Thursday, April 30, 2009
Patient Involvement in Decisions to Limit Treatment: The Crucial Role of Agreement Between Physician and Patient
"Conclusion Only half of the patients were involved in DLT. Surprisingly, the main predictor of patient involvement was not their medical condition, but agreement with physicians' palliative treatment goals. These results show that if physicians switch to comfort care in terminally ill patients and patients are not yet prepared to follow this line, treatment limitations are often decided without involving the patient."
Wednesday, April 29, 2009
Wait times for chemotherapy in Ontario growing, say advocacy groups
Working On IT! a book in progress: Dana Martinez (husband Ron)
I don't mind making this journey as long as I know that I am helping someone else. Every Cancer survivor I have ever met, has felt this way. There is something that happens to you once you have Cancer, you become part of a larger family-- a family bound by a common thread- "survival".
Tuesday, April 28, 2009
Let Me In!
power point presentation: Let Me In!
access link below:
www.scribd.com/doc/13044110/Ovarian-Cancer-Let-Me-In
Ovarian Cancer: Let Me In!
"Doc, Should I See You or My Oncologist?" A Primary Care Perspective
“Doc, Should I See You or My Oncologist?” A
Primary Care Perspective on Opportunities and
Challenges in Providing Comprehensive Care for
Cancer Survivors
Monday, April 27, 2009
Saturday, April 25, 2009
Friday, April 24, 2009
A Rapid and Reliable Test for BRCA1 and BRCA2 Founder Mutation Analysis in Paraffin Tissue Using Pyrosequencing
The founder mutations in BRCA (BRCA1*185delAG, BRCA1*5382insC, and BRCA2*6174delT) account for 95% of the detectable BRCA mutations in breast and ovarian cancer families of Ashkenazi Jewish ancestry.
Thursday, April 23, 2009
Intercepting pelvic cancer in the distal fallopian tube: theories and realities
This review summarizes the recent data supporting the distal fallopian tube as an important site for serous carcinogenesis, stressing both the presence of a novel precursor (the p53 signature) and the application of this model to all women irrespective of BRCA status. The challenges and unmet needs unmasked by this paradigm shift in ovarian cancer research are discussed.
Revisiting perioperative chemotherapy: the critical importance of targeting residual cancer prior to wound healing
Revisiting perioperative chemotherapy: the critical importance of targeting residual cancer prior to wound healing
Wednesday, April 22, 2009
Tuesday, April 21, 2009
April 21, 2009 - NCI Ovarian Cancer Markers Validated for Early Detection
NCI Cancer Bulletin for April 21, 2009 - National Cancer Institute: "The current guidelines of the U.S. Preventive Services Task Force do not recommend ovarian cancer screening with CA-125. Earlier this month another study using PLCO data concluded that screening women for ovarian cancer often led to unnecessary surgeries and failed to detect the disease in its early stages."
Monday, April 20, 2009
Primary Care Physicians' Views of Routine Follow-Up Care of Cancer Survivors
CO Early Release, published online ahead of print Apr 20 2009
Journal of Clinical Oncology, 10.1200/JCO.2008.20.4883
Primary Care Physicians' Views of Routine Follow-Up Care of Cancer Survivors
M. Elisabeth Del Giudice,* Eva Grunfeld, Bart J. Harvey, Eugenia Piliotis, and Sunil Verma
Department of Family and Community Medicine and Dalla Lana School of Public Health, University of Toronto; Sunnybrook Health Sciences Centre; Ontario Institute of Cancer Research and Cancer Care Ontario, Health Services Research Program; and Divisions of Hematology and Medical Oncology, Department of Medicine, Odette Cancer Centre, Toronto, Ontario, Canada.
* To whom correspondence should be addressed. E-mail: lisa.delgiudice@sunnybrook.ca
Purpose: Routine follow-up of adult cancer survivors is an important clinical and health service issue. Because of a lack of evidence supporting advantages of long-term follow-up care in oncology clinics, there is increasing interest for the locus of this care to be provided by primary care physicians (PCPs). However, current Canadian PCP views on this issue have been largely unknown.
Methods: A mail survey of a random sample of PCPs across Canada, stratified by region and proximity to urban centers, was conducted. Views on routine follow-up of adult cancer survivors and modalities to facilitate PCPs in providing this care were determined.
Results: A total of 330 PCPs responded (adjusted response rate, 51.7%). After completion of active treatment, PCPs were willing to assume exclusive responsibility for routine follow-up care after 2.4 ± 2.3 years had elapsed for prostate cancer, 2.6 ± 2.6 years for colorectal cancer, 2.8 ± 2.5 years for breast cancer, and 3.2 ± 2.7 years for lymphoma. PCPs already providing this care were willing to provide exclusive care sooner. The most useful modalities PCPs felt would assist them in assuming exclusive responsibility for follow-up cancer care were (1) a patient-specific letter from the specialist, (2) printed guidelines, (3) expedited routes of rereferral, and (4) expedited access to investigations for suspected recurrence.
Conclusion: With appropriate information and support in place, PCPs reported being willing to assume exclusive responsibility for the follow-up care of adult cancer survivors. Insights gained from this survey may ultimately help guide strategies in providing optimal care to these patients.
Press release: Cochrane Library free access to all Canadians
Ottawa, April 15, 2009— The Canadian Cochrane Network and Centre announces today
that everyone in Canada with access to the Internet will be able to view the full content of
The Cochrane Library, an on-line resource that provides evaluations on health
treatments.
The Canadian Cochrane Network and Centre, in partnership with the Canadian Health
Libraries Association, has successfully secured a national license to The Cochrane
Library. In essence, the license provides a subscription for every Canadian with access to
the Internet to benefit from the immense volume of health information found in The
Cochrane Library. Everybody will be one click away from the best available evidence on
the effectiveness of treatment procedures including which ones may be harmful.
Sunday, April 19, 2009
Hobnail-like cells in serous borderline tumor do not represent concomitant incipient clear cell neoplasms.
Hum Pathol. 2009 Apr 13
Hobnail-like cells in serous borderline tumor do not represent concomitant incipient clear cell neoplasms.
Ohishi Y, Oda Y, Kurihara S, Kaku T, Yasunaga M, Nishimura I, Okuma E, Kobayashi H, Wake N, Tsuneyoshi M.
Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan; Department of Diagnostic Laboratory, Kyushu University Hospital at Beppu, Beppu 874-0838, Japan.
Hobnail-like cells, which suggest a diagnosis of clear cell carcinoma, are also focally observed in serous borderline tumor of the ovary, causing diagnostic confusion. However, the precise nature of hobnail-like cells in serous borderline tumor has not been well characterized. The purpose of this study was to clarify whether or not hobnail-like cells in serous borderline tumor represent concomitant incipient clear cell neoplasms. First, we carefully reviewed hematoxylin and eosin slides taken from 115 ovarian tumors diagnosed as clear cell carcinoma (73 cases), mixed adenocarcinoma containing clear cell carcinoma (5 cases), and serous borderline tumor (37 cases) to clarify the frequency of coexistence of typical clear cell carcinoma and serous borderline tumor. Through the hematoxylin and eosin review, we paid special attention to the cytologic features of hobnail-like cells in serous borderline tumor and serous borderline tumor-like papillary areas in clear cell carcinoma. Second, we selected 19 serous borderline tumors and 16 clear cell carcinomas, in which hobnail-like cells were easily recognizable, and investigated the immunohistochemical expression of estrogen receptor and Wilms tumor gene protein. No coexistence of clear cell carcinoma and serous borderline tumor was evident in any of the above 115 ovarian tumors. Hobnail-like cells were focally positive for estrogen receptor and Wilms tumor gene protein in nearly all serous borderline tumors. Hobnail-like cells in all clear cell carcinomas were completely negative for estrogen receptor and Wilms tumor gene protein, although estrogen receptor expression was very focally observed (less than 5% area) in non-hobnail cells of only one clear cell carcinoma. In conclusion, hobnail-like cells in serous borderline tumor do not represent concomitant incipient clear cell neoplasms because (1) clear cell carcinoma and serous borderline tumor do not coexist and (2) hobnail-like cells in clear cell carcinoma and serous borderline tumor are immunophenotypically distinct. Recognition of our conclusion may protect a patient with "conspicuous hobnail-like cells in serous borderline tumor" from an erroneous overdiagnosis of "concomitant clear cell carcinoma admixed with serous borderline tumor."
Saturday, April 18, 2009
article: Guidelines needed for optimal vitamin D supplementation in cancer patients
"There may be specific benefits and harms associated with vitamin D supplementation in cancer patients that are not present in the general population, despite the fact that these benefits and harms have not been conclusively demonstrated,” Dr. Goodwin writes. “As a result, oncologists making recommendations to individual patients should take a cautious approach.”
Bias in the exchange of arguments: the case of scientists' evaluation of lay viewpoints- Public Understanding of Science
Note: a bit off topic but the last point taken:
"Abstract
Most perspectives on public participation share the notion that dialogues should be open, allowing participants to articulate and evaluate different views and knowledge claims. We hypothesize that participants' evaluation of claims may be biased because participants have a preference for a particular type or source of a claim. This would hamper an open dialogue.....
Contrary to our expectation, scientists evaluated claims of the public more positively than claims of experts."
The risk of colorectal cancer with symptoms at different ages and between sexes: a case-control study
Differences with age and sex are important; current guidance for referral ignores age
The diagnosis of colorectal cancer in patients with symptoms: finding a needle in a haystack
Table 1. Presenting symptoms and signs for 194 patients with colorectal cancer
Symptom Percentage of patients:
Fecal occult blood test positive 77
Rectal bleeding 58
Anemia* 57
Abdominal pain 52
Weight loss 39
Anorexia 27
Constipation 27
Altered stools 25
Fatigue 25
Diarrhea 22
Nausea and vomiting 22
Tenesmus 8
Mucus in stools 6
Rectal pain 5
Obstruction 4
Adapted from . Majumdar et al. [1].
*Anemia = a hemoglobin of <13.4g/dl in men or <12.3g/dl in women.
Friday, April 17, 2009
Inhibition of functional HER family members increases the sensitivity to docetaxel in human ovarian cancer cell lines.
In conclusion, a combination of docetaxel with inhibitors of HER family members, such as cetuximab plus pertuzumab, may be considered for a clinical trial in ovarian carcinomas with functional receptors.
Parity and the risk of breast and ovarian cancer in BRCA1 and BRCA2 carriers
This is the third independent study to find that, as in the general population, parity appears to be associated with protection from breast cancer in women with mutations in BRCA1 and BRCA2. Parity appears to be protective for ovarian cancer in BRCA1 mutation carriers, but its role in BRCA2 mutation carriers remains unclear. Whether later age at first birth is also protective for ovarian cancer in mutation carriers requires further confirmation.
Cochrane Collaboration: Interval debulking surgery for advanced epithelial
* Rates of toxic reactions to chemotherapy were similar in both arms (RR = 1.3, 95%CI: 0.4 to 3.6), but little information is available for other adverse events.
* Only one trial reported quality of life (QOL), which was generally similar in both treatment arms.
* No conclusive evidence was found to determine whether IDS between cycles of chemotherapy would improve or decrease the survival rates of women with advanced ovarian cancer, compared with conventional treatment of primary surgery followed by adjuvant chemotherapy. IDS appeared to yield benefit only in the patients whose primary surgery was not performed by gynecologic oncologists or was less extensive.
OCATS: Cancer survivor helps launch awareness campaign
media article:
Cancer survivor helps launch awareness campaign
e-letter of response:
Now, after close to a decade as one of the minority who has survived ovarian cancer, it is apparent that the message concerning this highly lethal woman's cancer, still is not receiving the respect nor attention it deserves. How, as a society, is it that we fail and continue to fail not only ovarian cancer women/families, but, all those who envision best care for this woman's cancer? The impact of hearing: "well, they are going to die anyway" is distressingly commonplace even today. Those are infuriatingly painful words to hear time and time again. Yet, here we have a small group of women fighting not only for themselves but for the future of Saskatchewan's children - your children. Each time we lose an ovarian cancer woman to this deadly cancer, a part of us dies with her - again and again. In good and bad economic times, little has changed, so it should be obvious that funding is not the issue. Policy makers need to be reminded that these women are not number-crunching statistics, but walking, breathing, caring Mothers, Sisters, Grandmothers and Citizens who have much Hope in the face of extreme adversity. Stick your neck out on this issue and make the obvious right decisions! You could make worse decisions. Sandi Pniauskas
OCATS: Cancer survivor helps launch awareness campaign
media article:
Cancer survivor helps launch awareness campaign
e-letter of response:
Now, after close to a decade as one of the minority who has survived ovarian cancer, it is apparent that the message concerning this highly lethal woman's cancer, still is not receiving the respect nor attention it deserves. How, as a society, is it that we fail and continue to fail not only ovarian cancer women/families, but, all those who envision best care for this woman's cancer? The impact of hearing: "well, they are going to die anyway" is distressingly commonplace even today. Those are infuriatingly painful words to hear time and time again. Yet, here we have a small group of women fighting not only for themselves but for the future of Saskatchewan's children - your children. Each time we lose an ovarian cancer woman to this deadly cancer, a part of us dies with her - again and again. In good and bad economic times, little has changed, so it should be obvious that funding is not the issue. Policy makers need to be reminded that these women are not number-crunching statistics, but walking, breathing, caring Mothers, Sisters, Grandmothers and Citizens who have much Hope in the face of extreme adversity. Stick your neck out on this issue and make the obvious right decisions! You could make worse decisions. Sandi Pniauskas
Thursday, April 16, 2009
Caring for the Morbidly Obese GYN Oncology Patient - Oncology Nursing News
"“In addition, there are obesity bias issues,” Ms Stuckwisch revealed, explaining that many studies exist indicating that nurses view obese patients as overindulgent, lazy, noncompliant, and unsuccessful. Other research shows 31% of nurses would prefer not to care for an obese patient and 24% say obese patients repulse them."
“Obesity can happen to anyone,” Ms. Stuckwisch reminded the attendees. “Overweight is a product of many factors. Overweight is not just related to overeating. There are multiple issues and no real answer to what causes people to cross over to extreme morbid obesity.”
Wednesday, April 15, 2009
Novogen 'Ovature' trial hit by crisis - Phenoxodiol
Novogen 'Ovature' trial hit by crisis
April 15, 2009 - 2:54PM
Biotech Novogen Ltd's US subsidiary has decided to undertake an interim analysis of its phase III "Ovature" trial, saying slowing patient recruitment rates and the global financial crisis has made it imprudent to fund the trial to completion.
The Ovature (Ovarian Tumour Response) study is trialling the anti-cancer drug phenoxodiol in women with advanced ovarian cancer to determine its safety and effectiveness when used in combination with chemotherapy drug carboplatin.
Novogen said its US subsidiary, Marshall Edwards Inc, had announced that new patient recruitment to the Ovature trial would cease and available data from the 141 completed and current patients would be analysed for safety and efficacy outcomes.
"The company has decided to assess these data from the Ovature trial at this time as the current downturn in the global financial markets makes raising further equity or debt in the near term to fund the trial through to completion most unlikely," Marshall Edwards said....cont'd
Subscribe to:
Posts
(
Atom
)
