Press Release: Canada's Leading Ovarian Cancer "Patient" Advocate Speaks at Sask Conference

 

OCATS

Ovarian Cancer Awareness & Treatment in Saskatchewan

A SUPPORT & ACTION GROUP FOR ANYONE AFFECTED BY GYNECOLOGIC CANCERS

M E D I A   R E L E A S E

CANADA’S LEADING OVARIAN CANCER “PATIENT” ADVOCATE SPEAKS AT SASK CONFERENCE

For Immediate Release

REGINA, July 26, 2010  - Conference Co-Chairs Scott Livingstone, CEO Sask Cancer Agency and Darlene Gray, President, OCATS, in partnership with CNT Management Group, invite survivors, support people and the medical community to the first ever Gynecologic Cancer Conference, Strategies for Survival on September 24, 2010 at the Regina Inn.  Early Bird registration fees available until the end of July for this important event featuring some of the province’s most knowledgeable specialists in female reproductive cancers.  Experts will address clinical study trials for new drug therapies, managing cancer recurrence, the emotional aspects of cancer diagnoses, identifying families with hereditary risks, alternative and complimentary therapies available and the roles of our nurses, general practitioners, and pharmacists in cancer care delivery.

A conference highlight will be a presentation by Canada’s leading ovarian cancer “patient” advocate, Sandi Pniauskas.  Other experts presenting at the conference include the following.

Dr. Christopher Giede, Gynecologic Oncologist at the Royal University Hospital, Saskatoon and the team leader of Saskatchewan gynecologic oncology team of female reproductive cancer specialists.

Dr. Muhammad Salim, Medical Oncologist at the Allan Blair Cancer Centre, Regina and the specialist of all our Clinical Study Trials. 

Dr. Vicki Holmes, Medical Director of the Women’s Mid-Life Health Centre in Saskatoon. Dr. Holmes developed the concept of this centre and is the resident physician at the centre.

Rosalee Longmoore, RN, a Registered Nurse for 34 years with a wide range of experience on all Saskatchewan medical nursing issues.

Andrew Gilbertson, Pharmacist and owner of Hill Avenue Drugs, Regina, Regina’s first and currently only pharmacy that specializes in compounding custom prescription medications.

Dr. Heather Fox, Naturopath, a health specialist with over 30 years experienced and a registered doctor of Natural Medicine through the Examining Board of Natural Medicine Practitioners, Canada.

Monica Milas, Personal Growth and Healing Services Counsellor and Therapist.

Wendy Stoeber, Genetic Counsellor at the Division of Medical Genetics, Royal University Hospital, Saskatoon.

And a member of the Gynecologic Oncology Program Working Group, Scott Livingstone, the new CEO of the Sask Cancer Agency, will speak about Saskatchewan’s new Gynecologic Oncology Program.

The conference will include an exhibit hall marketplace and be followed by the OCATS Annual Benefit Gala and Silent Auction featuring Jack Semple and presentation of the OCATS 2010 Catleya Award of Collaboration & Vision.  Conference on-line registration at  http://guest.cvent.com/EVENTS/Info/Summary.aspx?e=ce9c4a0f-157e-4a42-ab49-0f19dae902e3. A group guestroom rate is available at the Regina Inn by asking for the OCATS event.  Discounted conference fees available for OCATS members and all students.  For more information please contact Darlene at 306-775-1848 or CNT Management Group Claire Bélanger-Parker [claire.belanger-parker@cntgrp.ca].

For more info contact Darlene Gray at OCATS at 306-775-1848, cell 529-3199 or darlenegray@sasktel.netdarlenegray@sasktel.net

# # #

e-Patients: Changing the Health Care System in Real-Time Tuesday, September 21, 2010 Toronto (Note: fees)

Note: conference fees which would exclude most patients/e-patients from attending

e-Patients: Changing the Health Care System in Real-Time
Tuesday, September 21, 2010
Novotel Toronto Centre
45 The Esplanade
Toronto, Ontario M5E 1W2

Registration
Registration will take place on Tuesday, September 21, 2010,
at 8:30am at the Novotel Toronto Centre, 45 The Esplanade,
Toronto.
Space is not guaranteed, unless payment is received
prior to the event.Registration FeeMember (OHA/OHPA/MOHLTC):
$495.00 + HST $64.35 = Total $559.35
Non-member:
$980.00 + HST $127.40 = Total $1107.40

EvidenceUpdates: Cochrane Collaboration review: Vaccines for preventing influenza in healthy adults including professional commentaries and warning

CONCLUSIONS: Influenza vaccines have a modest effect in reducing influenza symptoms and working days lost. There is no evidence that they affect complications, such as pneumonia, or transmission.

WARNING: This review includes 15 out of 36 trials funded by industry (four had no funding declaration). An earlier systematic review of 274 influenza vaccine studies published up to 2007 found industry funded studies were published in more prestigious journals and cited more than other studies independently from methodological quality and size. Studies funded from public sources were significantly less likely to report conclusions favorable to the vaccines. The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies. The content and conclusions of this review should be interpreted in light of this finding.

Also: link to the Cochrane Collaboration review (The Cochrane Library):

Background
Different types of influenza vaccines are currently produced worldwide. Healthy adults are presently targeted mainly in North America.

Objectives
Identify, retrieve and assess all studies evaluating the effects of vaccines against influenza in healthy adults

Authors' conclusions
Influenza vaccines have a modest effect in reducing influenza symptoms and working days lost. There is no evidence that they affect complications, such as pneumonia, or transmission.

WARNING:

This review includes 15 out of 36 trials funded by industry (four had no funding declaration). An earlier systematic review of 274 influenza vaccine studies published up to 2007 found industry funded studies were published in more prestigious journals and cited more than other studies independently from methodological quality and size. Studies funded from public sources were significantly less likely to report conclusions favorable to the vaccines. The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies. The content and conclusions of this review should be interpreted in light of this finding.





Plain language summary

Vaccines to prevent influenza in healthy adults
Over 200 viruses cause influenza and influenza-like illness which produce the same symptoms (fever, headache, aches and pains, cough and runny noses). Without laboratory tests, doctors cannot tell the two illnesses apart. Both last for days and rarely lead to death or serious illness. At best, vaccines might be effective against only influenza A and B, which represent about 10% of all circulating viruses. Each year, the World Health Organization recommends which viral strains should be included in vaccinations for the forthcoming season.

Authors of this review assessed all trials that compared vaccinated people with unvaccinated people. The combined results of these trials showed that under ideal conditions (vaccine completely matching circulating viral configuration) 33 healthy adults need to be vaccinated to avoid one set of influenza symptoms. In average conditions (partially matching vaccine) 100 people need to be vaccinated to avoid one set of influenza symptoms. Vaccine use did not affect the number of people hospitalised or working days lost but caused one case of Guillian-Barré syndrome (a major neurological condition leading to paralysis) for every one million vaccinations. Fifteen of the 36 trials were funded by vaccine companies and four had no funding declaration. Our results may be an optimistic estimate because company-sponsored influenza vaccines trials tend to produce results favorable to their products and some of the evidence comes from trials carried out in ideal viral circulation and matching conditions and because the harms evidence base is limited.

Cochrane Collaboration review: Elastic compression stockings for prevention of deep vein thrombosis

Background

One of the settings where deep vein thrombosis (DVT) in the lower limb and pelvic veins occurs is in hospital with prolonged immobilisation of patients for various surgical and medical illnesses. Using graduated compression stockings (GCS) in these patients has been proposed to decrease the risk of DVT.

Objectives

To determine the magnitude of effectiveness of GCS in preventing DVT in various groups of hospitalised patients.

Authors' conclusions

GCS are effective in diminishing the risk of DVT in hospitalised patients. Data examination also suggests that GCS on a background of another method of prophylaxis is more effective than GCS on its own.

Plain language summary

Elastic compression stockings for prevention of deep vein thrombosis during a hospital stay
Hospital patients can develop deep vein thrombosis (DVT) in the legs and pelvic veins immediately after surgery or if they are not mobile because of a medical illness. Symptoms vary from none to pain and swelling in the legs. A blood clot can move from the leg to the lungs with the danger of pulmonary embolism and death. Usually the DVT clears up or has long term effects such as high venous pressure in the leg, leg pain, swelling, darkening of the skin or inflammation.

DVT can be prevented using compression or drugs but drugs may cause bleeding, which is a particular concern in surgical patients. Graduated elastic compression stockings help prevent blood clots forming in the legs by applying varying amounts of pressure to different parts of the leg. Our review confirmed that graduated compression stockings reduce the risk of DVT in hospitalised patients. Our findings also suggest that wearing elastic stockings as well as receiving another method of prophylaxis has increased benefit. We identified 18 randomised controlled trials, eight comparing wearing stockings to no stockings and 10 comparing stockings plus another method with that method alone in patients undergoing surgery. The other methods used were Dextran 70, aspirin, heparin and mechanical sequential compression.

2nd source: EvidenceUpdates: Cochrane Collaboration review; Drug therapy for the management of cancer-related fatigue including professional comment

2010 Cochrane Collaboration Review: Drug therapy for the management of cancer-related fatigue

Blogger's disclaimer/comments:
1) consumer reviewer of this Cochrane Collaboration review; 
2) a special appreciation to our own ovarian cancer survivors for their input/opinions on this issue
                  ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Note: included in the review were recent studies on the side effects of 
erythropoietin and darbopoetin

Abstract

Background

This is an updated version of the original Cochrane review published in issue 1 2008 (Minton 2008). Cancer-related fatigue (CRF) is common, under-recognised and difficult to treat. There have been studies looking at drug interventions to improve CRF but results have been conflicting depending on the population studied and outcome measures used. No previous reviews of this topic have been exhaustive or have synthesised all available data.

Objectives

To assess the efficacy of drugs for the management of CRF.

Authors' Conclusions
There is increasing evidence that psychostimulant trials provide evidence for improvement in CRF at a clinically meaningful level. There is still a requirement for a large scale RCT of methylphenidate to confirm the preliminary results from this review. There is new safety data which indicates that the haemopoietic growth factors are associated with increased adverse outcomes. These drugs can no longer be recommended in the treatment of CRF. Readers of the first review should re-read the document in full.

Plain language summary

Drugs for cancer-related fatigue
Fatigue associated with cancer is a significant problem. It can occur because of side effects of treatment or because of the disease itself. It can have a significant impact on a person's ability to function. The causes of fatigue are not fully understood and so it is very difficult to treat appropriately. This review has examined drug treatment for fatigue as it represents one of the ways this problem can be tackled. The review authors looked at trials in all types of cancer and at all stages of treatment. Fifty studies met the inclusion criteria but only 31 (7104 participants) were deemed suitable for detailed analysis as they explored fatigue in sufficient detail. They found mixed results with some drugs showing an effect on fatigue - most notably drugs that stimulate red blood cell production and also drugs that improve levels of concentration. Methylphenidate, a stimulant drug that improves concentration, is effective for the management of cancer-related fatigue but the small samples used in the available studies mean more research is needed to confirm its role. Erythropoietin and darbopoetin, drugs that improve anaemia, are effective in the management of cancer-related fatigue. However safety concerns and side effects from these drugs mean that they can no longer be recommended to treat cancer fatigue.

abstract: Patients' perceptions of communication with the health care team during chemotherapy for the first recurrence of ovarian cancer

abstract: Continued chemotherapy after complete response to primary therapy among women with advanced ovarian cancer (meta-analysis)

CONCLUSIONS

Although individual studies have not yet convincingly shown a survival advantage with maintenance chemotherapy in OC, this meta-analysis demonstrates that continued chemotherapy after completion of primary therapy for OC improves PFS and OS. Benefits are greatest in patients with advanced stage OC who reach complete clinical or pathologic response after primary therapy.

Ranking prestige of medical diseases | KevinMD.com blogger + link to the study abstract Album/Westin authors

Note: the ranking list includes ovarian cancer but interestingly not breast

Soc Sci Med. 2008 Jan;66(1):182-8. Epub 2007 Sep 12.

Do diseases have a prestige hierarchy? A survey among physicians and medical students.

Album D, Westin S.

University of Oslo, Oslo, Norway. dag.album@sosiologi.uio.no

Abstract

Surveys have shown that the prestige of medical specialities is ordered hierarchically. We investigate whether similar tacit agreement in the medical community also applies to diseases, since such rankings can affect priority settings in medical practice. A cross-sectional survey was performed in three samples of physicians and medical students in Norway in 2002. A questionnaire was sent to 305 senior doctors (response rate, 79%), 500 general practitioners (response rate, 65%) and 490 final-year medical students (response rate, 64%). Outcome measures were ratings on a 1-9 scale of the prestige these respondents believed most health personnel would accord to a sample set of 38 different diseases as well as 23 medical specialities. Both diseases and specialities were clearly and consistently ranked according to prestige. Myocardial infarction, leukaemia and brain tumour were among the highest ranked, and fibromyalgia and anxiety neurosis were among the lowest. Among specialities, neurosurgery and thoracic surgery were accorded the highest rank, and geriatrics and dermatovenerology the lowest. Our interpretation of the data is that diseases and specialities associated with technologically sophisticated, immediate and invasive procedures in vital organs located in the upper parts of the body are given high prestige scores, especially where the typical patient is young or middle-aged. At the other end, low prestige scores are given to diseases and specialities associated with chronic conditions located in the lower parts of the body or having no specific bodily location, with less visible treatment procedures, and with elderly patients.

abstract: (repost) Differences in tumor type in low-stage versus high-stage ovarian carcinomas

Int J Gynecol Pathol. 2010
Köbel M, Kalloger SE, Huntsman DG, Santos JL, Swenerton KD, Seidman JD, Gilks CB; Cheryl Brown (ovarian cancer survivour/deceased) Ovarian Cancer Outcomes Unit of the British Columbia Cancer Agency, Vancouver BC.
Department of Pathology, University of Calgary, Calgary AB, Canada T2N 2T9. martin.kobel@cls.ab.ca


Abstract

Although there are recognized differences in the type of ovarian carcinomas between those tumors diagnosed at low versus high stage, there is a lack of data on stage distribution of ovarian carcinomas diagnosed according to the current histopathologic criteria from large population-based cohorts. We reviewed full slide sets of 1009 cases of 2555 patients diagnosed with ovarian carcinoma that were referred to the British Columbia Cancer Agency over a 16-year period (1984 to 2000).
On the basis of the reviewed cases we extrapolated the distribution of tumor type in low-stage (I/II) and high-stage (III/IV) tumors. We then compared the frequencies with those seen in a large hospital practice.
The overall frequency of tumor types was as follows: high-grade serous-68.1%, clear-cell-12.2%, endometrioid-11.3%, mucinous-3.4%, low-grade serous-3.4%, rare types-1.6%. High-grade serous carcinomas accounted for 35.5% of stage I/II tumors and 87.7% of stage III/IV tumors.
In contrast, clear-cell (26.2% vs. 4.5%), endometrioid (26.6% vs. 2.5%), and mucinous (7.5% vs. 1.2%) carcinomas were relatively more common among the low-stage versus high-stage tumors.
This distribution was found to be very similar in 410 consecutive cases from the Washington Hospital Center. The distribution of ovarian carcinoma types differs significantly in patients with low-stage versus high-stage ovarian carcinoma when contemporary diagnostic criteria are used, with consistent results seen in 2 independent case series. These findings reflect important biological differences in the behavior of the major tumor types, with important clinical implications.

Vascular Endothelial Growth Factor Is a Promising ... [Mol Cancer Ther. 2010] - PubMed result

Mol Cancer Ther. 2010 Jul 27. [Epub ahead of print]

Vascular Endothelial Growth Factor Is a Promising Therapeutic Target for the Treatment of Clear Cell Carcinoma of the Ovary.

Mabuchi S, Kawase C, Altomare DA, Morishige K, Hayashi M, Sawada K, Ito K, Terai Y, Nishio Y, Klein-Szanto AJ, Burger RA, Ohmichi M, Testa JR, Kimura T.

Authors' Affiliations: 1Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine; 2Department of Obstetrics and Gynecology, Osaka Police Hospital; 3Department of Obstetrics and Gynecology, Osaka Medical College, Osaka, Japan; 4Women's Cancer Program, 5Cancer Genetics and Signaling Program, and 6Department of Surgery, Fox Chase Cancer Center, Philadelphia, Pennsylvania; and 7Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Amagasaki, Japan.

Abstract

This study examines the role of vascular endothelial growth factor (VEGF) as a therapeutic target in clear cell carcinoma (CCC) of the ovary, which has been regarded as a chemoresistant histologic subtype. Immunohistochemical analysis using tissue microarrays of 98 primary ovarian cancers revealed that VEGF was strongly expressed both in early-stage and advanced-stage CCC of the ovary. In early-stage CCCs, patients who had tumors with high levels of VEGF had significantly shorter survival than those with low levels of VEGF. In vitro experiments revealed that VEGF expression was significantly higher in cisplatin-refractory human CCC cells (RMG1-CR and KOC7C-CR), compared with the respective parental cells (RMG1 and KOC7C) in the presence of cisplatin. In vivo treatment with bevacizumab (Avastin) markedly inhibited the growth of both parental CCC cell-derived (RMG1 and KOC7C) and cisplatin-refractory CCC cell-derived (RMG1-CR and KOC7C-CR) tumors as a result of inhibition of tumor angiogenesis.
The results of the current study indicate that VEGF is frequently expressed and can be a promising therapeutic target in the management of CCC. Bevacizumab may be efficacious not only as a first-line treatment but also as a second-line treatment of recurrent disease in patients previously treated with cisplatin.
Mol Cancer Ther; 9(8); OF1-12. (c)2010 AACR.

Prevalence of lymph node metastasis in primary mucinous carcinoma of the ovary

Abstract

OBJECTIVE:: To estimate the prevalence of lymph node involvement in women with primary mucinous ovarian carcinomas.
METHODS:: A retrospective study was performed of patients with primary mucinous ovarian carcinomas evaluated at a single institution between 1985 and 2007. A gynecologic oncology pathologist evaluated all cases. Patients with tumors of low malignant potential and mucinous carcinomas metastatic to the ovary from other primary sites were excluded.
RESULTS:: Patients with primary mucinous ovarian carcinomas were identified (n=107). All patients underwent primary surgery. At time of surgery, 93 patients (87%) had tumors that grossly appeared to be confined to the ovary, and 14 patients (13%) had evidence of extraovarian disease. Of the 93 patients with tumors that grossly appeared to be confined to the ovary at surgical exploration, 51 (55%) underwent lymphadenectomy (n=27 pelvic and paraaortic, n=19 pelvic only, n=5 paraaortic only). Of these 51 patients, none had metastatic disease to the pelvic or paraaortic lymph nodes. In addition, there were no significant differences in progression-free survival and overall survival rates between the patients who underwent lymphadenectomy and those who did not.
CONCLUSION:: There were no cases of isolated lymph node metastases among women with primary mucinous carcinoma grossly confined to the ovary, suggesting that routine lymphadenectomy may be omitted in these patients.
LEVEL OF EVIDENCE:: III.
(link to 'levels of evidence': http://www.cancer.gov/cancertopics/pdq/levels-evidence-adult-treatment

New Cancer Treatment Center to Open in Michiana, Indiana - Newsroom

Future Oncology -- Summary: Palonosetron for the prevention of chemotherapy-induced nausea and vomiting in patients with cancer

Drug Evaluation
Palonosetron for the prevention of chemotherapy-induced nausea and vomiting in patients with cancer
Rudolph M Navari‌1,2


Chemotherapy-induced nausea and vomiting (CINV) is associated with a significant deterioration in quality of life. The emetogenicity of the chemotherapeutic agents, repeated chemotherapy cycles and patient characteristics (e.g., female gender, younger age, low alcohol consumption and history of motion sickness) are the major risk factors for CINV. This article provides a detailed description of palonosetron, a second-generation 5-hydroxytryptamine-3 (5-HT3) receptor antagonist, which has been approved for the prevention of acute CINV in patients receiving either moderately or highly emetogenic chemotherapy and for the prevention of delayed CINV in patients receiving moderately emetogenic chemotherapy...... palonosetron in combination with dexamethasone demonstrated better control of delayed CINV in patients receiving highly emetogenic chemotherapy and had a similar safety profile. Owing to its efficacy in controlling both acute and delayed CINV, palonosetron may be very effective in the clinical setting of multiple-day chemotherapy and bone marrow transplantation.

Editorial: The Elusive Goal of Maintaining Population (Breast) Cancer Screening: It Is Time for a New Paradigm JNCI

"The promise of breast cancer screening has fallen short of its goals because of its imprecision, failure to screen those at highest risk, lack of compliance with screening continuance over recommended periods of time, and gaps in access to or quality of diagnostic follow-up and treatment (20). It is no longer enough to simply conduct more interventions to understand which work best in motivating individuals to undergo repeat cancer screening. New paradigms, guided by evidence from modeling, novel trials, and new scientific discovery, will be needed to realize the promise of eliminating the burden of cancer."

Team Continuum - Home - "What We're About" - (NY/Marathon)

Note: the Mission Statement is worthy of note, as a FYI.




What We're About

Team Continuum is dedicated to helping cancer patients and their families minimize the disruptions, hardships and uncertainties of everyday life so that they can focus on crucial medical care. We provide immediate and vital assistance - both practical and personal - every step of the way, such as paying household expenses, offering friendship and moral support, and funding health care facilities to enhance the delivery of care, communications and educational services.

Study Indicates Ginkgo biloba Does Not Reduce the Risk of Cancer [NCCAM Research Results]

Note: age specific/comments

Women Won't Wait - Document Details | What's the Budget? Where's the Staff? (not cancer specific related)

Social networks: The great tipping point test - tech - 26 July 2010 - New Scientist

Racial differences in stage at diagnosis and survival from epithelial ovarian cancer: A fundamental cause of disease approach

Social Science & Medicine

abstract:

Associations between race, socioeconomic status (SES) and health outcomes have been well established. One of the ways in which race and SES affect health is by influencing one’s access to resources, which confers ability to avoid or mitigate adverse outcomes. The fundamental cause of disease approach argues that when a new screening tool is introduced, individuals with greater resources tend to have better access to the innovation, thus benefiting from early detection and leading to better survival.  

Conversely, when there is no established screening tool, racial and SES differences in early detection may be less pronounced.

Most ovarian cancer is diagnosed at advanced stages, because of the lack of an effective screening tool and few early symptoms. However, once detected, racial differences may still be observed in mortality and survival outcomes. We examined the racial differences in diagnosis and survival among ovarian cancer cases diagnosed during 1994–1998, in Cook County, Illinois (N = 351). There were no racial differences in the stage at diagnosis: 51.7% of white and 52.9% of black women were diagnosed at later stages (III and IV). Only age was associated with the stage at diagnosis. Tumor characteristics also did not differ between white and black women. Compared to white women, black women were less likely to be married, less educated, more frequently used genital powder, had tubal ligation, and resided in higher poverty census tracts. As of December 31, 2005, 44.3% of white and 54.5% of black women had died of ovarian cancer. Controlling for known confounding variables, the hazard ratio for ovarian cancer death between black and white women was 2.2. The findings show that fundamental cause perspective provides a potential framework to explore subtleties in racial disparities, with which broader social causes may be accounted for in explaining post diagnosis racial differences.

Genetic Risk Score Associated With Breast Cancer Risk; Predictive of Type of Disease

>“In this large study including 10,306 women with breast cancer and 10,393 without the disease, we confirm that some of the more important common genetic variants for breast cancer have different effects on different tumor types.”

PLoS ONE: Functional Exploration of the Adult Ovarian Granulosa Cell Tumor-Associated Somatic FOXL2 Mutation p.Cys134Trp (c.402C>G)

Conclusions/Significance

Here, we confirm the specificity of the FOXL2 c.402C>G mutation in adult OGCTs and begin the exploration of its molecular significance. This is the first study demonstrating that the p.Cys134Trp mutant does not have a strong impact on FOXL2 localization, solubility, and transactivation abilities on a panel of proven target promoters, behaving neither as a dominant-negative nor as a loss-of-function mutation. Further studies are required to understand the specific molecular effects of this outstanding FOXL2 mutation.

Think tank calls for FDA to forgo approval of drugs cleared by European regulator - media article

2010 Conference | Ovarian Cancer National Alliance - video, pics, information

"In case you missed this year’s Conference, we have provided with you educational materials for you to print and disseminate in your local communities. You can also find video clips and pictures from the Conference using the teal button above. Please check back as this will be updated in the next few days."

Canadian Medicine: Little sympathy for lung cancer patients "Can't we do better?"

blogger's Note: really the question is not can we do better, but why we have not (aside from stigmatization aka: judging others)  given:
1) science's apparent apolitical stance;
2) decision-makers' rationale (evidence based??);
3) politicization of science/results 

"...Heather McQuaid, an oncology social worker maintains that lung cancer patients feel stigmatized. The superficial attitude that gives way to this stigma may very well be the reason why $25 million was invested in breast cancer research in 2007, compared with a paltry $8 million towards lung cancer, directly “impacting on the support these cancer victims receive, particularly from the healthcare system,” according to CEO and President of the Canadian Lung Association, Heather Borquez. Can’t we do better?"

“Smile, Open Your Eyes, Love and Go On.” « Libby's H*O*P*E* 2 year anniversary - Libby's death

Today marks the 2nd anniversary of Libby’s death from ovarian cancer at the age of 26. Although the family healing process continues, we celebrate Libby’s life formally on this day to honor her memory, and remind ourselves that life is precious and should not be taken for granted.

full access: Risk of urothelial bladder cancer in Lynch syndrome is increased, in particular among MSH2 mutation carriers

"In eight out of 21 patients with bladder cancer, this was their first cancer diagnosis, whereas at this stage five of them developed another Lynch syndrome associated cancer at an older age. Therefore, early diagnosis of Lynch syndrome may prevent development of a second primary cancer..."

Recommendations for urothelial carcinomas surveillance in Lynch syndrome

1. Surveillance with a combination of ultrasound of the bladder and upper urinary tract, urinary cytology and sediment.
2. In every MSH2 mutation carrier
3. From age 40 and up
4. Performed every 1–2 years

J Surg Oncol. 2010 Aug 1;102(2):187-95.

Indications and approach to surgical resection of lung metastases.

Kaifi JT, Gusani NJ, Deshaies I, Kimchi ET, Reed MF, Mahraj RP, Staveley-O'Carroll KF.

Section of Surgical Oncology, Department of Surgery, Penn State Hershey Cancer Institute, Penn State College of Medicine, Hershey, Pennsylvania.

Abstract

Pulmonary metastasectomy is a curative option for selected patients with cancer spread to the lungs. Complete surgical removal of pulmonary metastases can improve survival and is recommended under certain criteria. Specific issues that require consideration in a multidisciplinary setting when planning pulmonary metastasectomy include: adherence to established indications for resection, the surgical strategy including the use of minimally invasive techniques, pulmonary parenchyma preservation, and the role of lymphadenectomy.

J. Surg. Oncol. 2010;102:187-195. (c) 2010 Wiley-Liss, Inc.

PMID: 20648593 [PubMed - in process]

Health Canada Warns Canadians about Buying Prescription Drugs Online from www.globalpharmacycanada.com - Health Canada Advisory 2010-07-27

Note: if your server (ISP) is from Canada then you are blocked from the globalpharmacycanada link

Health Canada is informing Canadians about the potential dangers of buying
prescription drugs online from www.globalpharmacycanada.com. The company
responsible for the website recently removed Canadian access to it, but
Canadians may have purchased from this website in the past.

For more information, please visit:
http://www.hc-sc.gc.ca/ahc-asc/media/advisories-avis/_2010/2010_127-eng.php

The understanding of spirituality and the potential role of spiritual care in end-of-life and palliative care: a meta-study of qualitative research — Palliat Med

Abstract

Spirituality and spiritual care are gaining increasing attention but their potential contribution to palliative care remains unclear. The aim of this study was to synthesize qualitative literature on spirituality and spiritual care at the end of life using a systematic (‘meta-study’) review.

Eleven patient articles and eight with healthcare providers were included, incorporating data from 178 patients and 116 healthcare providers, mainly from elderly White and Judaeo-Christian origin patients with cancer. Spirituality principally focused on relationships, rather than just meaning making, and was given as a relationship. Spirituality was a broader term that may or may not encompass religion. A ‘spirit to spirit’ framework for spiritual care-giving respects individual personhood. This was achieved in the way physical care was given, by focusing on presence, journeying together, listening, connecting, creating openings, and engaging in reciprocal sharing. Affirmative relationships supported patients, enabling them to respond to their spiritual needs. The engagement of family caregivers in spiritual care appears underutilized. Relationships formed an integral part of spirituality as they were a spiritual need, caused spiritual distress when broken and were the way spiritual care was given. Barriers to spiritual care include lack of time, personal, cultural or institutional factors, and professional educational needs. By addressing these, we may make an important contribution to the improvement of patient care towards the end of life.

Attitudes towards weight and weight assessment in oncology patients: survey of hospice staff and patients with advanced cancer — Palliat Med

"...A little over half of hospice staff, 81/146 (56%) considered that weighing could cause patients to be upset.
However, 124/129 (96%) of patients with advanced cancer reported that they had never found the experience of being weighed in a healthcare facility upsetting.
Some 95/129 (74%) of patients weighed themselves at home and 89% would want to know if their weight was changing.
While there is reluctance on the part of many hospice staff to weigh patients, most patients with advanced malignancy in the hospital setting do not report weight measurement to be upsetting."

Incidental Adnexal Masses Detected at Low-Dose Unenhanced CT in Asymptomatic Women Age 50 and Older: Implications for Clinical Management and Ovarian Cancer Screening - Radiology (abstract)

 Results: One hundred eighteen women (mean age, 56.2 years), representing 4.1% of the screening cohort, had an indeterminate adnexal mass (108 unilateral, 10 bilateral; mean size, 4.1 cm) at prospective CT interpretation......No ovarian cancers were prospectively identified, although four cases of ovarian cancer developed subsequent to a negative adnexal finding at CT examination during a 15–44-month interval among the remaining 2751 women. cont'd

 Materials and Methods: This study was institutional review board approved and HIPAA compliant. Informed consent was waived. The fate of indeterminate adnexal lesions identified at unenhanced CT in 2869 consecutive women (mean age, 57.2 years; age range, 50–97 years) undergoing colonography screening between April 2004 and December 2008 was evaluated.
Conclusion:
Incidental indeterminate adnexal lesions were relatively common at unenhanced CT (4.1%), but subsequent work-up revealed no ovarian cancers. Furthermore, a normal finding at CT was not protective against short-term development of ovarian cancer. More sophisticated risk factor assessment is needed to identify women at higher risk.

Colorectal adenomas in the lynch syndromes: Results of a colonoscopy screening program

Abstract
Forty-four asymptomatic putative Lynch syndrome patients participated in a colonoscopy screening program. There were 18 men and 26 women; mean age was 44 yr. Thirty percent of Lynch syndrome patients had at least one adenoma; 20% had multiple adenomas. In 18% of the patients, adenomas were discovered proximal to the splenic flexure. In a reference group of 88 age- and sex-matched patients, 11% had adenomas, 4% had multiple adenomas, and 1% had right-sided adenomas. Twenty-one Lynch syndrome patients had follow-up colonoscopies. Of 7 patients with adenomas on initial examinations, 6 had adenomas at follow-up. Of 14 patients with negative initial examination results, 3 had adenomas at follow-up. The prevalence of adenomas in the Lynch syndromes is greater than in an unselected reference group. The adenomas are more proximally located, corresponding to the site of cancer distribution in the Lynch syndromes. A high rate of synchronous and metachronous lesions is found. Our findings support the hypothesis that adenomatous changes are the premalignant lesion in the Lynch syndromes. We also found evidence of heterogeneity among Lynch syndrome families in adenoma incidence.

One to 2-Year Surveillance Intervals Reduce Risk of Colorectal Cancer in Families With Lynch Syndrome

Conclusions

With surveillance intervals of 1–2 years, members of families with Lynch syndrome have a lower risk of developing CRC than with surveillance intervals of 2–3 years. Because of the low risk of CRC in non-Lynch syndrome families, a less intensive surveillance protocol can be recommended.

Risk and Epidemiological Time Trends of Gastric Cancer in Lynch Syndrome Carriers in The Netherlands

" Lifetime risk of developing gastric cancer was 8.0% in males vs 5.3% in females  and 4.8% and 9% for MLH1 and MSH2 carriers, respectively."

 

 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.

MabCure, Inc. Announces Positive Results For New Ovarian Cancer Diagnostic Blood Test -- HASSELT, Belgium, July 27 - press release

"...MabCure will soon commence a follow-on study in collaboration with one of the foremost experts in women's cancers, Ignace Vergote, M.D., Head of the Department of Obstetrics and Gynaecology and Gynaecologic Oncology at the Catholic University of Leuven, Belgium. The study will access a large number of previously collected clinical blood samples stored at the Bio-bank of the Catholic University Hospital, Leuven.

Following the conclusion of this study, MabCure plans to launch a multi-center prospective trial in Europe and in the U.S., as well as initiate commercialization of its diagnostic ovarian cancer MAbs in Europe through strategic partnerships and licensing. In parallel, MabCure plans to embark on the regulatory process for obtaining marketing approval in the U.S.

MabCure is currently evaluating the diagnostic potential of it MAbs in detecting ovarian cancer in high-risk patients in a clinical study in Thailand...."

NCI Cancer Bulletin - Expert Panel Reports on Knowledge Gaps for 20 Suspected Carcinogens

In a monograph released July 15, a coalition of leading health organizations called for more research into the possible cancer-causing effects of exposure to 20 chemical agents. Some of the named agents are commonly found in the environment, whereas others are more often limited to occupational exposures. A summary paper in Environmental Health Perspectives provides an overview of the technical report.

The monograph, titled Identification of research needs to resolve the carcinogenicity of high-priority IARC carcinogens, summarizes available evidence and provides specific guidance on the appropriate studies needed to definitively classify these agents. Several overarching issues were identified that pertain to multiple agents, including recognizing that carcinogenic agents can act through multiple pathways and mechanisms of toxicity.

“This report highlights the importance of conducting research in occupational settings to identify human carcinogens,” said Dr. Debra Silverman, a co-author of the report and chief of the Occupational and Environmental Epidemiology Branch in NCI’s Division of Cancer Epidemiology and Genetics. “Findings from such occupational studies often allow experts to extrapolate the possible effects of low-level exposure to these agents in the general environment.”

“There is significant concern among the public about substances or exposures in the environment that may cause cancer, and there are some common occupational agents and exposure circumstances where evidence of carcinogenicity is substantial but not yet conclusive for humans,” added the report’s lead author, Dr. Elizabeth Ward, from the American Cancer Society (ACS).

The project originated as part of the National Institute for Occupational Safety and Health’s National Occupational Research Agenda to enhance occupational cancer research, and it involves collaboration with NCI, the International Agency for Research on Cancer (IARC), the ACS, and the National Institute of Environmental Health Sciences.

NCI Cancer Bulletin The Evolving Science of Cancer Stem Cells

".....The CSC concept is “a work in transition,” said Dr. William Matsui, from the Johns Hopkins School of Medicine, whose lab studies the role of stem cells in hematologic cancers. “To me, as a clinical person, the ideal model is one where you can find something that is going to work in humans. We’re far from that.”.."cont'd

Genomics in our own hands : The Lancet Neurology

Note: the paper is freely accessible (requires registration (free)

CaringBridge - Zaida

note from her Mom (Nichol):
"Zaida's disease is stable, and has been for about a year!  Her last CA-125 (from a couple weeks ago) was 24.9...."

Do You REALLY Want to Read What Your Doctor Wrote? « WebMD Newsroom

Radiation Therapy for Cancer - National Cancer Institute

Note: lists different forms of radiation therapy

CTV Montreal - Power of one: Laptops for cancer patients (apparently Canadian Cancer Society doesn't have time.......)

Note: maybe then, based on this article, the Canadian Cancer Society could have funded the project ?? "I first approached the Canadian Cancer Society and asked them if they had any projects [for] computers in cancer wards," she recounts. "They said that they didn't have the time, but thought it was a great idea, so maybe I could start something."

HealthNewsReview.org - Hate needles? Flu patch may take sting out of your fears

HealthNewsReview.org Tips for Understand Studies

subject areas covered:

Tips for Understand Studies

* Does The Language Fit The Evidence? - Association Versus Causation
* "Off-label" Drug Use and Marketing
* 7 Words (and more) You Shouldn't Use in Medical News
* News from Scientific Meetings
* Absolute vs. Relative Risk
* Number Needed to Treat (NNT)
* Commercialism
* Single Source Stories
* FDA Approval Not Guaranteed
* Phases of Drug trials
* Medical Devices
* Animal & Lab Studies

HealthNewsReview.org - Can Ecstasy help ease post-traumatic stress?

Deandra Trevino Salem - The final chapter: Fight with (ovarian) cancer ends for young Boulder woman

OvaCheck - Correlogic Files for Chapter 11 Bankruptcy Protection | GenomeWeb Daily News | DxPGx | GenomeWeb

Patient Safety Day - July 25th -- PRNewswire-USNewswire/ "Save the Patient"

Press release authors:

http://www.savethepatient.org/stp/index.php

End of life 'quality' index | Open Medicine Blog

Cancer Docs 'Frustrated' By Lack of Useful Info - Cancer Information (Cancers, Symptoms, Treatment) on MedicineNet.com

Labor's e-health plan misses patient safety mark say doctors | The Australian

127 women seek separate suits against Scarborough doctor - media (update) gynecologist Richard Austin

Note: this is an update from a prior investigation which is ongoing but of particular importance is the fact that 3 similar incidents in the GTA have occurred in the past ~decade.

Obesity is associated with improved survival in patients with organ-confined clear-cell kidney cancer (see 'Note')

Note: while not ovarian cancer specific (noting the common cell type of clear cell) the conclusion is interesting

CONCLUSION: We identified overweight as an independent prognostic marker of improved cancer specific survival in patients with organ-confined but not advanced RCC. Basic research is required to resolve the dilemma of why, if a higher BMI predisposes to RCC, it concurrently prolongs survival after patients have undergone (partial) nephrectomy.

EPGM-Munich | prIME Oncology - numerous (free) ovarian cancer presentations

Program Slides

Interactive Case #1—Primary ovarian cancer: What’s optimal surgery?
Interactive Case #2—Initial systemic therapy for ovarian cancer
Interactive Case #3—Recurrent ovarian cancer: Partially platinum–sensitive (Recurrence after 6-12 months)
Interactive Case #4—Stage IIIB ovarian cancer: Recurrence >12 months following completion of induction chemotherapy
—Progress report on novel & targeted therapies for ovarian cancer
Interactive Case #5—Platinum resistant/refractory ovarian cancer: Optimizing quality of life

media: - Cancer research renaissance in our own backyard (B.C.)

".....In the first of a series of major breakthroughs in this past year, a pioneering team of ovarian cancer researchers, led by the Agency’s Dr. David Huntsman, found the single genetic mutation or “spelling mistake” in the three billion “letters” that make up the genetic code of an ovarian tumour cell.
This was a true eureka moment for Huntsman’s team. They recognized that this one consistent mutation could be the bull’s eye target in developing new treatments for all patients with this particular cancer. Their game-changing discovery was published in the prestigious New England Journal of Medicine and widely acknowledged in the global cancer community.
The next-generation computer technology provided by the BC Cancer Agency’s Genome Sciences Centre that decoded and sequenced the tumour cell’s three-billion-letter genome is another milestone achievement. A genomic task of this magnitude was unfathomable, in terms of both cost and complexity, even two years ago."

NEJM -- Mutation of FOXL2 in Granulosa-Cell Tumors of the Ovary

Primary ovarian trabecular carcinoid tumor: a case report and literature review

INTRODUCTION: Carcinoid tumors are uncommon neoplasms in the diffuse peripheral endocrine system. Ovarian carcinoids are rare and can be primary or transplanted. Primary ovarian carcinoids make up approximately 0.5-1.7% of all carcinoid tumors.

.....The immunohistochemical study revealed a neuroendocrine origin with strong positivity for NSE, CgA and Syn. Other markers, such as a-inhibin and Calretinin, were negative. Finally, the case was diagnosed as a primary ovarian trabecular carcinoid tumor.

CONCLUSION: Primary ovarian trabecular carcinoid tumors are very rare. The patients lack clinical indicators, and final diagnosis depends on pathological examination, special staining and inmmunohistochemistry staining to confirm the neuroendocrine differentiation.

International distribution and age estimation of the Portuguese BRCA2 c.156_157insAlu founder mutation

"We recommend that all suspected HBOC families from Portugal or with Portuguese ancestry are specifically tested for this rearrangement (BRCA2 c.156_157insAlu)."

Life Beyond Cancer Foundation - applications for November 18-21st event

• 
  

  Upcoming Events

  Applications are here (CLICK) for the 2010 Life Beyond Cancer Retreat will be held at Lakeway Resort in beautiful Austin, TX – November 18-21. This popular event fills up quickly. . .
  

Self Help Resource Centre - seminar for self help individuals/groups (Toronto area)

TO ALL PEER SUPPORT GROUPS IN THE GTA

During Self-Help Awareness Week, Sept. 20th to 25th, 2010, the Self-Help Resource Centre will be hosting a two-day information fair at the Yonge-Eglinton Centre to raise the profile of peer support in the City of Toronto. This is an opportunity for an agency which hosts a peer support group or a community peer support group to get the word out about their issue and provide information to the general public about how to become involved.

The fair will be held over a two day period - Fri. Sept. 24th and Sat. Sept 25th - and agencies hosting peer support groups and community peer support groups are invited to sign up for either of the two days. We do ask that representatives from the groups commit to staffing their table from 10 am to 4 pm, with coverage during the lunch hour.

Groups would be encouraged to display and give away any materials about their issue or group. Peer support groups listed on the Self-Help Resource Centre's website would be offered a printout from our database listing all their basic information for display at their table.

If interested in having your group represented at the info fair, please get in touch as soon as possible to confirm your participation. Space is limited. For more information or to register for a table, please contact Rick Henry at shrc@selfhelp.on.ca or call (416) 487-4355 ext. 21, and he will return your call as soon as he is able.

Peer Support Group Info Fair

When: Fri. Sept. 24th 10 am - 4 pm
Sat. Sept. 25th 10 am - 4 pm

Where: Yonge-Eglinton Centre,
Upper Mezzanine (Toys 'R Us level)

Who: Agencies hosting peer support groups and
Community peer support groups are invited to participate

To confirm your table email Rick Henry at shrc@selfhelp.on.ca or call (416) 487-4355, ext. 21

OVA1 - Vermillion Announces Relocation of Corporate Offices to Austin, Texas - MarketWatch

Disease Information from NORD, National Organization for Rare Disorders, Inc.

"In the United States, there are between 6,000 and 7,000 diseases considered rare, according to the National Institutes of Health. To be classified as "rare", a disease must be believed to affect fewer than 200,000 Americans. This is the definition used by the Food and Drug Administration and by the National Institutes of Health. Since many of these diseases are genetic, many of the patients are children. It is believed that more than two thirds of the individuals affected by rare diseases in the U.S. are children.

Furthermore, most rare diseases are serious and chronic or lifelong. Many are life threatening....."cont'd

Sandy Rollman Ovarian Cancer Branch to Open in South Jersey - Cape May County Herald

New Advances in Ovarian Cancer - Cancer Network

Note: registration for this site is required/free

Conclusion

Significant advances in the understanding of the pathogenesis and management of both newly diagnosed and recurrent ovarian cancer have occurred over the past few years, making the possibility of better outcomes for women with advanced ovarian cancer a reality. Recent studies have raised the question of the ideal timing of cytoreductive surgery for newly diagnosed disease and demonstrated benefit with alternative weekly paclitaxel dosing, while ongoing studies continue to clarify the roles of IP chemotherapy and biological agents in this setting. In the setting of recurrence, new chemotherapy combinations are being explored, and investigation of the activity of various targeted agents, including anti-angiogenic agents, PARP-inhibitors, and PI3K/AKT pathway inhibitors, remains an area of active interest.

This article is reviewed in the following articles:

Challenges to the Paclitaxel/Carboplatin Algorithm in Ovarian Cancer Treatment
Ovarian Cancer Care: It’s Time for “Personalized” Approaches

Challenges to the Paclitaxel/Carboplatin Algorithm in Ovarian Cancer Treatment - Cancer Network

ONCOLOGY. Vol. 24 No. 8

THE LIU/MATULONIS ARTICLE REVIEWED

Challenges to the Paclitaxel/Carboplatin Algorithm in Ovarian Cancer Treatment

By
Kristin K. Zorn, MD
Gynecologic Cancer Program
Magee-Womens Hospital of UPMC
Pittsburgh, Pennsylvania
| July 22, 2010

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* membership required

Financial Disclosure: The author has no significant financial interest or other relationship with the manufacturers of any products or providers of any service mentioned in this article.

---

After years of maintaining the status quo in ovarian cancer treatment, a number of recent advances have challenged the paradigm based on intravenous (IV) taxane and platinum as the therapy of choice for advanced ovarian cancer. These new data are summarized concisely by Liu and Matulonis in this issue.[1]
Interestingly, a review of recent history reveals that a major milestone in ovarian cancer chemotherapy is reached about every 10 years. The publication of Gynecologic Oncology Group (GOG) protocol 47 in 1986 provided randomized evidence of a 4-month improvement in overall survival with the addition of cisplatin to the previous standard of doxorubicin and cyclophosphamide.[2] In 1996, GOG 111 was published, documenting a 14-month improvement in overall survival with the addition of paclitaxel to cisplatin.[3] GOG 172 was published in 2006, becoming the third in a series of GOG trials to demonstrate a survival advantage with the use of combined IV and intraperitoneal (IP) chemotherapy.[4] Despite a 17-month improvement in overall survival that triggered an NCI alert commenting on the results, combined IV/IP therapy has yet to be broadly accepted as a new standard of care.[5] Widespread acceptance of the GOG 172 regimen has been limited by the relative complexity of the treatment (especially when compared to IV paclitaxel/carboplatin); the increased potential for toxicity; the requirement for IP port placement and maintenance; and the relative lack of experience in community centers with IP chemotherapy administration. Perhaps the most challenging part about incorporating IV/IP treatment into routine management of ovarian cancer is the idea that a route of administration—rather than a particular drug, such as cisplatin in the 1980s and then paclitaxel in the 1990s—appears to be the advance.
Concurrent with the evolution of the IP chemotherapy story has been the development of targeted or biologic therapy, particularly the antiangiogenic agent bevacizumab. Results from a phase II trial in women with recurrent ovarian cancer were published in 2007 and revealed a response rate of 21%, made more remarkable by a 51.6% stable disease rate.[6] This level of activity in recurrent disease led to a randomized phase III trial in the frontline setting, GOG 218, which tested the inclusion of bevacizumab both with IV paclitaxel/carboplatin and as a maintenance strategy. Preliminary results from GOG 218 were presented at ASCO 2010, showing a significant improvement in progression-free survival in the arm where patients received bevacizumab maintenance after their initial six cycles of chemotherapy plus bevacizumab, but not in the arm where patients received bevacizumab only during their initial chemotherapy.[7] The improvement was somewhat disappointing at 3.8 months, however, making it a difficult question of whether, despite the added toxicity and expense, bevacizumab merits inclusion in frontline regimens. The overall survival data from GOG 218, when mature, as well as the results from the ongoing ICON study with a comparable design, will help inform that question. In the meantime, oncologists caring for women with ovarian cancer have been left with the decision of whether to prioritize IV/IP therapy or bevacizumab in treatment plans.
Liu and Matulonis point to the GOG's attempt to incorporate both of these treatment advances in the current phase III trial, GOG 252. An additional confounder has been introduced by recent Japanese results, which showed a benefit from weekly IV paclitaxel compared to the traditional IV dose given every 3 weeks.[8] GOG 252 incorporates bevacizumab into IV/IP therapy, while also trying to address the toxicity issue by comparing a modified GOG 172 regimen to an IP carboplatin regimen. It also addresses the dose-density issue by utilizing weekly paclitaxel in the IV arm.
Besides the renewed hope for meaningful improvement in outcomes with advanced ovarian cancer that these trials have provided, we are witnessing another development that has the potential to advance ovarian cancer care on an even more fundamental level. The pathogenesis of ovarian cancer has been exhaustively investigated but never fully elucidated. The identification of the BRCA1 and BRCA2 genes in the early 1990s, however, has allowed a population at high risk for the development of ovarian cancer to be clearly defined. These women, in turn, have been able to undergo risk-reducing bilateral salpingo-oophorectomy to manage their risk. Studies of the specimens collected at the time of prophylactic surgeries have identified an unexpectedly high rate of tubal cancers.[9] Further study of serous cancers thought to be ovarian in origin has shown the unexpectedly frequent presence of fallopian tube dysplasia (termed tubal intraepithelial neoplasia or TIC).[10] Although larger-scale confirmation of these studies is needed, the high-risk population has provided a potential insight into the development of sporadic ovarian cancer. As we move to a more mechanistic understanding of cancer therapy and its targets, these insights into the BRCA pathway may well provide the next big advance in ovarian cancer care through manipulation with agents such as PARP inhibitors. For a disease that saw only halting advances for too long, ovarian cancer is now on the verge of being better understood and more effectively treated than ever before.
—Kristin K. Zorn, MD

Who’s who in the world of personalised cancer treatments? - Cutting Edge Cancer World - Education & knowledge through people & facts

Genetic-Testing Firms Gave Misleading Results, Government Says - WSJ.com

abstract: Examining the potential relationship between multidisciplinary cancer care and patient survival: An international literature review

CONCLUSIONS: Due to methodological limitations, this review is unable to assert a causal relationship between multidisciplinary care and patient survival

abstract: Ovarian Cancer Development and Metastasis American Journal of Pathology

The Arts in Psychotherapy : The Effects of an Art Education Program on Competencies, Coping, and Well-Being in Outpatients with Cancer–Results of a Prospective Feasibility Study

A sad day for personal genomics « Genomes Unzipped

Ovarian Cancer Care: It’s Time for “Personalized” Approaches - Cancer Network

Note: requires registration to view (free)

ONCOLOGY. Vol. 24 No. 8
THE LIU/MATULONIS ARTICLE REVIEWED
Ovarian Cancer Care: It’s Time for “Personalized” Approaches

Gene-Testing Companies May Need U.S. Regulators Review, FDA Letters Say - Bloomberg

Jerusalem International conference - Integrative Medicine Oct 19-24th

Postmenopausal Hormone Therapy: An Endocrine Society Scientific Statement abstract only/multinational statement - Journal of Clinical Endocrinology & Metabolism

Conclusions: The major conclusions related to the overall benefits and risks of MHT expressed as the number of women per 1000 taking MHT for 5 yr who would experience benefit or harm. Primary areas of benefit included relief of hot flashes and symptoms of urogenital atrophy and prevention of fractures and diabetes. Risks included venothrombotic episodes, stroke, and cholecystitis. In the subgroup of women starting MHT between ages 50 and 59 or less than 10 yr after onset of menopause, congruent trends suggested additional benefit including reduction of overall mortality and coronary artery disease. In this subgroup, estrogen plus some progestogens increased the risk of breast cancer, whereas estrogen alone did not. Beneficial effects on colorectal and endometrial cancer and harmful effects on ovarian cancer occurred but affected only a small number of women. Data from the various Women’s Health Initiative studies, which involved women of average age 63, cannot be appropriately applied to calculate risks and benefits of MHT in women starting shortly after menopause. At the present time, assessments of benefit and risk in these younger women are based on lower levels of evidence.

in research: The Cognitive Effects of Conjugated Equine Estrogens Depend on Whether Menopause Etiology Is Transitional or Surgical -- Endocrinology

Note: abstract only/$$$ full access

"Type of menopause, surgical vs. transitional, impacts cognitive outcome in women. However, whether type of menopause impacts cognitive effects of HT has not been methodically tested in women or an animal model...........That we now show surgical vs. transitional modes of menopause result in disparate cognitive effects of HT has implications for future research and treatments optimizing HT for menopausal women."

Did Washington Post's Rob Stein exaggerate negative stories about personal genomics? : Genetic Future

Rob Stein needs your positive experiences of personal genomics : Genetic Future

How to read a genome-wide association study « Genomes Unzipped

Green Tea and Cancer

The Benefits of Oncology Massage

full access: Risk Factors for Colorectal Cancer in Patients with Multiple Serrated Polyps: A Cross-Sectional Case Series from Genetics Clinics-multi-national study

 Introduction

Familial non-syndromic colorectal cancer (CRC) constitutes one of the most difficult and diverse patient groups encountered in a genetics clinic, with no apparent germline mutation, an often-indeterminant mode of inheritance, and questions arising as to how to manage the probands, and how to identify which family members are also at risk for CRC........ The clinical significance of HPS is that it is associated with an increased personal and familial risk of CRC , and extra-colonic cancers in the wider family setting .

 Conclusion

A decreased odds for CRC was identified in females with multiple serrated polyps who currently smoke, independent of age and the presence of a traditional adenoma. Investigations into the biological basis for these observations could lead to non-smoking-related therapies being developed to decrease the risk of CRC and colectomy in these patients.

How to Be an Optimist (Without Being an Idiot) OPEN Forum

The authors define disciplined optimism as “faith you will prevail plus discipline to confront the brutal facts.”

Technology Review: Fine-tuning Cancer Treatments

Scientists at the Wellcome Trust Sanger Institute and Massachusetts General Hospital will test 400 compounds, including chemotherapy drugs and molecularly targeted treatments, on 1,000 cancer cell lines containing cancer-related genetic mutations in an effort to advance personalized medicine. The findings are expected to help drugmakers design clinical studies that include only patients who are most likely to benefit from experimental cancer drugs.
 
"...While a number of molecularly targeted cancer drugs, such as gleevec and herceptin, are already on the market, the effectiveness of most of these drugs depends on a single genetic mutation or molecular marker in the tumor. Scientists say that incorporating the diversity of cancer genomics in much greater detail will enable more personalized treatment for a broader number of patients...cont'd

A KRAS-Variant in Ovarian Cancer Acts as a Genetic Marker of Cancer Risk (full access)

Toward Improving the Quality of Cancer Care: Addressing the Interfaces of Primary and Oncology-Related Subspecialty Care

Note: excerpt with numerous related references/$$$ 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

Interfaces Across the Cancer Continuum Offer Opportunities to Improve the Process of Care -- JNCI (pay-per-view - excerpt only)

Note: comparisons U.S./Canada

Brain tumor headaches: from bedside to bench. (abstract)

Note: abstract gives very limited information while noting 80 years of research on this issue

Comparative effectiveness of screening and prevention strategies among BRCA1/2-affected mutation carriers

Conclusion: Our analysis suggested that among BRCA1/2 mutation carriers, prophylactic surgery would dominate or be cost effective compared to chemoprevention and screening. Annual screening with MRI and mammography was the most effective strategy because it was associated with the longest quality-adjusted survival, but it was also very expensive.

Duke researcher suspended, accused of lying about credentials (genetics research)

"The studies used a prediction model for genetic analysis to determine which chemotherapy drugs would work best for particular cancer patients."

What the Doctor Is Really Thinking - WSJ.com

"The year-long OpenNotes study, funded with a $1.5 million grant from the Robert Wood Johnson Foundation, involves 25,000 patients and their primary-care physicians at Beth Israel Deaconess, Geisinger Health System in Danville, Pa., and Harborview Medical Center in Seattle. "We want to break down an important wall that currently separates patients from those who care for them," says lead investigator Tom Delbanco, a Harvard Medical School professor who treats patients at Beth Israel."

"Patients have a legal right to see their entire medical record including doctor's notes."

Lynch Syndrome symposium (free) Saturday August 28th, 2010 Indianapolis IN

see brochure (pdf file) for registration details:
www.stvincent.org/.../Cancer/LynchCMESymposium_Brochure.pdf
St.Vincent Cancer Care
Attention: Heather Tibbs
8402 Harcourt Road, Suite 324
Indianapolis, IN 46260
317-338-3188
317-583-2325 (fax)
hrtibbs@stvincent.org
sponsors:
AmeriPath; Myriad

U.S. FDA Panel Nixes Bevacizumab (Avastin) for Breast Cancer

Vanderbilt First to Use Specialized PET/CT Scan to Uncover Cancerous Tumors

"....The 68Ga-DOTATATE PET/CT scan offers higher resolution and sensitivity locating tumors. Although performed in Europe, this specialized type of radiologic scan has been viewed in the U.S. as offering only limited benefit to a small number of cancer patients. However a recent increase of neuroendocrine cancers seen at Vanderbilt led Walker and his associates to more widely apply usage of this new technology...."

Transparency Through Open Notes: The Risks And Rewards Of Inviting Patients To Review Their Medical Records-media article

"In “Open Notes: Doctors and Patients Signing On,” published in the July 20 issue of the Annals of Internal Medicine, researchers speculate about the risks and rewards of making clinicians’ notes transparent to patients."

Image-Processing Algorithm Reduces CT Radiation Dose By As Much As 95 Percent (perfusion CT)

Understanding Prognosis and Cancer Statistics - National Cancer Institute

"Because survival rates are based on large groups of people, they cannot be used to predict what will happen to a particular patient. No two patients are exactly alike, and treatment and responses to treatment vary greatly."

Understanding risk : Cancer Research UK

Understanding risk

Every week it seems that there’s a news story about something that increases or cuts the risk of cancer.
Often, these reports are full of numbers - 11 per cent lower risk, 65 per cent increased risk, double the risk - but what do they actually mean?
To make things clearer, there’s a detailed explanation of risk on our Healthy Living pages.
Read our other top tips:

• Look at the numbers
• Look for controls
• Is the research published? If so, where?
• Who funded it?
• Still early days
• Weird, wacky and wonderful

abstract: Presenting the Results of Cochrane Systematic Reviews to a Consumer Audience: A Qualitative Study

Results. Participants preferred results presented as words, supplemented by numbers in a table. There was a lack of understanding regarding the difference between a review and an individual study, that the effect is rarely an exact number, that evidence can be of low or high quality, and that level of quality is a separate issue from intervention effect.
 Conclusion. Through testing and iteration the authors identified and addressed several problems, using explanations, rephrasing, and symbols to present scientific concepts. Other problems remain, including how best to present confidence intervals and continuous outcomes. Future research should also test information elements in combination rather than in isolation. The new Plain Language Summary format is being evaluated in a randomized controlled trial.

Weight, Physical Activity, Diet, and Prognosis in Breast and Gynecologic Cancers --JCO (abstract)

ABSTRACT
Diet, physical activity, and weight may affect prognosis among women who are diagnosed with breast or gynecologic cancer. Observational studies show associations between being overweight or obese and weight gain with several measures of reduced prognosis in women with breast cancer and some suggestion of poor prognosis in underweight women. Observational studies have shown an association between higher levels of physical activity and improved breast cancer–specific and all-cause mortality, although a dose-response relationship has not been established. One large randomized controlled trial reported increased disease-free survival after a mean of 5 years in patients with breast cancer randomly assigned to a low-fat diet versus control. However, another trial of similar size found no effect from a high vegetable/fruit, low-fat diet on breast cancer prognosis. The few reported studies suggest that obesity negatively affects endometrial cancer survival, while the limited data are mixed for associations of weight with ovarian cancer prognosis. Insufficient data exist for assessing associations of weight, physical activity, or diet with prognosis in other gynecologic cancers. Associations of particular micronutrient intake and alcohol use with prognosis are not defined for any of these cancers. The effects of dietary weight loss and increase in physical activity on survival or recurrence in breast and gynecologic cancers are not yet established, and randomized controlled trials are needed for definitive data.

Trabectedin (Yondelis) plus pegylated liposomal doxorubicin in relapsed ovarian cancer delays third-line chemotherapy and prolongs the platinum-free interval (full access)

Trabectedin (Yondelis) plus pegylated liposomal doxorubicin in relapsed ovarian cancer: outcomes in the partially platinum-sensitive (platinum-free interval 6–12 months) subpopulation of OVA-301 phase III randomized trial — Ann Oncol (full free access)

full access: Essay Beneficent Persuasion: Techniques and Ethical Guidelines to Improve Patients’ Decisions

A review of PARP inhibitors: from bench to bedside — Ann Oncol

Conclusion: PARP inhibitors show promise as a powerful therapeutic tool, especially in the management of BRCA-associated breast and ovarian cancers but also in tumours where BRCA genes may be dysfunctional. Clinical studies are ongoing and many translational questions remain unanswered that will help clarify how to determine the best way to use PARP inhibitors.

abstract: Cochrane Collaboration review: DNA-repair pathway inhibitors for the treatment of ovarian cancer (PARP inhibitors)

"Our objective was to compare effectiveness and side effects of PARP inhibitors compared to conventional chemotherapy in women with ovarian cancer. The identification of a safe dose of AZD2281 (a PARP inhibitor) has been found by small non randomised trials, with encouraging results. For ovarian cancer, there are currently two ongoing RCTs, but outcome data are not yet available. Results of these trials are awaited to determine if DNA repair inhibitors have a role in addition to conventional chemotherapy in the treatment of ovarian cancer."

Main results
The search strategy identified 473 unique references of which 461 were excluded on the basis of title and abstract. The remaining 12 articles were retrieved in full, but none satisfied the inclusion criteria. However, two ongoing randomised phase II clinical trials were identified from the clinical trials databases that met our inclusion criteria, but no preliminary data were available.


Authors' conclusions

There are to date no published RCT data on the effectiveness and side effects of DNA-repair pathways inhibitors used alone or in association with conventional chemotherapy in the treatment of ovarian cancer. On-going trials have been identified and results are awaited and will be included in future updates of this review.

Identifying Adverse Drug Reactions Associated with Drug-Drug Interactions: patient/drug safety

Conclusions: This study validates that spontaneous reporting, despite its limitations, can be an important resource for detecting ADRs associated with the concomitant use of interacting drugs. Moreover, our data confirm that DDIs could be a real problem in clinical practice, showing that more than one in five patients exposed to a potential DDI (drug-drug-interaction) experienced a related ADR (adverse drug reaction).

Chronic Fatigue Syndrome FAQ

Overcoming TRAIL resistance in ovarian carcinoma

CONCLUSION: Continued efforts with combination therapy designed to target multiple steps in apoptotic pathways may not only improve the efficacy of TRAIL-mediated therapies, but may also improve quality of life for ovarian cancer patients by reducing toxicity associated with cancer therapy.

abstract: Measuring the effect of including multiple cancers in survival analyses using data from the Canadian Cancer Registry

Background: In survival analyses using cancer registry data, second and subsequent primary cancers diagnosed in individuals are typically excluded.

Conclusion: Inclusion of second and subsequent primary cancers in the analysis tended to lower estimates of relative survival, the extent of which varied by cancer and age and depended in part on the proportion of first primary cancers.

July 19th: Another FDA Advisory Panel Meeting: This Time, It’s Avastin - Health Blog - WSJ

FDA to Hold Hearing on Regulation of Consumer Genetic Tests - WSJ.com

Blog: Why We Blame Cancer Patients for Their Illness

Abstract/full acess: Hypertension and hand-foot skin reactions related to VEGFR2 genotype and improved clinical outcome following bevacizumab and sorafenib

Background: Hypertension (HT) and hand-foot skin reactions (HFSR) may be related to the activity of bevacizumab and sorafenib. We hypothesized that these toxicities would correspond to favorable outcome in these drugs, that HT and HFSR would coincide, and that VEGFR2 genotypic variation would be related to toxicity and clinical outcomes.

METHODS
Patients and treatment
The analyses were performed on genomic DNA from 178 patients (143 males and 35 females) with solid tumors who received sorafenib (VEGFR2 inhibitor) and/or bevacizumab (anti-VEGF) with or without other agents....cont'd (excerpt from pdf file)

Conclusions: This study suggests that HT and HFSR may be markers for favorable clinical outcome, HT development may be a marker for HFSR, and VEGFR2 alleles may be related to the development of toxicities during therapy with bevacizumab and/or sorafenib.

FDA questions effectiveness of breast cancer drug Avastin - media article

Drug Watch a heads-up on pharmaceuticals in late-stage development

New drugs Product type/proposed indication FDA status/notes

abagovomab
Menarini Group
an anti-idiotype antibody, able to mimic a tumor antigen
highly expressed by ovarian cancer cells/used to prevent
or delay the tumor relapse in patients whose disease
responded to the first-line chemotherapy by activating
an immune response toward cancer cells
phase 2/3

karenitecin/BNP1350
BioNumerick Pharmecuticals
in the camptothecin class of chemotherapy drugs/
treatment of advanced ovarian cancer
phase 3

pazopanib (Votrient)
GlaxoSmithKline
multi-kinase angiogenesis inhibitor/maintenance therapy
for the treatment of ovarian cancer
phase 3
 references/sources:

Long-Acting Methylphenidate Falls Short for Cancer Fatigue - Drug not linked to reduced fatigue; may be more helpful in advanced cancer or worse fatigue - ModernMedicine

Cancer Statistics, 2010. now online (U.S.)

Statistics

Now Published Online!
Cancer Statistics, 2010
View the Abstract or read the full-text PDF today!

Ovary incident rate: 21,880  

Ovary deaths  13,850

http://cacancerjournal.org/

in research: Magnetic nanoparticles remove ovarian cancer cells from the abdominal cavity

(Nanowerk News) A major complicating factor in the treatment of ovarian cancer is that malignant cells are often shed into the patient's abdominal cavity. These cells can then spread to other tissues, seeding new tumors that make effective therapy difficult. To overcome this problem, researchers at the Georgia Institute of Technology created magnetic nanoparticles that can selectively bind to and remove ovarian tumor cells from abdominal cavity fluid. John F. McDonald led the research team that reported their work in the journal Nanomedicine ("Selective removal of ovarian cancer cells from human ascites fluid using magnetic nanoparticles").

Research by other investigators had identified a protein known as EphA2 as a highly selective marker for free-floating ovarian cancer cells. Dr. McDonald and his collaborators coated magnetic cobalt-iron oxide nanoparticles with a molecular mimic of the natural ligand for this protein, a molecule known as ephrin-A1, to serve as a trap for ovarian cancer cells floating in ascites fluid, the liquid found in the intestinal cavity. The idea behind this approach is that the nanoparticles could be added to ascites fluid and then trapped with a magnetic, removing any ovarian cancer cells that had bound to the eprhin-A1 mimic.

They first tested their nanoparticles using ascites fluid from mice with human ovarian tumors and found that they could trap free-floating tumor cells using magnetic separation. They then repeated this experiment using ascites fluid obtained from four women with ovarian cancer, and again showed that they could remove all of the EphA2-positive cells from the intestinal fluid samples. The researchers suggest that these nanoparticles could be used in a system that removes ascites fluid from the intestinal cavity, using a relatively non-invasive method akin to dialysis, in conjunction with standard ovarian cancer therapy.

Source: National Cancer Institute

repost: full text Angiogenesis Inhibitors: Current Strategies and Future Prospects

INHIBITOR OTHER NAMES INHIBITS Axitinib AG013736 VEGFR, PDGFR, and c-kit Canertinib CI-1033 EGFR, HER2, HER3, and HER4 Cediranib Recentin, AZD2171 VEGFR, PDGFR-, and c-kit Dasatinib Sprycel, BMS-354825 Abl, Src, and Tec Erlotinib Tarceva, OSI-774 EGFR/HER1 Gefitinib Iressa EGFR/HER1 Imatinib Gleevec, STI571 Abl, PDGFR, and c-kit Lapatinib Tykerb, GW-572016 EGFR and HER2 Leflunomide Arava, SU101 PDGFR (EGFR and FGFR) Motesanib AMG 706 VEGFR, PDGFR, and c-kit Neratinib HKI-272 EGFR and HER2 Nilotinib Tasigna Abl, PDGFR, and c-kit Pazopanib Armala, GW786034 VEGFR, PDGFR- and -, and c-kit Regorafenib BAY 73-4506 VEGFR-2 and Tie-2 Semaxinib SU5416 VEGFR Sorafenib Nexavar, BAY 43-9006 Raf, VEGFR-2 and -3, PDGFR-, and c-kit Sunitinib Sutent, SU11248 VEGFR, PDGFR, Flt-3, c-kit, RET, and CSF-1R Tandutinab MLN518, CT53518 PDGFR, Flt-3, and c-kit Toceranib Vandetanib Zactima, ZD6474 VEGFR-2, PDGFR-, EGFR, and RET Vatalanib PTK787 VEGFR, PDGFR-, and c-kit

Caring Voices upcoming (moderated) chat sessions

The Big Flap About Pathway Genomics and Walgreen's: Topol on Genomics

A few weeks ago, Pathway Genomics, a consumer genomics company, had planned to have its saliva kits at all US Walgreen's drug stores. The FDA put a stop to it. Congress is now investigating the matter. What is going on here?
http://www.nytimes.com/2010/06/12/health/12genome.html?scp=1&sq=pathway%20genomics&st=cse

Search of: parp | Open Studies - List Results - ClinicalTrials.gov

Found 33 studies with search of: parp | Open Studies

Second primary cancers following borderline ovarian tumors (abstract)

Note: (in the abstract) the onset of a  basal cell carcinoma of the eyelid (genetics?)

CONCLUSIONS: These findings do not suggest increased risk of subsequent cancers in patients with BOT. However, population-based studies are needed for evaluating exact risk of developing second primary malignancies in women with BOTs

A double-blind, randomized trial of pyridoxine versus placebo for the prevention of pegylated liposomal doxorubicin-related hand-foot syndrome in gyne

Blogger's Note: in the absence of full access to the article, this conclusion 'needs more research'


"CONCLUSIONS:: Pyridoxine as administered in the current study did not prevent HFS in patients who received PLD. It is possible that QOL is not compromised in patients with HFS because they may have increased social well being while coping with their disease."

6-Thioguanine Selectively Kills BRCA2-Defective Tumors and Overcomes PARP Inhibitor Resistance

"Altogether, our data show that 6TG efficiently kills BRCA2-defective tumors and suggest that 6TG may be effective in the treatment of advanced tumors that have developed resistance to PARP inhibitors or platinum-based chemotherapy. Cancer Res; 70(15); OF1-9. (c)2010 AACR."

abstract: Clinical syndromes associated with ovarian neoplasms: a comprehensive review

Radiographics. 2010 Jul-Aug;30(4):903-19.

Functional ovarian neoplasms have unique clinical manifestations related to hormone overproduction and may give rise to a broad spectrum of clinical syndromes.

Sex cord-stromal tumors, the most common functional ovarian neoplasms, are associated with either hyperestrogenism (as in granulosa cell tumor and thecoma) or hyperandrogenism (as in Sertoli-Leydig cell tumor and Leydig cell tumor). Other, less common ovarian neoplasms that may have endocrine or nonendocrine syndromic manifestations include germ cell tumors associated with the excessive production of human chorionic gonadotropin (eg, choriocarcinoma, dysgerminoma), monodermal teratomas (eg, carcinoid tumor, struma ovarii) associated with carcinoid syndrome and hyperthyroidism, and primary epithelial ovarian cancers associated with paraneoplastic syndromes.

The application of diagnostic algorithms based on patient demographic information, clinical manifestations, laboratory findings, and cross-sectional imaging features may help identify ovarian neoplasms in complex clinical settings.