47. 2008Sept CHCI Final.pdf (application/pdf Object)
No province in Canada has legislation defending the rights of patients.
Thursday, September 18, 2008
2008 Canada Health Consumer Index
47. 2008Sept CHCI Final.pdf (application/pdf Object)
Wednesday, September 17, 2008
Modification of risk for subsequent cancer after female breast cancer by a family history of breast cancer
Modification of risk for subsequent cancer after f...[Breast Cancer Res Treat. 2008] - PubMed Result
- Breast Cancer Res Treat. 2008 Sep;111(1):165-9. Epub 2007 Sep 27.
-
Modification of risk for subsequent cancer after female breast cancer by a family history of breast cancer.
Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. k.hemminki@dkfz.de
An increased risk of second primary cancers may depend on many reasons, including therapy for the first cancer and heritable causation. Population level data are not available exploring the risks of subsequent cancers after breast cancer considering a familial history of breast cancers. We used the nation-wide Swedish Family-Cancer Database to investigate such risks, based on 43,398 first invasive female breast cancers. Standardized incidence ratios (SIRs) were calculated for the second cancer after breast cancer using rates for first cancer as a reference. Many cancers at discordant sites were increased after breast cancer. SIRs for subsequent neoplasms in women who had a family history of breast cancer were increased for ovarian (2.0) and endometrial (1.8) cancers and for acute lymphoid leukemia (12.7) and myelofibrosis (9.4). The data suggest that the familial aggregation of breast and endometrial cancers may be explained by yet unidentified heritable causes. The remarkably high risks for second acute lymphoid leukemia and myelofibrosis, both characterized by chromosomal aberrations, in women with a family history of breast cancer may signal heritable defects in the ability to process DNA damage caused by ionizing radiation and chemotherapy.
Tuesday, September 16, 2008
Lymphadenectomy Improves 5-Year Survival Rates in Ovarian Cancer Patients: Presented at ESSO
"Since there might be some overlap between performing radical surgery and performing lymphadenectomy, maximal cytoreduction should remain the main objective in ovarian cancer surgery," Dr. Bergzoll concluded.
[Presentation title: The Therapeutic Role of Lymph Node Resection in Ovarian Cancer: Analysis of the Surveillance, Epidemiology, and End Results Database. Abstract 152]
2008 OCNA award winners: Carolyn Benivegna and Karen Mason
OCNA 2008 Award Winners! CONGRATULATIONS!
Cindy Melancon Spirit of Survivorship AwardHailing from Novi, Michigan, Carolyn Benivegna will be this year’s recipient in honor of her persistent advocacy for promoting awareness for ovarian cancer. Carolyn is an ovarian cancer survivor and the founder of the Ovarian Cancer Alliance of Florida-Gulf Coast. She then moved to Michigan when she made a great impact by working with Governor Jennifer Granholm to declare September as Ovarian Cancer Awareness Month. Carolyn and her husband were also recognized by The Henry P. Tappan Society from the University of Michigan for establishing an endowed Ovarian Cancer Research Fund at UM.
The Voice for Ovarian Cancer Research Award
Taking the trip from Woodbury, NJ will be Karen Mason. After being diagnosed at the age of 49, she quickly discovered that getting involved in the ovarian cancer community was a great coping mechanism. Last Fall Karen was invited to be a member of the Dept of Defense’s Integration Panel where proposals are chosen for funding by the Department of Defense’s Ovarian Cancer Research Program. She also serves as a patient advocate for the Fox Chase Cancer Center ovarian SPORE as a full participating member of their Institutional Review Board evaluating consent forms for clinical trials. Karen is continually involved with NED (no evidence of disease) and is a part-time ICU nurse, wife and mother of two sons.
JCO.2008 Progress in Cancer Care: The Hope, the Hype, and the Gap Between Reality and Perception
Progress in Cancer Care: The Hope,JCO.2008.17.6198v1.pdf (application/pdf Object)
the Hype, and the Gap Between Reality
and Perception
abstract:
JCO Early Release, published online ahead of print Sep 15 2008
Journal of Clinical Oncology, 10.1200/JCO.2008.17.6198
| |
Progress in Cancer Care: The Hope, the Hype, and the Gap Between Reality and Perception
Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, and Weill Medical College of Cornell University, New York, NY
Monday, September 15, 2008
Monday September 15th, 2008: CANO conference presentation - Survivors' Debate: The Past Decade in Ovarian Cancer
Survivors Debate: The Past Decade in Ovarian Cancer
Pamela J. West1, Sandi Pniauskas2, Carolyn Benivegna3. 1Rouge Valley Health System, Toronto,
ON, Canada, 2No Institution - patient, Whitby, ON, Canada, 3No Institution - patient,
Novi, MI, USA.
Thursday, March 27, 2008
Wednesday, September 05, 2007
Thursday, July 26, 2007
Survivors Debate: "the Past Decade in Ovarian Cancer"
Carolyn Benivegna and Sandi Pniauskas
contact: Sandi Pniauskas 905 668-0767
email: sandipn@sympatico.ca
further information/registration: http://ovariancancerdebate.blogspot.com
online poll: http://cancerissues.blogspot.com/
Survivors' Debate: “The Past Decade in Ovarian Cancer”
WHAT: Ovarian cancer survivors, Carolyn Benivegna (U.S.) and Sandi Pniauskas (Canada), announce the first ever Ovarian Cancer Survivors Debate. The two conferences are survivor-led and survivor-organized with debate and discussion surrounding the multitude of issues - the past and the present. Open and lively dialogue will be encouraged.
WHO SHOULD ATTEND: All cancer survivors/caregivers, healthcare professionals, researchers, pharmacists and the general public are encouraged to attend and participate.
WHERE/
WHEN:
#1: Sheraton Hotel, Novi, MI Sat. October 27th, 2007
#2: Metropolitan Hotel, Toronto, ON Sat. November 3rd, 2007
Time: 10:00 am - 12:30 pm
BACKGROUND:
Ovarian cancer has the highest mortality rate of all gynecologic cancers. Ovarian cancer has no early detection test. The debate and ensuing open forum public discussions will include the specifics of disease-related issues including genetics, access to care and communications. Carolyn Benivegna is a nine year ovarian cancer survivor, a BRCA1 carrier and Founder/Board Member of OCAG-GC. Sandi Pniauskas is an eight ovarian cancer survivor with a genetic predisposition to Lynch Syndrome/Hereditary NonPolyposis Colorectal Cancer and a member of the Cochrane Collaboration. Carolyn and Sandi are energetic, knowledgeable ovarian cancer advocates and activists since the beginning of their journeys.
Ovarian cancer survivors Annamarie DeCarlo and Dr. Yi Pan will co-moderate both events. Bridget Capo (R.N.) and Pamela J. West (R.N.) will provide support and collaborate with Benivegna and Pniauskas in formal publication of the event proceedings.
Friday, July 20, 2007
Sunday, July 15, 2007
Lynch Syndrome - Cancer Prevention with Lynch Syndrome
Sandi's comments: One of the issues that I have is the reference in the article: "If you're a woman with Lynch syndrome, you may want to mention this study to your doctor and get her take on how it might apply to you."
As a generalization, the vast majority of hcps have never heard of the Lynch Syndrome (HNPCC).
Lynch Syndrome - Cancer Prevention with Lynch Syndrome: "If you're a woman with Lynch syndrome, you may want to mention this study to your doctor and get her take on how it might apply to you."
Saturday, July 14, 2007
The quality of the operative report for women with ovarian cancer in Ontario.
The quality of the operative report for women with...[J Obstet Gynaecol Can. 2006] - PubMed Result: "
All: 1
Review: 0
[Click to change filter selection through My NCBI.]
1: J Obstet Gynaecol Can. 2006 Oct;28(10):892-7."
Review:
J Obstet Gynaecol Can. 2006 Oct;28(10):892-7.
The quality of the operative report for women with ovarian cancer in Ontario.
Elit L, Bondy S, Chen Z, Law C, Paszat L.
Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada.
OBJECTIVE: To assess the quality of the operative reports from cases of ovarian cancer surgery in Ontario.
METHODS: We undertook a population cohort study including all newly diagnosed ovarian cancer patients treated initially with surgery from January 1996 to December 1998 in Ontario (n = 1341). We abstracted charts from hospitals and cancer centres. All surgical and pathology notes were abstracted into an ACCESS database.
RESULTS: A total of 1,341 women had surgery as the first step in management of ovarian cancer. A vertical abdominal incision was used in 87.6% of these cases. Peritoneal cytology was obtained in 87.8% of cases overall, but in only 69.5% of stage 1 cases. A description of the ovaries was provided in 85% of reports, of the uterus in 70%, the diaphragm in 53%, the liver in 69%, the pelvic lymph nodes in 10%, and the para-aortic lymph nodes in 41%. In stage 1 cases, the ovaries were assessed histologically in 89% of cases, the uterus in 80%, the omentum in 69%, the peritoneum in 20%, the appendix in 9%, the pelvic lymph nodes in 10%, and the para-aortic lymph nodes in 7%. Frozen section was obtained in half of the stage 1 cases, and the false negative rate for identifying malignancy was 6%. In all, 23% of women received adequate surgical staging for stage 1 disease, and 12% of women with advanced disease had optimal debulking (to less than 1 cm residual disease). There are clear differences between centres with a gynaecologic oncologist on staff and other centres in the adequacy of surgical staging in women with stage 1 disease (chi2 = 60.6, P < 0.0001) and in optimal debulking for advanced disease (chi2 = 39.1, P < 0.0001). In 40% of cases with advanced disease, the amount of residual disease following surgery is not reported.
CONCLUSION: The current approach of dictating operative notes does not provide sufficient detail in a large number of cases; this affects treatment decisions and limits our ability to assess quality indicators for operative care in ovarian cancer. This problem is pervasive but is more significant in centres without a gynaecologic oncologist.
Thursday, July 12, 2007
Wednesday, July 11, 2007
Monday, July 09, 2007
Researchers Identify Genetic Mutation That May Alter Patients' Response To Cancer Therapeutics
Researchers Identify Genetic Mutation That May Alter Patients' Response To Cancer Therapeutics: "Researchers from Eli Lilly & Company and the Phoenix-based Translational Genomics Research Institute (TGen) today announced finding a novel recurring mutation of the gene AKT1 in breast, colorectal and ovarian cancers. "
Saturday, July 07, 2007
Halifax, The Daily News: News | Ovarian cancer deadliest: experts
""If anything, it will get them off their duff and get them into the doctor's office to say 'Something's not right here.'"
Halifax, The Daily News: News | Ovarian cancer deadliest: experts
Wednesday, July 04, 2007
Complications at the End of Life in Ovarian Cancer. [J Pain Symptom Manage. 2007] - PubMed Result
Complications at the End of Life in Ovarian Cancer. [J Pain Symptom Manage. 2007] - PubMed Result
J Pain Symptom Manage. 2007 Jun 30; [Epub ahead of print]
Complications at the End of Life in Ovarian Cancer.
Herrinton LJ, Neslund-Dudas C, Rolnick SJ, Hornbrook MC, Bachman DJ, Darbinian JA, Jackson JM, Coughlin SS.
Division of Research (L.J.H., J.A.D.), Kaiser Permanente Northern California, Oakland, California; Henry Ford Health Systems (C.N.-D.), Detroit, Michigan; HealthPartners Research Foundation (S.J.R., J.M.J.), Minneapolis, Minnesota; Center for Health Research, Northwest/Hawaii (M.C.H., D.J.B.), Kaiser Permanente Northwest, Portland, Oregon; and Division of Cancer Prevention and Control (S.S.C.), United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Women dying of ovarian cancer vary considerably in their complications and in the types of health care they receive. The objective of this study was to describe the complications of ovarian cancer, other than pain, and their treatment at the end of life. This study used a cohort of 421 enrollees in three nonprofit managed-care organizations who died with ovarian cancer during 1995-2000. Data were collected from abstraction of paper and electronic medical records. Proportions of women experiencing complications and undergoing treatments were calculated. Logistic regression was used to evaluate the association of patient characteristics with the probability of receiving an intervention for complications. The most common complications recorded in the medical record were fatigue or weakness (75%), nausea or vomiting (71%), constipation (49%), edema of the extremities (44%), and anemia (34%). The prevalence of major complications was as follows: ascites, 28%; bowel obstruction, 12%; pleural effusion, 10%; bladder obstruction, 3%; and disordered nutrition that required support with parenteral nutrition, 9%. Patients may not always have received interventions for major complications; for example, pleural effusion apparently was left untreated in almost half of the women with this problem. After adjustment, women who died at younger ages were more likely to receive an intervention, compared to older women (odds ratio for each decade of age, 0.71, 95% confidence interval=0.53-0.94, P for trend=0.02). The study, which preceded the establishment of palliative care programs, suggests that care given to ovarian cancer patients at the end of life may be inadequate.
PMID: 17606360 [PubMed - as supplied by publisher]
Tuesday, July 03, 2007
Endometriosis Raises Risk Of Ovarian, Kidney And Thyroid Cancer
Endometriosis Raises Risk Of Ovarian, Kidney And Thyroid Cancer
The scientists found the endometriosis raised the risk of developing the following types of tumors:
-- Ovarian tumors - 37% greater risk
-- Endocrine tumors - 38% greater risk
-- Kidney tumors - 36% greater risk
-- Thyroid tumors - 33% greater risk
-- Brain tumors - 27% greater risk
-- Malignant melanoma - 23% greater risk
-- Breast cancer - 9% greater risk
Surprisingly, women with endometriosis seem to have a 29% lower risk of developing cervical cancer.
Sunday, July 01, 2007
Saturday, June 30, 2007
Friday, June 29, 2007
Thursday, June 28, 2007
Tuesday, June 26, 2007
Monday, June 25, 2007
The Lancet
The Lancet: "The problem with the received wisdom is that it is wrong...........On the other hand, the statement provides no specific guidance for doctors about what to do when such women present to them; the need for the challenging art of clinical judgment remains acute."
Friday, June 22, 2007
Wednesday, June 20, 2007
Tuesday, June 19, 2007
Women's Health Matters: Toronto -Sunnybrook Regional Cancer Centre (TSRCC)
Colorectal Cancer: Our Program at Toronto-Sunnybrook Regional Cancer Centre
Familial Cancer Clinics
Three hereditary cancer clinics are offered at the TSRCC:
* the familial breast cancer clinic (breast/OVARIAN)
* familial colorectal cancer clinic
* the familial melanoma clinic.
How to contact us:
Toronto-Sunnybrook Regional Cancer Centre 2075 Bayview Avenue
Toronto, Ontario
M4N 3M5
416-488-5801
For more information about the Toronto-Sunnybrook Regional Cancer Centre (TSRCC) refer to the web site at www.tsrcc.on.ca
Sunday, June 17, 2007
Saturday, June 16, 2007
June 15th, 2007: Closing the Knowledge to Action Gap: Is Health Promotion and Health Education on the Verge of a Breakthrough?
Ontario Health Promotion E-Bulletin
A graduate student at the plenary session, "Knowledge Translation: Linking Research and Policy" took her stand at the microphone and clearly asked: "Where are the community members? Where's the citizen engagement?"
Thursday, June 14, 2007
Wednesday, June 13, 2007
Wednesday, June 06, 2007
2Guidelines for the clinical management of Lynch syndrome (hereditary non-polyposis cancer) -- Vasen et al. 44 (6): 353 -- Journal of Medical Genetics
Guidelines for the clinical management of Lynch syndrome (hereditary non-polyposis cancer) -- Vasen et al. 44 (6): 353 -- Journal of Medical Genetics
Table 2 Lifetime risk of cancer reported in families with an identified mismatch repair mutation
Colorectal cancer (men) 28–75%
Colorectal cancer (women) 24–52%
Endometrial cancer 27–71%
Ovarian cancer 3–13%
Gastric cancer 2–13%
Urinary tract cancer 1–12%
Brain tumour 1–4%
Bile duct/gallbladder cancer 2%
Small-bowel cancer 4–7%
Saturday, June 02, 2007
Health Affairs Blog - Patient Safety
The bottom line, according to Groopman, is that doctors often don’t ask the right questions and don’t listen carefully enough when the patient answers. Expect to hear more about this. The blogs are already buzzing.
Health Affairs Blog: "The bottom line, according to Groopman, is that doctors often don’t ask the right questions and don’t listen carefully enough when the patient answers. Expect to hear more about this. The blogs are already buzzing."
Friday, June 01, 2007
Influence of the Gynecologic Oncologist on the Survival of Ovarian Cancer Patients -- Chan et al. 109 (6): 1342 -- Obstetrics & Gynecology
Thursday, May 17, 2007
Saturday, May 12, 2007
Int J Gynecol Cancer (Article Abstract)
Blackwell Synergy - Int J Gynecol Cancer, Volume 17 Issue 3 Page 557 - May/June 2007 (Article Abstract): "International Journal of Gynecological Cancer
Professionals’ and patients’ views of routine follow-up: a questionnaire survey
International Journal of Gynecological Cancer 17 (3), 557–560.
doi:10.1111/j.1525-1438.2007.00839.x
* F.M. KEW**Northern Gynaecological Oncology Centre, Queen Elizabeth Hospital, Gateshead, EnglandFiona M. Kew, MB, ChB, MRCOG, Northern Gynaecological Oncology Centre, Queen Elizabeth Hospital, Sheriff Hill, Gateshead, Tyne and Wear NE9 6SX, England. Email: fiona.kew@ghnt.nhs.uk,
* K. GALAAL**Northern Gynaecological Oncology Centre, Queen Elizabeth Hospital, Gateshead, England,
* H. MANDERVILLE**Northern Gynaecological Oncology Centre, Queen Elizabeth Hospital, Gateshead, England &
* L. VERLEYE**Northern Gynaecological Oncology Centre, Queen Elizabeth Hospital, Gateshead, England
*Northern Gynaecological Oncology Centre, Queen Elizabeth Hospital, Gateshead, England
Abstract
Traditionally, women who have been treated for a gynecological cancer have undergone long-term follow-up by hospital doctors. Recently, there has been interest in alternative models of follow-up, including nurse-based review. The project compares patients’ and professionals’ views of follow-up. A questionnaire was completed by 96 women attending routine follow-up clinics and by 32 professionals involved in delivering follow-up. A large majority of women (82/96, 92%) and professionals (25/34, 73%) thought that follow-up should be provided by a hospital doctor. However, professionals were more likely to think that specialist nurses and general practitioners should be involved in the provision of follow-up (P < 0.01). Professionals thought that the most important part of the follow-up visit was the consultation, whereas women thought it was the examination (P < 0.001). Women thought that detection of recurrence was the most important reason for continuing surveillance, whereas professionals regarded addressing patients’ concerns as the primary reason for follow-up (P < 0.001). We conclude that the views of women undergoing follow-up after gynecological cancer differ significantly from the professionals providing follow-up care. These views must be considered when developing alternative follow-up strategies.
2007 UK abstract: The research priorities of patients attending UK cancer treatment centres: finding from a modified nominal group study
Entrez PubMed
Br J Cancer. 2007 Mar 26;96(6):875-81. Epub 2007 Mar 6.Click here to read Links
The research priorities of patients attending UK cancer treatment centres: findings from a modified nominal group study.
* Corner J,
* Wright D,
* Hopkinson J,
* Gunaratnam Y,
* McDonald JW,
* Foster C.
School of Nursing and Midwifery, University of Southampton, Southampton SO17 1BJ, UK.
Members of the public are increasingly consulted over health care and research priorities. Patient involvement in determining cancer research priorities, however, has remained underdeveloped. This paper presents the findings of the first consultation to be conducted with UK cancer patients concerning research priorities. The study adopted a participatory approach using a collaborative model that sought joint ownership of the study with people affected by cancer. An exploratory, qualitative approach was used. Consultation groups were the main method, combining focus group and nominal group techniques. Seventeen groups were held with a total of 105 patients broadly representative of the UK cancer population. Fifteen areas for research were identified. Top priority areas included the impact cancer has on life, how to live with cancer and related support issues; risk factors and causes of cancer; early detection and prevention. Although biological and treatment related aspects of science were identified as important, patients rated the management of practical, social and emotional issues as a higher priority. There is a mismatch between the research priorities identified by participants and the current UK research portfolio. Current research activity should be broadened to reflect the priorities of people affected by the disease.
PMID: 17342090 [PubMed - indexed for MEDLINE]
Wednesday, May 09, 2007
Tuesday, May 08, 2007
Saturday, May 05, 2007
Thursday, April 26, 2007
Thursday, April 19, 2007
April 19th, 2007 - message from New York reported event Friday April 20th - 10-12:30 pm Central Park at West 67th St, NY
I'm a reporter at New York Magazine, and we're organizing a big photo shoot
in Central Park TOMORROW.
I'm hoping that you could post it on your blog, and maybe even attend the
shoot yourself, if you live in the NY area! We're really working hard to
find just another 40 people to
come, and time is running out!
All the best,
Katie Charles
212 508 0668
New York Magazine Cover Shoot
New York Magazine is currently working on a very important feature story
about New Yorkers living with cancer. For a potential cover, we would like
to gather 300-350 New Yorkers living with cancer or in remission, in one
place, for an incredibly positive & moving picture. We are looking for
people of all ages, and of all races to to be photographed together.
We want to show the unity of the fight, so we are asking everyone to dress
on their own, as they normally would- no organization specific t-shirts. We
want the picture to look like a beautiful group of wildflowers. We hope this
will help raise awareness & funding for all.
Any interested participants should contact me directly at
alex_pollack@newyorkmag.com.
Logistical info below:
FINAL CALL SHEET/NEW YORKERS LIVING WITH CANCER
Date: Friday April 20th, 2007
Time: 10AM-12:30PM
Check-In Location: Tavern on the Green, Central Park at West
67th Street
Phone: 212.873.3200
New York Magazine contacts: Katie Charles 202.368.1836; Alex Pollack
917.538.1054
*Map attached
**IMPORTANT: Please arrive on time, as we have a very narrow window for the
permit from the Parks Department.
Let¹s try to have some color even though spring is late. Please dress in the
brightest color coat that you have- we don¹t want everyone in black or navy
coats, or the picture will look dreary. Please bring minimal bags/stuff with
you so we don¹t add unnecessary clutter to the photo. You will be asked to
fill out the attached 2 page form at the check-in table at Tavern on the
Green. To expedite the check-in process, if you are able to fill out the
form, print it & bring it with you, it would be very helpful. We will be
making individual portraits of each of you prior to the group shot.
IN CASE OF RAIN:
We have set up a rain date, should the weather not cooperate on Thursday
night/Friday. We have also set up a rain hotline. For updated information on
Friday morning, please call 212.508.0551.
Rain Date: Sunday April 22, 2007
Time: 11AM
Location: Pier 59 Studios, 59 Chelsea Piers
(btwn. 17th & 18th Streets on the water), Studio C
http://www.pier59studios.com/home.html
Phone: 212.691.5959
We¹re very excited to meet you all and to collaborate on this beautiful and
inspiring image.
Sincerely,
Katie Charles and Alex Pollack
Wednesday, April 18, 2007
Friday, April 13, 2007
Monday, April 09, 2007
Wednesday, April 04, 2007
April 2007: Gynecologic Oncology : A cost–effectiveness analysis of chemotherapy for patients with recurrent platinum-sensitive epithelial ovarian
Conclusions.
Second-line chemotherapy is cost-effective for patients with platinum-sensitive recurrent EOC. Due to minimal improvements in overall survival, third- and fourth-line chemotherapy are not cost-effective strategies.
ScienceDirect - Gynecologic Oncology : A cost–effectiveness analysis of chemotherapy for patients with recurrent platinum-sensitive epithelial ovarian cancer
Tuesday, April 03, 2007
Saturday, March 31, 2007
Sunday, March 25, 2007
Saturday, March 24, 2007
Gynecologic Oncology : A cost–effectiveness analysis of chemotherapy for patients with recurrent platinum-sensitive epithelial ovarian
ScienceDirect - Gynecologic Oncology : A cost–effectiveness analysis of chemotherapy for patients with recurrent platinum-sensitive epithelial ovarian cancer:
"Conclusions.
Second-line chemotherapy is cost-effective for patients with platinum-sensitive recurrent EOC. Due to minimal improvements in overall survival, third- and fourth-line chemotherapy are not cost-effective strategies."
Genentech: Avastin - Full Prescribing Information
Genentech: Avastin - Full Prescribing Information
Sandi's note: increased attention needs to be paid to nasal perforations ( Respiratory: nasal septum perforation) in patient populations
JAMA -- Abstract: Recommendations for the Care of Individuals With an Inherited Predisposition to Lynch Syndrome: A Systematic Review
JAMA -- Abstract: Recommendations for the Care of Individuals With an Inherited Predisposition to Lynch Syndrome: A Systematic Review, September 27, 2006, Lindor et al. 296 (12): 1507
CLINICIAN'S CORNER
Recommendations for the Care of Individuals With an Inherited Predisposition to Lynch Syndrome
A Systematic Review
JAMA. 2006;296:1507-1517.
Context About 2% of all colorectal cancer occurs in the context of the autosomal dominantly inherited Lynch syndrome, which is due to mutations in mismatch repair genes. Potential risk-reducing interventions are recommended for individuals known to have these mutations.
Objectives To review cancer risks and data on screening efficacy in the context of Lynch syndrome (hereditary nonpolyposis colorectal cancer) and to provide recommendations for clinical management for affected families, based on available evidence and expert opinion.
Data Sources and Study Selection A systematic literature search using PubMed and the Cochrane Database of Systematic Reviews, reference list review of retrieved articles, manual searches of relevant articles, and direct communication with other researchers in the field. Search terms included hereditary non-polyposis colon cancer, Lynch syndrome, microsatellite instability, mismatch repair genes, and terms related to the biology of Lynch syndrome. Only peer-reviewed, full-text, English-language articles concerning human subjects published between January 1, 1996, and February 2006 were included. The US Preventive Services Task Force's 2-tier system was adapted to describe the quality of evidence and to assign strength to the recommendations for each guideline.
Evidence Synthesis The evidence supports colonoscopic surveillance for individuals with Lynch syndrome, although the optimal age at initiation and frequency of examinations is unresolved. Colonoscopy is recommended every 1 to 2 years starting at ages 20 to 25 years (age 30 years for those with MSH6 mutations), or 10 years younger than the youngest age of the person diagnosed in the family. While fully acknowledging absence of demonstrated efficacy, the following are also recommended annually: endometrial sampling and transvaginal ultrasound of the uterus and ovaries (ages 30-35 years); urinalysis with cytology (ages 25-35 years); history, examination, review of systems, education and genetic counseling regarding Lynch syndrome (age 21 years). Regular colonoscopy was favored for at-risk persons without colorectal neoplasia. For individuals who will undergo surgical resection of a colon cancer, subtotal colectomy is favored. Evidence supports the efficacy of prophylactic hysterectomy and oophorectomy.
Conclusions The past 10 years have seen major advances in the understanding of Lynch syndrome. Current recommendations regarding cancer screening and prevention require careful consultation between clinicians, clinical cancer genetic services, and well-informed patients.
Author Affiliations: Departments of Medical Genetics (Drs Lindor and Petersen) and Health Sciences Research (Dr Petersen), Mayo Clinic College of Medicine, Rochester, Minn; Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Md (Mr Hadley); Department of Medicine and Huntsman Cancer Institute, University of Utah, and Veterans Affairs Medical Center, Salt Lake City (Dr Kinney); Medical Oncology, Maine Center for Cancer Medicine and Blood Disorders and Maine Medical Center, Portland (Dr Miesfeldt); Departments of Gynecologic Oncology (Dr Lu) and Gastrointestinal Medicine and Nutrition (Dr Lynch), M. D. Anderson Cancer Center, University of Texas, Houston; Department of Medical History and Ethics, University of Washington, Seattle (Dr Burke); and Schools of Nursing and Medicine, Oregon Health and Science University, Portland (Dr Press).
This Week in JAMA
JAMA. 2006;296:1437.
Prediction of MLH1 and MSH2 Mutations in Lynch Syndrome
Judith Balmaña, David H. Stockwell, Ewout W. Steyerberg, Elena M. Stoffel, Amie M. Deffenbaugh, Julia E. Reid, Brian Ward, Thomas Scholl, Brant Hendrickson, John Tazelaar, Lynn Anne Burbidge, and Sapna Syngal
JAMA. 2006;296:1469-1478.
Prediction of Germline Mutations and Cancer Risk in the Lynch Syndrome
Sining Chen, Wenyi Wang, Shing Lee, Khedoudja Nafa, Johanna Lee, Kathy Romans, Patrice Watson, Stephen B. Gruber, David Euhus, Kenneth W. Kinzler, Jeremy Jass, Steven Gallinger, Noralane M. Lindor, Graham Casey, Nathan Ellis, Francis M. Giardiello, Kenneth Offit, Giovanni Parmigiani, and for the Colon Cancer Family Registry
JAMA. 2006;296:1479-1487.
Predicting and Preventing Hereditary Colorectal Cancer
James M. Ford and Alice S. Whittemore
JAMA. 2006;296:1521-1523.
Colon Cancer
John L. Zeller, Cassio Lynm, and Richard M. Glass
JAMA. 2006;296:1552.
Friday, March 23, 2007
Thursday, March 22, 2007
Wednesday, March 21, 2007
Tuesday, March 20, 2007
Monday, March 19, 2007
March 2007 news item: What Couldn't Get Worse On the News Just Did
The Evening Bulletin - What Couldn't Get Worse On the News Just Did: "What Couldn't Get Worse On the News Just Did"
Saturday, March 17, 2007
this is not a singular issue - as reported in the Toronto Star: "The Unkindest Cut"
Here is what this particular article today (link at the end of this note)
does not say with respect to other gynecologists all working in my own
area in the past few years:
1) Centenary Hospital (Scarborough, Ontario) vs Armstrong: case before
the courts (I am not aware if the courts have made their final decision
on this one):
Hansard:
http://www.canlii.org/eliisa/simpleSearch.do?language=en&requestOrigin=requestSimpleOrAdvanced&defaultQuery=armstrong+vs+centenary&queryMethod=allQuery&Search=Search
http://www.canlii.org/on/cas/onca/2005/2005onca10427.html
Armstrong v. Centenary Health Centre
Citation : 2002 CanLII 42546 (ON S.C.) Date: December 20, 2002
Language: en
Ontario > Superior Court of Justice
Armstrong v. Centenary Health Centre
Citation : 2005 CanLII 20712 (ON C.A.) Date: June 13, 2005 Language: en
Ontario > Court of Appeal for Ontario
2) Whitby (Ontario) obstetrician-gynecologist Dr. Errol Wai-Ping
http://www.cbc.ca/fifth/donoharm.html
3) Dr. Richard Neale, a gynecologist and obstetrician, who worked in
Durham Region (Ajax/Pickering) and was prohibited from practicing in
Ontario before
he returned to England. (note: his licence was taken away while
practicing in England)
http://www.cmaj.ca/cgi/content/full/163/5/584-a
4) Toronto obstetrician and gynecologist Dr. Richard Austin
http://www.thestar.com/printArticle/193080
_*The unkindest cut TheStar.com - News - The unkindest cut*_
March 17, 2007
Tuesday, March 13, 2007
Saturday, March 10, 2007
2007 A new varian database for mismatch repair genes associated with Lynch Syndrome: Memorial University of Newfoundland - Faculty of Medicine
Memorial University of Newfoundland - Faculty of Medicine
Hum Mutat. 2007 Mar 8
A new variant database for mismatch repair genes associated with Lynch syndrome.
* Woods MO,
* Williams P,
* Careen A,
* Edwards L,
* Bartlett S,
* McLaughlin JR,
* Younghusband HB.
Discipline of Genetics, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada.
Mutations in some mismatch repair (MMR) genes are associated with Lynch syndrome (LS; also called hereditary nonpolyposis colorectal cancer [HNPCC]), an autosomal dominant cancer susceptibility syndrome. Colorectal cancer (CRC) is the most frequent cancer observed in LS. However, tumors occur at a variety of extracolonic sites and individuals may have multiple primary cancers. LS is the most common hereditary form of CRC, accounting for approximately 1% of all CRC. Since the first account of mutations in MSH2 causing this cancer susceptibility syndrome in 1993, mutations in three additional MMR genes, MLH1, MSH6, and PMS2, have been shown to cause LS. More than 1,500 different variants have been identified in these four genes and approximately 80% of the alterations have been identified in MLH1 and MSH2. There have been a few previous attempts to systematically record MMR variants associated with LS patients; however, they were not complete nor were they continuously updated. Thus, it was our goal to generate and maintain a comprehensive catalogue of MMR variants from genes known to be mutated in LS (http://www.med.mun.ca/MMRvariants; last accessed 8 February 2007). Providing such a resource should aid investigators in understanding the significance of the variants. Hum Mutat 0, 1-5, 2007. (c) 2007 Wiley-Liss, Inc.
PMID: 17347989
Thursday, March 01, 2007
Thursday, February 22, 2007
Wednesday, February 21, 2007
NO RESPONSE BY DECISION-MAKERS - sad! Ovarian Advocate - Caelyx for British Columbia Ovarian Cancer Women - funding vs life
FYI - Re: http://www.ovarianadvocate.ca/
February 17th, 2007
Sandi Pniauskas
117 Glen Hill Drive
Whitby, Ontario, Canada
L1N6Z8
Dear Madam/Sirs;
Re: Funding Caelyx for Treatment of Recurrent Ovarian Cancer in British
Columbia
I am writing to appeal to you to ensure that Caelyx is funded as a
treatment for recurrent ovarian cancer, or as deemed necessary, through
patient/physician decision-making. I do this because I have compassion,
understanding and intimate knowledge of the issues which ovarian cancer
women, their families and their friends face. From the initial
pre-surgery consultations to the last breath our ovarian cancer women
take. Research for decades is proof positive that ovarian cancer is the
most lethal of all gynecologic cancers. And yet, how far have we
actually progressed? 'Lethal' today is still the word used to describe
ovarian cancer. And yet, with our lack of decision-making, we actually
in fact consider our ovarian cancer women to be dispensable. They
deserve every chance and in light of extensive research, which you have
already received, the underlying issue of lack of actual access is not
comprehensible to me. I don't believe that I need to educate you on the
evidence-based research which provides sufficient criteria for simply
funding this chemotherapy for ovarian cancer women - today.
Further, it is irresponsible to confuse the economies of providing
Caelyx to ovarian cancer women in need. Confusion - because it is with
the hopes of remission or extension of life which no economies can ever
truly value in concrete terms. Further, recent reports indicate that
B.C.'s coffers are flush with funds. It therefore is a matter of
morality and quite simply the ability of the decision-makers to actually
make this decision.
Let us not continue to make mistakes of the past. The disparities in
access to either life-saving or life-extending therapies across
Provinces are well known. As a matter of fact, in the late 1990's,
Canadian ovarian cancer women experienced the very same issue between
Quebec and Ontario. Taxol was accessible to ovarian cancer women in
Quebec, and not in Ontario. It seems we have not yet learned our lessons
and are repeating the same mistakes but at the sacrifice of the valuable
women in our lives. The obvious lesson is that ovarian cancer does not
care where you live, but your survival does. How sad, in fact, that
while Health Care Ministers, Provincially and at the Federal level
discuss these issues, we simply are unable to recognize the deaths - the
actual realities while we wait for decisions. This is not acceptable and
our ovarian cancer women cannot wait. More importantly, the system which
you represent, has failed these women. It is a moral issue and only a
moral issue which stands in the way of ovarian cancer women in British
Columbia having access to this particularly effective chemotherapy.
Since my ovarian cancer diagnosis in 1999, I have been in the very
fortunate situation of surviving. But this survival comes at a price. It
is and has been typically a short term friendship, but one of value,
which words defy. It is and has been their absolute strength and will to
live and, yes, to suffer in silence, that alone deserves our respect by
doing the 'right thing'. You have the ability to give my ovarian cancer
women friends in British Columbia the will and the ability to improve
their life. This is a 'gift' through really a few strokes of the pen.
You can fund Caelyx for our ovarian cancer women in British Columbia. We
cannot wait, we should not have to wait.
Thank you.
Sincerely,
Sandi Pniauskas
email: sandipn@sympatico.ca
Tuesday, February 20, 2007
Saturday, February 17, 2007
Ovarian Cancer Advocate
Ovarian Cancer Advocate
"This webpage has been established by a group of women diagnosed with ovarian cancer in British Columbia. "
Friday, February 09, 2007
Thursday, February 08, 2007
July 11-13, 2007: Ovarian Cancer National Alliance 10th Anniversary Conference
The Ovarian Cancer National Alliance 10th Anniversary Conference (Washington, DC)
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A personal or family history of breast, colon or ovarian cancer may increase your risk for ovarian cancer
Family history includes both your mother and your father’s sides of the family
Friday, January 26, 2007
2007 January: Sunnybrook cancels some cancer surgery
Sunnybrook cancels some cancer surgeryGlobe and Mail - Toronto,Ontario,Canada
TORONTO -- Sunnybrook Health Sciences Centre is cancelling dozens of operations, including those of cancer patients....
2007 January: Wait times for cancer patients decreasing: report - Ontario - reference surgical waits Sunnybrook Regional Cancer Centre
".....Sunnybrook Health Sciences Centre is cancelling dozens of surgeries as it tries to deal with a patient backlog, and those waiting for cancer treatment...."
2007 UK - 3rd annual conference: "Where's the Patient's Voice in Health Professional Education?"
An exceptional opportunity for patients/carers and healthcare professionals.
Sunday, December 31, 2006
Entrez PubMed
Entrez PubMed: "Adjuvant chemotherapy with irinotecan hydrochloride and cisplatin for clear cell carcinoma of the ovary."
Friday, December 29, 2006
Friday, December 22, 2006
Saturday, December 02, 2006
Friday, December 01, 2006
CancerWise - December 2006 - Trial Studies Ovarian Cancer Screening Test
CancerWise - December 2006 - Trial Studies Ovarian Cancer Screening Test
Trial Studies Ovarian Cancer Screening Test
Healthy Postmenopausal Women Being Recruited
Should women be screened for ovarian cancer? Researchers hope to answer that question through a new study in which blood and urine samples from healthy, postmenopausal women are collected and analyzed.
Goal of study
M. D. Anderson researchers conducting the Low-Risk Ovarian Cancer Study hope the clinical trial and others like it one day may lead to a more effective screening test to increase early detection of the disease.
“Unfortunately, there’s no effective screening test, like the mammogram or colonoscopy, to detect ovarian cancer at an early stage when the chance of cure is greatest,” says Karen Lu, M.D., associate professor in M. D. Anderson’s Department of Gynecologic Oncology. “As a result, more than two-thirds of all ovarian cancers are found at an advanced stage.”
The purpose of the study is to not only evaluate a blood marker called CA-125 over a period of time, but also to create new markers for ovarian cancer detection. Urine also will be collected so that its proteins can be used to help create new markers.
ScienceDirect - Gynecologic Oncology : Screening for ovarian cancer by transvaginal ultrasound and serum CA125 measurement in women with a familial pr
ScienceDirect - Gynecologic Oncology : Screening for ovarian cancer by transvaginal ultrasound and serum CA125 measurement in women with a familial predisposition: A prospective cohort study: "Screening for ovarian cancer by transvaginal ultrasound and serum CA125 measurement in women with a familial predisposition: A prospective cohort study"
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