Monday, March 30, 2009
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
Treatments of epithelial ovarian cancer by histological subtype
note specific reference to clear cell ovarian cancer international trial
Cumulative lifetime incidence of extracolonic cancers in Lynch Syndrome: a eport of 121 families with proven mutations
Cumulative risk for females of an extracolonic tumour is 47.4% (95% CI 43.9-50.8). The risk to males is 26.5% (95% CI 22.6-30.4). There was no reduction in gynaecological malignancies due to gynaecological screening (examination, transvaginal ultrasound scan, hysteroscopy and endometrial biopsy).
Thursday, March 12, 2009
Wednesday, March 11, 2009
Medical News: SGO: Novel Drug Combination Shows Promise in Advanced Ovarian Cancer - in Meeting Coverage, SGO from MedPage Today
Oxaliplatin (Eloxatin), Docetaxel (Taxotere) and Bevacizumab (Avastin)
CBC news report: Tests may detect ovarian cancer sooner: study
Comment: spniauskas
Posted 2009/03/11
at 3:42 PM ET
Dr Jacobs published a randomised trial in the Lancet in 1999. This study was again specific to screening/early detection of ovarian cancer. In this study, now a decade old, 22,000 women enrolled. The abstract can be viewed at: http://www.ncbi.nlm.nih.gov/pubmed/10217079?holding=ukpmc
or: http://tinyurl.com/alo2st
Similar results were found in that of the 22,000 in the prior study (1998), 468 women had an elevated CA125 with 6 actual detections of malignancy. The current study indicates that of the 50,000 women screened with a CA125, 38 were found to have a malignancy. Without having read the full paper recently published, but relying on the abstracts, it would seem the 1999 and 2009 results do not differ in any appreciable way. The only question I might have would be in any technological advances in the ultrasounds which were used. There are several issues here which will and have always impacted decision-making specific to ovarian cancer. One is based on the fact that a public screening (meaning all women) of the CA125 will not be adopted, such as the PSA, because the cost are too high and the results are two low. Even the PSA test for public screening has been debated widely over the years. Assuming patients symptoms are acknowledged and there is a suspicion of ovarian cancer then nothing really has changed as it is the responsibility of the health care professional to order the appropriate tests. This brings us back to the same issues we have faced in ovarian cancer (forever) and that is recognizing the symptoms, however, complicated this may be. Lastly, Australia/UK today are using a test called the HE4 which, when added to the CA125, apparently improves detection of ovarian cancer. It would be most interesting for someone to compare the 2 Jacob trials.
IGF2BP3 (IMP3) Expression Is a Marker of Unfavorable Prognosis in Ovarian Carcinoma of Clear Cell Subtype
"The same prognostic significance is shown and validated here for ovarian clear cell carcinomas, but not other subtypes of ovarian carcinoma, suggesting a unique role of IGF2BP3 in these morphologically similar tumors."
Tuesday, March 10, 2009
AcademyHealth Issues: Consumer Choice
also: 2009 Robert Wood Johnson Foundation - Increasing consumer engagement
http://www.rwjf.org/qualityequality/af4q/focusareas/consumer.jsp
Monday, March 09, 2009
Management of women with clear cell endometrial cancer: a SGO review
"It shares many similarities with clear cell neoplasms of the ovary and kidney."
Saturday, March 07, 2009
Medical societies' recommendations for immunization with HPV and disclosure of conflicts of interest
"One of the Canadian documents did not include any conflict of interest statement, although Merck and GSK are listed among the sponsors.
CONCLUSIONS: Disclosure of conflicts of interest in documents where medical societies issue recommendations on HPV vaccination is very unusual. However, lack of disclosure is more frequent (near twice) when recommendations are in favour of the vaccination."
Breast and ovarian cancer risk perception after prophylactic salpingo-oophorectomy due to an inherited mutation in the BRCA 1 or BRCA 2 gene
Breast and ovarian cancer risk perception after prophylactic salpingo-oophorectomy due to an inherited mutation in the BRCA1 or BRCA2 gene
note:in the absence of the full paper, a small study which confuses the issues/results by using actual numbers and then % results
Friday, March 06, 2009
Inequalities, patient safety, and waste : The Lancet Oncology
"Fragmented decision-making by government departments, agencies, and insurers, often working in isolation and without a common framework of objectives, is causing an increasingly unfair distribution of cancer services. In the current global recession, a root and branch re-evaluation of services, focused on patient-centred medicine rather than government or insurer-imposed medicine, would undoubtedly improve care for patients with cancer; reduce polarisation in accessibility; and possibly even shrink healthcare budgets."
Thursday, March 05, 2009
Genetic Risks: Should Physicians Inform Relatives?
Genetic Risks: Should Physicians Inform Relatives?
Do physicians have an obligation to disclose genetic-risk information to relatives, even without the consent of the patient?
Wednesday, March 04, 2009
Bodies and barriers : The Lancet Oncology - review
Bodies and barriers : The Lancet Oncology
"Take the preface to Whose Life is it Anyway? which informs us that “the hero's actions are an assertion of those contractual rights [between doctor and patient] viewed in terms of current philosophical arguments which hold that the dual principles of autonomy and contract keeping, conceptually linked, provide the sole moral foundation for clinical practice consistent with the social context in which the practice occurs”. I've read this sentence at least twelve times now, and I'm still no nearer to knowing what it means."
"Presented together, the plays form an intriguing whole, each focussed on a different aspect of medicine and mortality. “We are discussing life and death, and not in the abstract either”, explains Vivian Bearing.
They've done a fine job."
Tuesday, March 03, 2009
Cancer Cell - Accelerated Metastasis after Short-Term Treatment with a Potent Inhibitor of Tumor Angiogenesis - Sunitinib/SU11248
definition: orthotopic = in the normal position
Accelerated Metastasis after Short-Term Treatment with a Potent Inhibitor of Tumor Angiogenesis
John M.L. Ebos,Christina R. Lee,William Cruz-Munoz,Georg A. Bjarnason,James G. Christensen and Robert S. Kerbel1
Molecular and Cellular Biology Research, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
Department of Medical Biophysics, University of Toronto, Toronto, ON M5G 2M9, Canada
Sunnybrook Odette Cancer Centre, Toronto, ON M5G 2M9, Canada
Pfizer Global Research and Development, La Jolla Labs, La Jolla, CA 92121, USA
Summary
Herein we report that the VEGFR/PDGFR kinase inhibitor sunitinib/SU11248 can accelerate metastatic tumor growth and decrease overall survival in mice receiving short-term therapy in various metastasis assays, including after intravenous injection of tumor cells or after removal of primary orthotopically grown tumors. Acceleration of metastasis was also observed in mice receiving sunitinib prior to intravenous implantation of tumor cells, suggesting possible metastatic conditioning in multiple organs. Similar findings with additional VEGF receptor tyrosine kinase inhibitors implicate a class-specific effect for such agents. Importantly, these observations of metastatic acceleration were in contrast to the demonstrable antitumor benefits obtained when the same human breast cancer cells, as well as mouse or human melanoma cells, were grown orthotopically as primary tumors and subjected to identical sunitinib treatments.
Epithelial ovarian cancer: Does the time interval between primary surgery and postoperative chemotherapy have any prognostic importance?
Worldwide, much effort is used every day to perform optimal surgery in the treatment of epithelial ovarian cancer. Treatment of ovarian cancer is a combination of surgery with optimal debulking followed by chemotherapy. However, the optimal timing of postoperative chemotherapy for ovarian cancer remains poorly defined. The literature is made up of seven studies performed in different ways and which have included varying prognostic factors. The general supposition is that the time interval (TI) does not have a prognostic influence but experimental studies have shown that it does affect the prognosis of the cancer. This commentary focuses on the importance of the TI between surgery and postoperative chemotherapy in this horrible disease.
Steps and Time to Process Clinical Trials at the Cancer Therapy Evaluation Program
At least 296 distinct processes are required for phase III trial activation: at least 239 working steps, 52 major decision points, 20 processing loops, and 11 stopping points. Of the 195 trials activated during the January 1, 2000, to December 31, 2007, study period, a sample of 167 (85.6%) was used for gathering timing data. Median calendar days from initial formal concept submission to CTEP to trial activation by a cooperative group was 602 days (interquartile range, 454 to 861 days). This time has not significantly changed over the past 8 years. There is a high variation in the time required to activate a clinical trial.
Monday, March 02, 2009
Has pain management in cancer patients with bone metastases improved? A seven year review at an outpatient palliative radiotherapy clinic
Sunday, March 01, 2009
Selection Endometrial Carcinomas for DNA Mismatch Repair Protein IMHC Using Patient Age and Tumor Morphology Enhances Detection of MMR Abnormalities
- Am J Surg Pathol. 2009 Feb 20
- Women with hereditary nonpolyposis colorectal cancer (HNPCC) (Lynch Syndrome) have a high risk for endometrial cancer (EC) and frequently present with a gynecologic cancer as their first or sentinel malignancy. Identification of these patients is important given their personal and family risk for synchronous and metachronous tumors........... more frequent synchronous clear cell carcinomas of the ovary..........cont'd
Saturday, February 28, 2009
Health Canada: Cancer
related Globe and Mail article with reader commentaries:
http://www.theglobeandmail.com/servlet/story/RTGAM.20090226.wcancer26/BNStory/specialScienceandHealth/home
Friday, February 27, 2009
Wednesday, February 25, 2009
Tuesday, February 24, 2009
Current role and future aspects of Topotecan in relapsed ovarian cancer
"A number of alternative dosing regimens and formulations have been investigated in an attempt to improve the toxicity profile of topotecan without compromising anti-tumour activity. A novel oral formulation of topotecan has shown clinical promise in patients with advanced and relapsed disease. Administration of i.v. topotecan on a weekly basis produced encouraging results in several phase II trials, with less haematological toxicity and similar response rates to the day 1-5 regimen."
Old Bones, New Data: Emmett Hall, Private Insurance and the Defeat of Pharmacare :: Vol. 4 No. 3 2009 :: Healthcare Policy / Politiques de Santé :: Longwoods Publishing
"The class war? We lost. Catastrophically."
pharma press release: Phenoxodiol/OVATURE
http://www.marketwatch.com/News/Story/Story.aspx?guid={40DC8D57-A36F-4DA7-A132-83469C5C89F8}&siteid=nbkh
Phase III Phenoxodiol Clinical Trial for Ovarian Cancer Continues
"The OVArian TUmor REsponse (OVATURE) trial is a major multi-center multinational Phase III clinical trial of orally administered phenoxodiol in combination with carboplatin in women with advanced ovarian cancer resistant or refractory to platinum-based drugs, to determine its safety and effectiveness when used in combination with carboplatin. More information on the trial can be found at http://www.OVATUREtrial.com.
The OVATURE trial is recruiting ovarian cancer patients whose cancer initially responded to chemotherapy, but has since become resistant or refractory to traditional platinum treatments. The trial consists of two double blind treatment arms. Patients in one trial arm are receiving weekly carboplatin and phenoxodiol. Patients in the other trial arm are also receiving weekly carboplatin, but a placebo (an inactive control pill) is substituted for phenoxodiol. Neither patients nor their doctors know to which trial arm the patients are randomly assigned.
A change from receiving platinum in the traditional dose pattern (every two to three weeks) to a weekly dosing regimen has been reported to provide a tumor response in some patients with recurrent ovarian cancer.(2-4) Thus, in addition to learning more about the safety and efficacy of phenoxodiol, researchers will learn more about the efficacy and safety of weekly carboplatin.
The primary outcome of the trial is the assessment of the relative time it takes for the ovarian cancer to progress. An analysis of interim results will be possible after patient recruitment to this study is completed and 95 patients have disease progression.
Patients are being recruited at hospital sites across the USA, UK, Europe and Australia. The trial design has been approved by the US Food and Drug Administration (FDA) under a Special Protocol Assessment (SPA) program, and provides for an interim analysis of the data, which, if statistically significant, can be used to support a request for accelerated marketing approval."
U.S. Patient Safety community - Tell It Like It Is!
Note: While this article is specific to the U.S., the basis/assumptions would be of significance to the many.
e-ESO Online educational resource - online - Advanced epithelial ovarian cancer: Are there improvements in first and second line treatment?
e-Grandrounds CME:
GR36 - 19 February 2009
Expert: Jan B. Vermorken, University Hospital of Antwerp, Edegem, Belgium
Discussant: Sergio Pecorelli, University of Brescia, Ospedali Civili, Brescia, Italy"
Monday, February 23, 2009
Surgery for Recurrent Ovarian Cancer: Role of Peritoneal Carcinomatosis: exploratory analysis DESKTOP 1 trial about risk factors, surgical .....
Surgery for Recurrent Ovarian Cancer: Role of Peritoneal Carcinomatosis: Exploratory Analysis of the DESKTOP I Trial About Risk Factors, Surgical Implications, and Prognostic Value of Peritoneal Carcinomatosis
ecancer.tv: Ovary and Gynaecology (5 video presentations)
Ovary and Gynaecology:
1) prophylactic surgery for BRCA Dr Wood U.S.;
2) executive summary (discussion of future ECCO congress) video;
3) Prof Douglas Easton 10 new genes increase risk of breast cancer UK; 4) Dr Monk (sea squirt also known as Trabectedin/Ecteinascidin/ET-743/Yondelis ) U.S.;
5) Prof Michael Friedlander (can't quite understand the therapy he speaks of) Australia (oral inhibitor antiogenesis).
For other videos select main page of website.
Sunday, February 22, 2009
Friday, February 13, 2009
Health Consumer Council
Health Consumer Council
"International Health Rights Consumers International
The Rights of Patients
Prescription for healthy consumers
All patients have the right to:
1. appropriate and accessible health care
2. freedom from discrimination
3. information and education
4. choose a doctor or other health worker
5. choose a health care establishment
6. informed consent about treatment
7. participate in their own health care
8. respect, privacy, confidentiality and dignity
9. complain
10. redress in the event of injury."
Wednesday, February 11, 2009
Tuesday, February 10, 2009
Cancer Patients Versus Cancer Survivors: Social and Emotional Consequences of Word Choice -- abstract
Cancer Patients Versus Cancer Survivors: Social and Emotional Consequences of Word Choice -- Mosher and Danoff-Burg 28 (1): 72 -- Journal of Language and Social Psychology
Cancer Patients Versus Cancer Survivors
Social and Emotional Consequences of Word Choice
State University of New York, Albany, mosherc@mskcc.org
State University of New York, Albany
Two studies examined the social and emotional implications of different linguistic classifications of individuals with cancer. Undergraduates were randomly assigned to rate their reactions to either cancer patients or cancer survivors. Across studies, participants held more favorable perceptions of the character of cancer survivors relative to cancer patients and displayed more positive attitudes toward the former group. In addition, participants in Study 1 reported greater willingness to interact with cancer survivors compared with cancer patients. Positive perceptions of prognosis did not appear to account for favorable attitudes toward cancer survivors; most participants in Study 2 did not assume that cancer survivors were beyond the treatment phase of their illness or cured of their disease. Findings point to a potentially powerful effect of word choice on reactions to individuals with cancer.
Key Words: cancer • perceptions • attitudes
Monday, February 09, 2009
UK - Target Ovarian Cancer Pathfinder study
http://tinyurl.com/cglvlf
02.02.09
Target Ovarian Cancer Pathfinder Study Advisory Panel announced Women with ovarian cancer and senior healthcare professionals and researchers are joining together to shape this important study.
Target Ovarian Cancer today announced the members of the independent advisory panel who are overseeing the groundbreaking Target Ovarian Cancer Pathfinder Study. They include patient and relative representation in addition to a wide range of senior healthcare professionals and researchers involved in diagnosing, treating and caring for women with ovarian cancer......cont'd
............................................................................................
Media resources (click on link to Media): Note the last sentence for the call for ovarian cancer participants:
Welcome to the Target Ovarian Cancer media hub. You'll find a host of media friendly materials here such as the stories of women living with ovarian cancer plus our latest news releases.
In the coming months we will be adding more and more unique data to this section making it a genuine 'hub' of ovarian cancer news and real life stories.
Right now, we are asking media to assist in our search for women with ovarian cancer, specialist gynae cancer nurses, clinicians and researchers to take part in the Target Ovarian Cancer Pathfinder Study. It is the first national study of its kind devoted to mapping the gaps in current patient care, clinical research, funding and identifying the routes forward for ovarian cancer management. All working towards our aim of a long and good life for every woman with ovarian cancer.
Nationally, March is Ovarian Cancer Awareness Month, so if you are planning a feature, please do include a 'call to action' for people to enroll in the Target Ovarian Cancer Pathfinder Study via www.targetovarian.org.uk . Our recruitment will continue on an ongoing basis.
Progestins in HRT: Sufferance or desire?
ScienceDirect - Maturitas : Progestins in HRT: Sufferance or desire?
".... recent epidemiological data may have been not only wrongly translated in relation to the clinical settings, but also to the whole class of therapies. The various progestins available for hormonal therapy exert different partial effects at cellular level according to the biochemical composition."
Markman: Intraperitoneal chemotherapy in the management of ovarian cancer: focus on carboplatin
article: http://www.dovepress.com/intraperitoneal-chemotherapy-in-the-management-of-ovarian-cancer-focus-peer-reviewed-article
open text pdf file: http://www.dovepress.com/getfile.php?fileID=4267
Worth noting:
Finally, as it is known that patients with “high risk”
early stage ovarian cancer have a 30% to 50% chance of
experiencing recurrence of the disease process, and those
recurrences are largely within the peritoneal cavity, it is
perhaps reasonable to consider delivering some, or perhaps
all, of a planned adjuvant chemotherapy approach via the
intraperitoneal route.
"N.E.D." :: UNC doctor-rockers score record deal
WRAL.com :: UNC doctor-rockers score record deal
N.E.D's music is rock, but with a niche all its own: It's Gynecologic Oncology rock – with a mission.
Sunday, February 08, 2009
Role of surgical outcome as prognostic factor in AEOC: a combined exploratory analysis of 3 prospectively randomized ph 3 trials
Wiley InterScience :: JOURNALS :: Cancer
CONCLUSIONS:The goal of primary surgery should be complete resection. The prognostic impact of tumor biology seemed to be partially overruled by residual tumor and further evaluation of biologic factors should stratify for residual tumor.
Saturday, February 07, 2009
Friday, February 06, 2009
globeandmail.com: Breast cancer risk, HRT link confirmed - Comments
globeandmail.com: Breast cancer risk, HRT link confirmed - Comments
(S Pniauskas, from Canada) wrote: Most of these unresolved issues stem from the well know publication of the WHI study (Women's Health Initiative). It is important to view this related research as it applies to oneself and in conjunction with a knowledgeable health care provider. The WHI publication authors acknowledged the media events were damaging and did not adequately relay pertinent or clear information to neither the consumer/public nor health care providers - so a lesson not well learned.
Further, there is a significant population of women for whom the WHI did not address which includes pre-menopausal women and those surgically and/or treatment-related induced menopause. For these women, and in particular, for those with surgically induced menopause, a one-size fits all - does not. There are significant differences between natural menopause and surgically/treatment-related menopause.
This Future Medicine editorial may be of interest:
http://tinyurl.com/cmgxek
HRT/ERT/MRT is an area of concern not only to breast cancer women (those at risk of whom there are many) but also those genetically predisposed to breast, ovarian, uterine (endometrial) and colo-rectal women.
A blanket statement on definitve implications is impossible at the moment. While some criticize the many post analyses in sub-groups of the WHI, it is necessary due to the often critical and criticized absences of important information that was not included in the WHI.
Wednesday, February 04, 2009
Commentary: The National Pharmaceuticals Strategy: Rest in peace, revive or renew?
cmaj.082087v1.pdf (application/pdf Object)
Table 1: International comparisons of prescription drug access, affordability, quality and safety
Tuesday, February 03, 2009
PLoS Medicine - Ovarian Carcinoma Subtypes Are Different Diseases: Implications for Biomarker Studies
PLoS Medicine - Ovarian Carcinoma Subtypes Are Different Diseases: Implications for Biomarker Studies
Note: (funding) Cheryl Brown was an ovarian cancer survivour and was one of the original founders of Ovarian Cancer Canada.
"Cheryl Brown Ovarian Cancer Outcomes Unit, British Columbia Cancer Agency, Vancouver, British Columbia, Canada"
Why Was This Study Done?
Although it is usually regarded as a single disease, there are actually several distinct subtypes of ovarian carcinoma. These are classified according to their microscopic appearance as high-grade serous, low-grade serous, clear cell, endometrioid, and mucinous ovarian carcinomas. These subtypes develop differently and respond differently to chemotherapy. Yet scientists studying ovarian carcinoma usually regard this cancer as a single entity, and current treatment protocols for the disease are not subtype specific. Might better progress be made toward understanding ovarian carcinoma and toward improving its treatment if each subtype were treated as a separate disease? Why are some tumors confined to the ovary, whereas the majority spread beyond the ovary at time of diagnosis? In this study, the researchers address these questions by asking whether correlations between the expression of “biomarkers” (molecules made by cancer cells that can be used to detect tumors and to monitor treatment effectiveness) and the stage at diagnosis or length of survival can be explained by differential biomarker expression between different subtypes of ovarian carcinoma. They also address the question of whether early stage and late stage ovarian carcinomas are fundamentally different.
PLoS Medicine - Ovarian Cancer: A Clinical Challenge That Needs Some Basic Answers
PLoS Medicine - Ovarian Cancer: A Clinical Challenge That Needs Some Basic Answers
From a clinical perspective, epithelial ovarian cancer is something of an enigma. Despite improvements in aggressive debulking surgery and the initial good response of patients to platinum-based chemotherapies, there has been little improvement in the survival rates for over three decades..... About 65% of women with epithelial ovarian cancer will die within five years of their diagnosis [1].
Unfortunately, there are no effective biomarkers that can identify early-stage disease and no reliable prognostic markers for predicting clinical response and guiding treatment regimes. Furthermore, there remains intense debate about the cellular origins, precursor lesions, and histological classification of the disease. With so many unknowns, it is perhaps not surprising that progress in reducing mortality in women diagnosed with ovarian cancer has been so limited.
Sunday, February 01, 2009
Anlaysis of hMLH1 and hMSH2 expression Cisplating-treated ovarian cancer patients
HighWire Press -- Medline Abstract
"CONCLUSION: The immunohistochemical expression of hMLH1 and hMSH2 proteins in ovarian cancer has no predictive value in resistance to cisplatin."
Dietary patterns and ovarian cancer risk
Dietary patterns and ovarian cancer risk -- Kolahdooz et al. 89 (1): 297 -- American Journal of Clinical Nutrition
"Conclusions: A diet characterized by high meat and fat intake may increase the risk of epithelial ovarian cancer. A diet high in fruit and vegetables was not associated with reduced risk."
The Surprisingly Complex World of e-Communities -
The Surprisingly Complex World of e-Communities -
CHAPTER FOUR (See Summary)
Contents
[hide]- 1 The Surprisingly Complex World of e-Communities
- 1.1 Online Support Communities
- 1.2 This is Crazy! This Information Needs to be Saved!
- 1.3 Braintalk: An e-Patient-driven Online Educational and Support Community
- 1.4 Building from the Bottom Up
- 1.5 Online Groups Supplement, but Don't Replace, Doctors
- 1.6 Forgotten Heroes
- 1.7 Evidence of the Effectiveness of Online Groups
- 1.8 Putting a Human Face on Medical Information
- 1.9 Practical Day-to-Day Illness Management Advice
- 1.10 e-Groups Are Always There
- 1.11 Providing Continuing Support for the Incurable
- 1.12 Special Benefits for Those with Rare Conditions
- 1.13 A Godsend for Those with Limited Access to Professional Care
- 1.14 Keeping Up on the State of the Art for Your Condition
- 1.15 References
REPOST: e-Patients: How they can help us heal healthcare
Main Page -
Table of Content
- Editors' Note and Dedication
- Acknowledgements
- Foreword by Lee Rainie and Susannah Fox
- Preface
- Introduction
- Hunters and Gatherers of Medical Information
- Content, Connectivity, and Communityware
- Patient-Centered Networks: Connected Communities of Care
- The Surprisingly Complex World of e-Communities
- e-Patients as Medical Researchers
- Learning from e-Patients
- The Autonomous Patient and the Reconfiguration of Medical Knowledge
Abstract | Large family with both parents affected by distinct BRCA1 mutations: implications for genetic testing
Abstract | Large family with both parents affected by distinct BRCA1 mutations: implications for genetic testing
Ideally, all family members affected by breast or ovarian tumor disease have to be subjected to the DNA testing, and failure to detect the mutation in any of them calls for the search of the second cancer-associated allele."
Saturday, January 31, 2009
Genetic classification of ovarian carcinoma based on microsatellite analysis: Relationship to clinicopathological features and patient survival
abstract:
Genetic classification of ovarian carcinoma based on microsatellite analysis: Relationship to clinicopathological features and patient survival
These findings suggest that some ovarian carcinomas have a significant degree of overlap between the two pathways of genomic instability and that the genetic classification using microsatellite markers may represent a potential new biomarker of risk prediction in ovarian carcinoma.
Distribution of microsatellite instability in Danish ovarian tumor patients and the prognositic value in ovarian cancer patients
Distribution of microsatellite instability in Dani...[Oncol Res. 2008] - PubMed Result
In conclusion, we found no association to any of the clinical parameters evaluated, although a tendency of a higher frequency of MSI was observed among serous OC.
Systematic Review and Meta-analysis of Ovarian Cancers: Estimation of Microsatellite-High Frequency and Characterization of Mismatch Repair Deficient Tumor Histology
abstract:
Systematic Review and Meta-analysis of Ovarian Cancers: Estimation of Microsatellite-High Frequency and Characterization of Mismatch Repair Deficient Tumor Histology -- Pal et al. 14 (21): 6847 -- C
The frequency of the MSI-H phenotype in unselected ovarian cancers approximates 12%. MMR-deficient ovarian cancers also seem to be characterized by an overrepresentation of nonserous histologic subtypes. Knowledge of histologic subtype may aid clinicians in identifying the relatively large proportion of ovarian cancers due to MMR defects; such knowledge has potential implications for medical management.
Friday, January 30, 2009
Thursday, January 29, 2009
news article: Self-diagnosis can be risky - Dee Williams/ACOR ovarian listserv
Self-diagnosis can be risky | courier-journal | The Courier-Journal
"And she's found camaraderie by connecting with other ovarian cancer patients through such sites as The Association of Cancer Online Resources.
'The ovarian list is very active,' she said. 'Every day there's probably at least 50-60 posts. Someone will say, 'Hey, I'm starting this chemo treatment. What can you tell me about it?' and women will reply, 'Oh, I've been on it and it made me sick,' or 'It gave me diarrhea.' '
Women from inside and outside the United States participate, sometimes sharing journal articles and recommending doctors to each other, in addition to offering support, Edwards said.
Thanks to them, she said, 'I feel like I have a local support group and then I have my global support group' on the Internet."
Hanging in the Balance: Making Decisions About the Benefits and Harms of Breast Cancer Screening Among the Oldest Old Without a Safety Net of Scientific Evidence
Hanging in the Balance: Making Decisions About the Benefits and Harms of Breast Cancer Screening Among the Oldest Old Without a Safety Net of Scientific Evidence -- Mandelblatt and Silliman 27
Editorial:
"Aside from the acknowledged methodological caveats and the potentially misleading press surrounding the article by Badgwell et al,5 the study's investigators and the Journal of Clinical Oncology are to be commended for raising difficult questions in gero-oncology, especially when the answers are imperfect. The intensity about the controversy that followed this publication reflects the fact that we are ill-prepared from a scientific knowledge perspective to provide health care rationally, ethically, equitably, and humanely to the 'booming' older population."
When Informed, All Women Do Not Prefer Breast Conservation
When Informed, All Women Do Not Prefer Breast Conservation -- Throckmorton and Esserman 27 (4): 484 -- Journal of Clinical Oncology
The key to offering a choice is respecting the choices patients make. Some people will choose one path, others a different one. We need to accept that women will have different values and want different choices. Our job should be to make sure patients have the choices, the information, the time, and environment in which to make an informed, value-driven decision.
Should patient-rated performance status affect treatment decisions - ECOG score
PS=performance status
Should patient-rated performance status affect tre...[J Thorac Oncol. 2008] - PubMed Result
"CONCLUSIONS: Pt-PS and MD-PS were not congruent in over half of the cases, with Pt-PS scores usually poorer. Almost half the patients would have excluded themselves from a hypothetical clinical trial (Pt-PS >/=2). This requires prospective evaluation."
Wednesday, January 28, 2009
Meta-analysis of Risk Reduction Estimates Associated With Risk-Reducing Salpingo-oophorectomy in BRCA1 or BRCA2 Mutation Carriers
note: Table 4 does not include self image etc in gyn cancers but does in breast cancer
Meta-analysis of Risk Reduction Estimates Associated With Risk-Reducing Salpingo-oophorectomy in BRCA1 or BRCA2 Mutation Carriers -- Rebbeck et al. 101 (2): 80 -- JNCI Journal of the National Cancer
Tuesday, January 27, 2009
Monday, January 26, 2009
HE4 Test with CA125 for Risk Stratification of Women with Suspected Ovarian Cancer
Pivotal Data Published For First Biomarker Combination Test to Determine Risk of Ovarian Cancer in Women Who Present With Pelvic Mass
ZAIDA - Caring Bridge journal
(Posted with permission of Mom): Zaida (ZAY-da) turned 4 in September. We learned she has cancer on 10/31/07, after six very emotional days in the hospital. Two days later we learned it was ovarian cancer. More recently, the diagnosis is mesothelioma of the peritoneum, with an ovarian promotor.
Older Patients and the Shifting Focus of Cancer Care
Older Patients and the Shifting Focus of Cancer Care - Cancer Network
"Conclusions
Society has treated elderly cancer patients poorly, even in cases where curative therapy exists."
Sunday, January 25, 2009
Diversity of participants in clinical trials in an academic medical center
Wiley InterScience :: JOURNALS :: Cancer
Further research also should consider whether differentially recruiting
good patients
can impact the ethnic/racial diversity or other characteristics of trial participants in ways that may bias the outcomes or conclusions of therapeutic trials.
Friday, January 23, 2009
webcast presentation: Menopause and Osteoporosis | January 22, 2009 | Media Advisories | Media Centre | SOGC
Prevalence, distress, management, and relief of pain during the last 3 months of cancer patients' life - Italian mortality follow-back survey
Annals of Oncology Advance Access published online on January 22, 2009
Annals of Oncology, doi:10.1093/annonc/mdn700
| |
Prevalence, distress, management, and relief of pain during the last 3 months of cancer patients' life. Results of an Italian mortality follow-back survey
1 Regional Palliative Care Network, National Cancer Research Institute, Genoa
2 Palliative Care Unit, IRCCS Foundation, National Cancer Institute, Milan
3 Department of Epidemiology, National Cancer Research Institute, G. Pascale Foundation, Naples
4 ASP Lazio, Rome
5 Liguria Cancer Registry, Descriptive Epidemiology, National Cancer Research Institute, Genoa
6 Clinical Epidemiology, Center for the Study and Prevention of Cancer, Florence, Italy
* Correspondence to: Dr M. Costantini, Regional Palliative Care Network, National Cancer Research Institute, Largo R. Benzi, 10 16132 Genova, Italy. Tel: +39-010-5737482; Fax: +39-010-354103; E-mail: massimo.costantini@istge.it
Background: This study estimates prevalence, management, and relief of pain during the last 3 months of life of a representative sample of dying cancer patients in Italy.
Patients and methods: This is a mortality followback survey (the Italian Survey of the Dying of Cancer). Caregivers were interviewed, after the patient's death, about pain experienced by the patients in all settings of care.
Results: According to caregivers' reports, 82.3% [95% confidence interval (CI) 79.9% to 84.4%] patients experienced pain, and 61.0% (95% CI 57.9% to 64.0%) very distressing pain. The younger population experienced a higher prevalence of pain in respect to older patients (P <> central nervous system experienced the lowest prevalence (51.9%). According to caregivers' reports, only 59.5% (95% CI 3.7% to 65.0%) received analgesic treatment with opioids for moderate to severe pain. Not surprisingly, pain was ‘only partially relieved’ or ‘not relieved at all’ in 54% of the patients with very distressing pain.
Conclusions: Although potentially slightly biased, the results from this survey regarding undermedication and poor treatment results for cancer related pain are unequivocal. The research agenda should focus on testing the effectiveness of interventions to improve the quality of pain assessment and management.
cancer, effectiveness, opioids, pain, prevalence, treatment
Received for publication March 25, 2008. Revision received August 1, 2008. Accepted for publication October 7, 2008.
Thursday, January 22, 2009
Canada NewsWire Group
Canada NewsWire Group: "The webcast will explain key findings from the clinical review, with a focus on hormone therapy, osteoporosis, cardiac health and cognitive function.'"
The effect of obesity on survival in patients with ovarian cancer
Conclusion
Although obesity has been reported as an independent prognostic factor for survival, this data demonstrates that survival rates are similar between obese and non-obese patients when optimal debulking statuses are the same. Therefore, maximal effort should be directed towards optimal debulking obese patients with EOC.
Wednesday, January 21, 2009
Tuesday, January 20, 2009
Monday, January 19, 2009
Information exchange between provider and patient -- Brown 180 (2): 207 -- Canadian Medical Association Journal
Information exchange between provider and patient -- Brown 180 (2): 207 -- Canadian Medical Association Journal
"Emerging technologies such as patient-accessible electronic health records should be considered as a means of facilitating the transmission of information not only between providers but also between provider and patient to address gaps in the continuity of care."
CDC Issues Cancer Genetic Test Recommendations | GenomeWeb
CDC Issues Cancer Genetic Test Recommendations | GenomeWeb
"After conducting an evidence-based analysis, the CDC's Evaluation of Genomic Applications in Practice and Prevention Working Group, or EWG, said it could recommend offering genetic testing for Lynch syndrome to newly diagnosed colorectal cancer patients, but that it did not find enough evidence to recommend for or against two other types of genetic tests, for breast cancer and metastatic colorectal cancer."
Meta-analysis of Risk Reduction Estimates Associated With Risk-Reducing Salpingo-oophorectomy in BRCA1 or BRCA2 Mutation Carriers -- Rebbeck et al., 10.1093/jnci/djn442 -- JNCI Journal of the National
Meta-analysis of Risk Reduction Estimates Associated With Risk-Reducing Salpingo-oophorectomy in BRCA1 or BRCA2 Mutation Carriers -- Rebbeck et al., 10.1093/jnci/djn442 -- JNCI Journal of the National
In conclusion, the summary risk reduction estimates presented here confirm that BRCA1/2 mutation carriers who have been treated with RRSO have a substantially reduced risk of both breast and ovarian cancer. However, residual cancer risk remains after surgery. Therefore, additional cancer risk reduction and screening strategies are required to maximally reduce cancer incidence and mortality in this high-risk population.
The HPV Vaccine Controversy
The HPV Vaccine Controversy
"Gardasil was fast-tracked and received FDA approval before its final safety evaluation trials were complete, and its final safety evaluation trials won’g be concluded until September 2009. Despite this, the drug is being aggressively mass-marketed on TV and at the movies in adverts pitched to young girls, including preteens, and state legislators were heavily lobbied to make the drug mandatory for school girls ages 11 and up. Parents are understandably reluctant to give the shots to daughters who are not yet sexually active, and the long-term impacts of which are entirely unknown."
Sunday, January 18, 2009
Awards of excellence 2008 CANO: Pamela J. West
Awards of excellence
CANO/NOCA Award for Excellence in Gynecology-Oncology Nursing
Previous recipients of this award include:
2008 Pamela West
2007 Lynne Jolicoeur
2006 Joanne Brodeur
Australia What changes are needed to the current direction and interpretation of clinical cancer research to meet the needs of the 21st century?
Abstract
In this 21st century, we will need to better analyse the outcomes of our spending on newer and more expensive anticancer drugs, particularly through postmarketing assessment, to ensure that these investments are justified.
Evidence-based medicine is only as good as the evidence available, and we advocate for more independently designed and funded trials that concentrate on the minimum effective dose and duration of therapies to reduce toxicity to patients and to control costs. There is a place for governments to provide funding for these studies in the public good.
Although improving survival over standard care is the gold standard for proving the efficacy of a new therapy, surrogate endpoints such as early biological marker changes, functional imaging changes or earlier measures such as progression-free survival must be investigated to enable drug therapies to be discontinued earlier if they are ineffective.
Studies searching for the presence of biological targets must be funded to exploit the potential advantage of targeted therapies.
Treatment guidelines are best written by experts who are independent of the pharmaceutical industry.
Existing databases should be linked to better monitor the outcomes of new therapies. Privacy safeguards are important, but privacy legislation may need to be modified to serve the greater public good from the information gained from linking databases.
Friday, January 16, 2009
Medical News: Final Medicare Rule Shuts Off Payment for Erroneous Surgeries
Medical News: Final Medicare Rule Shuts Off Payment for Erroneous Surgeries - in Geriatrics, Medicare from MedPage Today
"The surgical mistakes join 12 categories of errors and preventable complications already on the CMS blacklist, which went into effect on Oct. 1:
* Objects left in after surgery
* Air embolisms
* Blood incompatibility
* Pressure ulcers
* Falls in the hospital
* Catheter-associated urinary tract infections
* Catheter-associated vascular infections
* Mediastinitis after CABG
* Inadequate glycemic control
* Surgical site infections
* Deep vein thrombosis and pulmonary embolism
* Drug-induced delirium
For those 12 errors, however, CMS is denying claims only for hospital inpatient reimbursements."
Thursday, January 15, 2009
Wednesday, January 14, 2009
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
ABSTRACT
Standard oncological therapies, such as chemotherapy and cranial radiotherapy, frequently result in a spectrum of neurocognitive deficits that includes impaired learning, memory, attention, and speed of information processing. In addition to classical mechanisms of neurotoxicity associated with chemo- and radiotherapy, such as radiation necrosis and leukoencephalopathy, damage to dynamic progenitor cell populations in the brain is emerging as an important etiologic factor. Radiation- and chemotherapy-induced damage to progenitor populations responsible for maintenance of white matter integrity and adult hippocampal neurogenesis is now believed to play a major role in the neurocognitive impairment many cancer survivors experience.
Tuesday, January 13, 2009
18F-FDG PET and PET/CT in the Evaluation of Cancer Treatment Response - The Journal of Nuclear Medicine
18F-FDG PET and PET/CT in the Evaluation of Cancer Treatment Response -- Ben-Haim and Ell 50 (1): 88 -- The Journal of Nuclear Medicine
Note: Ovarian Cancer is discussed under the Miscellaneous section.
WHI Participant website
WHI Participant website
January 2009 New results from the Women’s Health Initiative Memory Study of Magnetic Resonance Imaging (WHIMS-MRI)
Monday, January 12, 2009
The effect of obesity on survival in patients with ovarian cancer (repost from 2008)
Conclusion
Although obesity has been reported as an independent prognostic factor for survival, this data demonstrates that survival rates are similar between obese and non-obese patients when optimal debulking statuses are the same. Therefore, maximal effort should be directed towards optimal debulking obese patients with EOC.
news item: Colonoscopy Fails to Identify Many Colorectal Cancers
Daily Cancer News - CancerConsultants.com
While researchers have long estimated that colonoscopy reduces colorectal cancer deaths by 90%, the results of this analysis indicate that the reduction might be closer to 60%. More research is needed to understand the implications of this analysis. In the meantime the researchers caution that the results of this study should not change the colonoscopy screening recommendations. A 60% reduction in mortality is still an important benefit; in comparison, mammography reduces breast cancer mortality by only 25%.
Globe and Mail: 2 articles: Obesity and Ovarian Cancer and McHealth stories leave us all hungry
globesports.com: McHealth stories leave us all hungry
Media articles of interest:In fact, the paper Body Mass Index and Risk of Ovarian Cancer (2009 American Cancer Society/Cancer Journal) as published:
Obesity / Ovarian cancer article: http://tinyurl.com/9ak8st
McHealth stories: http://tinyurl.com/7xmwsf
My online response as below: http://tinyurl.com/9554b6
(S Pniauskas, from Canada) wrote:
A prime example of the ethical, moral and professional duty of apparent
medical reporting is Andre's recent article: "Obesity raises risk of ovarian cancer".
"Conclusions: Based on the results of the current study, the authors SUSPECT that obesity....As observed in numerous previous investigations summarized in a recent meta-analysis of the available literature, BMI at baseline was associated with a modest but statistically NONSIGNIFICANT INCREASE IN RISK for ovarian cancer in our cohort as a whole... "
The whole article in the Globe regarding Obesity and Risk of Ovarian Cancer is significantly pathetic including the fact that the last sentence regarding risk of recurrence/higher rate of death is not accurate. What is accurate is the fact that if chemotherapy treatments are given according to BMI then the risk is Nil.
Ovarian Cancer and most cancers cannot simply be explained away by simple one page articles and to try to do so places additional burdens on our populations which are in fact fighting for and often losing the challenge of trying to live with life threatening cancers. Research communities publish their work as a 'work in progress' and not as the final solution to extremely complicated issues. Many factors influence the onset and risk of ovarian and other cancers and we simply are not there yet in understanding the full implications of any particular one or two potential issues.
It is an old lesson yet learned that medical reporting has a duty to understand the full context of the issues, as well as a duty to do no harm, which is not exclusively held to medical professionals but to also to medical reporting.
There are educational courses available to medical journalists and consumers, one being through the Cochrane Collaboration.
Diagnostic experience among 4,334 women reporting surgically diagnosed endometriosis
"...Sometime before diagnosis, 63% were told nothing was wrong with them."
(Editorial note: since there is a known connection between endometrioid and clear cell ovarian cancer cell types to endometriosis, it would be interesting to note followup on those subsequently diagnosed not only with endometriosis but also with ovarian cancer)
The government’s role in health care | Health Innovation Forum
The government’s role in health care | Health Innovation Forum
"More importantly, after nearly 30 years of overt attempts to manage provincial systems, they are still not stable or sustainable. This worrisome outcome results from the convergence of three probably uncontrollable and partially self-imposed factors I like to call the “Bermuda Triangle” of health care."
Sunday, January 11, 2009
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