Saturday, February 06, 2010
abstract: Pathway analysis of gene lists associated with platinum-based chemotherapy resistance in ovarian cancer: The big picture
"We propose that future international cooperation should aim at a uniform pooled analysis of the wealth of ovarian cancer array data already available. This will enhance the power of each separate ovarian cancer study and can lead to promising results."
Protein That Splices And Dices Genes Identified By Scientists
"A novel finding, described Feb. 4 on the Science Express Web site by teams from the National Cancer Institute, The University of Texas Health Science Center at San Antonio and the University of Toronto, offers a clue as to how genes can have what you might call multiple personalities...."
Association of pegylated liposomal doxorubicin and ifosfamide in early recurrent ovarian cancer patients: A Multicenter Phase II Trial
Conclusion
The combination of PLD and continuous IFO is a feasible and efficient treatment in patients with relapsed ovarian cancer, especially with TFI between 6 and 12 months. This regimen may represent an alternative to platinum reintroduction and should be evaluated in a randomized trial.Survival after recurrence in early-stage high-risk epithelial ovarian cancer: A Gynecologic Oncology Group study
Abstract
Objective
This study aimed to evaluate the clinical outcome of recurrent early-stage high-risk epithelial ovarian cancer patients.The potential benefit of 6 vs. 3 cycles of chemotherapy in subsets of women with early-stage high-risk epithelial ovarian cancer: An exploratory analysis of a Gynecologic Oncology Group study
Abstract Objectives A prior clinical trial on early-stage high risk ovarian cancer showed a lower recurrence rate in those treated with six vs. three cycles of chemotherapy. We proposed to identify subsets of patients who may benefit from more cycles of chemotherapy.
abstract: From randomized trial to practice: single institution experience using the GOG 172 i.p. chemotherapy regimen for ovarian cancer
Note: patients enrolled between January 2006 to December 2007 "Background: The objective of the study was to evaluate completion rates and toxic effects of an i.p. chemotherapy regimen in a cross-section of nonselected patients with ovarian cancer (OC). Conclusions: The i.p. chemotherapy regimen used in a consecutive cohort of patients carries could be completed in only a small percentage of patients. Less toxic regimens with higher acceptability should be considered."
Chemotherapy Resistance as a Predictor of Progression-Free Survival in Ovarian Cancer Patients Treated with Neoadjuvant Chemotherapy and Surgical Cytoreduction Followed by Intraperitoneal Chemotherapy: A Southwest Oncology Group Study
re: tumour assay testing
"Conclusions: While the small patient numbers in this trial do not permit definitive conclusions, these data fail to provide support for the argument that prospectively obtained in vitro data regarding platinum or paclitaxel resistance will be highly predictive of clinical outcome in advanced ovarian cancer."
Oncogene - Abstract (technical): Cadherin switching and activation of p120 catenin signaling are mediators of gonadotropin-releasing hormone to promote tumor cell migration and invasion in ovarian cancer
Definition: Cadherins - (Calcium dependant adhesion molecules) are a class of type-1 transmembrane proteins. They play important roles in cell adhesion.
Definition: Gonadotropin - hormone secreted by the anterior pituitary gland and placenta; stimulates the gonads and controls reproductive activity. A hormone that stimulates the ovaries (such as to produce estrogen).
"These results identify for the first time cadherin switching and p120ctn signaling as important targets of GnRH function and as novel mediators of invasiveness and tumor progression in ovarian cancer."
Menopausal Hormone Therapy Use and Risk of Invasive Colon Cancer: The California Teachers Study -- American Journal of Epidemiology
" ....perimenopausal or postmenopausal....
Dying at home: community nurses' views on the impact of informal carers on cancer patients' place of death European Journal of Cancer Care
Note: abstract; one of the few articles which challenges mainstream research discussing the issues of dying at home and the wishes of patients/caregiver.
HTML Full Text - Risk assessment model for first-cycle chemotherapy-induced neutropenia in patients with solid tumours
(included ovarian cancer patients in study)
Friday, February 05, 2010
Safe Work Hours, Safe Patients | WakeUpDoctor.org
"Other industries responsible for public safety (e.g., the transportation and nuclear power industries) have been subject to federal regulations that limit the number of hours their employees can work for decades."
Grants.gov - 2010 (research) Ovarian Cancer
Expected Number of Awards: 12
Estimated Total Program Funding: $4,100,000
Description:
NEW for FY10, the OCRP Translational Pilot Award mechanism supports innovative translational research addressing a critical problem or question in ovarian cancer that will accelerate the movement of promising ideas toward clinical applications.
IGRT, SBRT Guidelines Issued By ASTRO, ACR
"The American Society for Radiation Oncology (ASTRO) and the American College of Radiology (ACR) have released practice guidelines for image guided radiation therapy (IGRT) and stereotactic body radiation therapy (SBRT) in the February issue of the International Journal of Radiation Oncology*Biology*Physics, the official journal of ASTRO."
Surgical Mesh - Complications Associated with Transvaginal Implantation of Surgical Mesh for the Treatment of Stress Urinary Incontinence and Pelvic Organ Prolapse - Notice to Hospitals
Note: warnings on surgical mesh complications exist for other procedures as well (search adverse events reports)
Thursday, February 04, 2010
Cochrane Canada Symposium (includes consumers/patients)
Subject: Cochrane Canada Symposium Workshop: Cochrane Canada 8th Annual Symposium - Evidence in Uncertain Times: Meeting the Challenge Date: 19-20 May 2010, Presymposium: 17-18 May 2010 Location: Ottawa, Ontario, Canada Details: We invite researchers, health policy makers and managers, health professionals, and patients to join the Canadian Cochrane Centre as we discuss Evidence in Uncertain Times at our 8th annual symposium. Abstract submission for workshop, oral and poster presentations is open until 12 February 2010. Early Bird registration ends on 19 March 2010 Email: ccnc.symposium@uottawa.ca Website: www.ccncsymposium.com
Topics – Lack of Appetite and Loss of Weight – Canadian Virtual Hospice
Lack of Appetite and Loss of Weight
Rare ovarian tumours: therapeutic strategies in 2010, national website observatory for rare ovarian cancers and delineation of referent centers-France
Note: ignore the small spelling errors in the article as it was translated from French to English
Peritoneal-based Malignancies and Their Treatment. [Ann Acad Med Singapore. 2010] - PubMed result
Conclusion: It is important to recognise the role of and indications for CRS and HIPEC
MicroRNAs in ovarian carcinomas -- Dahiya and Morin 17 (1): F77 -- Endocrine-Related Cancer
(abstract) FOCUS REVIEW
MicroRNAs in ovarian carcinomas
Neetu Dahiya1 and Patrice J Morin1,2
1 Laboratory of Cellular and Molecular Biology, National Institute on Aging, NIH Biomedical Research Center, 251 Bayview Boulevard, Suite 100, Room 6C228, Baltimore, Maryland 21224, USA
2 Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA
Phase 1Trial Bi-shRNA-furin and Granulocyte Macrophage Colony Stimulating Factor (GMCSF) Augmented Autologous Tumor Cell Vaccine for Advanced Cancer
Trial of Bi-shRNA-furin and Granulocyte Macrophage Colony Stimulating Factor (GMCSF) Augmented Autologous Tumor Cell Vaccine for Advanced Cancer - Full Text View - ClinicalTrials.gov
In Research: Yale Makes Possible Breakthrough in Ovarian Cancer Treatment | NBC Connecticut
"Genetic researchers prevent genes from performing their function, "knocking down" the gene, by inserting small interfering RNA (siRNA) molecules into the cells. The next steps in the team's research will be to examine the effect of siRNA in ovarian cancer samples in the lab, and to test the technique on mice."
EPGM-Munich - Expert Practice in Gynecologic Oncology - free access
There are a number of slide presentations (free full access)
Muir-Torre syndrome-is it really a new syndrome? Am J Dermapathology
Note: that there is an overlap here with Lynch Syndrome
"This syndrome is defined as the coexistence of sebaceous adenomas, sebaceus carcinomas, keratoacanthomas, and pedunculated tumors, some with lobulated structure. The cutaneous involvement (sebaceous gland tumor) is associated with at least a single internal malignancy; mostly colonorectal or genitourinary malignancies."
Medical News: Hidden Dangers of Herbal Meds Reviewed - in Primary Care, Alternative Medicine from MedPage Today
discusses some of the negative interactions
Wednesday, February 03, 2010
Deadline February 28th: Nominations: Becoming a Member
Ideal Candidates for the NCI Director's Consumer Liaison Group:
Ideal candidates must:
1. have first-hand knowledge of the cancer experience;
2. be affiliated with a cancer-related constituency; and
3. possess relevant non-scientific skills and perspectives that will allow them to help improve research outcomes by identifying new approaches, promoting innovation, recognizing unforeseen risks or barriers, and identifying unintended consequences that could result from NCI decisions.
Wait Times For Medical Care: How The US Actually Measures Up - Better Health
Note: ACOR ovarian cancer members - the report will be in the archives - Commonwealth Fund
Immunohistochemical panel to identify the primary site of invasive micropapillary carcinoma
Note: technical/abstract
Journal of Chemotherapy 2009 full access: What is the Benefit of 'Avastin' Combined with Chemotherapy in Patients - recurrent Ovarian, Primary ....
Journal of Chemotherapy 2009 full access: What is the Benefit of 'Avastin' Combined with Chemotherapy in Patients - recurrent Ovarian, Primary Peritoneal, Fallopian Tube Cancers.
Note: 64 patients in study; descriptive (stage 1C+); stage 1/11=4 pts; clear cell (2);endometrioid (3); mucinous (2);platinum resistant; side effects....(paper takes time to download)
Cochrane Collaboration Review: Retroperitoneal drainage versus no drainage after pelvic lymphadenectomy for the prevention of lymphocyst formation in patients with gynaecological malignancies
Authors' conclusions:
Placement of retroperitoneal tube drains has no benefit in prevention of lymphocyst formation after pelvic lymphadenectomy in patients with gynaecological malignancies. When the pelvic peritoneum is left open, the tube drain placement is associated with a higher risk of short and long-term symptomatic lymphocyst formation.
Antibodies Against Abnormal Glycoproteins Identified as Possible Biomarkers for Cancer Detection press release - National Institutes of Health (NIH)
"The team used this approach to screen blood specimens from breast, ovarian and prostate cancer patients....They found distinct abnormal mucin-type O-glycopeptide epitopes (parts of molecules that antibodies will recognize and bind to) that were targeted by autoantibodies in cancer patients — but such antibodies were absent in healthy controls.....Although larger sets of specimens will have to be analyzed to fully appreciate the clinical value of this technology, the preliminary results are very promising.The study was an international collaboration that was funded in part by NCI through the trans-NIH Alliance of Glycobiologists for Detection of Cancer and Cancer Risk."
Stanford's Canary Center strives to find cancer sooner than every before - 2/01/10 - San Francisco News
"Scientists at the Canary Center say their first blood test, developed for ovarian cancer, is about to begin phase one clinical trials at Stanford. The first patient group will be women at high risk for ovarian cancer."
In Research: Magnetic Nanoparticles Latch On, Ferry Cancer Cells Out of Body
includes reference to ovarian cancer
End of LIfe Care in the 21st Century: Advanced Directives in Universal Rights Discourse
....legally binding international convention that would outlaw human rights violations in end-of-life decision-making.
Evidence-Based Medicine Requires Appropriate Clinical Context - re: Deep VeingThrombosis (excerpt)
"What if a patient—after diagnostic tests have been performed and there is no more certainty to obtain—still has a 1 in 100 chance of having venous thromboembolism (VTE)? Should the patient's physician engage the patient in a discussion of the harm and benefit of anticoagulation? What if the chance of VTE was 1 in 20? Or even 1 in 10?"
Effectiveness of a home care nursing program in the symptom management of patients with colorectal and breast cancer receiving oral chemotherapy
Note: includes professional commentaries; Implications for all patients ($$)
Searching for the roots of ovarian cancer | Health & Fitness News - OregonLive.com
"It's very frustrating for patients and for researchers that there hasn't been significant advances in ovarian cancer," says Dr. Tanja Pejovic, a gynecologic oncologist and associate professor at Oregon Health & Science University......Pejovic's group at OHSU is among those seeking to understand the basic biology as a means to zero in on likely markers of early disease. In a study reported in December, the group monitored the action of 69 genes in cells that make up the ovarian surface epithelium. They identified a set of genes that appear to become more active as cells progress from normal to cancerous......"We are still trying to understand early events," she says. But Pejovic remains optimistic."We have to understand early events to the point where it can lead us to markers that circulate in the blood."
Reuters Health Information (2010-02-02): Simple ovarian cysts not linked to cancer in postmenopausal women
"Women with and without simple cysts were at similar risk of invasive ovarian cancer after nearly 8 years of follow-up evaluation, the authors write. Furthermore, traditional ovarian cancer risk factors, such as increasing age, family history of breast or ovarian cancer, nulliparity, and infertility, were not associated with simple cysts. Finally, changes in average CA-125 were not correlated with increases in the number or progression of simple cysts.Thus, Dr. Greenlee and his group conclude, "Simple cysts are not likely cancer precursors or markers of increased risk and can be followed conservatively.""
full free access: A novel germline PALB2 deletion in Polish breast and ovarian cancer patients
Conclusions:
The c.509_510delGA is a novel PALB2 mutation that increases the risk of familial breast cancer. Occurrence of the same PALB2 alteration in seven unrelated women suggests that c.509_510delGA (p.R170fs) is a recurrent mutation for Polish population.
Tuesday, February 02, 2010
Cochrane Symposium - Ottawa May 2010
Upcoming Cochrane Collaboration conference includes seminars for consumers/patients
Fertility-sparing surgery in young women with invasive epithelial ovarian cancer.
Note: this study also discusses tumour rupture/survival; the abstract does not include specific cell types, however, clear cell can be possibly presumed given the research data on Japanese women with clear cell ovarian cancer.
Clinical Activity of Gemcitabine Plus Pertuzumab in Platinum-Resistant Ovarian Cancer, Fallopian Tube Cancer, or Primary Peritoneal Cancer
Note: The response rates in this study either alone or in combination were low. The side effects appear to be understated (abstract).
Monday, February 01, 2010
Drugs A-Z List - A on RxList
This is a useful website for finding a lot of information relating to drugs, including chemotherapies. It includes drug interactions, warnings, generic names, pill identifier, medical dictionary etc. The website has been around for many years.
full free access: from the series - the Art of Oncology : "Pessimism Is No Poison"
"....The fellow asked the oncologist why he was so pessimistic when talking with the patient. Why did he say things to make the patient and her husband cry? Shouldn't he have given the patient more hope? Would it not have been better for the patient to hear this dire news in chunks over the course of several clinic visits? After all, the patient was so young she may just beat the odds....."
PLoS ONE: Risk of Ovarian Cancer and Inherited Variants in Relapse-Associated Genes
"...We previously reported results of tumor mRNA expression studies which suggested that altered expression of a particular set of genes predicted response to chemotherapy among women with advanced-stage high-grade epithelial ovarian cancer.......Conclusions: "Tumor studies can reveal novel genes worthy of follow-up for cancer susceptibility. Here, we found that inherited markers in the gene encoding MSL1, part of a complex that modifies the histone H4, may decrease risk of invasive serous ovarian cancer."
full free access: Duration and magnitude of the postoperative risk of venous thromboembolism in middle aged women: prospective cohort study
Note: the full access to this publication is available for free; professional comments included CONCLUSION: The risk of deep vein thrombosis and pulmonary embolism after surgery is substantially increased in the first 12 postoperative weeks, and varies considerably by type of surgery.
Journal of Experimental & Clinical Cancer Research | Full text | Viscum album L. extracts in breast and gynaecological cancers: a systematic review of clinical and preclinical research
Note: there is a specific section on ovarian cancer
Background: Viscum album L. extracts (VAE, European mistletoe) are a widely used medicinal plant extract in gynaecological and breast-cancer treatment. Conclusion: VAE shows some positive effects in breast and gynaecological cancer. More research into clinical efficacy is warranted.
Use of CT Scans Linked to Cancer Risk, Studies Say | netReturns | e-Newsletter
"There is considerable disagreement in the scientific community about the validity of these models," notes Rosaleen Parsons, M.D., chair of the department of diagnostic imaging at Fox Chase Cancer Center. "And some scientists believe the radiation dose from these CT scans may not lead to any increased risk of cancer."
In the second study, conducted at the University of California-San Francisco, researchers compared CT scan use at four San Francisco Bay area facilities. They found that the amount of radiation from a CT scan may be up to four times greater than estimated in previous studies. In addition, they noted significant differences among different institutions and, in some instances, within the same institution, when looking at the radiation dose associated with CT scans.
Sunday, January 31, 2010
Editorial: The heterogeneity of epithelial ovarian cancer. Getting it right David M. Gershenson
Editorial
The heterogeneity of epithelial ovarian cancer
Getting it right
David M. Gershenson, MD *
Department of Gynecologic Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
email: David M. Gershenson (DGERSHEN@mdanderson.org)
Abstract
Epithelial ovarian cancer is heterogeneous and comprises 4 major rare subtypes - mucinous, clear cell, low-grade serous, and endometrioid - all distinct from the more common high-grade serous carcinoma. Women with uncommon histotypes should be triaged to separate clinical trials.
Search of: ovarian cancer | Open Studies | Adult - Results by Topic - ClinicalTrials.gov
Search results for Dietary Supplement - ovarian cancer:
Acidophilus 1 study
Arginine 1 study
Calciferol 4 studies
Cholecalciferol 3 studies
Citrate 13 studies
Folate 7 studies
Folic Acid 7 studies
Folinic Acid 8 studies
Orange 1 study
Tea 1 study
Tyrosine 1 study
Vitamin B9 7 studies
Vitamin D3 3 studies
Cancer patients 'must know rights' UK/Macmillan Cancer Centre
"Macmillan Cancer Support said that workers don't realise the Disability Discrimination Act (DDA) also protects cancer patients. A survey for the charity found more than half (53 per cent) of the 1,000 people questioned did not realise the act also applied to cancer patients."
media article: The inherited malignancy of breast cancer (and ovarian cancer)
Note: good article, albeit complicated subject matter - excerpts of important information:
Soy product and isoflavone intake and breast cancer risk defined by hormone receptor status. 2009; Cancer Science
"he association between soy food consumption and breast cancer risk has been inconsistent. A hospital-based case–control study was conducted to assess the relationship between soy food intake and breast cancer risk according to the estrogen receptor (ER) and/or progesterone receptor (PR) status of breast cancer in Chinese women .....The protective effects of soy did not seem to differ by ER and PR breast cancer status."
(abstract) Aberrant DNA methylation in contrast with mutations. 2009; Cancer Science
Note: technical/short abstract
Saturday, January 30, 2010
videos: The Chemotherapy Foundation Symposium
Note: there are some key videos (free to view) from a variety of subjects
Meeting Archives
Chemotherapy Foundation Symposium XXVI
November 4 -8, 2008
Marriott Marquis Hotel , New York , NY
November 4 -8, 2008
Marriott Marquis Hotel , New York , NY
Innovative Cancer Therapy for Tomorrow
Friday, January 29, 2010
2007 Open-label safety and efficacy pilot trial of intraperitoneal bevacizumab as palliative treatment in refractory malignant ascites
reference: Journal of Clinical Oncology, 2007 ASCO Annual Meeting Proceedings (Post-Meeting Edition). Vol 25, No 18S (June 20 Supplement), 2007: 9043
Intraperitoneal VEGF Inhibition Using Bevacizumab: A Potential Approach for the Symptomatic Treatment of Malignant Ascites? -- The Oncologist
"Despite the very strong preclinical evidence for an obligatory role of VEGF in the formation of malignant ascites and for a possible therapeutic efficacy of anti-VEGF therapies in the setting of malignant effusions, there are currently no reports from clinical studies addressing this point in cancer patients..........To date, only very few patients with malignant ascites have received i.p. bevacizumab and, therefore, this route of administration as well as this particular patient population need to be examined stringently regarding the safety of the treatment. However, we believe that i.p. application might be the route of choice in this particular setting."
Immunotherapy of Cancer: Key Findings and Commentary on the Third Tegernsee Conference -2009- The Oncologist
*the Oncologist now requires a subscription $$/abstracts available for free
FDA Drug Approval Summary: Bevacizumab plus Interferon for Advanced Renal Cell Carcinoma -- The Oncologist
*the Oncologist now requires a subscription $$/abstracts available for free
Patient Safety: note the adverse effects
"In the reviewed trial, serious adverse events and National Cancer Institute Common Terminology Criteria for Adverse Events grade
3 adverse events were reported more frequently in
bevacizumab-treated patients (31% versus 19% and 63% versus
47%, respectively). The most common bevacizumab-related
toxicities were bleeding/hemorrhage, hypertension,
proteinuria, and venous or arterial thromboembolic events."
Combining Targeted Therapies: Practical Issues to Consider at the Bench and Bedside -- The Oncologist
*the Oncologist now requires a subscription $$/abstracts available for free
Preventing Future Cancers by Testing Women With Ovarian Cancer for BRCA Mutations -- University of British Columbia/MD Anderson
"BRCA testing of women with ovarian cancer based on personal/family history of cancer or Ashkenazi Jewish ancestry is a cost-effective strategy to prevent future breast and ovarian cancers among FDRs (first degree relatives). More inclusive testing strategies prevent additional cancer cases but at significant cost."
GenSpera Announces First Cancer Patient Treated With G-202 In Phase I Trial
WARNING: this information is from a media article and gives virtually no information, so cautions. This obviously is not intended to discredit Johns Hopkins/Wisconsin Cancer Center, but the lack of information in the article.
"Patients interested in enrolling in the G-202 trial may contact the University of Wisconsin Carbone Cancer Center Connect line at (800) 622-8922. Patients who want to be evaluated for eligibility for this study at Johns Hopkins should call 410-955-8964, option #2. "
Expression of interleukin-1 (IL-1) ligands system in the most common endometriosis-associated ovarian cancer subtypes
Note: highly technical paper comparing serous, clear cell and endometrioid ovarian cancer cells type/endometriosis/Interleukins (in research)
Patient Advocate Foundation :: 1-800-532-5274
help for solving insurance and access problems (U.S.):
Patient Advocate Foundation :: 1-800-532-5274
Thursday, January 28, 2010
media article: Plant-based flavonoid may cut ovarian cancer risk (Apigenin)
language issues: borderline - significant ??
"women reporting the highest apigenin intake had a "borderline significant decrease" in ovarian cancer risk"
Time to end pelvic exams done without consent - The Globe and Mail
This article by Andre Picard of the Globe and Mail is a regurgitated column previously noted media columns. Interestingly enough the SGOC has an 'award' for columnists at the moment so it is highly suspect in its timing.
However, included are comments from both public and healthcare individuals.
Illumina to Complete Analysis of Ovarian Cancer - Sequencing - Genome Web
"The original plan was to analyze 25 ovarian and 25 gastric tumor/normal pairs by the end of 2009 using the company's Genome Analyzer, including whole-genome sequencing to at least 30-fold coverage, mRNA-seq, methylation sequencing, and chip genotyping. That timeline got delayed somewhat, and the company now expects to finish the ovarian tumors by the end of March and move into a validation phase, and then tackle the gastric cancer samples.
The delay was largely due to a longer-than-expected process of acquiring and qualifying the samples, Heath explained. For the ovarian cancer project, for example, he said the company was looking for stage I or II samples with a tumor content of at least 70 percent from non-smokers who did not have mutations in the BRCA 1 or 2 genes. He also said that the type of consent required for whole-genome sequencing is "quite a bit different from what is normally consented" and required the company, in some instances, to go back and ask for additional consent."
Contrast-enhanced ultrasound in the detection and characterization of liver tumors
"Contrast-enhanced ultrasound (CEUS) has unique advantages over contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) in the characterization of hepatic tumors."
Now's the time to find biomarkers on purpose -- Annals of Oncology
"Studies need to be conducted to determine the optimal design for using genome-wide profiling to identify putative biomarkers of drug response. To date, most biomarkers of drug response identified through genome-wide profiling have occurred through retrospective analysis of available tissue. To really progress this field, realistic planning for biomarker discovery and validation in clinical trials needs to be conducted. We, as clinical scientists, need to progress from only using convenient clinical cohorts to identify biomarkers to actually planning and following through with prospective clinical trials whose aims are to discover and/or validate putative biomarkers of drug response. To initiate a study without a realistic plan for discovery and validation reflects a lack of serious desire to find robust clinical predictors..... Until this becomes more commonplace, the genomic revolution will be focused on manuscript generation and investigator career development, leaving the benefit to patients nothing more than an unrealized dream."
Patient Participation: Current Knowledge and Applicability to Patient Safety — Mayo Clinic Proceedings
"...Patient-related factors, such as acceptance of the new patient role, lack of medical knowledge, lack of confidence, comorbidity, and various sociodemographic parameters, all affect willingness to participate in the health care process. Among health care workers, the acceptance and promotion of patient participation are influenced by other issues, including the desire to maintain control, lack of time, personal beliefs, type of illness, and training in patient-caregiver relationships. Social status, specialty, ethnic origin, and the stakes involved also influence patient and health care worker acceptance.
Cancer Causes and Controls: abstract - Microsatellite instability and survival in rectal cancer (Lynch Syndrome)
"Abstract
Objective High levels of microsatellite instability (MSI-H) have been associated in many studies with improved prognosis in colon cancer. Very few studies have evaluated the effect of MSI-H on rectal cancer survival. We assessed MSI-H and other genetic and epigenetic changes on survival of 990 individuals diagnosed with first primary rectal cancer.
Conclusion The genetic and epigenetic characteristics of MSI-H rectal cancers suggest that they are enriched for Lynch-associated tumors; adverse prognosis associated with MSI-H in these tumors may reflect the relatively high frequency of Lynch-associated cancers and/or the effect of radiation or chemotherapy on Lynch-associated rectal cancers or MSI tumors in general."
Women's decision-making needs related to treatment for recurrent ovarian cancer: a pilot study
"abstract:
The purpose of this pilot study was to describe the decision-making needs of women with ovarian cancer related to treatment of recurrent disease. ..... CONCLUSIONS: The findings provide some beginning direction for an inter-professional decision support approach, as well as implications for future research.
Email Guidelines for Patients (Patient Handout)
About these guidelines
Adopting appropriate email practices with patients is an important step
to safeguarding the integrity of the doctor-patient relationship and
maintaining the confidentiality of sensitive patient information.
The email guidelines that you are about to generate will outline when, why and how your patients may use email to contact you.
These guidelines can be:
- printed and used as a patient handout
- used as a patient consent form
- used as a statement of best practices for you and your staff
- saved on your computer
- downloaded from your practice website
A Revision Of The EU Clinical Trials Directive Supported By European Cancer Organization
"Certain groups of patients have been particularly hard hit: children, patients with rare cancers, patients who would profit greatly from international trials that optimise already existing treatments and which, therefore, do not find commercial sponsorship, and elderly patients with other health problems, including secondary cancers due to earlier treatments."
Wednesday, January 27, 2010
2009 Expert Perspectives on Challenges, Controversies, and Opportunities in Ovarian Cancer Therapy: The Present and the Future | PeerView Press
(free) viewing:
Includes: Dr's Markman, Armstrong & Coleman
Topics:
- Expert Perspectives on Challenges, Controversies, and Opportunities in Ovarian Cancer Therapy: The Present and the Future
- Taking Stock of the Current Research: Which New Therapies Are Showing Promise in Ovarian Cancer?
- Audio - Q&A Lightning Round: Expert Opinions on Unanswered Questions and Controversies in Ovarian Cancer
quick search - ovarian cancer - Clinical Research as at 1/28/2010 9:51 pm EST
There are 5 clinical trials at NIH that match your search criteria
Cancer by type/disease: Ovarian Cancer
A Phase II Study of Sorafenib and Bevacizumab in Epithelial Ovarian, Fallopian, and Peritoneal Cancer
A Phase II Study of Sorafenib and Bevacizumab in Epithelial Ovarian, Fallopian, and Peritoneal Cancer Clinical, Genetic, Behavioral, Laboratory, and Epidemiologic Characterization of Individuals and Families at High Risk of Breast/Ovarian Cancer
A Phase I Study With an Expansion Cohort of the PARP Inhibitor AZD2281 (KU-0059436) Combined With Carboplatin in Breast and Ovarian Cancer in BRCA 1/2 Mutation Carriers, Familial Breast and Ovarian Cancer, and Sporadic Triple Negative Breast Cancer and Ovarian Cancer
A Phase I, Open-Label Study of MEDI-547 to Evaluate the Safety, Tolerability, Pharmacokinetics, and Biologic Activity of Intravenous Administration in Subjects With Refractory Solid Tumors Associated With EphA2 Expression
A Phase I Study of Dasatinib in Combination With Bevacizumab in Advanced Solid Tumors
Healthcare-Associated Infection: Not on My Watch - Kimberly-Clark Health Care
"When someone develops an infection at a hospital or other patient care facility that they did not have prior to treatment, this is referred to as a healthcare-associated (sometimes hospital-acquired) infection (HAI).
Healthcare-associated infections (HAIs) are a global crisis affecting both patients and healthcare workers.
According to the World Health Organization (WHO), at any point in time, 1.4 million people worldwide suffer from infections acquired in hospitals."
A Link between mir-100 and FRAP1/mTOR in Clear Cell Ovarian Cancer- Molecular Endocrinology
"Our experiments have revealed strong candidate miRNAs and their target genes that may contribute to the pathogenesis of clear cell ovarian cancer, thereby highlighting alternative therapeutic strategies....."
Columns - Focus on Policy - Outliers: The Story of Success
"Gladwell asks why it is so difficult to acknowledge the fact that each of us comes from a culture with its own distinctive mix of strengths and weaknesses, tendencies, and predispositions. "Who we are cannot be separated from where we are from -- and when we ignore that fact, planes crash."
And patients die."
Why doctors' stories matter
"...As I read the winning stories, I had a fantasy, which is probably not a good idea to apply literally, but it’s useful as what philosophers would call a thought experiment. My fantasy was that in a doctor’s waiting room, instead of old magazines and public health brochures, patients might pick up stories that the doctor had written—stories not unlike these winning stories. And maybe patients would then bring in their stories and leave copies of those on the rack next to the doctor’s stories. That would open the silent world on both sides."
Does computer use in patient-physician encounters influence patient satisfaction?
EDITOR’S KEY POINTS
- Patient-physician communication is central to every physician’s practice and to patient satisfaction. Physicians have been concerned that the introduction of computers into patient consultations will lead to a breakdown of communication.
- This study sought to examine patients’ opinions about the effects of computer use on patient-physician interaction and on their satisfaction with their visits.
- Results of this study suggest that concerns about computer use negatively affecting patient-physician relationships and patient satisfaction are largely unfounded. Most patients had no preference for whether computers were used or not, and computer use actually seemed to have a positive effect on overall satisfaction. Other studies have shown that patients’ main concerns about computer use have to do with privacy, but in this study only 3.4% of respondents were concerned about a "negative" or "very negative" effect on privacy.
Interview: The Health 2.0 Blog: ACOR, Health 2.0 in the US & Europe: Gilles Frydman tells all
"Gilles Frydman is one of the leading ePatients. He started and runs ACOR (Association of Cancer Online Resources) and has discussed the role of engaged patients with rare diseases at the last few Health 2.0 Conferences."
Inherited Determinants of Ovarian Cancer Survival
"Conclusion: An extensive multiple-pathway assessment found evidence that inherited differences may play a role in outcome of ovarian cancer patients, particularly in genes within the angiogenesis and inflammation pathways. Our work supports efforts to target such mediators for therapeutic gain."
Tuesday, January 26, 2010
NCI clincial trial: A Targeted Phase I/II Trial of ZD6474 (Vandetanib; ZACTIMA) Plus the Proteasome Inhibitor, Bortezomib (Velcade(Registered Trademark)), in Adults With Solid Tumors With a Focus on Hereditary or Sporadic, Locally Advanced or Metastatic Medullary Thyroi... - Full Text View - ClinicalTrials.gov
Drug: VELCADE, PS-341 (Bortezomib, NSC #681239) Drug: ZACTIMA (Vandetanib) (ZD6474) Phase I Phase II
audio available: The latest in cancer research | Minnesota Public Radio NewsQ
Forty years into the war on cancer, the death rate for many cancers has not changed significantly. Scientists say a new approach is needed. Midmorning talks with two cancer researchers about the latest and most promising research.
Moral angst for surgical residents: a qualitative ... [Am J Surg. 2010] - PubMed result
"BACKGROUND: The ethical dilemmas that residents experience throughout their training have not been explored qualitatively from surgical residents' perspectives.
METHODS: Grounded theory methodology was used. All University of Toronto surgical, otolaryngology, and obstetrics and gynecology residents were invited to participate.Twenty-eight face-to-face interviews were conducted. Interviews were transcribed and analyzed by 3 reviewers.
RESULTS: Five encompassing themes emerged: (1) residents prefer operating with another resident while the staff watches; (2) residents felt that patients were rarely well informed about their role; (3) residents develop good relationships with patients; (4) residents felt ethically obliged to disclose intraoperative errors; and (5) residents experience ethical distress in certain teaching circumstances.
CONCLUSIONS: Residents encounter ethical dilemmas leading to moral angst during their surgical training and need to feel safe to discuss these openly. Staff and residents should work together to establish optimal communication and teaching situations."
Editorial : Measuing performance is essential to patient-centred care
"A health care system should, first and foremost, be organized to meet the needs of patients rather than the needs of institutions and providers. More often than not, however, the needs of institutions and health providers come first. How often do we see patients repeatedly
return to clinics on different days for poorly coordinated visits for diagnostic tests and follow-up with their physician?..."
Evidence Updates: Impact of two supportive care interventions on anxiety, depression, quality of life, and unmet needs in patients (advanced cancer)
Evidence Updates: Impact of two supportive care interventions on anxiety, depression, quality of life, and unmet needs in patients
Girgis A, Breen S, Stacey F, et al. Impact of two supportive care interventions on anxiety, depression, quality of life, and unmet needs in patients with nonlocalized breast and colorectal cancers. J Clin Oncol. 2009 Dec 20;27(36):6180-90. Epub 2009 Nov 16. PMID: 19917842 (Original)
DISCIPLINE RELEVANCE TO PRACTICE IS THIS NEWS?
Oncology - Breast 3 / 7 3 / 7
Oncology - Gastrointestinal 4 / 7 4 / 7
Oncology - Palliative and Supportive Care 6 / 7 6 / 7
Abstract PURPOSE: Patients with cancer experience considerable symptom burden, psychological morbidity, and unmet psychosocial needs. Research suggests that feedback of patient-reported outcomes to clinicians or caseworkers, alongside management strategies, may result in improved patient functioning. Two intervention models were developed to test this effect in a randomized, controlled trial against usual care (UC): a telephone caseworker (TCW) model and an oncologist/general practitioner (O/GP) model. Primary end points included anxiety, depression, physical/emotional functioning, and unmet supportive care needs.
PATIENTS AND METHODS: Participants with nonlocalized breast or colorectal cancers were surveyed by computer-assisted telephone interview (CATI) at three time points: baseline, 3 months, and 6 months. Data collected from participant CATIs in the supportive care models were used to generate feedback to either each participant`s designated TCW, or their nominated O/GPs. Data obtained from participants in the UC model were used only to assess the impact of supportive care models. In total, 356 participants consented to study participation, completed the baseline CATI, and were randomly assigned to the UC, TCW, or O/GP groups.
RESULTS: No overall intervention effect was observed. Physical functioning was significantly improved at the third CATI for participants in the TCW model (P = .01), and there was a trend toward fewer participants with unmet needs (P = .07). TCW group participants also were more likely to have the following: identified issues of need discussed (P < .0001); referrals made (P < .0001); and strong agreement that the intervention improved communication with their health care team (P = .0005).
CONCLUSION: The TCW model holds some promise; however, additional work in at-risk populations is required before we recommend implementation.
Monday, January 25, 2010
full free access: Use of a surgical safety checklist to reduce morbidity and mortality
Note: the use of surgical site checklists stemmed from WHO's Patient Safety group/s.
Cancer Recurrence Fears - MD Anderson Cancer Center
Clinical Trials Matching Service - Ovarian Cancer National Alliance
press release: Women's College Hospital (Toronto) offers Jewish women genetic screening for breast cancer
“Our study identified two major concerns with current breast cancer screening guidelines,” says Dr. Kelly Metcalfe, adjunct scientist at the Women’s College Research Institute and associate professor at the University of Toronto. “The first is that over half of the women we identified with a mutation would never have known that they were at an increased risk of cancer because they were not eligible for genetic testing outside of this study. The second concern was that although 45 per cent of the women with mutations were eligible for genetic testing based on their family history of cancer, none were referred by their health-care provider for screening. "
Two Combination Treatment Regimens Added to Updated NCCN Guidelines for Ovarian Cancer - media item
NCCN updates their guidelines annually - the guidelines on a variety of subjects (cancers/genetics etc) can be found at: http://www.nccn.org
Access requires registration but is free. There is a specific area for the genetics of breast/ovarian but to find genetics relating to Lynch Syndrome you need to go to the colorectal cancer section.
A Study Comparing Oral Picoplatin With Intravenous Picoplatin in Subjects With Solid Tumors - Full Text View - ClinicalTrials.gov
A Study Comparing Oral Picoplatin With Intravenous Picoplatin in Subjects With Solid Tumors - Full Text View - ClinicalTrials.gov:
"This study has been completed.
First Received: April 23, 2007 Last Updated: September 23, 2009
Sponsor: Poniard Pharmaceuticals
Information provided by: Poniard Pharmaceuticals
ClinicalTrials.gov Identifier: NCT00465725"
Pharma press release: re Phase 2 Trial of Picoplatin in Metastatic Colorectal Cancer Meets Primary Endpoint and Study Objectives
"Our ultimate goal is to secure a strategic partnership to support further development of picoplatin in CRC and other solid tumor indications, including prostate and ovarian cancers.'"
article: (Focused Microwave Thermotherapy) breast cancer therapy reduces mastectomies, saves breast
"In theory, Dooley said the technique could be used on any organ that could be "held relatively still." Scientists are now working to integrate heat-sensitive nanotechnology that would more precisely target cancer cells. They also plan to study a byproduct of the rapid disintegration of the tumor – a boosted immune system."
Sunday, January 24, 2010
Green Tea May Have Cancer Benefit - in Meeting Coverage, AACR-IASLC 2010 conference
"Experimental studies have suggested that one mechanism for chemoprevention with green tea may be its impact on insulin-like growth factors."
Search of: Open Studies | Interventional Studies | solid tumors | Adult | Phase II III IV - List Results - ClinicalTrials.gov
search results = 137 clinical trials
Saturday, January 23, 2010
full free access: Early-onset breast cancer in a Lebanese family with Lynch syndrome due to MSH2 gene mutation
"Background: There are still controversies about the integration of breast cancer as a part of the disease spectrum in Lynch syndrome."
full free access: Type D personality in the general population: a systematic review of health status, mechanisms of disease, and work-related problems
"Type D personality in the general population: a systematic review of health status, mechanisms of disease, and work-related problems."
Jan 23, 2009: Authors' Reply: Dose-dense paclitaxel for advanced ovarian cancer – Authors' reply : The Lancet
Authors' explanation to Commentaries 1 & 2
Jan 23, 2009: Commentary (1 of 2): Dose-dense paclitaxel for advanced ovarian cancer : The Lancet
Note: may require registration (free):
updated 2010 - MSH2 (one of the Lynch Syndrome genes)
- "People with mutations in the MSH2
gene have an increased risk of developing several other types of cancer (colorectal),
including cancers of the endometrium (lining of the uterus), ovary,
stomach, small intestine, liver, gallbladder duct, upper urinary tract,
brain, and skin.
Some mutations in the MSH2 gene increase the likelihood of several uncommon skin tumors occurring in addition to colorectal cancer, a combination called Muir-Torre syndrome. These rare skin tumors include sebaceous adenomas and carcinomas, which occur in skin glands (sebaceous glands) that produce an oily substance called sebum. Multiple, rapidly growing skin tumors called keratoacanthomas may also occur, usually on sun-exposed areas.
media item: Father's long crusade for answers
Note: "In 2006, a respected cancer research charity started losing donors when it was mistaken for the CCRG following the W5 program."
Understanding the problem of inadequately staging of early ovarian cancer (subanalysis of ACTION trial)
CONCLUSIONS: Even in a randomised trial in which comprehensive surgical staging was strongly advised in the study protocol the majority of patients (66%) were incompletely staged. Factors relating to a lack of surgical skills attributed most to the number of incompletely staged patients, but insufficient knowledge of the tumour behaviour and routes of spread of ovarian cancer also contributed substantially to this problem. Multicentre trials recruiting patients from many institutes with small volume contribution to the study, run the risk of inadequate adherence to the study protocol.
Venous Thromboembolism Risk and Prophylaxis in the Acute Care Hospital Setting (ENDORSE Survey): Findings in Surgical Patients
Note: study of data from 2004
"Use of prophylaxis varied according to major surgery type from 86.0% for orthopedic surgery to 53.8% in urologic/gynecologic...." "Conclusions: The majority of surgical patients are at high-risk for VTE. Despite long-standing recognition of the high-risk for VTE in surgical patients, thromboprophylaxis remains underutilized."
March 1, 2010 abstract: Conundrums in screening for cancer
Mini Review
Conundrums in screening for cancer
|
| Anthony
B. Miller * |
| Dalla
Lana School of Public Health, University of Toronto, ON, Canada |
| email:
Anthony B. Miller (ab.miller@sympatico.ca) |
This article is based upon the Joint International Journal of Cancer and Meyenburg-Stiftung Lectureship, delivered at Deutsches Krebsforschungszentrum, February 18, 2009.
| Keywords |
| screening
for cancer • breast cancer • cervix cancer • prostate cancer |
| Abstract |
| Screening for cancer has to be
carefully organized for maximum effectiveness, and introduced in full
understanding of the natural history of the disease. There are major
potential harms as well as benefits from screening. The current state of
art for breast, cervix and prostate cancer screening is reviewed, only
for breast and cervix are policies of screening in the population
justified. |
Friday, January 22, 2010
Neoadjuvant Bevacizumab May Increase Serious Surgical Complications - OncologySTAT
Note: free access (sign up):
Neoadjuvant_Bevacizumab_May Increase Serious Surgical Complications
media article: Neoadjuvant Bevacizumab May Increase Serious Surgical Complications
"Most complications started in the immediate postoperative period, stuttered along, then worsened weeks later when bevacizumab was restarted, according to Dr. Golshan." "This observation caused one audience member to quip, “Perhaps these wounds, even though they may appear to be healed, should receive more respect and less bevacizumab.”"
Ten-year follow-up of a phase 2 study of dose-intense paclitaxel with cisplatin and cyclophosphamide as initial therapy for poor-prognosis, advanced-stage epithelial ovarian cancer
"METHODS:: Patients with stage III/IV EOC received cyclophosphamide 750 mg/m(2), followed by a 24-hour infusion of paclitaxel 250 mg/m(2) and cisplatin 75 mg/m(2) on Day 2. Filgrastim began on Day 3 at 10 mug/kg daily for 9 days. Patients received 6 cycles of all drugs." CONCLUSIONS:: The studied regimen yielded a high response rate and encouraging overall survival."
Vermillion Emerges From Bankruptcy -- FREMONT, Calif., Jan. 22 /PRNewswire-FirstCall/ --
"This is a great day for all of our stakeholders as well as women who will benefit from OVA1,' said Gail Page, executive chair of Vermillion. 'We are in a position to resume development of our other programs in ovarian cancer and peripheral arterial disease,' she added."
full free access: Progress in Cancer Care: A Rational Call To Do Better - CA: A Cancer Journal for Clinicians
Editorial by incoming American Cancer Society President - Dr Alan G. Thorson
Study Finds Omission of Axillary Lymph Node Dissection Safe for Patients with Sentinel Node Micrometastases (early stage breast cancer)
full free access: link: http://caonline.amcancersoc.org/cgi/reprint/60/1/2.pdf
BRCA1 185delAG mutant protein, BRAt, up-regulates Maspin in ovarian epithelial cells
"Consequently, understanding early genotypic and phenotypic changes in the context of high risk disease may provide a better understanding of the mechanism of mutation-associated ovarian cancer and provide new targets for therapeutic intervention."
Maintenance immunotherapy in recurrent ovarian cancer: Long term follow-up of a phase II study
"Therapy consisted of low-dose subcutaneous IL-2 and oral RA, administered on intermittent schedules for up to 5 years."
Trial design for evaluation of novel targeted therapies
"Conclusions:Alternatives to traditional phase II trial design including alternative end points, randomized designs, biomarkers, and imaging tools should allow ineffective agents to be discarded and promising agents to undergo further investigation."
Phase II study of gefitinib in combination with paclitaxel (P) and carboplatin (C) as second-line therapy for ovarian, tubal or peritoneal adenocarcinoma
"Conclusion: Gefitinib, administered in combination with paclitaxel and carboplatin, provides a good clinical response but associated with an increased risk of hematologic disorders."
Nurses oppose the Ontario government's physician assistant role citing inadequate education, concerns over patient safety and unnecessary cost
Note: the RNAO also made the same statement regarding pharmacists (2009)
Toronto, January 22, 2010
"Members of the public will not be well served if the provincial government pursues a plan to allow physician assistants (PAs) to work in hospitals, family health teams, community health centres, and family physician offices. The board of directors of the Registered Nurses' Association of Ontario (RNAO) has unanimously endorsed a position statement, which raises serious questions about the level of education and regulatory oversight physician assistants have and how these could jeopardize patients..."
abstract: Association of Skeletal Muscle Wasting With Treatment With Sorafenib
Note: this study is not specific to ovarian cancer but may be of interest for those deciding on Sorafenib:
Risk factors for reproductive and breast cancers among older lesbians.
Note: the term 'older' in the study was >40 yrs
Cochrane Collaboration review: Antigen-specific active immunotherapy for ovarian cancer
"AUTHORS' CONCLUSIONS: We conclude that despite promising immunological responses no clinically effective antigen-specific active immunotherapy is yet available for ovarian cancer. Furthermore, the adoption of guidelines to ensure uniformity in trial conduct, response definitions and trial reporting is recommended to improve quality and comparability of immunotherapy trials."
Cochrane Collaboration Review: Management of drainage for malignant ascites in gynecologic cancer
"AUTHORS' CONCLUSIONS: Since no relevant studies were identified, we are unable to make recommendations regarding the management of drains for malignant ascites in women with gynaecological cancer. Large, multi-centre RCTs are required to evaluate the efficacy and safety of the management of ascitic drains when in situ and their impact on QOL."
Analysis of Marshall Edwards, Inc.'s OVATURE Trial to Proceed Following Database Lock
"The OVATURE trial is a major multi-center international Phase III clinical trial of orally-administered investigational drug 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.......The Company expects the final analysis will be performed strictly according to the protocol and now is expected to be completed in the second quarter of 2010"
Search of: Open Studies | Interventional Studies | ovarian cancer | Adult | received from 01/01/2010 to 01/22/2010
Results = 3 (new interventional studies since Jan 1/10)
The cost-effectiveness of genetic testing strategies for Lynch Syndrome among newly diagnosed patients with colorectal cancer
MRI, CT, and PET/CT for Ovarian Cancer Detection and Adnexal Lesion Characterization
"CONCLUSION. The goal of imaging in ovarian cancer detection is to expeditiously distinguish benign adnexal lesions from those requiring further pathologic evaluation for malignancy. For lesions indeterminate on ultrasound, MRI increases the specificity of imaging evaluation, thus decreasing benign resections. CT is useful in diagnosis and treatment planning of advanced cancer. Although 18F-FDG-avid ovarian lesions in postmenopausal women are considered suspicious for malignancy, PET/CT is not recommended for primary cancer detection because of high false-positive rates."
MRI of Endometriotic Cysts in Association With Ovarian Carcinoma
Risk Assessment and Genetic Testing for Ovarian Cancer
abstract: Current Update on Borderline Ovarian Neoplasms
CONCLUSION. Borderline tumors are considered to be precursors of low-grade ovarian cancers. Accurate diagnosis and staging facilitate optimal patient management particularly in patients desiring to preserve fertility.
MRI in the planning of initial lumpectomy for invasive breast carcinoma: effect on ipsilateral breast tumor recurrence after breast conserving therapy
CONCLUSION: MRI evaluation of invasive carcinoma in the planning of initial lumpectomies was not associated with improved local outcomes after BCS (breast conserving surgery) with RT in this cohort of patients.
Thursday, January 21, 2010
now accepting applications: Genetic Alliance
"We are now accepting applications for the Advocates Partnership Program at the American College of Medical Genetics (ACMG) Annual Clinical Genetics Meeting March 24-28 in Albuquerque, New Mexico."
ACOR - Association of Online Cancer Resources - Home Page
ACOR.org delivered 1,819,859 individual emails across the globe last week.
Omega-3 Fatty Acids for Neuropathic Pain: Case Series : The Clinical Journal of Pain
abstract/study of 5 patients
Jan 2009 full free access - Development of PARP inhibitors in oncology; Expert Opinion on Investigational Drugs + Expert Opinion
Note: highly technical but worth reviewing (BRCAness, sporadic, specific therapies (combination/single agent/+radiotherapy), those in clinical studies (Table 1),
differing cancers etc
Wednesday, January 20, 2010
now acceptng applications - Director's Consumer Liaison Group (U.S.)
The DCLG indentifies and responds to issues and challenges facing the Institute at the request of the Director. The DCLG provides relevant, non-scientific skills and perspectives in order to improve research outcomes by identifying new approaches, promoting innovation, recognizing unforeseen risks or barriers, and identifying unintended consequences that could result from NCI decisions.
full free access: Identifying the barriers to conducting outcomes research in integrative health care clinic settings
Conclusions
"..... as IHC clinics are often complex systems, a whole systems approach to research should be used taking into account the multidimensional and complex nature of such treatment systems so that the results are useful and reflect real life."
Dec 2009 article: Influenza Vaccination in Immune Compromised Persons: Practical Advice for Oncologists - OncologySTAT
Note: if you are unable to view the full article then you need to register (it's free)
abstract: Combining Targeted Therapies: Practical Issues to Consider at the Bench and Bedside -- The Oncologist
"Recent and continuing developments in high-throughput and multiplexed assay platforms as well as in disciplines such as bioinformatics and biostatistics will surely shape the future of clinical trials. Application of novel techniques in a comprehensive approach, revealing the interrelations among targets and the mechanisms of action underlying cancer (systems biology), may lead to comprehensive diagnostic tools (systems pathology) and specific combinations of drugs (cocktails of monoclonal antibodies, RNA therapeutics, or others) in what has been called the actualization of personalized medicine. We know that momentum in the era of targeted therapy will continue to accelerate, bringing new hope to our patients
with cancer and their families"
Abstract/free full access: High penetrances of BRCA1 and BRCA2 mutations confirmed in a prospective series
define: deleterious = harmful
Note: genetic modifying factors of penetrance = factors which result in lower or high risks of cancer
The quality of dying and death: a systematic review of measures-- Palliative Medicine
These are important issues for us as patients/caregivers:
"Less than half were based on an explicit definition of quality of dying and death and even fewer relied on a conceptual model that incorporated multidimensionality and subjective determination.The specified duration of the dying and death phase ranged from the last months to hours of life."
Tuesday, January 19, 2010
Pharma Pipeline News: Preliminary results from Nektar Therapeutics' NKTR-102 Phase 2 study in platinum-resistant ovarian cancer
Note: conference reporting news item
Cooking with anti cancer herbs and spices better than some medicines
Submitted by Kathleen Blanchard RN- Jan 19th, 2010
Quick Poll - question
Note: The quick poll is anonymous, so for the person who answered 'other' please email me - you can do this direct from the blog, if you wish. Thanks! Sandi
Jan 19, 2009: I’m a Cancer Patient. Should I Ask About PARP Inhibitors? - Health Advice Deborah K. Armstrong
Health Advice
Q. I’m a Cancer Patient. Should I Ask About PARP Inhibitors?
By Deborah K. Armstrong, M.D.
submit your application between March 15-22nd, 2010 - ASCO Patient Advocate Scholarship Program
pdf file - application/criteria
abstract: Safety and efficacy results of the advanced renal cell carcinoma Sorafenib expanded access program in North America
Note: while this is not specific to ovarian cancer knowing the side effects which patients experienced may be helpful
abstract: Clinicopathological features of 67 cases of endometriosis-associated epithelial ovarian carcinoma (China)
"CONCLUSION: Patients of endometriosis-associated epithelial ovarian carcinoma, especially patients with tumors arising from endometriosis, were found to be younger, having a significant lower stage and a better survival, and were mostly diagnosed with the subtype of clear-cell."
abstract: Understanding the support needs of patients accessing test results online. PHRs offer great promise, but support issues must be addressed to
Understanding the support needs of patients accessing test results online. PHRs offer great promise, but support issues must be addressed to ensure appropriate access.
abstract: Phase II biomarker trial of a multimarker diagnostic for ovarian cancer-Australia
CA-125; C-reactive protein (CRP); serum amyloid A (SAA); interleukin 6 (IL-6); and interleukin 8 (IL-8)
"CONCLUSIONS: The use of a panel of plasma biomarkers for the identification of women with ovarian cancer delivers a significant increase in diagnostic performance when compared to the performance of CA-125 alone."
Consistency of self-reported first-degree family history of cancer in a population-based study - Brazil
"The prevalence of cancer history in an FDR (first degree relative) was similar to previous reports in other populations. Consistency and reliability of the self-reported information was high, regardless of educational level."
full free access: Targeting the EGF Receptor for Ovarian Cancer Therapy
Note: numerous different treatments are discussed
News: Docs Feel Stress When Patients Can't Make Own Decisions - survey of Chicago physicians
"In only 10% of cases was a living will involved -- and in fully 35% of cases, the physician did not know if there was a living will or not."
2010 full free access: The prosurvival activity of ascites against TRAIL is associated with a shorter disease-free interval in patients with ovarian c
( highly technical )The prosurvival activity of ascites against TRAIL is associated with a shorter disease-free interval in patients with ovarian cancer
Monday, January 18, 2010
The C.A.M. Report » Blog
Note: This is a huge site with a vast amount of information including institutional based research etc.
National Center for Complimentary and Alternative Medicine
searchable database: eg. green tea oil, fish oil....
abstract (in research) HMGA2: a potential biomarker complement to P53 for detection of early-stage high-grade papillary serous carcinoma in FT
"Our findings of immunoreactivity for HMGA2 may lead to a novel, useful biomarker to complement p53 in the detection of early-stage serous carcinoma."
media item: In Research: OMRF identifies new method that may improve treatment of ovarian cancers
Who is OMRF?
"Founded in 1946, OMRF is one of the nation’s oldest and most respected nonprofit biomedical research institutes. Located in Oklahoma City, OMRF fosters a worldwide reputation for excellence by following an innovative cross-disciplinary approach to medical research."
Breaking down the breakthrough claims - Blog
Note: this one was all over the news this past week: partial excerpt: "A new drug called dabigatran prevents more strokes with less bleeding than warfarin." Dr. Atlas says: "Dabigatran may be a game changer, but there is one thing the story didn't mention. The group that got Dabigatran had more heart attacks than those who got coumadin. Oops! This could be the real game changer from the FDA's perspective. Note it's still under review there."
abstract: The treatment of menopausal symptoms by traditional East Asian medicines: Review and perspectives
Note: abstract provides very limited information
AMA news: Participatory medicine: A high-tech alliance with patients
"At its most basic level, participatory medicine means shared decision-making and deep patient engagement. Because of the rise in technology use -- as well as an increase in out-of-pocket health care expenses -- this has gone well beyond the traditional tell-me-where-it-hurts conversation between patient and doctor in the exam room....Physicians "are afraid this is something that will cost them time and money, and it will create arguments with patients," Dr. Greene said."
abstract: Body mass index as a prognostic factor in epithelial ovarian cancer and correlation with clinico-pathological factors (1994–2003)
"The prognostic impact of BMI on survival was only noted for underweight patients with serous tumors."
Sunday, January 17, 2010
abstract: Pharmacogenomics of taxane/platinum therapy in ovarian cancer
epigentics: The study of heritable changes in gene function that occur without a change in the DNA sequence
"CONCLUSIONS: Other mechanisms of variability, including epigenetic control of gene expression and copy number variation, may play important roles. In addition, nongenetic influences such as concurrent medications, and physiological and environmental factors could also affect individual responses to taxane and platinum therapy."
August 2009: Safety of (Avastin) Bevacizumab in Advanced Ovarian and Müllerian Cancers: A Review: Bevacizumab and Ovarian Cancer
"To date, several investigators (Table 1) have explored bevacizumab as a single agent or in combination with metronomic chemotherapy in the management of advanced ovarian cancer. All studies to date with bevacizumab as a single agent or in combination with chemotherapy have shown promising responses. The concern is centered on whether the benefit of this therapeutic agent outweighs its potential toxicity."
Clinical Trial: How Our Immune System Can Help Fight Cancer
Note: not yet recruiting for patients - An interesting study bringing together genetics and immune system. Location: New York, U.S.A.
Clinical Trials Search of: Open Studies ovarian cancer Adult- new studies received from 12/01/2009 to 01/17/2010
13 new studies shown (non specific)
Dr Dizon's blog: The Women's Cancer Blog
"Dr. Dizon is a medical oncologist specializing in women's cancers. He takes care of both breast and gynecologic cancers and has interests in new treatments, survivorship, and sexuality, and is Director of Medical Oncology at the Program in Women's Oncology at Women and Infants hospital of Rhode Island. He is also an Assistant Professor of Obstetrics-Gynecology and Internal Medicine at Alpert Medical School of Brown University."
Search of: Open Studies "ovarian cancer"
as at: January 17th, 2010 6:26 pm search results = 447 studies (general non specific search) - all types of studies, all phases
free full access: JAMA -- Funding of US Biomedical Research, 2003-2008, January 13, 2010, Dorsey et al. 303 (2): 137
Note: charts for quick overviews
full free access April 2009: Repertoire of microRNAs in Epithelial Ovarian Cancer
"...Small RNA cDNA libraries were constructed from RNA sample pools....and epithelial ovarian cancer specimens of serous, clear cell and endometrioid histologies....This report expands the body of miRNAs known to be expressed in epithelial ovarian cancer and provides a useful resource for future studies of the role of miRNAs in the pathogenesis and early detection of ovarian cancer."
Cancer Blood Tests
"...The team made the discovery partly by accident. They were studying short pieces of RNA called micro RNAs in human tissue samples. These tiny pieces of RNA, discovered only a few years ago, play a big role in regulating genes, and are now known to be altered in cancer..... In a large majority of the cases, just by measuring the amount of micro RNA in the blood, we could tell who had cancer and who didn’t,” Tewari says."
PBS: Genetic Genealogy on Faces of America - airing February-March 2010
Eva Longoria, Meryl Streep, Mario Batali, Stephen Colbert, Malcolm Gladwell, Yo-Yo Ma, Mike Nichols, Kristi Yamaguchi, Elizabeth Alexander, Queen Noor and Louise Erdrich have all submitted DNA tests for a new PBS television series FACES OF AMERICA.
Faces of America with Henry Louis Gates, Jr. airs on Wednesdays, February 10 – March 3, 2010 from 8-9 p.m. ET on PBS.
abstract: An effect from anticipation also in hereditary nonpolyposis colorectal cancer families without identified mutations.(Lynch Syndrome)
Note: this would apply to the many with no known mutations in the many genetic syndromes (eg. BRCA, Peutz-Jeghers Syndrome...)
"This observation suggests that anticipation may apply also to families without identified mutations and serves as a reminder to initiate surveillance programmes at young age also in HNPCC families with undefined genetic causes."
Saturday, January 16, 2010
A Link between mir-100 and FRAP1/mTOR in Clear Cell Ovarian Cancer --joint study Japan/U.S.
Note: This abstract is highly technical, but the significance is that there is a focus on clear cell ovarian cancer.
"...Our experiments have revealed strong candidate miRNAs and their target genes that may contribute to the pathogenesis of clear cell ovarian cancer..."
Hereditary breast and ovarian cancer: Referral source for genetic assessment and communication regarding assessment with nongenetic clinicians in the
Hereditary breast and ovarian cancer: Referral source for genetic assessment and communication regarding assessment with nongenetic clinicians in the community setting:
2009 Yi and St Louis Ovarian Cancer at OneTrueMedia.com
see the Montage from last year's (2009) ovarian cancer ACOR & friends August weekend
WWOX tumour suppressor gene polymorphisms and ovarian cancer pathology and prognosis.
"One-third of ovarian tumours show loss of WWOX expression, and this loss significantly associates with clear cell and mucinous histology, advanced stage, low progesterone receptor expression and poor survival, suggesting that WWOX status affects ovarian cancer progression and prognosis."
Friday, January 15, 2010
FDA (U.S.)Basics - new website
The tool answers questions such as (and more):
How and where do I find out if a drug is approved for use?
Why are there still food recalls?
How do I report a pet food compliant?
You can also submit your own questions, provide feedback, and view interviews with FDA staff.
Bazedoxifene, a selective estrogen receptor modulator: effects on the endometrium, ovaries, and breast from a randomized controlled trial in osteoporo
Bazedoxifene, a selective estrogen receptor modulator: effects on the endometrium, ovaries, and breast from a randomized controlled trial in osteoporotic postmenopausal women
Urinary angiostatin levels are elevated in patients with epithelial ovarian cancer.
Note: further research required
Immunohistochemical analysis of hMLH1 and hMSH2 proteins in serous ovarian tumours.
Note: Immunohistochemical = tumour sample; hMLH1 and hMSH2 (2 of) Lynch Syndrome genes
"Our results suggest that hMLH1 and hMSH2 proteins may be involved in ovarian carcinogenesis."
AACR upcoming conference: Cancer Epigenetics
"The study of epigenetic mechanisms in cancer, such as DNA methylation, histone modifications, nucleosome positioning and non-coding RNA expression, has revealed a plethora of events that contribute to the neoplastic phenotype through stable changes in the expression of genes critical to transformation pathways...Therefore, improved understanding of normal epigenetic programs is necessary to better understand malignancy-specific epigenetic alterations.....numerous other clinical applications of the field being explored in areas such as cancer screening and early detection, prevention, classification for epidemiology and prognostic purposes, and predicting outcomes after standard therapy."
Exons: Researchers Sequence 'Exomes' Of New Strategy For Finding Disease Genes
"....demonstrated the feasibility and value of a new strategy for identifying relatively rare genetic variants that may cause or contribute to disease....The new strategy involves isolating and sequencing all exons which are the parts of the human genome that contain the information needed to produce proteins, the building blocks of the body. The complete set of exons – referred to as the "exome" – makes up only one percent of the human genome. By selecting only the exome to sequence, the important information about an individual can be obtained at a much lower cost than sequencing a person's entire genome."
2010 Who Is Responsible? The Role of Family Physicians in the Provision of Supportive Cancer Care
Note: the issues from the family physicians' perspective
Editorial: Who Should Follow Our (Cancer) Patients?
Note: Good plain english article generalizing the issues - $$/capacity/knowledge
Thursday, January 14, 2010
abstract : Laparoscopic optical coherence tomography imaging of human ovarian cancer
Note: advances in the imaging of ovarian cancer
Surgery duration linked to infectious complications, hospital stay - Anesthesiology Videos - The Doctor's Channel
not specific to ovarian cancer
full free access: Targeting Insulin and Insulin-Like Growth Factor Pathways in Epithelial Ovarian Cancer
Note: a highly technical paper - look at Table 2; 7.5 = clinical trials link; 8.0 = Conclusion
Contemporary Management of and Future Directions in Ovarian Cancer - Cancer Network
Note: this was posted in November, but I have brought the posting date forward to coincide with other like articles, so both can be viewed at the same time. Access to this article requires that you sign on to the website (free).
full free access: Jan 2/2010 - Targeted Therapy in Ovarian Cancer
Review Article
Targeted Therapy in Ovarian Cancer
Lyndsay J. Willmott and John P. Fruehauf
Chao Family Comprehensive Cancer Center, University of California Irvine, Orange, CA 92868, USA Academic Editor: Charles F. Levenback
full free access: (2010) Germline Mutations and Polymorphisms in the Origins of Cancers in Women
Note: a good explanation in (close to) plain english on a subject that is anything but easy to understand.
Defective Mismatch Repair, Microsatellite Mutation Bias, and Variability in Clinical Cancer Phenotypes -- Shah et al. 70 (2): 431 -- Cancer Research
Abstract:
"Microsatellite instability is associated with 10% to 15% of colorectal, endometrial, OVARIAN, and gastric cancers, and has long been used as a diagnostic tool for hereditary nonpolyposis colorectal carcinoma–related cancers. Tumor-specific length alterations within microsatellites are generally accepted to be a consequence of strand slippage events during DNA replication, which are uncorrected due to a defective postreplication mismatch repair (MMR) system. Mutations arising within microsatellites associated with critical target genes are believed to play a causative role in the evolution of MMR-defective tumors. In this review, we summarize current evidence of mutational biases within microsatellites arising as a consequence of intrinsic DNA sequence effects as well as variation in MMR efficiency. Microsatellite mutational biases are generally not considered during clinical testing; however, we suggest that such biases may be clinically significant as a factor contributing to phenotypic variation among microsatellite instability–positive tumors."
ACS :: Possible Risks of Blood Product Transfusions
Comment: Before Erythropoiesis-stimulating agents were introduced, blood transfusions were widely used for the improvement of platelet counts etc. With recent negative research regarding Erythropoiesis-stimulating agents, blood transfusions will be a choice - seek professional/oncologist opinion. This article from the ACS describes some of the concerns with blood transfusions.
NCI - main site
There are quite a few different clinical trials listed for 'chemotherapy induced neuropathy" - check the search box at the top of the website for clinical trials underway
Phase III Randomized Study of Glutathione for the Prevention of Paclitaxel/Carboplatin-Induced Peripheral Neuropathy in Patients With Ovarian, Fallopi
Phase III Randomized Study of Glutathione for the Prevention of Paclitaxel/Carboplatin-Induced Peripheral Neuropathy in Patients With Ovarian, Fallopian Tube, and/or Primary Peritoneal Carcinoma
Biological Therapies for Cancer: Q & A - National Cancer Institute
What are interleukins?
"Like interferons, interleukins (ILs) are cytokines that occur naturally in the body and can be made in the laboratory. Many interleukins have been identified; interleukin-2 (IL–2 or aldesleukin) has been the most widely studied in cancer treatment. IL–2 stimulates the growth and activity of many immune cells, such as lymphocytes, that can destroy cancer cells. The FDA has approved IL–2 for the treatment of metastatic kidney cancer and metastatic melanoma.
Researchers continue to study the benefits of interleukins to treat a number of other cancers, including leukemia, lymphoma, and brain, colorectal, ovarian, breast, and prostate cancers."
Wednesday, January 13, 2010
CA-125 Response Patterns in Patients With Recurrent Ovarian Cancer Treated With Pegylated Liposomal Doxorubicin (PLD)
Conclusions: "Our ROC analysis did not demonstrate any reliable CA-125 cutoff on response. Discontinuation of the therapy before cycle 3 may exclude some patients who will benefit from PLD."
Five emotions you never knew you had - life - 13 January 2010 - New Scientist
"CAN you name the six basic emotions? Take a straw poll of your friends and we guarantee that you will find no consensus. Yet psychologists are unequivocal: joy, sadness, anger, fear, surprise and disgust...."
media item: new anti-cancer drug called "COTI-2" TD2 and Critical Outcome Technologies Inc. Develop Novel Anti-Cancer Drug
"....small molecule compound was discovered and developed by COTI of London, Ontario, Canada. This working relationship resulted through the expanded relationship between Canadian companies and the Phoenix-based Translational Genomics Research Institute (TGen). TD2, TGen's Scottsdale-based drug-development subsidiary, will work with COTI to complete the Investigational New Drug (IND) enabling research necessary to gain U.S. Food and Drug Administration approval of clinical trials,perhaps by the end of 2010, and eventually move the drug to market where it can benefit patients.....Researchers hope to demonstrate that this oral pill will be especially beneficial for patients with small- cell lung cancer (SCLC), endometrial cancer and ovarian cancer, but may also help treat those with colorectal and pancreatic cancers."
Surgical Technician Schools » 10 Famous Doctors who Made Medicine What it is Today + more
Beyond the history, at the bottom of the page, there are a number of links which you may find interesting such as:
* 100 Best Blogs for Living Healthy on a Budget
* The Surgery is Over… Now What? 4 Tips for A Successful Rehab
* Top 100 Doctor Bloggers
* 100+ Ways to Spring Clean Your Mind and Body
* The Top 50 Surgeon Bloggers
* What Does a Surgical Technician Do?
full free access: Is no news good news? Inconclusive genetic test results in BRCA1 and BRCA2 from patients and professionals' perspectives
Small study but included view of patients and physician views.
Use of Four Biomarkers to Evaluate the Risk of Breast Cancer Subtypes in the Women's Contraceptive and Reproductive Experiences Study
"Our findings offer evidence of differences in the hormone-related risk factors between triple-negative cancers and other ER/PR/HER2-defined subtypes of breast cancer."
Vandetanib, Designed to Inhibit VEGFR2 and EGFR Signaling, Had No Clinical Activity as Monotherapy for Recurrent Ovarian Cancer and No Detectable Modulation of VEGFR2
"Twelve patients entered the study, and accrual was terminated in the first stage because of lack of response or disease stabilization beyond 6 months."
abstract - Impact of bowel obstruction at the time of initial presentation in women with ovarian cancer.
plus read commentary from gyn/onc
NCI Cancer Bulletin: PARP Inhibitor and Metronomic Chemotherapy for Refractory Cancer - Phase I Study of ABT-888 and Metronomic Cyclophosphamide ....
Name of the Trial:
Phase I Study of ABT-888 and Metronomic Cyclophosphamide in Patients with Refractory Solid Tumors or Lymphoma (NCI-09-C-0048).
For More Information (read the article to see direct links to the information):
See the lists of eligibility criteria and trial contact information or call the NCI Clinical Trials Referral Office at 1-888-NCI-1937. The call is toll free and confidential.
Tuesday, January 12, 2010
full free access : Proteomic effects of hormone therapies - new research in Genome Medicine
"New research by Samir Hanash, Ross Prentice and colleagues, recently published in Genome Medicine, suggests that the different proteomic effects of estrogen-alone and estrogen plus progestin treatments may explain the distinctive clinical effects of each therapy."
UC Academic Health News : Findings: UC Gynecologic Cancer Team Expands Services to Northern Kentuck-Dayton
"His goal is to recruit three additional double board-certified gynecologic oncologists who are qualified to perform both cancer care as well as advanced pelvic surgery. This team will cover a wide range east and west of the I-75 stretch between Northern Kentucky and Dayton."
abstract: Identification of an ovarian clear cell carcinoma gene signature that reflects inherent disease biology and the carcinogenic processes
definitions we need to know when reading this abstract:
1) microenvironment: a specific set of physical, biological, and chemical factors immediately surrounding the organism;
2) epigenetic: - something that affects a cell, organ or individual without directly affecting its DNA.
Predicting the Outcome of Cytoreductive Surgery for Advanced Ovarian Cancer
"Conclusions: The rates of optimal cytoreduction vary among surgeons. A universally applicable clinical model that can predict which patients will undergo optimal cytoreduction remains elusive. More research is needed to devise a set of uniform criteria that can be used to predict ovarian cancer resectability among different patient populations."
Cancer Survivorship Research Conference 2010: Recovery and Beyond
June 17-19, 2010
Marriott Wardman Park Hotel
Washington, DC
The Biennial Cancer Survivorship Research Conference, initiated in 2002 by the National Cancer Institute’s Office of Cancer Survivorship and the American Cancer Society’s Behavioral Research Center, brings together investigators, clinicians, and survivors to share and learn about the most up-to-date cancer survivorship research. In 2010, the 5th biennial conference is co-sponsored by the National Cancer Institute, the American Cancer Society, LIVESTRONG, and the Centers for Disease Control and Prevention.
press release: Nektar Announces Positive Topline Results for NKTR-102 From First Stage of Phase 2 Study in Platinum-Resistant Ovarian Cancer
"The first stage of the NKTR-102 Phase 2 study showed an overall GCIG response rate of 32% (6/19) in the once every 14 days (q14 day) dose schedule and 35% (7/20) for the once every 21 days (q21 day) dose schedule.
Confirmed objective response rates using RECIST were 21% (4/19) and 22% (4/18) for the q14 day and q21 day dose schedules, respectively.
CA-125 response rates were 31% (5/16) and 38% (6/16), for each dose schedule, respectively.
The Phase 2 study has now completed enrollment with a total of 71 patients. Approximately one-third of the patients in the study remain on NKTR-102 treatment, including a number of patients in the first stage of the study."
abstract: Generational risks for cancers not related to tobacco, screening, or treatment in the United States
"CONCLUSIONS:
Despite declining overall cancer death rates, adults are experiencing increased incidence of cancers that are not associated with tobacco or screening relative to their parents. Future research should examine whether similar patterns are exhibited in other modern nations and should identify population-wide avoidable risks that could account for unexplained increases in these residual cancers."
abstract: Physician factors associated with discussions about end-of-life care
this link is the actual research article and from which the media item was based (abstract/only-pay-per-view)
Second Opinion - Doctors Often Delay Conversations About Death With Terminal Patients - NYTimes.com
this is a good article for everyone, IMHO
Obesity and cancer: Effects on risk, screening and mortality | HemOncToday
My response, assuming it gets posted:
"As a cancer (ovarian) survivour, the value of the research and 'weight' concerns are ever present. However, at this very moment weight issues in cancer are primarily a health issue with many unknowns as it relates to specific implications in specific cancers. I see many websites/programs who arbitrarily have included 'weight' issues as a risk factor. Until the exact mechanisms and results are known, I urge great caution as this adds to significant burdens on patients who at this very moment are fighting to survive. It is not ethically or morally appropriate to add to these burdens for those dying of cancer."
Sandi Pniauskas
FDA calls for more research into erythropoiesis-stimulating agents | HemOncToday
"PERSPECTIVE
It should be emphasized that the FDA release focuses solely on patients with chronic renal disease, not cancer. It's a different population, so nothing in this release applies to the anemia of chemotherapy or patients with myelodysplastic syndrome. Right now, the ASCO/ASH ESA guideline committee is looking at present data to see if they need to make any modifications in the guidelines for the use of ESAs. The NCCN modified its guideline about a year ago and agree with the FDA recommendations that ESAs shouldn't be used in a standard fashion in patients being treated for curative intent. That's become standard of care, and for patients on chemotherapy, nothing has changed in the past year.
- Samuel Silver, MD, PhD
HemOnc Today Editorial Board member"
Special Report: NCI Cancer Bulletin - Ovarian Cancer
Special Report: NCI Cancer Bulletin - Ovarian Cancer
Depression assessment and classification in palliative cancer patients: a systematic literature review
"The full range of the DSM-IV diagnostic criteria was seldom assessed,i.e. less than one-third of the assessments in the review tookinto account the duration of symptoms and 18% assessed consequences and impact upon patient functioning. A diversity of assessment methods had been used. Few studies classified depression byreferring to a diagnostic system or by using cut-off scores.Evidently, there is a need for a consensus on how to assessand conceptualize depression and related conditions in palliative care."
Monday, January 11, 2010
media item: Imaging studies help detect underlying cancers in patients with neurologic symptoms
Paraneoplastic neurologic disorders occur in some people with cancer—including lung, breast or ovarian cancer
Letter of Response: Disregarding clinical trial-based patient-reported outcomes is unwarranted: Five advances to substantiate the scientific stringency of quality-of-life measurement
Dear Dr Sprangers;
I want to express my appreciation for your paper detailing these Patient and research issues which have been outstanding and often unheeded far too long. Unfortunately, I must add, even as we speak. These issues have been of great concern to our cancer communities over much time. Without the inclusion of Patients in all that affects the research, at and as the bottom line issue, the value and efforts are, yes, meaningless. Patient QOL measurements, need to be addressed, so that the real life issues are not censured through statistical analyses and re-interpretation.
Without an emphasis encompassing integrity and ethics, if not a moral obligation, QOL research and all research, is futile. It is one of our largest failings. I have never found a way to quite understand how we have gotten to this place, not only in research but often times in practice.
I do see glimmers of hope, but over time these 'glimmers' have been replaced with consistently witnessing, as a patient/survivour, much suffering combined with a profess lack of urgency. While understanding of course that the specific issue of Patient QOL does not operate in a silo, it is because we are.
Acknowledging special exceptions in clinical practice/s, when someone mentions: "I know how you feel" my response is quite simply this: "No, actually, you do not."
Thank you once again, I greatly appreciate your efforts.
Sandi Pniauskas
Canada
http://ovariancancerandus.blogspot.com
abstract:
http://tinyurl.com/ykmf39w
or:
http://informahealthcare.com/doi/abs/10.3109/02841860903440288?prevSearch=authorsfield%253A%2528Sprangers%252C%2BMirjam%2BA.%2BG.%2529&searchHistoryKey=
Reporting on Cancer Research
While this site's intended target audience is journalists/media, there is some good information here for everyone. Some of it though is still pretty technical.
Disregarding clinical trial-based patient-reported outcomes is unwarranted: Five advances to substantiate the scientific stringency of quality-of-life
"Background. The clinical impact of trial-based quality of life (QL) outcomes is frequently underestimated due, in part, to prejudice and lack of knowledge by the medical community ....It is a waste of effort and money and also unethical when collected trial-based QL data are not used to their full power. QL and other patient-reported outcomes deserve to be included in more trials, with full disclosure of all results, and standardized interpretation."
Sunday, January 10, 2010
Comparison of extended colectomy and limited resection in patients with Lynch syndrome.
abstract for our Lynch Syndrome/ovarian members or also those who family members may have been diagnosed with advanced colorectal cancer
2009 University of Health Network Toronto Patient Relations report - Office of the (hospital) Ombudsman
This report is of questionable value to patients as the Office of the Ombudsman is not independent but within the institution.
"The Patient Relations Department (Office of the Hospital Ombudsman)"
(repost): Combination therapy: intermittent sorafenib with bevacizumab yields activity and decreased toxicity : BMJ
abstract only - BMJ does not have open access (pay per view/subscription req'd)
Saturday, January 09, 2010
Cancer genetic predisposition: information needs of patients irrespective of risk level.
"Participants were stratified by risk level and included those concerned about an inherited predisposition to breast, ovarian or colorectal cancer."
"Findings indicated that irrespective of a person's actual or perceived level of risk, cancer worry, demographic background or personal motivation; priorities in the type of information required were similar. Greatest emphasis focused on information provision about how risk was assessed. Least important was acquiring an understanding about genes and inheritance patterns. Most participants reported difficulties accessing or finding information."
Improving the Quality of Colorectal Cancer Screening: Assessment of Familial Risk.
"Many patients reporting a known familial cancer syndrome or a very strong family history did not have that history indicated on the endoscopist's procedure form, and recommended follow-up intervals were beyond guideline recommendations for 60.4% of the very high-risk group."
(Texas) Cedar Park woman, fearing high cancer risk, chooses hysterectomy, double mastectomy
plus commentaries from oncologists
Avemar - corporate website
This page shows past research with the pdf files being fully accessible. I haven't looked at the research/quality, so have no comment on this one - anyone?
Current Issue : Menopause
Note: this journal requires a subscription to access the full text of the articles. You can, however, access the abstracts.
Occult fallopian tube carcinoma detected in routine pelvic washing specimens submitted for staging: another justification for pelvic washing cytology?
Diagn Cytopathol. 2009 Dec;
Department of Pathology, University of Michigan, Ann Arbor, Michigan 48109, USA. jjorns@umich.edu
"Peritoneal washing cytology is important in the staging, prognosis, and treatment schema for women diagnosed with gynecologic malignancies. Additionally, peritoneal washings are often performed before the specific diagnosis or even the distinction between benign or malignant lesion is known. Occasionally, the cytology and surgical pathology specimens, although obtained during the same procedure, will show unexpected and/or discordant findings. Perhaps, the greatest dilemma occurs when atypical cells suggestive of malignancy are identified in peritoneal washing specimens when a corresponding benign or discordantly low grade malignant diagnosis is made in the surgical pathology specimen. We present two such cases in which further investigation proved extremely valuable, not only leading to resolution of initially discrepant cytologic and surgical pathology findings but also in the process leading to second diagnoses of early fallopian tube carcinoma. Increasing evidence appears to be pointing to the fallopian tube as the site of origin of many serous carcinomas previously thought to be of primary pelvic or ovarian origin. These cases further confirm the utility of peritoneal washing cytology as a diagnostic modality when routine gross examination and sampling of the surgical specimens alone would have failed to provide the complete diagnosis."
2010 surgical oncology: Lymph node involvement in ovarian serous tumors of low malignant potential: a clinicopathologic study of thirty-six cases.
"Experience with lymph node involvement (LNI) in ovarian serous tumors of low malignant potential (OSLMP) is limited, which has led to an uncertainty about the clinical significance of this phenomenon....."
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