Wednesday, December 31, 2008
Tuesday, December 30, 2008
Monday, December 29, 2008
Message from Gilles Frydman, ACOR founder
| From Gilles Frydman, ACOR founder | |
Dear list member,
Today I am going to ask you to support ACOR with a donation. If this sounds unusual, read on! Why does one of the world's largest cooperative of patient-run medical online communities ask for financial support from its users?
ACOR, which I founded in 1996, is built differently from almost every other cancer advocacy organization. We exist only online. We have a number of volunteer staff, just over 100. ACOR content is free to use by anyone. Our annual expenses are currently less than $350,000 dollars. We do a lot with very little money! But we should be doing more!
At its core, ACOR is driven by a global community of cancer patients and caregivers (more than 50,000 of you) - all dedicated to sharing knowledge freely. Over almost thirteen years, listmembers have contributed countless email messages, many of them of great value to other community members. More than 75,000 people come to our website/ listservs every day to access information, free of charge, free of bias and free of advertising.
But ACOR is more than a website. We share a common cause: Imagine a world in which every single cancer patient is given free and immediate access to valid, current and accurate knowledge to help them understand their disease, assess all available treatments and understand the long-term impact of a cancer diagnosis. That's our commitment. Day after day, we push a little more to make sure no one becomes another victim of the opaque medical world.
Your donation helps us in several ways. Most importantly, you will help us cover the increasing cost of managing global traffic to one of the most popular cancer websites on the Internet. Funds also will help us improve the software that runs the ACOR communities -- making it easier to search the archives, easier to read and to classify messages from others, and easier to organize the information you need to become a truly engaged and empowered patient/caregiver. We want to build new services that will help all of you meet others socially in more engaging ways than is possible with plain listservs. We want to give you new tools to tell your story and share with others pictures and videos. We would like to build the largest gallery of art from cancer patients, including visual art, moving images, poetry, etc. Finally we are committed to growing the free knowledge access world-wide, by recruiting new volunteers, developing communities in many languages and geared to minorities, and building strategic partnerships with foreign medical institutions.
ACOR is different. It's probably the largest cancer support system in history, run by volunteers and with content entirely generated by patients and caregivers. Like any real public health service, we don't believe advertising should have any place in an ACOR community or anywhere on our website(s). We want to keep all of these free and strong, but in order to make it happen we need the support of thousands of people like you.
I invite you to join us, at any level you feel comfortable: Your donation will help keep ACOR free for all those who need and will need access to support and information.
Come visit http://www.acor.org/donate/now/
Thank you,
Gilles Frydman
Founder, ACOR.org
ICES 2008: Cancer surgery in Ontario
Cancer surgery in Ontario
Overview [2.62 MB PDF]
Chapter 1: Introduction [2.38 MB PDF]
Chapter 2: Surgery for Breast Cancer [3.79 MB PDF]
Chapter 3: Surgery for Prostate Cancer [3.25 MB PDF]
Chapter 4: Surgery for Colorectal Cancer [4.22 MB PDF]
Chapter 5: Surgery for Lung Cancer [3.45 MB PDF]
Chapter 6: Surgery for Uterine Cancer [3.03 MB PDF]
Chapter 7: Surgery for Ovarian Cancer [3.00 MB PDF]
Chapter 8: Surgery for Cervical Cancer [3.79 MB PDF]
Chapter 9: Surgery for Vulvar Cancer [2.37 MB PDF]
Chapter 10: Reflections and Recommendations [2.05 MB PDF]
Technical Appendix (full version) [2.44 MB PDF]
Sunday, December 28, 2008
Patients with a history of epithelial ovarian cancer presenting with a breast and/or axillary mass
Patients with a history of epithelial ovarian canc...[Gynecol Oncol. 2008] - PubMed Result
CONCLUSION:
The interval between EOC diagnosis and the breast and/or axilla event, an elevated CA125 level, and a family history of breast and/or ovarian cancer may help differentiate patients with metastatic EOC to the breast and/or axilla from those patients with a second primary breast cancer. The presence of a metastatic EOC portends a poor prognosis.
(Note: EOC = Epithelial Ovarian Carcinoma)
Challenges in multidisciplinary cancer care among general surgeons in Canada
Abstract | Challenges in multidisciplinary cancer care among general surgeons in Canada:
"Conclusions
General surgeons appear to use a wide range of information resources but they may not address the complex needs of many cancer patients. Decision-making is challenged by informational and logistical issues related to the coordination of multidisciplinary care. This suggests that limitations in system capacity may, in part, contribute to variable guideline compliance. Further research is required to evaluate the appropriateness of information seeking, and both concurrent and consecutive mechanisms by which to achieve multidisciplinary care."
Clinical Patterns and Biological Correlates of Cognitive Dysfunction Associated with Cancer Therapy
Clinical Patterns and Biological Correlates of Cognitive Dysfunction Associated with Cancer Therapy -- Dietrich et al. 13 (12): 1285 -- The Oncologist
"Adult patients typically report cognitive symptoms, such as difficulties with memory and attention, soon after initiating treatment. Frequently, these symptoms persist after completion of therapy and are a cause of considerable distress for individuals who are unable to return to their previous academic, occupational, or social activities, or are able to do so only with significant additional mental effort. Long-term evaluation of cancer survivors has raised concerns that cancer and cancer therapy may result in persistent and late emerging cognitive dysfunction [25–27]. This observation has been supported by recent experimental studies. Both radiation and commonly used chemotherapy agents have been shown to cause acute and delayed injury to the CNS"
Saturday, December 27, 2008
Health 2.0 & The Widening Digital Divide: A Call to Action | e-Patients.net
Health 2.0 & The Widening Digital Divide: A Call to Action | e-Patients.net
"Too many years witnessing the same thing. First in the ACOR system. Then in many conferences about eHealth, e-Patients and now Health 2.0 and the Connected Health symposium at Harvard Medical School. Why is an entire segment of the US population almost completely absent from the fast evolving world of Health 2.0 and Participatory Medicine?............And if we do not force a change there is no reason this sad situation should change."
Friday, December 26, 2008
Influence of Intraoperative Capsule Rupture on Outcomes in Stage I Epithelial Ovarian Cancer.
- Obstet Gynecol. 2009 Jan;113(1):11-17.
-
Influence of Intraoperative Capsule Rupture on Outcomes in Stage I Epithelial Ovarian Cancer.
From the 1Division of Gynecologic Oncology, Mayo Clinic, Rochester, Minnesota; 2Division of Gynecologic Oncology, the Ohio State University College of Medicine, Columbus; and 3Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota.
OBJECTIVE:: To evaluate the effect of tumor capsule rupture on disease prognosis in stage I epithelial ovarian cancer.
METHODS:: All patients with International Federation of Gynecology and Obstetrics stage I epithelial ovarian cancer operated on at the Mayo Clinic and The Ohio State University between January 1991 and December 2007 were identified. Relevant tumor characteristics, procedures performed, adjuvant therapies, and follow-up were recorded and analyzed. Inclusion criteria included comprehensive staging. Cox proportional hazards, Kaplan-Meier estimation, log rank test, and chi test were used for statistical analyses.
RESULTS:: There were 161 cases that met inclusion criteria. Seventy-four (46%) patients had intact capsules without positive cytology or surface involvement; 61 (38%) had capsule rupture; 33 (20%) had positive cytology; and 22 (14%) had surface involvement. Overall, 22 of 161 (14%) patients recurred and 12 of 161 (7%) patients died of their disease. In univariable analysis, both intraoperative capsule rupture and positive cytologic washings portended worse disease-free survival (hazard ratio [HR] 3.6, 95% confidence interval [CI] 1.5-8.9; P=.004 and HR 5.2, 95% CI 2.1-12.3; P<.001, respectively) and disease-specific survival (HR 4.1, 95% CI 1.3-15.4; P=.018 and HR 5.9, 95% CI 1.8-19.3; P=.005, respectively). In multivariable analysis, capsule rupture (HR 4.2, 95% CI 1.8-10.9; P=.001) and positive cytologic washings (HR 6.4, 95% CI 2.5-16.0; P<.001) remained independent predictors of worse disease-free survival. Disease-free survival and disease-specific survival were shortest for stage IC cases with positive cytology, surface involvement, or both, that also had intraoperative rupture.
CONCLUSION:: In stage I epithelial ovarian cancer, intraoperative capsule rupture portends a higher risk of disease recurrence and death from disease. Careful intraoperative removal of ovarian masses is important, and recognizing the higher-risk nature of such cases is imperative. LEVEL OF EVIDENCE:: III.
Monday, December 22, 2008
Research Summary: Australia - blood test for ovarian cancer OvPlex
Bloodtest-ovariancancer
"On 28 October 2008, OvPlex™ was released to the Australian market as a diagnostic test for women suspected of having ovarian cancer. The test is initially available through general practitioners in Melbourne at a cost of $200 to the patient. Healthlinx Limited plans to roll the availability of the test out across the country. OvPlex™ is not being marketed for use as a population screening test."
Sunday, December 21, 2008
Relapse and survival in early-stage ovarian cancer
Relapse and survival in early-stage ovarian cancer. [Arch Gynecol Obstet. 2008] - PubMed Result
CONCLUSION:
Patients with early ovarian cancer stage pT1c and pT2a or low grade tumor have to be
monitored closely in oncologic follow-up as they bare a significant risk for disease recurrence.
Ascites at primary diagnosis, pT1c or pT2a tumor stage or recurrent disease are associated
with a poor survival even in early ovarian cancer.
Patient satisfaction with quality of life as a prognostic indicator in ovarian cancer patients treated in an integrative treatment setting
Patient satisfaction with quality of life as a pro...[J Soc Integr Oncol. 2008] - PubMed Result
"Our study has demonstrated no statistically significant prognostic association of patient satisfaction with QoL, as measured by the QLI, with survival in ovarian cancer."
Canadian Doctors for Medicare-Position on Activity-based funding in Canadian Hospitals and other Surgical Facilities (references intl sources)
ABF-final-9.8.8.pdf (application/pdf Object)
What is activity-based funding?
Widespread confusion exists around the jargon used to describe different ways of funding
hospitals.
Activity-based funding (ABF) is also known in the UK as payment-by-results
(PbR), as patient-focused funding (PFF) by the Canadian Medical Association, as servicebased
funding or case-mix funding by the Kirby Commission, as prospective payment
system (PPS) in the US, and elsewhere as payment-for-volume, or volume-based funding.
We use the relatively neutral term of activity-based funding, because the focus is not
necessarily on the patient, but rather on the type and volume of service delivered.
Health and QOL Outcomes: How do medical students value health - evaluation of hypothetical health states compared to the general population
1477-7525-6-111.pdf (application/pdf Object)
In a recent European survey on the acceptance of quality of life measurement between 72-90% of
the physicians accepted quality of life (QoL) as an outcome measure, however with less than 50%
accepting the concept of quality adjusted life years (including utility measurement) [2]. In a similar
survey in the United States and Canada only about one third of the physicians had ever collected
data on quality of life or had taken it systematically into account in clinical decision making [3].
Medical students gain a different perspective on health problems during their medical education by developing the role of a medical doctor. The participation in a health state
valuation task potentially allows them to reflect on a patients’ perspective on decision making when
being confronted with hypothetical health states. Further it has been acknowledged that there is a
need for health related quality of life education in medical school [4]......Futures studies should investigate the change of health states valuations of health care professionals over the period of their medical training.
SABCS: Breast Cancer Risk No Higher for BRCA1/2-Negative Women from Mutation-Positive Families - Meeting Coverage
Medical News: SABCS: Breast Cancer Risk No Higher for BRCA1/2-Negative Women from Mutation-Positive Families - in Meeting Coverage, SABCS from MedPage Today
Action Points
* Explain to patients that women who are not carriers of BRCA1/2 mutations do not have an increased risk of breast cancer, even if they come from a mutation-positive family.
* Note that this study was published as an abstract and presented orally at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
Saturday, December 20, 2008
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