Multidisciplinary Meeting on Male Breast Cancer: Summary and Research Recommendations -- JCO

"Therefore, the Breast International Group and North American Breast Cancer Group have joined efforts to develop an International Male Breast Cancer Program and to pool epidemiologic data, clinical information, and tumor specimens. This international collaboration will also facilitate the future planning of clinical trials that can address essential questions in the treatment of male breast cancer."

Editorial: Conventional and Complementary Therapies: A Tale of Two Research Standards? -- Levine 28 (12): 1979 -- Journal of Clinical Oncology

"Recently, there has been a shift from single CAM modalities for cancer management to a more comprehensive approach called integrative oncology, which is "an evolving, evidence-based specialty that uses CAM therapies in concert with biomedical cancer treatments to enhance its efficacy, improve symptom control, alleviate patient distress and reduce suffering. I am encouraged that the leaders of the Society of Integrative Oncology (Dundas, Ontario, Canada) have developed evidentiary levels to gauge the strength of evidence for CAM therapies. It is not surprising that these levels are based on the foundational principles of evidence-based medicine established by Sackett et al.15 I look forward to future well-designed clinical trials that provide high-quality evidence on how CAM therapies can improve the quality of life of our patients."

Toronto hospital goes global to understand cancer treatments - Healthcare in Canada - C-Health

"The research will target lung, prostate, breast, colorectal, gynecological as well as certain blood cancers."

3rd Annual Conference CAM for Cancer.mp4 - Ann Fonfa

Decoding genomes from 25,000 cancer samples

The International Cancer Genome Consortium (ICGC) today set out its bold plan to decode the genomes from 25,000 cancer samples and create a resource of freely available data that will help cancer researchers around the world. The publication outlines research design and projects as well as the important ethical framework for this science.
The ICGC also announced that new projects in Italy and the European Union will contribute to efforts already underway in Australia, Canada, China, France, Germany, India, Japan, Spain, the United Kingdom, and the United States. As the UK's arm of the ICGC, the Wellcome Trust Sanger Institute will decode hundreds of breast cancer genomes as part of the Consortium's international efforts.
Other funded projects will examine more than 10,000 tumours for cancer types that affect organs including blood, brain, breast, colon, kidney, liver, lung, pancreas, stomach, oral cavity and ovary.
The paper, by over 200 authors participating in ICGC projects, is published today in the journal Nature. The paper describes how the projects will proceed, outlining the ethical framework, study design and policies. ICGC leaders will also present progress on their projects at the annual conference of the American Association for Cancer Research in Washington DC, 17 - 21 April, 2010.

Advanced ovarian carcinoma: Does a high-dose short-duration schedule of paclitaxel trump prolonged low-dose therapy? - Cancer Network

Note: This is a good discussion debating pros/cons (requires registration to view/free) - some excerpts from article:

Point / Counterpoint

Impact of gene patents and licensing practices on access to genetic testing for inherited susceptibility to cancer: Comparing breast and ovarian cancer

Genetics in Medicine:
April 2010 - Volume 12 - Issue 4
Article
Impact of gene patents and licensing practices on access to genetic testing for inherited susceptibility to cancer:
Comparing breast and ovarian cancers with colon cancers

Abstract

Genetic testing for inherited susceptibility to breast and ovarian cancer can be compared with similar testing for colorectal cancer as a “natural experiment.” Inherited susceptibility accounts for a similar fraction of both cancers and genetic testing results guide decisions about options for prophylactic surgery in both sets of conditions.

One major difference is that in the United States, Myriad Genetics is the sole provider of genetic testing, because it has sole control of relevant patents for BRCA1 and BRCA2 genes, whereas genetic testing for familial colorectal cancer is available from multiple laboratories.

Colorectal cancer-associated genes are also patented, but they have been nonexclusively licensed.

Prices for BRCA1 and 2 testing do not reflect an obvious price premium attributable to exclusive patent rights compared with colorectal cancer testing, and indeed, Myriad's per unit costs are somewhat lower for BRCA1/2 testing than testing for colorectal cancer susceptibility. Myriad has not enforced patents against basic research and negotiated a Memorandum of Understanding with the National Cancer Institute in 1999 for institutional BRCA testing in clinical research. The main impact of patenting and licensing in BRCA compared with colorectal cancer is the business model of genetic testing, with a sole provider for BRCA and multiple laboratories for colorectal cancer genetic testing.

Myriad's sole-provider model has not worked in jurisdictions outside the United States, largely because of differences in breadth of patent protection, responses of government health services, and difficulty in patent enforcement.

Note: see abstract for authors which include: Robert Cook-Deegan, MD. Director, IGSP Center for Genome Ethics, Law & Policy.

Clinical pathways: effects on professional practice, patient outcomes, length of stay and hospital costs. Cochrane Database Systemati Rev. 2010

Note: there are many different comments from a variety of healthcare professionals and more than a normal number of comments

Abstract

BACKGROUND: Clinical pathways are structured multidisciplinary care plans used by health services to detail essential steps in the care of patients with a specific clinical problem. They aim to link evidence to practice and optimise clinical outcomes whilst maximising clinical efficiency. OBJECTIVES: To assess the effect of clinical pathways on professional practice, patient outcomes, length of stay and hospital costs.
CONCLUSIONS: Clinical pathways are associated with reduced in-hospital complications and improved documentation without negatively impacting on length of stay and hospital costs.

Front-line Bevacizumab in Serous Epithelial Ovarian Cancer: Biomarker Analysis of the FINAVAST Trial — Anticancer Research

Background: Potential tissue and serum biomarkers were assessed for predicting efficacy of bevacizumab in ovarian cancer (OC).

Conclusion: Our results indicate differences in MMP-9 and HIF-1α expression in relation to duration of PFS (progression free survival) and effects on serum VEGF when bevacizumab (Avastin) is used in combination with chemotherapy.

Meat, fish, and ovarian cancer risk: results from 2 Australian case-control studies, a systematic review, and meta-analysis

ABSTRACT

Background: Variation in meat and fish intakes has been associated with a risk of some cancers, but evidence for ovarian cancer is limited and inconsistent.
Objective: We examined the association between intakes of total meat, red meat, processed meat, poultry, and fish and ovarian cancer risk.
Conclusion: Our results suggest that low consumption of processed meat and higher consumption of poultry and fish may reduce the risk of ovarian cancer.

News from People First -Total Solutions: Effective People "Volunteers may wreck your work"

How Not to Cheer Up a Cancer Patient - Seattle - Seattle Weekly

"During my recovery from surgery a couple years ago, I received a basket of limes....Our Friend's Friend's Piano Teacher's Life Coach: Yes, I know your sister's neighbor's dog's master's hairdresser survived cancer 20 years ago. But I don't have ovarian cancer. "

Phase I dose escalation study of MK-0457, a novel Aurora kinase inhibitor, in adult patients with advanced solid tumors.

RESULTS: Twenty-seven patients received a total of 86 infusions of MK-0457. Dose-limiting toxicity at 96 mg/m(2)/h included grade 4 neutropenia and grade 3 herpes zoster (shingles). The MTD was identified as 64 mg/m(2)/h. The most common adverse events were nausea, vomiting, diarrhea, and fatigue. Pharmacokinetic analyses revealed that CIV infusion MK-0457 had an estimated mean terminal half-life of approximately 6.6-10.2 h and that end-of-infusion concentrations and mean AUCs were approximately dose proportional. The estimated mean oral bioavailability of MK-0457 was 7.9%.
One patient with advanced ovarian cancer attained prolonged stable disease for 11 months.  
CONCLUSIONS: MK-0457 was well tolerated in this schedule. Almost half the patients attained stable disease. Further development of this class of agents will likely occur in combination with other anti-cancer treatments.

Letter to the Edfitor: Leader Post April 14th Loss of gynecologic specialist putting women's lives at risk

media item: Magee-Womens Hospital - ovarian cancer recruitment - ABT-888/PARP

Drug Tested Against Women's Cancers
Pittsburgh Post-Gazette (PA) - Apr. 14, 2010

Apr. 14--Magee-Womens Hospital of UPMC is recruiting patients with recurrent ovarian, fallopian tube or peritoneal cancers who have already had chemotherapy for a national, Phase 2 clinical trial of the drug ABT-888.

ABT-888 works by targeting the PARP family of enzymes, which are responsible for a wide variety of cancer cell processes, principal investigator Kristin Zorn said. The PARP pathway is one of the mechanisms used by cancer cells to repair damage caused by chemotherapy....cont'd

full access (2 reports) U.S. 2009 National Healthcare Disparities and Quality Reports

full access: U.S. - Agency for Healthcare Research and Quality (AHRQ) Home

Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1. Introduction and Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 .7
2. Effectiveness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
End Stage Renal Disease (ESRD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 .9
Heart Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
HIV and AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Maternal and Child Health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6 .4
Mental Health and Substance Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 .1
Respiratory Diseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. 7
Lifestyle Modification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 .3
Functional Status Preservation and Rehabilitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 7
Supportive and Palliative Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9 .2
3. Patient Safety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
4. Timeliness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
5. Patient Centeredness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 .2 9
6. Efficiency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139

on a lighter note for the day: It’s Official: Cats Love iPads [VIDEO]

2 short videos

Cancer prevention: major initiatives and looking into the future

2nd article: The interface of primary and oncology specialty care: from diagnosis through primary treatment.

The interface between primary and oncology specialty care: treatment through survivorship

What keeps you up at night? Genetics professionals' distressing experiences in patient care

Abstract 
PURPOSE:
 To explore specific patient care experiences that genetics professionals associate with distress and the emotions engendered by those experiences.
METHODS:: We conducted semistructured telephone interviews with clinical geneticists, genetic counselors, and genetic nurses that focused on a single distressing experience. RESULTS:: Fourteen clinical geneticists, 25 genetic counselors, and 14 nurses were interviewed. We categorized the situations that interviewees associated with distressing patient care experiences into seven major types: patient/family decisions (27% of total situations), giving bad news (17%), colleague behavior (15%), end-of-life issues (12%), unintended outcomes (12%), difficult patients (8%), and injustice/inhumanity (8%). Interviewees reported experiencing a variety of negative emotions during these situations, including anger, guilt, helplessness, and inadequacy.
CONCLUSIONS:: The distress and resulting emotions experienced by genetic service providers must be acknowledged. Interventions are needed to assist the clinician in becoming self-aware by reflecting on experienced emotions, examining belief systems and values, and understanding the connection between their emotions and behavior. Involvement in mindfulness meditation, reflective writing, peer support groups or additional communication skill-based training could address this need. In addition, clinicians should seek ways to increase personal meaning derived from providing patient care.

media item: Stress hormones may suppress tumor growth: Study - stress hormones

Full text - The hope of progress

Note: not specific to ovarian/cancer

Abstract/full text - Reporting bias in medical research - a narrative review

Review
Reporting bias in medical research - a narrative review
Published: 13 April 2010
Abstract (provisional) (click on pdf for full access)

Reporting bias represents a major problem in the assessment of health care interventions. Several prominent cases have been described in the literature, for example, in the reporting of trials of antidepressants, Class I anti-arrhythmic drugs, and selective COX-2 inhibitors. The aim of this narrative review is to gain an overview of reporting bias in the medical literature, focussing on publication bias and selective outcome reporting. We explore whether these types of bias have been shown in areas beyond the well-known cases noted above, in order to gain an impression of how widespread the problem is. For this purpose, we screened relevant articles on reporting bias that had previously been obtained by the German Institute for Quality and Efficiency in Health Care in the context of its health technology assessment reports and other research work, together with the reference lists of these articles. We identified reporting bias in 40 indications comprising around 50 different pharmacological, surgical (e.g. vacuum-assisted closure therapy), diagnostic (e.g. ultrasound), and preventive (e.g. cancer vaccines) interventions. Regarding pharmacological interventions, cases of reporting bias were, for example, identified in the treatment of the following conditions: depression, bipolar disorder, schizophrenia, anxiety disorder, attention-deficit hyperactivity disorder, Alzheimer's disease, pain, migraine, cardiovascular disease, gastric ulcers, irritable bowel syndrome, urinary incontinence, atopic dermatitis, diabetes mellitus type 2, hypercholesterolaemia, thyroid disorders, menopausal symptoms, various types of cancer (e.g. ovarian cancer and melanoma), various types of infections (e.g. HIV, influenza and Hepatitis B), and acute trauma. Many cases involved the withholding of study data by manufacturers and regulatory agencies or the active attempt by manufacturers to suppress publication. The ascertained effects of reporting bias included the overestimation of efficacy and the underestimation of safety risks of interventions.  
In conclusion, reporting bias is a widespread phenomenon in the medical literature.
Mandatory prospective registration of trials and public access to study data via results databases need to be introduced on a worldwide scale. This will allow for an independent review of research data, help fulfil ethical obligations towards patients, and ensure a basis for fully-informed decision making in the health care system.

Is the Kaiser Permanente model superior in terms of clinical integration?: a comparative study of Kaiser Permanente, Northern California and the Danish healthcare system

Note: full access "Finally, further research needs to be conducted on the nature of integration, and on its effect on costs and benefits to healthcare delivery systems and most importantly to the patients."

Abstract/fulll text: Four minutes for a patient, twenty seconds for a relative - an observational study at a university hospital

Abstract/full text - In vivo intratumor angiogenic treatment effects during taxane-based neoadjuvant chemotherapy of ovarian cancer

Conclusion
Taxane-based chemotherapy appears to promote tumor vascularization when administered every 3 weeks. A possible explanation is the secondary recovery of MVD in response to immediate cytotoxic and antiangiogenic effects of taxane-based chemotherapy. If confirmed prospectively, these findings favor shorter treatment intervals of taxane-based chemotherapy to counteract proangiogenic recovery.

Association between DNA damage response and repair genes and risk of invasive serous ovarian cancer.

Note: in research/technical

Ethics committees for biomedical research in some African emerging countries: which establishment for which independence? A comparison with the USA and Canada

Ethics committees for biomedical research in some African emerging countries: which establishment for which independence? A comparison with the USA and Canada

Dignity: not such a useless concept -abstract- Journal of Medical Ethics

abstract: Imaging ovarian cancer and peritoneal metastases - current and emerging techniques Nature Reviews Clinical Oncology

Sorafenib in combination with carboplatin and paclitaxel as neoadjuvant chemotherapy in patients with advanced ovarian cancer

Note: this would have been a phase 1 trial Results
Four patients were enrolled. After preoperative treatment and cytoreductive surgery, all patients were excluded from protocol due to severe toxicities. Three patients had life threatening events (cardiac output failure, myocardial infarction, anastomotic leak); two patients had primary progressive disease. The study was terminated on the basis of the recommendation of an independent data safety monitoring board.
Conclusion
The addition of sorafenib to carboplatin/paclitaxel chemotherapy was not feasible within this neoadjuvant regimen in primary advanced ovarian cancer. Although the occurrence of serious adverse events might have emerged at random, a detrimental effect of preoperative study medication could not be denied. Further evaluations of sorafenib in ovarian cancer are warranted.

A Phase Ib trial of CA4P (combretastatin A-4 phosphate), carboplatin, and paclitaxel in patients with advanced cancer

Conclusion:
The combination of CA4P with carboplatin and paclitaxel was well tolerated in the majority of patients with adequate premedication and had antitumour activity in patients who were heavily pretreated.

Facebook | Darlene Gray: Sask Minister of Health Questioned in Leg Assembly Over the Closure of Regina Gyne Onc Office

Sask Minister of Health Questioned in Leg Assembly Over the Closure of Regina Gyne Onc Office

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THIRD SESSION - TWENTY-SIXTH LEGISLATURE
of the
Legislative Assembly of Saskatchewan
N.S. VOL. 52 NO. 42A MONDAY, APRIL 12, 2010, 1:30 p.m.
LEGISLATIVE ASSEMBLY OF SASKATCHEWAN 4697 April 12, 2010
April 12, 2010 Saskatchewan Hansard 4705

ROUTINE PROCEEDINGS
INTRODUCTION OF GUESTS

Ms. Junor: — Mr. Speaker, I too on behalf of the opposition want to welcome the members from the Red Hat Society, all the women that have come today. From what I know about this group, not only are they very visible because of their hats — and it’s unfortunate that the member didn’t wear hers; that would have been entertaining — I understand that these women are extremely enthusiastic and they have a lot of fun. That’s what I always hear, that you have a lot of fun. Look at all the hats nodding. So I too would like to welcome all the women here today to the legislature.

While I’m on my feet, Mr. Speaker, I want to introduce others who are in the gallery. On the very top row is Darlene Gray, the director of OCATS, the Ovarian Cancer Awareness and Treatment in Saskatchewan, and Elan Morgan board member. Wave? And sitting beside Elan are Joan and Harvey Schneider, also board members. I just want to say about Joan before I sit down and welcome them, Joan was the executive secretary to the president of SUN [Saskatchewan Union of Nurses] when that was me. So I’m very happy to see Joan here today and welcome them all to the Assembly.

QUESTION PERIOD
Gynecologic Oncologists

Ms. Junor: — Mr. Speaker, for two years the minister has ignored the pleas of women with ovarian cancer and gyne-oncologists to address substandard working conditions in southern Saskatchewan. As a result, Dr. Brydon, one of only two gyne-oncologists practising in southern Saskatchewan, has closed her practice because she is burned out. To quote Dr. Brydon, “Physically and emotionally, I can’t cope any more.”
Mr. Speaker, the minister’s incompetence and failure to address the substandard working conditions of gyne-oncologists in Regina is putting at risk the lives of women with ovarian cancer. Why?

The Speaker: — I recognize the Minister of Health.
Hon. Mr. McMorris: — Thank you, Mr. Speaker. First of all, Mr. Speaker, on behalf of the government, we want to thank Dr. Brydon for all the work that she has done in southern Saskatchewan. These people are very specialized doctors. They are, Mr. Speaker, gynecology oncologists, which is a very specialized area. We have had four in our province, Mr. Speaker. Dr. Brydon is closing her practice to move on to other options. The health region, the health region as well as the government, is working hard to ensure that that position will be filled, Mr. Speaker.
But what I will say is that in the last two and a half years of our government, we have done more to recruit physicians into this province compared to the 16 years. And especially when you look at the front page of the Leader-Post, from 2001 to 2006 the net out-migration of health care workers in Saskatchewan was 1,160 health care workers out, Mr. Speaker. In our first two and a half years, we have attracted 164 more physicians to our province than under that government, Mr. Speaker.

The Speaker: — I recognize the member from Saskatoon Eastview.
Ms. Junor: — Mr. Speaker, that tired rhetoric is no consolation to women who have ovarian cancer. Mr. Speaker, in every other jurisdiction, including Saskatoon, gyne-oncologists work in a hospital setting with the proper support around them — not so in Regina where the specialists have to find their own office space and work without the support of a nurse.

Mr. Speaker, to the minister: is he going to provide immediate office space and examining room space in the Regina General Hospital along with the proper nursing support, or is he going to continue to ignore the issue until the second gyne-oncologist closes her practice?

The Speaker: — I recognize the Minister of Health.
Hon. Mr. McMorris: — Mr. Speaker, we have a gynecological oncology program working group that was established, Mr. Speaker, under our government. This working group has patient support, is represented through patient support groups. It also has a gynecology oncologist, the four that were in the province, working on this group as well as the health authorities of Regina Qu’Appelle, Saskatoon, and the Saskatchewan Cancer Agency to deal with this issue to have an ongoing program.

Mr. Speaker, the ministry officials have informed me that progress is being steadily made, Mr. Speaker. And yes, there are going to be decisions made by physicians to step aside. But, Mr. Speaker, we’re going in the right direction. It isn’t the working of that group . . .
[Interjections]

The Speaker: — Order. Order. I’d ask the opposition members to give the minister the same opportunity to respond as the government gave the member to ask the question. I recognize the minister.
Hon. Mr. McMorris: — Mr. Speaker, it isn’t the working of that group that would get into the micromanagement of what happens within a health region or the Cancer Agency. That is the auspices of the Cancer Agency or the regional health authority in their particular area, Mr. Speaker.

The Speaker: — I recognize the member from Saskatoon Eastview.
Ms. Junor: — Mr. Speaker, this is clearly a lack of leadership. The working group has been ongoing for over two years. They’re going to just keep spinning their wheels unless the minister says, do this. The minister’s incompetence and failure to address the problems means there’s now only one gyne-oncologist looking after all of southern Saskatchewan women. This will put additional pressures on the remaining gyne-oncologist and potentially will increase the wait time for women who are waiting for even an initial diagnosis.

My question to the minister is this: will the Sask Party government be forced to send women out of the province for diagnosis and treatment because of their incompetence and failure?

The Speaker: — I recognize the Minister of Health.
Hon. Mr. McMorris: — As I had mentioned earlier that the health region, the Saskatchewan Cancer Agency, the Regina Qu’Appelle Health Region will be working hard in the next . . . in the past but as we move forward over the next month or so to attract another gyne-oncologist into the province. I am very proud of our government having set up a physician recruitment agency that will deal with this very issue, these very issues, Mr. Speaker.

Unfortunately that hadn’t been done for many, many years — never even contemplated under the former government when we saw hundreds and hundreds of doctors leaving this province, Mr. Speaker. In the last two and a half years, we’ve seen more doctors come to the province than leave — an increase of about 164. There is more work to do. That’s why we set up a recruitment agency, Mr. Speaker. And that’s why we’ve also increased the number of training seats in the College of Medicine and the number of residency positions, up to 108 residency positions in the province, Mr. Speaker, that will bode this province very well into the future.

The Speaker: — I recognize the member from Saskatoon Eastview.
Ms. Junor: — Mr. Speaker, ducking and weaving, I mean there is no answer in the minister’s rhetoric. And Dr. Brydon’s leaving her practice now because the province will not set up a gyne-cancer unit in Regina. This unit would allow women to be diagnosed, treated, and receive follow-up care in one place. To quote Dr. Brydon:
I actually don’t think that the way the system is structured in this province at this time allows anybody to do the job that needs to be done properly and that is because we do not have a gynecologic women’s cancer unit the way all other provinces do.
Mr. Speaker, to the minister: is the minister going to establish a gyne women’s cancer unit in the province now, or is he going to wait and wait and wait, and talk and talk, and talk and continue to risk the lives of women with ovarian cancer?

The Speaker: — I recognize the Minister of Health.
Hon. Mr. McMorris: — Mr. Speaker, we know and understand the very importance of this issue, Mr. Speaker. That’s why we set up a working group that has patient representative groups on it, that has the oncologists on it, that has the Cancer Agency, that has the health regions, to look at how to best manage this project, Mr. Speaker. There has been progress made, absolutely. But it’s interesting that they would stand and criticize the way the program and the way the health system is being run, when they have been in government for 16 years prior, setting up the very program they’re criticizing now, Mr. Speaker.
Mr. Speaker, we’re looking at how we can improve this program as we move forward. We’re looking at how we can have the proper complement of gyne-oncologists within the province, Mr. Speaker, because we know that it is a very important issue, and we’re working to improve the health of women in our province, Mr. Speaker.

Detection of the HE4 protein in urine as a biomarker for ovarian neoplasms

Abstract

The HE4 protein is overexpressed in ovarian carcinomas and can be detected in serum by an ELISA with sensitivity similar to CA125 and higher specificity for malignant disease. We now demonstrate that HE4 can also be detected in the urine at a specificity level of 94.4%, including 13/15 (86.6%) with stage I/II and 57/64 (89.0%) with stage III/IV disease and including 90.5% of patients with serous ovarian carcinoma. Assaying serum and urine from the same patients showed similar sensitivity. Our data indicate that measuring HE4 in urine may aid diagnosis and the monitoring of response to therapy.

Which factors predict bowel complications in patients with recurrent epithelial ovarian cancer being treated with bevacizumab? (Avastin)

EpCAM-autoantibody levels in the course of disease of ovarian cancer patients.

Med Oncol. 2010 Apr 10
EpCAM-autoantibody levels in the course of disease of ovarian cancer patients.

Heubner M, Errico D, Kasimir-Bauer S, Herlyn D, Kimmig R, Wimberger P.
Clinic of Obstetrics and Gynaecology, Medical Faculty, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany, Martin.heubner@uk-essen.de.

Abstract

EpCAM is a tumor-associated antigen, which is frequently expressed in ovarian cancer.

Feasibility of extension of platinum-free interval with weekly bolus topotecan and subsequent platinum retreatment outcomes in recurrent ovarian cance

Abstract

PURPOSE: The goal of this study was to evaluate the outcomes and response in a cohort of patients with presumed platinum-sensitive disease who were subsequently retreated with platinum after receiving weekly bolus topotecan at the time of initial recurrence.

Restless legs syndrome and its relationship with anxiety, depression, and quality of life in cancer patients undergoing chemotherapy

Full text - Biology-driven cancer drug development: back to the future

Response: An opportunity to refine our understanding of "response shift" and to educate researchers on designing quality research studies

Journal Quality of Life Research
Issue Volume 19, Number 4 / May, 2010

Commentary
An opportunity to refine our understanding of “response shift” and to educate researchers on designing quality research studies: response to Ubel, Peeters, and Smith

Bryce B. Reeve1 Contact Information
(1) Outcomes Research Branch, Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, EPN 4088, 6130 Executive Blvd., MSC 7344, Bethesda, MD 20892-7344, USA

Abstract
There is no advantage at this time to abandon the term “response shift” as suggested by Ubel et al. (Qual Life Res, 2010). The term is well known in the research field and has impacted the way we think about measuring quality of life (QOL) longitudinally. However, Ubel et al. (Qual Life Res, 2010) have provided the incentive to start an open dialogue on the subject with opportunities to refine the language of response shift and educate researchers. In this article, we identify opportunities in designing research studies to minimize or account for response shifts by considering the (1) selection of QOL concepts to measure, (2) questionnaires used to assess the QOL concepts, (3) design of the research study, (4) target population, and (5) analyses and reporting of results. Careful consideration of each of these issues will help us identify new methodologies and improved study designs that will move the QOL research field forward.

Thomas J. Herzog, MD, Columbia University College of Physicians and Surgeons talks about liposomal doxorubicin, bevacizumab, and temsirolimus in patients with advanced malignancy/GOG reference to trials

Note: This is a repost of the video. Dr Herzog speaks briefly about the direction of GOG trials including the numerous drug combinations and trying to assess the best approaches.

QOL Research Journal: Abandoning the language of “response shift”: a plea for conceptual clarity in distinguishing scale recalibration from true changes in quality of life

"..they have shed light on important mysteries relevant to understanding the experiences of people with chronic illness and disability. And they have focused researchers on the challenge of explaining why people with disabilities often provide quality of life reports that seem to belie their objective circumstances....The term ('response shift') suggests that the high quality of life reported by many people with chronic illness and disability are measurements artifacts - their "responses" have "shifted" - and that such people are not really experiencing high quality of life. We think such connotations, even if not originally intended, are misleading."

commentary/Japanese study - Carbo/Taxol - Dose-Dense Chemotherapy for Ovarian Cancer - National Cancer Institute

"...Women with advanced ovarian cancer lived longer and without their tumors growing after receiving a modified regimen of a standard chemotherapy drug combination, Japanese researchers have reported. In a large phase III clinical trial, the researchers randomly assigned women to receive six cycles of carboplatin and paclitaxel (Taxol) every 3 weeks (standard regimen) or six cycles of carboplatin every 3 weeks and a lower dose of paclitaxel (Taxol) once a week (dose-dense regimen). Women in the dose-dense group had a 29 percent reduction in the risk of progression and a 25 percent reduction in the risk of death after 3 years of follow-up. The results were published online September 18, 2009, in The Lancet (see the journal abstract).
Although the dose-dense regimen had more toxic effects than the standard regimen, survival benefits of this magnitude "have been rare in women with advanced ovarian cancer," wrote. Noriyuki Katsumata, M.D., and colleagues from the Japanese Gynecologic Oncology Group (JGOG).
The results, explained Ted Trimble, M.D., M.P.H., from NCI's Division of Cancer Treatment and Diagnosis, are consistent with what has been seen in breast cancer using a dose-dense chemotherapy regimen. The idea, he continued, is "to balance efficacy and toxicity by using a weekly schedule rather than every 3 weeks."...."

Women's Health Matters: Women’s College scientist reports on the quality of medical studies

Methods of consumer involvement in developing healthcare policy and research, clinical practice guidelines and patient information material.

Authors’ conclusions There is little evidence from randomised controlled trials of the effects of consumer involvement in healthcare decisions at the population level. The trials included in this review demonstrate that randomised controlled trials are feasible for providing evidence about the effects of involving consumers in these decisions.
   Comment 1:This paper is an issue for public health policy-makers not clinicians. Consumer involvement has a great risk of being tokenistic.  Comment 2:As a community health professional, the results will serve as an evidence to involve health care consumers in the process of policy and guideline formulation.  Comment 3:
The evidence presented that face-to-face interactions with consumers is the most effective type of involvement for developing patient educational materials is helpful for clinicians.

Risk and epidemiological time trends of gastric cancer in Lynch syndrome carriers in the Netherlands.

CONCLUSIONS: Lynch syndrome mutation carriers have a substantial risk for gastric cancer, in particular patients with an MLH1 or MSH2 mutation. Family history for gastric cancer is a poor indicator for individual risk. Surveillance gastroscopy for Lynch syndrome patients carrying an MLH1 or MSH2 mutation should therefore be considered.

Does risk-reducing bilateral salpingo-oophorectomy leave behind residual tube?

CONCLUSION: The majority of the uterine cornua had a tubal remnant which suggests that RRSO may leave behind residual tubal epithelium. The clinical significance of this tubal remnant is unclear given the current understanding of tubal carcinogenesis

Referral and ascertainment bias in patients with synchronous and metachronous endometrial malignancy.

Abstract
The purpose of this study was to evaluate the frequency in patients with endometrial cancer of other malignancies and the influence of referral and ascertainment biases on these associations.
Analysis of 1,028 local and referred patients who had a hysterectomy for endometrial cancer was based on residence at the time of diagnosis.
Altogether, 208 patients had a history of another malignancy, most frequently breast, colon, and ovary. At the time of surgery for endometrial cancer, the prevalence of lymphoma and breast and ovarian cancers was greater than expected although the higher prevalence of lymphoma was limited to referred patients. During follow-up after hysterectomy, the incidence of lung cancer was lower than expected, whereas the incidence of lymphoma was higher. Breast, colorectal, and bladder cancers were more common than expected although this finding was limited to local patients.
We concluded that results of epidemiologic studies from tertiary care centers may be misleading if they do not account for referral and ascertainment biases.

Pure Sertoli cell tumor. a case report and review of the literature.

Treatment of ovarian cancer by monoclonal antibodies

"As the preclinical results of mAb's therapeutic effects on ovarian cancer have been encouraging, further investigations are needed to establish a more effective, specific, and less toxic treatment strategy for this malignancy."

Identification of early predictive imaging biomarkers and their relationship to serological angiogenic markers in patients with ovarian cancer with re

dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI)

"CONCLUSIONS: Imaging markers have a potential role in early prediction of disease progression in patients with residual ovarian cancer and may supplement current measures of progression. The correlation of DCE-MRI and serological biomarkers suggests that tumour angiogenesis affects these markers through common biological means and warrants further investigation."

Low malignant potential tumors with micropapillary features are molecularly similar to low-grade serous carcinoma of the ovary.

CONCLUSION: The gene expression profile of LMP-MP is similar to LGSC and distinct from LMP, reflecting their more aggressive clinical behavior. *Low-grade serous carcinoma (LGSC) *LMP with micropapillary features (LMP-MP)

Primary peritoneal and ovarian cancers: an epidemiological comparative analysis.

Cancer Causes Control. 2010 Mar 23

"We performed case-control analyses using data from the North Carolina Ovarian Cancer Study to determine risk factors that distinguish primary peritoneal cancer (PPC) from epithelial ovarian cancer (EOC).
Our risk factor analyses were restricted to invasive serous cancers including 495 EOC cases, 62 PPC cases and 1,086 control women....Although many case-control associations for the invasive serous PPC cases were similar to those of the invasive serous EOC cases, some differences were observed including a twofold increase in risk of invasive serous PPC in women who were >/=35 years at last pregnancy, whereas a decreased risk was observed for invasive serous EOC risk.
We could not confirm a previous report of an association between tubal ligation and PPC, a factor consistently associated with a decreased risk of EOC. The difference in the risk factor associations between invasive serous PPC and EOC cancers suggests divergent molecular development of peritoneal and ovarian cancers.
A larger study to determine risk factors for invasive serous PPC is warranted."

Underdiagnosis of Lynch Syndrome Involves More than Family History Criteria.

CONCLUSIONS:: Lynch syndrome is under-recognized, even when patients have clear criteria unrelated to family history. Multifaceted strategies focused on reducing providers' cognitive errors and harnessing EHR (electronic health record) capabilities to improve recognition of Lynch syndrome are needed "Among 244 patients with uncertainty, a suspicion for Lynch syndrome was documented in the EHR of 6 patients (2.5%); 3 received counseling."

Endometrial and ovarian carcinomas with undifferentiated components: clinically aggressive and frequently underrecognized neoplasms

"Endometrial and ovarian carcinomas with undifferentiated components have a broad histologic differential diagnosis, but they show specific histologic features that should enable accurate diagnosis. These tumors can occur in young women, may be associated with microsatellite instability and behave in a clinically aggressive manner." Modern Pathology

Potent preclinical impact of metronomic low-dose oral topotecan combined with the antiangiogenic drug pazopanib for the treatment of ovarian cancer.

Abstract

Low-dose metronomic chemotherapy has shown promising activity in many preclinical and some phase II clinical studies involving various tumor types. To evaluate further the potential therapeutic impact of metronomic chemotherapy for ovarian cancer, we developed a preclinical model of advanced human ovarian cancer and tested various low-dose metronomic chemotherapy regimens alone or in concurrent combination with an antiangiogenic drug, pazopanib. Clones of the SKOV-3 human ovarian carcinoma cell line expressing a secretable beta-subunit of human choriogonadotropic (beta-hCG) protein and firefly luciferase were generated and evaluated for growth after orthotopic (i.p.) injection into severe combined immunodeficient mice; a highly aggressive clone, SKOV-3-13, was selected for further study. Mice were treated beginning 10 to 14 days after injection of cells when evidence of carcinomatosis-like disease in the peritoneum was established as assessed by imaging analysis. Chemotherapy drugs tested for initial experiments included oral cyclophosphamide, injected irinotecan or paclitaxel alone or in doublet combinations with cyclophosphamide; the results indicated that metronomic cyclophosphamide had no antitumor activity whereas metronomic irinotecan had potent activity. We therefore tested an oral topoisomerase-1 inhibitor, oral topotecan, at optimal biological dose of 1 mg/kg/d. Metronomic oral topotecan showed excellent antitumor activity, the extent of which was significantly enhanced by concurrent pazopanib, which itself had only modest activity, with 100% survival values of the drug combination after six months of continuous therapy. In conclusion, oral topotecan may be an ideal agent to consider for clinical trial assessment of metronomic chemotherapy for ovarian cancer, especially when combined with an antiangiogenic drug targeting the vascular endothelial growth factor pathway, such as pazopanib. Mol Cancer Ther; 9(4); 996-1006. (c)2010 AACR.

CA 125 and the detection of recurrent ovarian cancer. Robert C. Bast Jr. 2010; Cancer - Wiley InterScience

Commentary

CA 125 and the detection of recurrent ovarian cancer A reasonably accurate biomarker for a difficult disease

Robert C. Bast Jr, MD

Department of Experimental Therapeutics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas

Abstract

Rising cancer antigen 125 (CA125) levels have been used to detect recurrence of ovarian cancer. A recent study questions the value of this practice, but the clinical trial has significant limitations and discounts the value of early detection to permit treatment of recurrence with novel and conventional agents.

British Journal of Cancer -Age of mother and grandmother in relation to a subject's breast cancer risk

Background:  On theoretical grounds, the age of the grandmother and the age of the mother at delivery of her daughter may affect the breast cancer risk of the granddaughter.

Conclusion: This study does not suggest a major role of maternal age at delivery or grandmaternal age at delivery of the mother for the (grand)daughters' breast cancer risk.

The winners of the 2010 Gairdner Awards : The Lancet

Medical researchers from the USA, Canada, UK, and France are recognised in this year's Gairdner Awards for their pioneering work in global health and biomedicine
.

Canada's Gairdner Foundation honoured seven medical researchers on April 6 with some of the world's largest annual international research awards.

Gairdner International Awards valued at CAN$100 000 each went to William Catterall of the University of Washington, WA, USA; Pierre Chambon of the Institut de Génétique et de Biologie Moléculaire et Cellulaire near Strasbourg, France; William Kaelin of the Harvard Cancer Center, MA, USA; Peter Ratcliffe of Oxford University, UK; and Gregg Semenza at the Johns Hopkins Institute for Cell Engineering in Baltimore, MD, USA.

Also recognised were Nicholas White of the Mahidol Oxford Tropical Medicine Research Unit at Mahidol University in Bangkok, Thailand, who won the Canada Gairdner Global Health Award, and Cal Stiller, chair of the Ontario Institute for Cancer Research, who won the Canada Gairdner Wightman Award for leadership in medicine in Canada.

Next to the Nobel Prize in Medicine, the Canada Gairdner Awards are the most prestigious global medical research awards, according to the Gairdner Foundation, which was established by Toronto stockbroker James Arthur Gairdner in 1957. The foundation began recognising pioneers in basic science in 1959. In 2008, the Government of Canada endowed CAN$20 million to support the awards.

Patient Safety: April 2010 Medication Events Related to Cancer Chemotherapy

U.S. Sebelius Continues Work to Implement Health Reform, Announces First Steps to Establish Temporary High Risk Pool Program

FDA & Digital Mammography: Why Has FDA Required Full Field Digital Mammography Systems to Be Regulated as Potentially Dangerous Devices for More Than 10 Years?

author: Bioptics Inc.

(Promestriene) Urogenital disorders associated with oestrogen deficiency: the role of promestriene as topical oestrogen therapy; Gynecological Endocrinology

"Given the absence of systemic activity, promestriene may be a good choice in women requiring purely locally oestrogen, and those who have survived, or who are at risk of breast cancer and who have severe vulvo-vaginal symptoms."

Strength in Numbers | Canadian Women's Health Network

Strength in Numbers

Project plans to unite support services for women with breast and reproductive cancers
By Jane Shulman

Cancer support networks in different parts of the country are looking at grouping women’s gynaecological cancers with breast cancer for the purpose of offering more support to women who have had a cervical, ovarian or uterine cancer diagnosis. Manitoba has been working on this for some time, explains Barbara Clow, director of the Atlantic Centre of Excellence for Women’s Health, and now New Brunswick and Newfoundland and Labrador are looking at their own models for delivering programming under the same umbrella.

In a 2008 report for Canadian Partnership Against Cancer, called “Where Do We Go From Here? Support services for women with breast, cervical, ovarian and uterine cancer in Atlantic Canada,” Clow and co-authors looked at the idea of merging services to meet the needs of the underserved gynaecological cancer population.

The idea is not without its detractors. Some have expressed concern that breast cancer groups might jeopardize their funding or lose their identity if they expand their mandate, or stretch their already overextended resources.

But the focus on breast cancer over the past several years, with fundraisers and awareness campaigns popping up all over the country, means that the disease has a lot of attention, and Clow notes that it’s the kind of attention that gynaecological cancers desperately need. While she says that fewer women are diagnosed with cervical, ovarian and uterine cancers combined than breast cancer in Canada each year, with the exception of cervical cancer, their prognosis is not as good. And the psychosocial support specific to their kind of cancer just does not exist.

Clow cites the work of volunteer-based Ovarian Cancer Canada as the only national gynaecologically-based cancer group. There are no national groups for people with cervical or uterine cancer. The needs are different, but there’s overlap, which is why a program that pools resources for cancers that affect women is so appealing.

The report recommendations included:
Foster new research on the needs of women from vulnerable and disadvantaged communities who are faced with a diagnosis of cancer;

Explore the possibility of adopting and adapting the processes and products developed by breast cancer support networks in Atlantic Canada to meet the needs of those with other women’s cancers;

Promote the creation of publicly funded cancer patient navigator programs throughout Atlantic Canada.

Clow says the next step is to look at how feasible this idea is, and where the desire lies. So far, nurses and service providers involved with the planning and delivering of programming are most passionate about it because they see the possibilities that lie in making the most of the services they can offer.

Jane Shulman is a the Director of Knowledge Exchange at the Canadian Women’s Health Network and a former staff member of Breast Cancer Action Montreal

Emerging drugs for the management of cancer treatment induced bone loss; Expert Opinion on Emerging Drugs

Take home message: The very high rate of bone loss and the high incidence of fractures indicate that cancer patients at risk of CTIBL (cancer treatment induced bone loss) need to be carefully monitored and stratified for fracture risk. Although there is a strong evidence of efficacy in prevention of bone loss and reduction of fracture risk for many drugs approved for postmenopausal osteoporosis (PMO) and male osteoporosis, for CTIBL there are actually no drugs approved for this indication.

Statin use and cancer risk: a comprehensive review; Expert Opinion on Drug Safety

Note: this study did not include ovarian cancer but numerous other cancers

Take home message: Few strong or consistent associations between statins and cancer incidence overall or for any of the sites reviewed were detected. Data for any effects of statins on cancer prognosis and secondary prevention are lacking; with the exception of consistent evidence that statins are associated with reduced risk of advanced/aggressive prostate cancer. Statins appear safe in relation to cancer risk but any chemopreventive effect in humans remains to be established and should not be recommended outside the context of clinical trials. It is encouraging that numerous trials are ongoing. The prospect of reducing the incidence and burden of some of the most prevalent cancers with safe, affordable and tolerable medication that already reduces the risk of the leading cause of death and cardiovascular disease warrants further exploration in clinical trials and observational studies of prognosis and survival.

Targeted therapies for rare gynaecological cancers : The Lancet Oncology

The Lancet Oncology, Early Online Publication, 1 April 2010

Targeted therapies for rare gynaecological cancers

Summary

Some gynaecological cancers are uncommon, such as sex cord-stromal tumours, malignant germ-cell tumours, vulvar carcinoma, melanoma of the female genital tract, clear-cell carcinoma of the ovary and endometrium, neuroendocrine tumours of the cervix, and gestational trophoblastic neoplasia.

All these cancers have different clinicopathological characteristics, suggesting different molecular biological pathogeneses. Despite aggressive treatment, some cancers recur or respond poorly to therapy. Comprehensive knowledge of the molecular biology of each cancer might help with development of novel treatments that maximise efficacy and minimise toxic effects. Targeted therapy is a new treatment strategy that has been investigated in various tumours in clinical and laboratory settings.

Since these cancers are rare and large clinical trials are difficult to do, molecular biological techniques might allow rapid proof-of-principle experiments in few patients. Novel targeted agents either alone or in combination with other treatments offer promising therapeutic options.

Genetics professionals' experiences with grief and loss: implications for support and training

full access: PLoS Clinical Trials: Updating Systematic Reviews: An International Survey

Conclusions/Significance:

Most organizations that sponsor and/or carry out SRs (systematic reviews) consider updating important. Despite this recognition, updating practices are not regular, and many organizations lack a formal written policy for updating SRs. This research marks the first baseline data available on updating from an organizational perspective.

ACS :: Statistics for 2009 and selected for 2010

Attitudes of the General Public Toward Alternative Consent Models. (Toronto)

Hospitals raise caution over uniform pay-for-performance rules - The Globe and Mail

Invitation to European-based patient groups/patients to participate in an online survey on patient information - PatientView alerts and updates

Ovarian Cancer and Our Pets

Yi's Twinkle and Rory have been been added to our video (Montage)

Make photo slide shows at www.OneTrueMedia.com

'New' Evidence for Clinical Practice Guidelines: 'New' Evidence for Clinical Practice Guidelines: Should we Search for 'Preference Evidence'?

Abstract

Clinical practice guidelines (CPGs) are systematically developed statements to assist both patient and practitioner decisions. They link the practice of medicine more closely to the body of underlying evidence, shift the burden of evidence review from the individual practitioner to experts, and aim to improve the quality of care. CPGs do not routinely search for or include evidence related to patients' values and preferences.

We argue that they should.

We think that such evidence can tell us whether a decision is preference sensitive; how patients feel about important health outcomes, treatment goals, and decisions; and whether preferences vary in different types of patients. The likely effects of reviewing the literature are a general sensitization to the importance of preferences in decision making, the recognition that some decisions are simply all about preferences, a more considered approach to forming preferences among patients and other stakeholders, and more effective integration of preferences into decisions.

repost: Bevacizumab toxicities and their management in ovarian cancer - abstract

Gynecol Oncol. 2010 Apr 1. [Epub ahead of print]

Bevacizumab toxicities and their management in ovarian cancer.

Randall LM, Monk BJ.

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California, Irvine, 101 The City Dr. South, Bldg 56 Room 264, 101 The City Dr., Orange, CA 92868, USA.

Abstract

OBJECTIVES: The purpose of this review is to discuss the side effect profile of bevacizumab, to discuss proposed mechanisms of these toxicities, and to provide suggestions for management of adverse events.

METHODS: A search of MEDLINE and ASCO and SGO abstract databases of articles published between January 1970 and August 2009 addressing the toxicity of bevacizumab in solid tumors was conducted. Reporting was limited to best available evidence including any available phase III studies and ovarian cancer phase II studies. Original publications addressing underlying mechanisms of bevacizumab toxicities were included.

RESULTS: Extensive experience with bevacizumab has proven the agent to be generally well tolerated, with an adverse event profile distinct from traditional cytotoxic chemotherapy and likely peculiar to its novel mechanism of action. The most common bevacizumab-attributable adverse event, hypertension, can be medically-managed, but more serious adverse events such as bowel perforation require drug discontinuation.

CONCLUSIONS: Current best evidence supports the use of bevacizumab in selected patients, and safe administration of bevacizumab requires an understanding of the management of adverse events attributable to its use.

Ovarian cancer: the duplicity of CA125 measurement. abstract

Ovarian cancer: the duplicity of CA125 measurement.

Nat Rev Clin Oncol. 2010 Apr 6. [Epub ahead of print]

Karam AK, Karlan BY.

Department of Obstetrics and Gynecology, Division of Gynecologic Oncology at the David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, CHS 24-130, Los Angeles, CA 90095, USA.

Abstract

Since it was first described in 1981, CA125 has held an important role in monitoring patients with ovarian cancer. CA125 is elevated in 80% of patients with epithelial ovarian cancer at initial diagnosis and correlates well with response to therapy. CA125 monitoring is used for the follow up of patients with epithelial ovarian cancer, and elevations in CA125 measurements often antedate any signs, symptoms or radiographic evidence of disease by several months.

Unfortunately, data favoring early therapeutic intervention for recurrent ovarian cancer is lacking, especially in patients with isolated CA125 elevations.

In asymptomatic patients, elevations in CA125 have been associated with considerable anxiety and deterioration in quality of life without any significant gains in survival.

Patients with ovarian cancer should, therefore, be counseled regarding the advantages and shortcomings of intensive CA125 testing.

While some patients may benefit from early detection of recurrent disease and be candidates for secondary cytoreductive surgery, others may choose to delay therapy until they develop symptoms of disease recurrence.

The results of a clinical trial suggest that withholding treatment in the event of isolated rising CA125 levels will not negatively impact these patients overall survival, highlighting the need for improved salvage therapies for recurrent ovarian cancer

David Silver to lead Warren Hospital effort to create new Women's Institute | - lehighvalleylive.com

New study confirms HRT helps ward off colon cancer | Reuters

 Note: this issue of a protective effect was known at the time the original WHI study information was published but also received very little attention

 New study confirms HRT helps ward off colon cancer

Fri Apr 9, 2010 5:19pm EDT

NEW YORK (Reuters Health) - Hormone replacement therapy (HRT) cuts a woman's risk of developing colon cancer, new research confirms.

Health

Millions of women stopped taking HRT when a Women's Health Initiative study showed in 2002 that the hormones raised the risk of stroke, heart disease and breast cancer.
But the Women's Health Initiative had also found that HRT protected against colon cancer. Some studies have also suggested that oral contraceptives might reduce the risk of the disease, while the fact that women are at lower risk of colon cancer than men also hints at a hormonal role in disease risk.
To investigate ties between HRT and colon cancer further, Dr. Millie D. Long of the University of North Carolina at Chapel Hill and her colleagues matched 443 women diagnosed between 2001 and 2006 with distal large bowel cancer (meaning tumors at the far end of the colon and the rectum) to 405 healthy control women. The average age of the study participants was around 63.
Long's team found that women who had ever used HRT were at half the risk of this type of colon cancer compared to women who'd never used hormone replacement, and the longer a woman was on HRT, the lower the risk.
For example, women who used hormones for less than four years cut their colon cancer risk by about one-quarter; four to eight years of HRT cut risk by a third; nine to 14 years of use halved risk; and 15 years or more of HRT reduced risk by two-thirds. The effects were the same for African-American women and white women.
However, there was no relationship between oral contraceptive use and colon cancer risk, the study team reports in the American Journal of Gastroenterology.
Long-term hormone therapy is no longer recommended for postmenopausal women, Long and her team note, although it is still sometimes prescribed on a short-term basis to help women with menopausal symptoms such as hot flashes. The major drop off in distal large bowel cancer in recent years could have been related to widespread use of HRT, the researchers say.
More research is needed to determine if HRT's protective effects persist after women stop taking hormones, the researchers add, or whether there might be a "rebound" effect with more pre-cancerous polyps developing after a woman halts
HRT.
"It may become important in the future to tailor timing of women's colorectal screening based on cessation of hormonal therapy," Long and her colleagues conclude.

SOURCE: The American Journal of Gastroenterology, online March 30, 2010.

Patented Genes - 60 Minutes - CBS News

North Carolina Man Denied Free Screening for Suspected Male Breast Cancer - ABC News

Gyn Congress 2010 Webcast - Novel Therapies (2) additonal videos free access

Session V: Ovarian Cancer III: Novel Therapies

* Emerging options in antiangiogenic targeted therapy for ovarian cancer
Andrew Clamp, MD, PhD

* Targeted therapy for ovarian cancer: Beyond angiogenesis
Stanley B. Kaye, MD

Gyn Congress 2010 Webcast Case-based approaches Recurrence (4) additional presentations/free access

Session IV: Ovarian Cancer II: A Case-Based Approach to Recurrence

* Interactive clinical case: non surgical Management of platinum sensitive ovarian cancer
Andreas du Bois, MD

* Interactive clinical case: Considerations for the management of a partially platinum sensitive relapse (6-12 months)
Bradley J. Monk, MD

* Interactive clinical case: Management of platinum resistant/refractory ovarian cancer
Eric Pujade-Lauraine, MD, PhD

* Keynote Lecture: Changing standards of care: The role of CA125 in the management of Ovarian Cancer
Gordon J.S. Rustin, MD, FRCP

Gyn Congress 2010 Webcasts (4) free online videos Surgery,systemic therapies,serous carcinomas

*State of the art surgical strategies in ovarian cancer: How to do it?
*State of the art surgical strategies in ovarian cancer: When to do it?
*Interactive clinical case: First-line systemic therapies for ovarian cancer
*Definition and characterization of low-grade and high-grade ovarian serous carcinomas

About consumer participation | Cochrane Consumer Network

Note: "prioritise topics for new reviews"
In response to a request from the Cochrane Network, ovarian cancer women/caregivers were asked to respond to a survey regarding priortisation. This was done, in part, through the ACOR Ovarian Cancer group (http://www.acor.org). A large response was received and the Cochrane Network responded in a positive manner.

 

About consumer participation

The authors of Cochrane reviews may consider a question for a review because of their own interests and experiences as a clinician or a healthcare researcher. These are not always the questions that are of most concern to healthcare consumers and their families and carers.

It is not easy for us, the public, to understand how the questions for Cochrane reviews need to be stated in order to be ‘answerable’ in research terms. You can learn more about this from our Training materials on the Resources webpage.

The purpose of consumer input during the review process is to:

• ensure that a review question is relevant to people requiring health care and who are offered an intervention by their healthcare providers;
• identify outcomes from healthcare interventions that are important for consumers – which may be different from those identified by service providers;
• improve access to reviews by ensuring that the review can be read by a wide audience, and the language is sensitive to consumers;
• weigh up the benefits of a healthcare intervention against the potential harms – from a healthcare user perspective;
• prioritise topics for new reviews.

Healthcare users in Cochrane | Cochrane Consumer Network

Purpose

The World Health Organization (1978) states: The people have the right and duty to participate individually and collectively in the planning and implementation of their health care.

Our core function is to provide consumer input into developing Cochrane systematic reviews of best evidence in health care and in utilising this evidence.

The purpose of this website is to tell you about The Cochrane Collaboration and how we receivers and users of health care, parents and carers can benefit from its work..

"No one will own the problem" Departing oncologist cites frustration - Dr. Lizabeth Brydon Saskatchewan

"No one will own the problem and it is a problem," Brydon said. "The fact of my leaving puts more pressure on it. I realize by doing this I have created a crisis, but we've given them two drop-dead dates saying, 'We're closing our office here because we can't cope.' "

Young Adult Cancer Canada . Community . Profiles Amy young adult with ovarian cancer

PennMed Clinical Trial: Phase 1/2a Study of DTA-H19 (IP) in Advanced Stage Ovarian Cancer With Symptomatic Ascites

Description This study is designed to assess the safety, tolerability, pharmacokinetics (PK) and preliminary efficacy for ascites palliation of DTA-H19 administered intraperitoneally (IP) in subjects with advanced stage ovarian cancer who have evidence of symptomatic ascites

Investigators George Coukos, M.D., Ph.D., Principal Investigator University of Pennsylvania Medical Center Philadelphia, Pennsylvania 19104-6142

2010 full free access: Analysis - When Should Surgical Cytoreduction in Advanced Ovarian Cancer Take Place?

Intraperitoneal chemotherapy for the initial management of primary epithelial ovarian cancer - Cochrane Collaboration - review 2007

MPEG LA Launches Initiative to Make Gene Patents Available for Diagnostic Testing - MarketWatch

"By aggregating patent rights for existing and emerging tests that may lead to personalized treatment (e.g., hereditary hearing loss in infants, breast cancer, ovarian cancer, cardiovascular disease, Lynch syndrome) and licensing them nonexclusively for diagnostic use, MPEG LA's diagnostic genetics patent licensing facility, or "supermarket," will assist laboratories, testing companies and researchers in obtaining rights they need to design comprehensive diagnostic genetics tests that the market wants, thereby making these tests widely available through multiple channels at affordable prices."

Erythropoietin and Ovarian Cancer - Response. [Mol Cancer Ther. 2010] - PubMed result

Four new cases of double heterozygosity for BRCA1 ... [Breast Cancer Res Treat. 2010] - PubMed result

"Double heterozygosity (DH) for BRCA1 and BRCA2 mutations is a very rare finding, particularly in non-Ashkenazi individuals, and only a few cases have been reported to date. In addition, little is known on the pathological features of the tumors that occur in DH cases and on their family history of cancer. Four carriers of pathogenic mutations in both BRCA1 and BRCA2 were identified among women who underwent genetic counseling for hereditary susceptibility to breast and ovarian carcinoma at three different Italian institutions"

Ovacome :News survey on cancer related fatigue (online) - survey is cancer related fatigue not specific to ovarian cancer

Can you help with research on cancer related fatigue?
"This study on cancer fatigue is being carried out by researchers in the School of Psychology, Trinity College Dublin. The study is funded by the Irish Cancer Society and the Irish Research Council for Science Engineering and Technology."

March 2010
Researchers in Trinity College Dublin are investigating the causes of cancer fatigue and the factors that contribute to the development of chronic fatigue in some cancer patients. The study is funded by the Irish Cancer Society and the IRCSET 'Embark Initiative'.
Who can participate?
Anyone who (a) has been treated for cancer or is currently being treated for cancer and (b) is experiencing fatigue.
What does participation involve?
Participation involves filling in a number of questionnaires about your fatigue, the factors you believe contribute to your fatigue, and the coping strategies you use to manage this symptom.
How can I participate?
If you would like to participate please complete this online questionnaire: http://www.surveymonkey.com/s/CancerFatigueStudy

If you would prefer to complete the questionnaire in hard copy or if you would like further information, please contact the researcher: Maria Pertl (Phone: 01 896 3083 / E-mail: pertlm@tcd.ie).

news article: US & Canada - Maker of cancer test loses right to DNA patent

Note: references to France, UK and Europe

Quest PharmaTech completes critical review of development status for its recently acquired therapeutic antibody platform - Oregovomab + chemo trials..

"An 80 patient multicentre Italian cooperative trial will establish evidence for the clinical benefit associated with enhanced specific T cell immunity achievable by combining oregovomab with carboplatin and paclitaxel in the initial treatment of advanced ovarian cancer. Concurrent to this effort, a 30 patient Canadian clinical trial will evaluate the ability of a TLR-3 agonist to enhance the strength of the oregovomab immune response generated in the 'maintenance' setting in advanced ovarian cancer patients following front-line chemotherapy. The third clinical trial to be conducted in the U.S. will use gemcitabine, another cytotoxic agent, in a cohort of patients with CA125 associated resectable pancreatic cancer in combination with oregovomab."

""Successful completion of our clinical strategy will lead to a product for one or all treatment phases of advanced ovarian cancer, starting with front line treatment followed by watchful waiting and finally retreatment or initial treatment of recurrent disease."

"The additional antibodies in the platform (anti-MUC1, anti-PSA, anti-CA19.9 and anti-TAG 72) will undergo continuing preclinical development in anticipation of rapid clinical development once the initial oregovomab studies establish the validity of the combination therapy premise."

"Quest PharmaTech is developing the high affinity monoclonal antibody oregovomab (MAb B43.13) for the treatment of ovarian cancer. Oregovomab targets the circulating tumour-associated antigen CA125."

Edmonton, Alta news item: Abnormal results don't always mean cancer (references robotic surgery)

"The Gynecologic Oncology Service at the Lois Hole Hospital for Women looks after patients from all over northern Alberta, the Arctic (Nunavut) and parts of northern B.C. Women initially seen at the Cross Cancer Institute with cervical, endometrial or ovarian cancer that require surgery will have it performed at the Lois Hole Hospital for Women."

U.S. Patient Advocate Foundation :: 1-800-532-5274

YouTube - Current Topics in Genome Analysis 2010

Note: Very long but interesting video - 1 1/2 hrs. The subject matter sounds very technical but the content is in good plain english language - talks about unresolved side effects, patient concerns....


http://www.youtube.com/watch?v=IMeJA_inoEM

GenomeTV — March 29, 2010 — March 23, 2010
Howard McLeod, Pharm.D.
Current Topics in Genome Analysis 2010

Validation of the pedigree assessment tool (PAT) in families with BRCA1 and BRCA2 mutations

CONCLUSIONS: In overall performance, the PAT is at least comparable to the Myriad II and Penn II models in screening women appropriate for genetic referral. Simplicity and identification of families with non-BRCA hereditary BC syndromes suggest that the PAT is better suited for BC risk screening.

Ovarian cancer: predictors of early-stage diagnosis - California Cancer Registry

"CONCLUSION: These findings suggest that, in addition to tumor biology, disparities in access to care may have a significant effect on the timely diagnosis of epithelial ovarian cancer."

Cancer Causes Control. 2010 Apr 3. [Epub ahead of print]
Ovarian cancer: predictors of early-stage diagnosis.
Morris CR, Sands MT, Smith LH.
California Cancer Registry, Public Health Institute, California Department of Public Health, 1825 Bell St., Suite 102, Sacramento, CA, 95825, USA, cmorris@ccr.ca.gov.

Bridging the Gap between Cytotoxic and Biologic Therapy with Metronomic Topotecan and Pazopanib in Ovarian Cancer

"Pazopanib therapy in combination with metronomic topotecan therapy showed significant antitumor and antiangiogenic properties in preclinical ovarian cancer models and warrants further investigation as a novel therapeutic regimen in clinical trials."

(abstract) Review: The use of proteomics as a research methodology for studying cancer-related fatigue: a review

Note: limited information in the abstract

JNCI Editorial: Fruits, Vegetables, and Cancer Prevention: Turmoil in the Produce Section

Some key excerpts - full text of Editorial available without cost:

•  In this issue of the Journal, Boffetta et al. (6) report findings from a European cohort of nearly 400 000 men and women who developed approximately 30 000 cancers at all sites combined over nearly 9 years of follow-up. After accounting for measurement error, a very weak but statistically significant inverse association was seen—a 4% lower incidence of all cancers combined for an increment of 200 g of total fruits and vegetables per day, which corresponds to about two extra servings per day.

• Most fundamentally, this study strongly confirms the findings from other prospective studies that the results of case–control studies were overly optimistic and that any association of intake of fruits and vegetables with risk of cancer is weak at best.

• Their more detailed analyses suggesting a stronge rbenefit among heavier consumers of alcohol lend some weight to a causal interpretation because other studies (7,8) have suggested that folate, primarily from fruits and vegetables,may be more beneficial in the context of regular alcohol consumption.

• A very weak or undetectable association between fruits and vegetables and risk of cancer does not exclude the possibility that oneor a small group of fruits or vegetables, or a specific substance in some of these foods, has an important protective effect.

• Even if we assume that the weak association seen in the EPIC cohort represents a true protective effect of fruits and vegetables,the question would still remain whether an effect of this magnitude should lead to clinical interventions or public health actions.Conveniently, although the evidence for benefits of fruits and vegetables against cancer was waning, data supporting benefits for cardiovascular disease were accumulating.

•  In summary, the findings from the EPIC cohort add further evidence that a broad effort to increase consumption of fruits and vegetables will not have a major effect on cancer incidence.

Fruit and Vegetable Intake and Overall Cancer Risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC) - JNCI abstract

Abstract:
Conclusions: A very small inverse association between intake of total fruits and vegetables and cancer risk was observed in this study. Given the small magnitude of the observed associations, caution should be applied in their interpretation.

CONTEXT AND CAVEATS
Prior knowledge
The association between high intake of fruits and vegetables and reduction in overall cancer risk is not conclusively established.
Study design
European Prospective Investigation into Cancer and Nutrition (EPIC) cohort study was conducted between 1992 and 2000. Diet and lifestyle data were self-reported by the participants. Cancer incidence and mortality data were obtained from country-specific national and regional registries. Association between overall cancer risk and high intake of total fruits, total vegetables, and total fruits and vegetables combined was assessed. Estimated cancer risks were adjusted for smoking, alcohol consumption, and many other variables.
Contribution
High intake of vegetables, and fruits and vegetables combined, was associated with a small reduction in overall cancer risk. The association was stronger in heavy alcohol drinkers but was restricted to cancers caused by smoking and drinking.
Implications
This study reveals a very modest association between high intake of fruits and vegetables and reduced risk of cancer.
Limitations
The inverse association between overall cancer risk and high intake of fruits and vegetables was weak. Errors inherent to self-reported dietary habits may have resulted in bias.
From the Editors

BBC News - Five-a-day has little impact on cancer, study finds

Ontario Medical Association-patients share your views

An open-label, non-randomized comparison of venlafaxine and gabapentin as monotherapy or adjuvant therapy in the management of neuropathic pain in patients with peripheral neuropathy

Note:

*click on 'pdf' to access the full paper (free)
* this paper is not specific to neuropathy as a treatment related adverse effect of cancer therapies
* it is written in fairly easy to understand language
* discusses side effects

Who owns your genes? video/news item - FORCE/Myriad

NCI Improving the Efficiency of Clinical Trials: Decreasing Activation Times by Fifty Percent

NCI Scientists Restore DNA Repair in Mice with BRCA1 Gene Mutations

Soy won't reduce cholesterol after menopause: MedlinePlus

Save the Date: Living with Lynch Syndrome An Update for Families with HNPCC - Mayo, Rochester

Save the Date: Living with Lynch Syndrome: An Update for Families with HNPCC

June 27, 2009, 10 a.m. -3 p.m., Mayo Clinic, Rochester

This half-day educational program will offer a variety of topics focusing on Lynch syndrome—also known as Hereditary Non-Polyposis Colorectal Cancer (HNPCC)—from the biological basis of the condition and psychological impact of a diagnosis to practical health care tips.

The program is designed for people living with Lynch syndrome, their family members, and interested health care professionals. Patients and families will be able to expand their knowledge, network with one another, and share their experiences. Anna Leininger, M.S., C.G.C., Minnesota Colorectal Cancer Initiative coordinator and consultant to the Masonic Cancer Center's William C. Bernstein MD Familial Cancer Registry, will be one of the presenters at the program.

The program is hosted by Mayo Clinic; organizing sponsors include the William C. Bernstein MD Familial Cancer Registry, HealthEast Cancer Care, and the Colon Cancer Coalition. Cost is $20 per person; $35 per couple; and $50 per family (up to 5 members). For more information or to register, call 507-284-2241 or e-mail canceredprog@mayo.edu

Awareness Day: Living with Lynch Syndrome : BC Cancer Agency June 12th Vancouver, B.C.

High-risk patients with hematuria are not evaluated according to guideline recommendations

CA 125: Value or addiction?. Patricia A. Goldman. 2010; Cancer

Note: journal article by paid subscription

Commentary

CA 125: Value or addiction?

Patricia A. Goldman, BA *

President Emerita, Ovarian Cancer National Alliance, Washington, DC

^*Correspondence to Patricia A. Goldman, Ovarian Cancer National Alliance, 910 17th Street, NW, Suite 1190, Washington, DC 20006; Fax: (202) 331-2292

Abstract

The author challenges a recent study indicating that there is no apparent benefit in routinely measuring cancer antigen 125 (CA 125) in the follow-up of women with ovarian cancer.

UICC International Union Against Cancer - A call to action (petition)

What is the World Cancer Declaration?

• Launched in 2006 and revised in 2008, the World Cancer Declaration is a call to action to substantially reduce the global cancer burden by 2020.
• It was developed by international cancer control advocates to bring the cancer crisis to the attention of policymakers worldwide.
• It lays out an ambitious set of 11 targets and action plan to stop and reverse current trends.
• It was unanimously adopted at the World Leader’s Summit of policymakers, leaders & health experts during the 2008 World Cancer Congress in Geneva, Switzerland.
• UICC is the “custodian” of the World Cancer Declaration and prioritizes development of a comprehensive response.

press release: Oregovomab: Quest PharmaTech Discloses Cancer Immunotherapy Development Strategy

press release: Driven by the Approval and Rapid Uptake of Avastin, the Ovarian Cancer Drug Market Will More Than Triple to Nearly $1.5 Billion in 2018

avastin

The 10th International Conference on Integrated Care conference notice: Tampere, Finland, INIC10

Sexual Morbidity Associated With Poorer Psychological Adjustment Among Gynecological Cancer Survivors

Note: excerpts from abstract

Objectives: Sexual morbidity is a distressing and undertreated problem in gynecological cancer survivorship known to occur early and persist well beyond the period of physical recovery.

Sexual Morbidity Associated With Poorer Psychological Adjustment Among Gynecological Cancer Survivors

Note: excerpts from abstract

Objectives: Sexual morbidity is a distressing and undertreated problem in gynecological cancer survivorship known to occur early and persist well beyond the period of physical recovery.
Methods: A cross-sectional design was used. The participants were gynecological (cervical, endometrial, ovarian, and vulvar) cancer survivors who were partnered (N = 186), whose cancer was diagnosed 2 to 10 years previously, and who were at least 6 months post any cancer therapy. Most had been found to have early-stage disease (70%) and were treated with hysterectomy (77%), chemotherapy (43%), and/or radiotherapy (23%).
Conclusions: These findings suggest that prevention or treatment of sexual morbidity might foster improved psychological adjustment/QoL. Given the high rates of sexual morbidity in this population and the connection between sexuality and broader psychological adjustment/QoL, there is a clear need for better integration of sexuality rehabilitation into routine clinical care.

Fecal Incontinence Affecting Quality of Life and Social Functioning Among Long-Term Gynecological Cancer Survivors

Conclusions: Among gynecological cancer survivors having undergone pelvic radiotherapy alone or as part of a combined treatment, fecal incontinence is associated with social, psychological, sexual, and functional consequences.

Follow-Up Study of the Correlation Between Postoperative Com... : International Journal of Gynecological Cancer

Follow-Up Study of the Correlation Between Postoperative Computed Tomographic Scan and Primary Surgeon Assessment in Patients With Advanced Ovarian, Tubal, or Peritoneal Carcinoma Reported to Have Undergone Primary Surgical Cytoreduction to Residual Disease of 1 cm or Smaller

Conclusions: On this follow-up analysis, only age, stage, and residual disease were significant prognostic factors for overall survival. Discordant findings between the primary surgeon's assessment and the postoperative CT scan findings of residual disease was not an independent prognostic factor.

econdary Surgery in Patients With Serous Low Malignant Potential Ovarian Tumors With Peritoneal Implants

Conclusions: Secondary surgery seems to reduce the risk of recurrence in patients with serous LMPOT and peritoneal implants. Patients with residual disease are probably those likely to benefit from such surgery. Further studies are needed to confirm these preliminary results.

Lymph Node Metastasis in Grossly Apparent Stages I and II Epithelial Ovarian Cancer

Conclusions: Based on diagnostic value, the result suggests that the role of lymphadenectomy might differ by histological type, as its therapeutic effect might be unclear. A multicenter analysis is essential for confirmation

Agency for Healthcare Research and Quality - Questions Are the Answer: Build Your Question List

Note: general

Physician-Ownership Of Ambulatory Surgery Centers Linked To Higher Volume Of Surgeries -- Health Affairs

Intraperitoneal Paclitaxel as Consolidation Treatment in Ovarian Cancer Patients: A Case Control Study

Conclusion: Weekly IP consolidation chemotherapy with paclitaxel 60 mg/mq is well tolerated and, in this experience, a prolongation of progression-free survival was observed.

abstract: Population-Based Study of the Risk of Second Primary Contralateral Breast Cancer Associated With Carrying a Mutation in BRCA1 or BRCA2

Results: Compared with noncarriers, BRCA1 and BRCA2 mutation carriers had 4.5-fold (95% CI, 2.8- to 7.1-fold) and 3.4-fold (95% CI, 2.0- to 5.8-fold) increased risks of contralateral breast cancer, respectively. The relative risk of contralateral breast cancer for BRCA1 mutation carriers increased as age of first diagnosis decreased. Age-specific cumulative risks are provided for clinical guidance.

Conclusion: The risks of subsequent contralateral breast cancer are substantial for women who carry a BRCA1/BRCA2 mutation. These findings have important clinical relevance regarding the assessment of BRCA1/BRCA2 status in patients with breast cancer and the counseling and clinical management of patients found to carry a mutation.

abstract: Apr 5, 2010: Development of a Multimarker Assay for Early Detection of Ovarian Cancer -- JCO

Note: accompanying Editorial notes that this study was comprised of postmenopausal women only
                                    ******************
JCO Early Release, published online ahead of print Apr 5 2010
Journal of Clinical Oncology, 10.1200/JCO.2008.19.2484
Received August 3, 2008
Accepted January 5, 2010

Development of a Multimarker Assay for Early Detection of Ovarian Cancer (reference link for authors)

Purpose: Early detection of ovarian cancer has great promise to improve clinical outcome.
Patients and Methods: Ninety-six serum biomarkers were analyzed in sera from healthy women and from patients with ovarian cancer, benign pelvic tumors, and breast, colorectal, and lung cancers, using multiplex xMAP bead-based immunoassays. A Metropolis algorithm with Monte Carlo simulation (MMC) was used for analysis of the data.
Results: A training set, including sera from 139 patients with early-stage ovarian cancer, 149 patients with late-stage ovarian cancer, and 1,102 healthy women, was analyzed with MMC algorithm and cross validation to identify an optimal biomarker panel discriminating early-stage cancer from healthy controls. The four-biomarker panel providing the highest diagnostic power of 86% sensitivity (SN) for early-stage and 93% SN for late-stage ovarian cancer at 98% specificity (SP) was comprised of CA-125, HE4, CEA, and VCAM-1. This model was applied to an independent blinded validation set consisting of sera from 44 patients with early-stage ovarian cancer, 124 patients with late-stage ovarian cancer, and 929 healthy women, providing unbiased estimates of 86% SN for stage I and II and 95% SN for stage III and IV disease at 98% SP. This panel was selective for ovarian cancer showing SN of 33% for benign pelvic disease, SN of 6% for breast cancer, SN of 0% for colorectal cancer, and SN of 36% for lung cancer.
Conclusion: A panel of CA-125, HE4, CEA, and VCAM-1, after additional validation, could serve as an initial stage in a screening strategy for epithelial ovarian cancer.

Editorial: A Step Forward for Two-Step Screening for Ovarian Cancer - Journal of Clinical Oncology

A Step Forward for Two-Step Screening for Ovarian Cancer
  Martee L. Hensley, Department of Medicine, Gynecologic Medical Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, NY

See accompanying article doi: 10.1200/JCO.19.2484

Ovarian Cancer and Our Pets -Cheryl's family has just been added!

'Ovarian Cancer and Our Pets' Montage (video) free to view - no passwords needed - just click on the link

Make an on-line slideshow at www.OneTrueMedia.com

NHGRI Names New Chief of Genome Technology Branch, April 5, 2010 News Release - National Institutes of Health (NIH) U.S.

"Dr. Brody has headed GTB's Molecular Pathogenesis Section, investigating genetic variants that lead to changes in normal metabolic pathways to cause cancer and birth defects. He has made key discoveries regarding the genetics of breast cancer and neural tube defects. For example, the Brody laboratory was among the first to report that women who carry mutations in the BRCA1 or BRCA2 genes are at a higher risk of developing both breast cancer and ovarian cancer compared to women without such mutations. In addition, his group was the first to report that the frequency of specific BRCA1 and BRCA2 gene mutations are elevated in the Jewish population. In collaboration with scientists at Howard University, Washington, D.C., he described a series of mutations and rare variants in BRCA1 carried by some African-American women with breast and ovarian cancer."

uTube - Bradley J. Monk, MD, University of California Irvine talks about early stage ovarian cancer including clear cell SGO

Note: the title on this video is wrong

utube: Thomas J. Herzog, MD, Columbia University College of Physicians and Surgeons talks about liposomal doxorubicin, bevacizumab, and temsirolimus in patients with advanced malignancy SGO

Thomas J. Herzog, MD, Columbia University College of Physicians and Surgeons talks about liposomal doxorubicin, bevacizumab, and temsirolimus in patients with advanced malignancy.