Monday, March 30, 2009
Big Cancer Bill Aims to Increase Biomarker Research and Use - U.S.
"ALERT (Act) also would have NCI report annually on its plans and progress regarding research on cancers with low incidence and survival rates, and would establish a grants program to conduct research on such cancers.
Among other measures, the act also would establish a grant program for the states that would fund colorectal cancer screening and referrals for medical treatment that is similar to the national breast and cervical cancer programs.
The bill also includes a number of measures and programs aimed at the issues surrounding patients and health insurance coverage, including a provision that would enable patients to continue to receive coverage for treatment while they are in clinical trials."
2009 Evidence Updates: Meat Intake and mortality: a prospective study of over a half a million people including commentaries
full free pdf file original article:
http://archinte.ama-assn.org/cgi/reprint/169/6/562.pdf
abstract + commentary:
http://plus.mcmaster.ca/EvidenceUpdates/HitParade.aspx?A=26486
Sunday, March 29, 2009
Early Cancer Detection Fizzles Again Newsweek article
How much less threatening are cancers detected early? Last November, scientists reported that about one quarter of breast cancers detected (early) on mammograms vanish spontaneously. Yet breast-cancer survivors swear early detection saved their life. Some melanomas, kidney cancers and neuroblastomas perform a similar vanishing act, says Kramer. Will doctors' enthusiasm and patients' demand for cancer screening diminish as a result of the science? After the PSA studies came out, a scientist told clinicians he assumed so. They looked at him as if he were crazy. No matter what science says, it will be a cold day in hell before patients let go of the one slender hope they feel they have to beat cancer.
Saturday, March 28, 2009
Cancer incidence in vegetarians: results from the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford) -- Key et al., 10.3945/ajcn.2009.26736M -- American Journal of Clinical Nut
"Conclusions: The overall cancer incidence rates of both the vegetarians and the nonvegetarians in this study are low compared with national rates. Within the study, the incidence of all cancers combined was lower among vegetarians than among meat eaters, but the incidence of colorectal cancer was higher in vegetarians than in meat eaters."
Friday, March 27, 2009
Knowledge about (Lynch Syndrome) hereditary nonpolyposis colorectal cancer; mutation carriers and physicians at equal levels
Two thirds of physicians and family members alike failed to recognize the increased risk of ovarian cancer in HNPCC
Conclusions
In summary, this study reveals weaknesses in HNPCC knowledge, particularly among physicians. By tradition, the medical perspective dominates and decides on relevant and evidence based interventions. When a majority of the physicians misinterpret hereditary mechanisms, underestimate the risk of cancer, and fail to recognize HNPCC associated tumor types the likelihood of misinformation is high. Physician behaviour may also influence patient adherence to surveillance programmes, and our findings strongly suggest that improved education in genetic medicine is needed for physicians responsible for diagnosis and management of the growing number of individuals at increased risk of cancer [31-33].
Thursday, March 26, 2009
AJG - Abstract of article: Incidence of Right-Sided Colorectal Cancer After Breast Cancer: A Population-Based Study (Manitoba)
note: right sided colorectal cancer specific
Microcystic stromal tumor of the ovary: report of 16 cases of a hitherto uncharacterized distinctive ovarian neoplasms
"These tumors, to date, have occurred over a wide age range in postpubertal females, are characteristically unilateral, and confined to the ovary at presentation. They represent, in addition to the sclerosing stromal tumor (segregated out 3 decades ago), a distinctive subtype of ovarian tumor, likely also belonging to the stromal category based on current evidence."
Wednesday, March 25, 2009
Ovarian cancers detected early may be less aggressive, questioning effectiveness of screening
For this study, researchers examined samples of advanced ovarian cancers from patients who had experienced long-term survival -- over seven years -- and patients who had done extremely poorly, and died within three years of diagnosis.
"We found that certain patterns predicted long-term survival and others predicted a poorer prognosis in advanced stage cases," Berchuck said. "Cancers that were detected at an early stage almost always shared gene expression characteristics with advanced stage cases that were long-term survivors, suggesting a shared favorable biology."
Tuesday, March 24, 2009
Medical News: JAMA Announces Gag Rule on Conflict-of-Interest Whistleblowers
CHICAGO, March 23 -- "Individuals who spot undisclosed conflicts of interest by authors published in the Journal of the American Medical Association are invited to inform the journal's editors -- but telling anyone else is forbidden under a new JAMA policy....."
Monday, March 23, 2009
WISE: Policies of Exclusion, Poverty & Health: Stories from the Front
"We will not give you statistics. We will not say how many of us are
students, retired, single mothers, living alone or living with a spouse,
working or on government assistance. We will say that we have all
those covered. We will not give our ages, since age is irrelevant to
who we are."
Sunday, March 22, 2009
Saturday, March 21, 2009
Quality of Care Review: Some Progress, and Toward What Goal? -- Chu (Correspondence JCO)
"However, patient and family involvement in the decision-making process has been peripheral."
Friday, March 20, 2009
Clinical Follow-up and Presence of Visceral Tumors in 12 Patients With Sebaceous Gland Tumors (Lynch Syndrome & Muir-Torre Syndrome & clear cell)
Excerpts:
Reports of MTS in families with hereditary nonpolyposis colorectal cancer (HNPCC), also known as Lynch
syndrome,8 appeared for the first time in the 1980s. It was subsequently discovered that patients with MTS and HNPCC had the same genetic defect involving proteins responsible for DNA mismatch repair.9,10 It is now believed that MTS is a clinical form of HNPCC.11
Visceral malignancies in HNPCC typically affect the colon, but they can also be found in the endometrium, the ovary, the stomach, the small intestine, the ureter, the renal pelvis, and the brain.12 Other features of MTS include the presence of multiple tumors, early-age onset of tumors, and, in some cases, improved prognosis when tumors appear spontaneously.11
Nonetheless, it should be borne in mind that breast cancer and indeed other cancers described
in patients with MTS have not been definitively associated with HPNCC,25 meaning that their existence may, on occasions, be purely coincidental. Another group of authors proposed performing a computed tomography scan of the abdomen and pelvis every 2 to 5 years19 because 35% of abdominal tumors in MTS occur at sites other than the colon.27
Dermatologists play a key diagnostic role in MTS. Our findings suggest that some dermatologists underestimate the potential severity of sebaceous tumors, disregard the importance of family history of cancer, and fail to order additional studies to exclude visceral malignancies.
Thursday, March 19, 2009
OWHN - e-Bulletin - archives
Written for the Ontario Women's Health Network with special attention to this section:
IN YOUR OWN WORDS:
(Sandi Pniauskas - Editorial note: These stories are unedited and while some of the details are difficult to imagine, we recognize in each and every one the actual goodness, caring and strengths of the human spirit.)
survivours helping survivours: "I am alive today because of my guardian angel.
My angel {who is an ovarian cancer survivor herself with the courage to learn and lobby for what should be our GIVEN rights) saved my life by validating my condition and personally fighting the system on my behalf."
Alicia : Ovarian cancer for twenty-something "dummies"
Barb B : The first time I saw him I knew I would be in trouble (since died)
Barb L : Our Mom, Faith and Alternatives
Beth : A nurse and her guardian angels
Bonnie: I am a survivour (since died)
David: Heroism....from a husband and an admirer and the goodness within
Donna: Closer bonds: hats, hats and more hats
Heidi: Being adopted complicates the decision-making process
Irene: Written off due to age - Living alone - Supporting Others
Lynda: Same year x 2: Mom and Me
Noreen: Surviving breast cancer twice, ovarian cancer and no options (since died)
Penny: Single, taking charge, my dog and it must have been the rum (since died)
Phil: Married between chemo #3 and #4
Phase II Evaluation of Nanoparticle Albumin–Bound Paclitaxel in Platinum-Sensitive Patients With Recurrent Ovarian, Peritoneal, Fallopian Tube Cancer
Main inclusion criteria were histologically or cytologically confirmed epithelial cancer of the ovary, fallopian tube, or peritoneum (any stage, grade 2 to 3 if stage I) and measurable disease according to Response Evaluation Criteria in Solid Tumors (RECIST) or elevated CA-125 (> 70 U/mL) in patients without measurable disease.
Wednesday, March 18, 2009
Tuesday, March 17, 2009
Patient Destiny: One Patient, One Record (OPOR) Symposium
By invitation only - April 21, 2009 symposium (Toronto)
Yet, even though the patient group represents the fundamental foundation of the healthcare system, patients have seldom been viewed as more than a “by-product” or “side-effect”. To illustrate, patients are not typically involved in (i) setting healthcare policy; (ii) conducting and disseminating research; (iii) coordinating patient networks; (iv) providing or managing individual care; and (v) evaluating the performance and outcomes of varied healthcare delivery plans.
Editorial: Health Behaviors Influence Cancer Survival
To date, however, no trial has tested a multiple-component intervention that includes smoking cessation, diet, exercise, and possibly alcohol components
among individuals diagnosed with cancer.
Monday, March 16, 2009
Early Detection Remains Key in Updated NCCN Guidelines for Ovarian Cancer
Press release from NCCN conference
see also: http://www.nccn.org
Sunday, March 15, 2009
eMJA: The benefits of oestrogen following menopause: why hormone replacement therapy should be offered to postmenopausal women
Abstract
Recently, two major epidemiological studies found that hormone replacement therapy (HRT) in postmenopausal women increased the risk of breast cancer. One of the studies also found that HRT increased the risk of cardiovascular disease and thrombosis. As a consequence, women were advised to cease this therapy.
However, detailed analysis of these studies suggests that the conclusions may be erroneous. Other studies suggest that the timing of initiation of HRT for healthy women is critical to achieving a beneficial outcome.
When begun within 5 years of menopause in healthy women, oestrogen-based HRT results in far greater benefits than adverse outcomes.
There is substantial objective evidence that the benefits of HRT include:
Reduced distressing symptoms of menopause.
Reduced risk of osteoporotic fractures, dementia and colorectal cancer.
Improved wellbeing, quality of life; improved vaginal epithelium, sexual enjoyment and bladder capacity.
Improved cardiovascular system, with reduced myocardial ischaemia and cardiovascular-related death.
Increased longevity.
The adverse effects of HRT include:
Oral HRT doubles the risk of thromboembolism.
HRT promotes growth of pre-existing breast cancer.
Genetics in Medicine - Abstract: March 2009 The impact of patents on the development of genome-based clinical diagnostics: an analysis of case studies
2009 abstract: The impact of patents on the development of genome-based clinical diagnostics: an analysis of case studies.
Saturday, March 14, 2009
Genetics in Medicine - Abstract: Volume 10(9) September 2008 p 648-654 Economic methods for valuing the outcomes of genetic testing: beyond cost-effectiveness analysis.
Genetics in Medicine - Abstract: Volume 10(9) September 2008 p 648-654 Economic methods for valuing the outcomes of genetic testing: beyond cost-effectiveness analysis.
Genetics in Medicine - Fulltext: Volume 11(1) January 2009 p 3-14 The Evaluation of Genomic Applications in Practice and Prevention (EGAPP) initiative: methods of the EGAPP Working Group.
Genetics in Medicine - Fulltext: Volume 11(1) January 2009 p 3-14 The Evaluation of Genomic Applications in Practice and Prevention (EGAPP) initiative: methods of the EGAPP Working Group.
Genetics in Medicine - Fulltext: Volume 11(1) January 2009 p 35-41 Recommendations from the EGAPP Working Group: genetic testing strategies in newly diagnosed individuals with colorectal cancer aime
Genetics in Medicine - Fulltext: Volume 11(1) January 2009 p 35-41 Recommendations from the EGAPP Working Group: genetic testing strategies in newly diagnosed individuals with colorectal cancer aimed at reducing morbidity and mortality from Lynch Syndrome in relatives
Genetics in Medicine - Abstract: Verification of consumers' experiences and perceptions of genetic discrimination and its impact on utilization of genetic testing
"Conclusion: These first cases of verified genetic discrimination make it essential for policies and guidelines to be developed and implemented to ensure appropriate use of genetic test results in insurance underwriting, to promote education and training in the financial industry, and to provide support for consumers and health professionals undertaking challenges of adverse decisions."
Cancer surveillance behaviors in women presenting presenting for clinical BRCA genetic susceptibility testing
"About 60% of participants engaged in at least the minimum recommended breast cancer surveillance behaviors, but 70% had suboptimal ovarian cancer surveillance behaviors. Lack of physician recommendation was the most frequently reported reason for not having surveillance procedures."
Friday, March 13, 2009
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