......

Physician and Stakeholder Perceptions of Conflict of Interest Policies in Oncology

Abstract

Conclusion COI policies are an important and relevant topic among physicians and patient advocates. Methods to simplify the disclosure process, improve transparency, and facilitate responsiveness are critical for COI management. 

Receipt of Psychosocial Care Among Cancer Survivors in the United States

Abstract

 Conclusion Many survivors do not report a discussion with providers about the psychosocial effects of cancer, which reflects a missed opportunity to connect survivors to psychosocial services. These data can benchmark the success of efforts to improve access to cancer-related psychosocial care.

Opportunities forEditorial: Improving Psychosocial Care for Cancer Survivors

Editorial - open access

"The quality of psychosocial care provided to patients with cancer
has received increased attention since the 2008 publication of the
Institute of Medicine (IOM) report entitled “Cancer Care for the
Whole Patient: Addressing Psychosocial Health Needs.”1 The report
concluded that, despite evidence for the effectiveness of psychosocial
care, many patients who could benefit from these services do not
receive them. Among the report’s main recommendations was that
processes should be in place to identify patients’ psychosocial needs
and then link patients with appropriate services to address those
needs. Since the report’s publication, there have been numerous efforts
to evaluate the extent to which psychosocial care is being provided
consistent with the IOM recommendations.......

"......The efforts of the last decade have established the importance of
ensuring access to psychosocial services for cancer survivors. Moving
forward, we need to determine the most effective practices and how
best to deliver them across diverse settings. Distress, like cancer, is not
a single entity, and one treatment does not fit all. Psychosocial
oncology needs to increase its research in comparative effectiveness,
health services, and outcomes. The ultimate impact of screening
programs, provider discussions, and increased access to
psychosocial care hinges on the treatment. The next few years will
include countless natural experiments as screening programs are
implemented. If we are proactive, we can use these data to create
successful systems in which all cancer survivors will have some discussion with their providers about psychosocial care, whether
or not they choose to use psychosocial services."

Laparoscopic restaging of borderline ovarian tumours (BLOT): a retrospective study of 142 cases

abstract

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Objectives

Primary objective: To analyse the impact of restaging, on recurrences and survival, in BLOT. Secondary objective: To cluster patients who could be exempted from restaging.

Study design

This retrospective study, included patients operated for a BLOT, between January 1990, and December 2007, in gynaecological surgery units of the University Hospital of Clermont-Ferrand.

Two groups were evaluated: patients with and without optimal restaging.

Results

One hundred and forty-two patients were included. Optimal initial staging rate was 38.7% (n = 55). Among the eighty-seven women not initially staged, two groups were compared: restaged (n = 45) and non-restaged patients (n = 42). Mean follow-up was 80.5 months. Overall survival was 93.7%. Relapse rate was 7.7% (n = 11). Disease free survival (DFS) was 88% after a mean follow-up of 80.5 months. One death was noted.

Optimal restaging rate was 31.7% (n = 45, 43 by laparoscopy). Mean follow-up was of 87.1 months among restaged patients, 84.5 months among non-restaged patients (p = 0.93).

Relapse incidence was significantly higher in non restaged, than in restaged patients (p = 0.008). DFS was significantly longer among restaged than non-restaged patients, (p = 0.072). Younger age (p = 0.04), conservative treatment (p < 10⁻⁴) or non-diploidy (p = 0.04) increased the incidence of relapse.

Conclusions

When initial staging is missing, restaging improves the patients outcome in comparison to non-restaged groups. Laparoscopy is a valuable surgical option. This study suggests that a selected group of patients, older than 30 years old, submitted to a radical treatment, presenting a diploid, non micropapillar, mucinous BLOT, without visible implants during careful peritoneal inspection, could be exempted from restaging. They represented 11.6% of our population.

PLOS ONE: Functional and Structural Analysis of C-Terminal BRCA1 Missense Variants

open access

Introduction

Between 10 and 20% of the breast cancer cases appearing in the general population present familial history of the disease [1]. Mutations in BRCA1 and BRCA2 genes confer high lifetime risks of breast and ovarian cancer, among other neoplasias [2], [3]. Inactivating germline mutations in these genes account for 20–50% of familial cases, depending on the population [4]. Thus, genetic analysis of BRCA1 and BRCA2 is a cornerstone of genetic counseling practice. However, classification of genetic variants as pathogenic is challenging, particularly for missense changes and for silent or intronic variants that cannot be directly associated with increased cancer risk and are classified as variants of uncertain significance (VUS), which are found in 13% of BRCA1 and BRCA2 genetic tests [5]......

Prophylactic pre-operative bilateral ureteric catheters for major gynaecological surgery

Abstract

PURPOSE:

The use of prophylactic pre-operative bilateral ureteric catheters for major gynaecological surgery is controversial. The aim of this study was to investigate the frequency of ureteric catheter-associated morbidity in our Unit, where systematic pre-operative ureteric catheterisation is performed.

METHODS:

We conducted a retrospective casenote review of 337 gynaecology patients undergoing laparotomy at Salford Royal Hospital between January 2007 and September 2010.

RESULTS:

The mean age was 56.36 (range 17-89). Procedures included TAH BSO (n = 249, 74 %), BSO (n = 17, 5 %), radical hysterectomy (n = 36, 11 %), and other (n = 35, 10 %), for indications of ovarian (n = 189, 56 %), uterine (n = 88, 26 %) or cervical cancer (n = 18, 5.3 %), massive fibroids (n = 27, 8 %), severe endometriosis (n = 6, 1.78 %), or other (n = 9, 2.67 %). Bilateral ureteric catheters were attempted in most patients and successfully placed in 315/337 (93 %) patients. In 22 patients (7 %), either no ureteric catheters or a single ureteric catheter was placed due to pre-existing ureteric anomaly, technical difficulty, or surgeon choice. Bilateral ureteric catheterisation took an average of 5.4 min (SD 2.0, range 3.2-9.2) for an experienced consultant or 8.4 min (SD 3.9, range 6.4-18.6) for an SpR trainee to complete. There were no intra-operative ureteric complications. Post-operative complications included urinary tract infection (5/337 patients, 1.48 %), acute renal failure (2/337, 0.6 %), and uretero-vaginal fistulae (1/337 patients, 0.3 %).

CONCLUSIONS:

Prophylactic pre-operative ureteric catheters are quick and easy to insert and associated with low complication rates. Routine use before major gynaecological surgery can expedite intra-operative identification of the ureters and may reduce accidental ureteric injury.

Pelvic Exenteration for Recurrent Gynecologic Malignancy

Abstract
 

Objective: The aim of this study was to assess the outcomes of patients undergoing pelvic exenteration (PE) for recurrent gynecologic malignancy.

Methods: A retrospective review using all medical records of 28 consecutive patients who underwent PE between January 2002 and December 2011 at a single institution was conducted. Complications were graded according to Clavien-Dindo. Overall survival (OS) and disease-free survival (DFS) were estimated by the method of Kaplan-Meier.

Results: Pelvic exenteration was performed for recurrent cancer in all patients. Distribution of primaries was as follows: cervix (n = 10), vagina (n = 5), ovary (n = 5), uterus (n = 4), tube (n = 2), Bartholin gland (n = 1), and vulva (n = 1). In all but 1 case, PE was performed with curative intent. Pelvic exenteration was total (n = 11), anterior (n = 2), or posterior (n = 15). Reconstructive procedures included urinary tract (n = 13), gastrointestinal tract (n = 26), pelvic floor (n = 6), and vagina (n = 5). There was no postoperative mortality within 30 days. All patients developed 1 or several early complications of various grades, and 22 patients (79%) developed late complications. Twelve patients (43%) underwent reoperation because of complications to PE, and 2 patients died within follow-up as a consequence of their PE. A complete tumor resection (R0) was obtained in 23 patients (82%). With a median follow-up of 27 months (range, 2–110 months), the 5-year OS and DFS rates were 70% and 41%, respectively. R0 resection was associated with increased OS (P < 0.001) and DFS (P = 0.015).

Conclusions: Pelvic exenteration for recurrent gynecologic malignancies can be associated with long-term survival in selected patients. However, postoperative complications are common and can be lethal.

Accuracy of Positron Emission Tomography/Computed Tomography in the Diagnosis and Restaging for Recurrent Ovarian Cancer: A Meta-Analysis

Abstract
 

Objective: A meta-analysis was performed to estimate the diagnostic accuracy of positron emission tomography/computed tomography (PET/CT) in suspected recurrent ovarian cancer.

Materials and Methods: PubMed, The Cochrane Library, Embase, and Web of Science were systematically searched. Studies that compared PET/CT and reference standards within patients for diagnosis of suspected recurrent ovarian cancer were included.

Results: Twenty-nine studies involving 1651 patients with ovarian cancer were analyzed. For recurrent versus nonrecurrent ovarian cancer, the pooled sensitivity, specificity, positive likelihood (LH) ratio, negative LH ratio, and diagnostic odds ratio of ovarian carcinoma were 88.6% (95% confidence interval [CI], 86.6%–90.3%), 90.3% (95% CI, 87.6%–92.7%), 6.104 (95% CI, 3.904–9.543), 0.122 (95% CI, 0.077%–0.192%), and 57.032 (95% CI, 30.764–105.73), respectively, for recurrence in the PET/CT. Because sensitivity, specificity, positive LH ratio, and negative LH ratio were all heterogeneous, random effects model was used, and a summary receiver operating characteristic curve was generated. The area under the curve was 0.9445 for recurrent versus nonrecurrent ovarian cancer.

Conclusions: Positron emission tomography/computed tomography is a useful tool for predicting the diagnosis and restaging of suspected recurrent ovarian carcinoma.

Tolerance of the Small Bowel to Therapeutic Irradiation: A Focus on Late Toxicity in Patients Receiving Para-Aortic Nodal Irradiation for Gynecologic Malignancies

Abstract

Objective: The recently published Quantitative Analysis of Normal Tissue Effects in the Clinic (QUANTEC) recommends dose constraints for acute small-bowel toxicity but does not fully address dose constraints for late small-bowel toxicity and the maximum dose tolerance of the small bowel. Radiation oncologists in practice frequently face a challenge when deciding what maximum point dose to accept in a patient’s treatment plan. Given this lack of guidance for maximum radiation dose tolerance on the small bowel, we performed a literature search on the topic.

Methods: We searched PubMed for English language publications up to December 2012 on pelvic and para-aortic lymph node (PALN) irradiation for gynecologic malignancies. The search was performed using the following key words: late small-bowel toxicity, cervical cancer, endometrial cancer, ovarian cancer, gynecologic malignancies, pelvic irradiation, PALN irradiation, extended-field radiation therapy. Relevant references were selected, and full articles were obtained for review. The predetermined criteria for deciding which studies to include were used.

Results: With photon irradiation, the incidence of grade 3 or greater late small-bowel toxicity, including small-bowel obstruction, is 9% ± 7% after a median follow-up of 5 years and with mean pelvic and para-aortic/whole abdominal prescription doses of 50 ± 5 Gy and 40 ± 10 Gy, respectively. Our estimate for the small-bowel T10/5 would be the maximum point dose of 55 Gy.

Conclusions: If possible, it is prudent to try to keep the maximum point dose to the small bowel at 55 Gy or less. Given the lack of substantial data to make firm guidelines, further studies are needed to clarify the dose-volume relationship for late toxicity. Dose escalation to PALN should continue to be used with caution.

Study Comparing Early and Late Nutrition in Cancer Patients Undergoing Abdominal Surgery - Estado de São Paulo

clinical trial

Clinical Trial Investigator Information

• Lead Sponsor
  • Instituto do Cancer do Estado de São Paulo
• Provider of Information About this Clinical Study
  • Principal Investigator: Patrícia Camargo Marques, Principal Investigator – Instituto do Cancer do Estado de São Paulo

Bereaved parents and siblings offer advice to health care providers and researchers (Canada/U.S.)

Abstract

 FINDINGS: 

Five major themes included the need for: (a) improved communication with the medical team, (b) more compassionate care, (c) increased access to resources, (d) ongoing research, and (e) offering praise. Interwoven within the 5 themes was a subtheme of continuity of care.

Recurrent granulosa cell tumors of the ovary (GCTs): A MITO-9 retrospective study

Abstract

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Optimal debulking surgery is the cornerstone of treatment in the recurrence setting and residual tumor affect the overall survival. Adjuvant chemotherapy seems to improve disease free survival but not overall survival

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Background and aim

Optimal treatment of recurrent GCTs is unknown. The aim of this study was to evaluate the characteristics of recurrent GCTs.

Methods

Data on 35 recurrent GCTs were reviewed.

Results

Initial FIGO stage was: 11 IA, 11 IC, 6 Ix, 1 IIB, 5 IIIC and 1 IV. All patients had undergone primary surgical treatment, and in 8 cases adjuvant chemotherapy was given. The median RFS was 53.2 months with differences between patients receiving adjuvant chemotherapy (72.5 months) and not(48 months)and between patients optimally staged(64.5 months) or not(47 months). Recurrence sites were: pelvic,13; abdominal,6; lymph-nodal,2; pelvic + abdominal,7; abdominal + lymph-nodal,4; pelvic + lymph-nodal,3. Twenty-five patients underwent debulking surgery + chemotherapy, 6 patients surgery, 2 surgery + radiotherapy, 1 chemotherapy and 1 palliation. 69% completed chemotherapy. No difference was found in OS among patients receiving or not chemotherapy after secondary surgery at recurrence and among the different relapse sites. Eleven patients developed a second relapse after a median time of 38 months. 81.8% had received adjuvant therapy at first recurrence. Four patients underwent surgery, 4 surgery + chemotherapy, 1 surgery + radiotherapy and 2 palliation. Four patients developed a third recurrence after a median time of 41 months. Two patients received chemotherapy and 2 hepatic resection. Nine patients (25.7%) died of disease. 5y-OS from the first recurrence was 55.6% and 87.4% for patients with or without residual tumor at subsequent debulking surgery, respectively.

Conclusions

In GCTs surgery remains the cornerstone treatment at relapse. RFS was higher in patients who received adjuvant therapy after initial diagnosis, with no difference in OS.

Pelvic inflammatory disease and risk of invasive ovarian cancer and ovarian borderline tumors

Abstract

PURPOSE:

The aim of the study was to examine the potential association between a history of pelvic inflammatory disease (PID) and risk of epithelial ovarian cancer or ovarian borderline tumors.

METHODS:

In a population-based case-control study in Denmark, we included 554 women with invasive ovarian cancer, 202 with ovarian borderline tumors, and 1,564 controls aged 35-79 years. The analyses were performed in multiple logistic regression models.

RESULTS:

We found a significantly increased risk of ovarian borderline tumors among women with a history of PID (OR = 1.50; 95 % CI 1.08-2.08) but no apparent association between PID and risk of invasive ovarian cancer (OR = 0.83; 95 % CI 0.65-1.05). We found no effect of age at time of first PID or time since first PID on the risk for either condition.

CONCLUSION:

Our results suggest that a history of PID is associated with an increased risk of ovarian borderline tumors, which may support the hypothesis that inflammation is an etiological factor. The lack of an association between previous PID and invasive ovarian cancer may indicate an etiological difference between ovarian borderline tumors and invasive ovarian cancer. However, an important limitation of the study is the use of self-reported PID.

Overexpression of clusterin promotes angiogenesis via the vascular endothelial growth factor in primary ovarian cancer

Abstract

Clusterin (CLU), a multifunctional glycoprotein, is ubiquitously produced in mammalian tissues. CLU has been shown to play significant roles in many of the biological behaviours of human tumors, such as cell proliferation, apoptosis, chemoresistance and angiogenesis. However, the relationship of CLU expression with angiogenesis in ovarian cancer has not been studied. A total of 275 epithelial ovarian tumors were obtained from archives of paraffin‑embedded tissues. Immunohistochemical (IHC) staining for CLU and vascular endothelial growth factor (VEGF) was performed on a tissue microarray (TMA) including 181 primary ovarian epithelial cancer, 40 borderline ovarian tumors and 54 ovarian cancer mesenteric metastasis samples. Of the 174 cases, overexpression of CLU and VEGF were detected in 107 (61.5%) and 109 (62.9%) cases of primary ovarian carcinoma, respectively. Of the 107 cases of primary ovarian carcinoma with overexpression of CLU, expression of VEGF was increased in 82 (75.2%) cases. However, in another 67 cases without CLU overexpression, overexpression of VEGF was observed in only 27 (24.8%) cases (P<0.05). Overexpression of CLU in epithelial ovarian cancer appears to be correlated with increased tumor angiogenesis, consistent with the established role of CLU as an oncogene in the biology of ovarian cancer. In the treatment of ovarian cancer, these two markers may be used in the selection of patients for targeted therapy.

Tumour lysis syndrome in a patient with intravascular spread from a recurrent epithelial ovarian cancer

Abstract

Summary

Tumour lysis syndrome is a potentially life-threatening oncological emergency most commonly encountered in patients with rapidly proliferating, treatment-responsive haematological malignancies. It is rarely observed in solid tumours and, to our knowledge, this is the first time that it has been reported in a cancer with an intravascular tumour extension. In this report, we describe a case of a woman who presented with recurrent ovarian cancer and was found to have tumour invading into her vasculature. The patient subsequently developed tumour lysis syndrome after receiving chemotherapy. The case highlights the importance of considering tumour lysis syndrome prophylaxis when treating patients with intravascular involvement from a solid malignancy even if, as in this case, it is a recurrent tumour. Included is a brief review of the literature. We propose that ‘intravascular tumour invasion is recognised as an important risk factor for the development of tumour lysis syndrome.

Research: Chemoresponse assay helps boost ovarian cancer survival

press release

 Public release date: 25-Apr-2013

"This spring, a team of researchers has released results from an eight-year study that shows improved survival rates for women diagnosed with ovarian cancer who undergo cancer tumor testing to determine the best treatment.
Part of the team was Richard G. Moore, MD, director of the Center for Biomarkers and Emerging Technologies and a gynecologic oncologist with the Program in Women's Oncology at Women & Infants Hospital of Rhode Island.
"Essentially, we have demonstrated that by using a tissue sample from the patient's tumor and a chemoresponse assay, we are able to determine which treatment may or may not work for her," Dr. Moore explains of the study, which was presented at a recent meeting of the Society of Gynecologic Oncology and in the trade publication Cure.
"This study shows that a woman with recurrent ovarian cancer could benefit from having a biopsy and chemosensitivity testing. The results from such testing will allow for the identification of chemotherapeutics that are active against the patient's disease and those that are not resulting in decreased toxicity from ineffective treatments. Learning that personal directed therapies may improve overall survival for these patients made this the first study in two decades to show a significant increase in survival in recurrent ovarian cancer."
The study, launched in 2004, included 283 women. Of those, 262 had successful biopsies which were tested in vitro, or in a test tube. The assay ChemoFx®, by Precision Therapeutics, tested up to 15 approved treatment regimens on the samples, identifying chemotherapy drugs and regimens to which each tumor might be sensitive. The study was non-interventional, meaning that physicians chose the treatment regimens without knowing of the assay results. The researchers then evaluated the assay's result against actual patient outcomes.
"The assay identified at least one treatment to which the tumor would be sensitive in 52% of patients in the study," Dr. Moore says. "Overall, median survival was 37.5 months for patients with treatment-sensitive tumors, compared to 23.9 months for intermediate and resistant tumors."
Assay-directed therapy has long been debated among oncologists, he continues. Such debate provided the impetus for this study."

Detection of MicroRNA as Novel Biomarkers of Epithelial Ovarian Cancer From the Serum of Ovarian Cancer (serous) Patient

Abstract

Objective: MicroRNA (miRNA) is an abundant class of small noncoding RNAs that act as gene regulators. Recent studies have suggested that miRNA deregulation is associated with the initiation and progression of human cancer. However, information about cancer-related miRNA is mostly limited to tissue miRNA. The aim of this study was to find specific profiles of serum-derived miRNAs of ovarian cancer based on a comparative study using a miRNA microarray of serum, tissue, and ascites.

Methods: From 2 ovarian cancer patients and a healthy control, total RNA was isolated from their serum, tissue, and ascites, respectively, and analyzed by a microarray. Under the comparative study of each miRNA microarray, we sorted out several miRNAs showing a consistent regulation tendency throughout all 3 specimens and the greatest range of alteration in serum as potential biomarkers. The availability of biomarkers was confirmed by qRT-PCR of 18 patients and 12 controls.

Results: Out of 2222 kinds of total miRNAs that were identified in the microarray analysis, 95 miRNAs were down-regulated and 88 miRNAs were up-regulated, in the serum, tissue, and ascites of cancer patients. Among the miRNAs that showed a consistent regulation tendency through all specimens and showed more than a 2-fold difference in serum, 5 miRNAs (miR-132, miR-26a, let-7b, miR-145, and miR-143) were determined as the 5 most markedly down-regulated miRNAs in the serum from ovarian cancer patients with respect to those of controls. Four miRNAs (miR-132, miR-26a, let-7b, and miR-145) out of 5 selected miRNAs were significantly underexpressed in the serum of ovarian cancer patients in qRT-PCR.

Conclusions: Serum miR-132, miR-26a, let-7b, and miR-145 could be considered as potential candidates as novel biomarkers in serous ovarian cancer. Also, serum miRNAs is a promising and useful tool for discriminating between controls and patients with serous ovarian cancer.

Clinical and Ultrasound Features of Type I and Type II Epithelial Ovarian Cancer

Abstract

Objective: The objective of this study was to assess whether there are differences on ultrasound features between epithelial ovarian cancer (EOC) type I and type II.

Methods: This was a retrospective study comprising 244 women (mean age, 55.2 years old) with histologically proven EOC treated at our institution over a 12-year period. Clinical (patient age and symptoms and tumor stage), ultrasound (tumor volume, tumor appearance on gray-scale ultrasound, and color score), and histopathologic records were reviewed. Tumors were classified as EOC type I or type II. Type I tumors comprise low-grade serous, low-grade endometrioid, clear cell, mucinous, and transitional cell carcinomas, whereas type II tumors comprise high-grade serous, high-grade endometrioid, malignant mixed mesodermal tumors, and undifferentiated carcinomas.....

Results: Sixty-seven women (27.5%) had type I EOC, and 177 (72.3%) had type II EOC. We observed that women with type I EOC were younger, presented asymptomatic at diagnosis more frequently, and had lower CA-125 levels and lower tumor stage than women with type II EOC. Type II EOCs were more frequently identified as a solid mass and were smaller lesions than type I EOC.

Conclusions: Some differences exist between type I and type II EOC in clinical and ultrasound manifestations. Although the clinical significance of these findings is still to be determined, this information could provide some clues to clinicians faced with the diagnosis of ovarian cancer.

The Use of Humor in Patients With Recurrent Ovarian Cancer

Abstract
 

Objective: Humor has been shown to decrease the use of pain medicine, improve mood, and decrease stress. However, the timing and setting for using humor can be perceived differently depending on the patient and the context. Our objective was to better understand how patients with recurrent ovarian cancer experience humor to gain insight into the feasibility of using humor as a therapeutic adjunct.

Methods: We conducted structured patient interviews with women being treated for recurrent ovarian cancer. The phenomenological method of Colaizzi was used to gain an in-depth understanding of how women with recurrent ovarian cancer use and view humor in relation to their diagnosis.

Results: Most patients used humor to cope with cancer and felt that humor alleviated their anxiety. The use of humor by physicians and nurses was perceived as appropriate and positive. A previous relationship with a physician was often felt necessary before the use of humor. Humor was often perceived not only in traditional jokes but was also found in humorous anecdotes from the caregiver’s life outside of medicine.

Conclusions: This study revealed that humor is an often used coping mechanism for women with recurrent ovarian cancer and subjectively helps alleviate anxiety. The use of humor by physicians was found to be universally perceived as appropriate and positive. The waiting area seems to be a place where humorous experiences would be welcomed. These findings provide additional insight into the role that humor plays in the lives of patients with recurrent ovarian cancer.

Call for Abstracts: Gynecologic Oncology- Special Issue on 'Obesity'

Gynecologic Oncology

Published: 25 April 2013: Nadir CA-125 level as prognosis indicator of high-grade serous ovarian cancer

open access