OVARIAN CANCER and US

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Friday, February 11, 2011

full free access: Histotype predicts the curative potential of radiotherapy: the example of ovarian cancers — Ann Oncol (stage/cell type)



Note: tables for survival data (longterm) eg. cell types

"....The Gynecology Tumour Group of our institution has elected to continue to advise the use of CRT in women with stage Ic and II endometrioid and mucinous lesions, and all stage I and II clear cell disease, on the basis of these data and a recently published analysis of histotype-specific outcomes [32]. However, RT will be targeted to the pelvis, with consideration of extending the field to include paraaortic nodes if stage IIc (given the higher rate of occult nodal involvement reported for this stage [26]). RT will be dropped from our prescription for those with serous tumors.
Our findings also bring into question the nonselective surgical and CT approaches that have characterized ovarian cancer care and are of potential clinical importance for those with other tumors, which have been collectively defined by presumed organ of origin rather than underlying biological features"

full free access abstract + full paper: Social and ethical implications of BRCA testing — Ann Oncol



Abstract:
"Oncologists are asked with increasing frequency to counsel their patients with respect to the medical, psychological and social repercussions of genetic testing for cancer susceptibility that may have been prescribed by physicians or carried out through direct-to-consumer tests. This article critically reviews the main ethical and social implications of BRCA testing, focusing on genetic responsibility and genetic discrimination. Genetic responsibility toward oneself and others is a highly debated implication of genetic testing for cancer predisposition that requires broad considerations of the boundaries between individual and community rights and a reappraisal of the notion of autonomy as relational. Physicians’ duty to warn ‘at risk’ relatives can be an ethical quandary, yet confidentiality is key to the patient–doctor relationship. Mutation carriers may be subject to different forms and degrees of genetic discrimination and many individuals at risk have forgone BRCA testing to avoid potential discrimination. The scientific and medical community, together with patients and the public, has actively engaged against genetic discrimination. The legislation in many countries now protects against genetic discrimination by insurance companies and employers. Legal and regulatory issues are not the final answer to discrimination and profound cultural changes are required to create understanding and acceptance of all differences...."

media - Light sentence would spare sex doc’s victims (unconcious female patients)



videotaped a naked and unconscious patient after removing her hospital gown

abstract: Analysis of postoperative complications associated with the use of anti-adhesion sodium hyaluronate-carboxymethylcellulose (HA-CMC) barrier after cytoreductive surgery for ovarian, fallopian tube and peritoneal cancers



Conclusions

HA-CMC adhesion barrier placement at the time of optimal cytoreductive surgery for ovarian, fallopian tube, and peritoneal cancer is not associated with major postoperative complications but may be associated with increased risk of pelvic abscess

abstract: A new index of priority symptoms in advanced ovarian cancer



Note: advanced ovarian cancer study

Ovarian cancer patient surveillance after curative-intent initial treatment



Nearly 25% of Women With Early Ovarian Cancer Not Given Recommended Biopsies - US News and World Report




Thursday, February 10, 2011

"The Lab - Avoiding Research Misconduct: (video) Office of Research Integrity: The Lab. An Interactive Video on Avoiding Misconduct



"To participate in this interactive experience, go to:


This interactive film is an extremely rich and substantively educational resource for teaching/learning research integrity and ethics. It deals with the issue of research misconduct. Filmed in a university research environment, it makes excellent use of the best knowledge and science regarding ethical decision-making and the responsible conduct of research. The video simulation allows users to assume the role of a graduate student, post-doc, research administrator, or PI and make decisions that affect the integrity of research."

Medscape: 'Unrealistic Optimism' Plagues Early-Phase Oncology Trials




Patients' Association of Canada



Patient Led, Patient Governed Promoting and enhancing the patient voice in health care

Tuesday, February 08, 2011

CORRECT(2/4): Roche CEO Defends Avastin Cancer Drug, Despite Scrutiny - WSJ.com




Less is Better in Early Stage Breast Cancer Care - ABC News




full free access: Journal of Oncology — Review Article: Potential Markers for Detection & Monitoring of Ovarian Cancer Feb 8, 2011



  Note:  pdf file


Conclusions and Emerging Trends in Biomarkers for Ovarian Cancer

"The ultimate aim of effective screening techniques is to bring about a reduction in mortality form ovarian cancer. As early detection continues to be vital in ovarian cancer patients, biomarkers may hold the key to unlocking effective screening strategies for the general population. It is also important to identify screening techniques with low false positive rates and high positive predictive value so that the number of negative surgical interventions can be minimized. Since our currently available single markers are not highly sensitive or specific, a combination of markers may be utilized as a profile for risk assessment. The current problem with screening panels is that the improvement in sensitivity usually correlates with a decrease in specificity, making the target positive predictive value hard to obtain. The multimodal screening profiles of the genetic markers could be utilized in the future for risk assessment, early diagnosis, prognosis and response to therapeutic treatment. Recent literature reports state that the screening is only recommended for the high risk population identified as those with a family history of the disease, women with BRCA1 and BRCA2 mutations, or with hereditary non polyposis colorectal cancer. Recent literature reports also emphasize that the different subtypes of ovarian cancer may have different genetic biomarker expression profiles. Current randomized controlled screening trials are directed towards finding the best molecular and genetic markers for the specific histology of the ovarian tumor with the most impact on reduction in morbidity and mortality. The tumor markers identified in these trials may also lead to novel targets for antitumor therapy."






full free access: Review Article: Cancer Stem Cells and Epithelial Ovarian Cancer





"This paper highlights the current experimental approaches that have been used in the field and discusses their limitations, with specific emphasis on the identification and characterisation of the CSC population in epithelial ovarian cancer."

UPDATE 2-Avastin helps ovarian cancer patients live longer | Reuters




Monday, February 07, 2011

Abstract: Peutz-Jeghers syndrome: a study of long-term surgical morbidity and causes of mortality



"Patients with Peutz-Jeghers syndrome (PJS) require lifelong multidisciplinary care for gastrointestinal polyposis and increased risk of cancer.

...The cause of death was unknown in 4 patients, but was due exclusively to malignancies in all other patients, most commonly due to metastatic gynecologic cancer (5)...."

abstract - BRCA1 mutations and colorectal cancer in Poland



"This study suggests that BRCA1 mutations may be associated with early-onset of colorectal cancer."

abstract: Treatment-Related Mortality With (Avastin) Bevacizumab in Cancer Patients JAMA (alone vs combo)



Data Synthesis "A total of 10 217 patients with a variety of advanced solid tumors from 16 RCTs were included in the analysis...."

January 5, 2011 Gynecologic Oncology Group Survival - White Paper



January 5, 2011 Gynecologic Oncology Group Survival In 2010


cancerletter.com/downloads/20110203/download

"In 2010, the Institute of Medicine (IOM) produced a report recommending wide-ranging changes in the Cooperative Group program and, in response the National Cancer Institute (NCI) has proposed a reorganization of the nation’s cancer Clinical Trials program that would significantly change the program’s current structure....."

Abstract/full free access: An evaluation of access to health care services along the rural-urban continuum in Canada



Conclusion

Inequities in access to care along the rural-urban continuum exist and can be masked when evaluation is done at a very large scale with gross indicators of rural-urban. Understanding the relationship between rural-urban and other determinants will help policy makers to target interventions appropriately: to specific demographic, provincial, community, or rural categories.

Why a journal (Emergency Medicine Australasia) decided to stop taking pharma ads - Gary Schwitzer's HealthNewsReview Blog



The journal, Emergency Medicine Australasia, announced it will no longer accept advertising from drug companies.
The full editorial making the announcement is available online.

Saturday, February 05, 2011

full free access: Gynaecological malignancies from palliative care perspective Mishra K Indian J Palliat Care (focus on symptoms/complications)




Hormone Therapy At Menopause May Pose Breast Cancer Risk — J. Natl. Cancer Inst.




abstract: Surgical-site infections and postoperative complications: agreement between the Danish Gynecological Cancer Database and a randomized clinical trial (patient safety)



Conclusions. The randomized trial reported significantly more surgical-site infections than the clinical database. The DGCD reported only 50% of the deep and organ-space infections, and hence, the low-overall agreement indicates a need for more careful database registration.

abstract: Phase II study evaluating consolidation whole abdominal intensity-modulated radiotherapy (IMRT) in patients with advanced ovarian cancer stage FIGO III - The OVAR-IMRT-02 Study



BACKGROUND:
".... Recurrences of the disease occur mostly intraperitoneally. Ovarian cancer is a radiosensitive tumor, so that the use of whole abdominal radiotherapy (WAR) as a consolidation therapy would appear to be a logical strategy. WAR used to be the standard treatment after surgery before the chemotherapy era; however, it has been almost totally excluded from the treatment of ovarian cancer during the past decade because of its high toxicity. Modern intensity-modulated radiation therapy (IMRT) has the potential of sparing organs at risk like kidneys, liver, and bone marrow while still adequately covering the peritoneal cavity with a homogenous dose. Our previous phase I study showed for the first time the clinical feasibility of intensity-modulated WAR and pointed out promising results concerning treatment tolerance. The current phase-II study succeeds to the phase-I study to further evaluate the toxicity of this new treatment. Methods / design: The OVAR-IMRT-02 study is a single-center one arm phase-II trial. Thirty seven patients with optimally debulked ovarian cancer stage FIGO III having a complete remission after chemotherapy will be treated with intensity-modulated WAR as a consolidation therapy. A total dose of 30 Gy in 20 fractions of 1.5 Gy will be applied to the entire peritoneal cavity including the liver surface and the pelvic and para-aortic node regions. Organ at risk are kidneys, liver (except the 1cm-outer border), heart, vertebral bodies and pelvic bones. Primary endpoint is tolerability; secondary objectives are toxicity, quality of life, progression-free and overall survival.

DISCUSSION: Intensity-modulated WAR provides a new promising option in the consolidation treatment of ovarian carcinoma in patients with a complete pathologic remission after adjuvant chemotherapy. Further consequent studies will be needed to enable firm conclusions regarding the value of consolidation radiotherapy within the multimodal treatment of advanced ovarian cancer. Trial registration: NCT01180504.

abstract: Phase II trial of combretastatin A4 phosphate, carboplatin, and paclitaxel in patients with platinum-resistant ovarian cancer



Note: searching blog for A4 will provide further research specific to  clear cell/A4


CONCLUSIONS: The addition of CA4P to paclitaxel and carboplatin is well tolerated and appears to produce a higher response rate in this patient population than if the chemotherapy was given without CA4P. A planned randomised trial will test this hypothesis.

abstract: Indication for oophorectomy during cytoreduction for intraperitoneal metastatic spread of colorectal or appendiceal origin



BACKGROUND: The incidence of ovarian metastases at the time of peritoneal carcinomatosis, and the influence of such metastases on survival after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), are unknown.
CONCLUSION: When peritoneal carcinomatosis of colorectal or appendiceal origin is confirmed, at least 52 per cent of ovaries will have synchronous metastases. Disease-free survival after a HIPEC procedure for PMCA or DPAM is significantly lower in women with ovarian metastases. Oophorectomy during CRS for peritoneal carcinomatosis should be strongly considered.

abstract: Whole abdominopelvic radiotherapy using intensity-modulated arc therapy in the palliative treatment of chemotherapy-resistant ovarian cancer with bulky peritoneal disease



CONCLUSION: WAPRT delivered using intensity-modulated arc therapy offers important palliation in the case of peritoneal metastatic ovarian cancer. WAPRT resolved intestinal obstruction for a substantial period.

abstract: Role of adjuvant radiotherapy in granulosa cell tumors of the ovary



PURPOSE: To review the role of adjuvant radiotherapy (RT) in the outcome and recurrence patterns of granulosa cell tumors (GCTs) of the ovary.

CONCLUSION: Ovarian GCTs can be indolent, with patients achieving long-term survival. In our series, adjuvant RT resulted in a significantly longer DFS. Ideally, randomized trials with long-term follow-up are needed to define the role of adjuvant RT for ovarian GCTs.

abstract: The perils of a vanishing cohort: a study of social comparisons by women with advanced ovarian cancer



Note: plain english language version??

Friday, February 04, 2011

Programs - INCTR – International Network for Cancer Treatment and Research




(no abstract) How Surgeon Age Affects Surveillance After Curative-Intent Primary Treatment for Ovarian Carcinoma



How Surgeon Age Affects Surveillance After Curative-Intent Primary Treatment for Ovarian Carcinoma

A.Y. Patel1, F. Gao2, D.G. Mutch2, R.K. Gibb2, K.S. Virgo3, F.E. Johnson1
18.2
No abstract is available. To read the body of this article, please view the Full Text online.
1 Saint Louis University, Saint Louis, MO
2 Washington University, Saint Louis, MO
3 American Cancer Society, Atlanta, GA
PII: S0022-4804(10)01509-X
doi:10.1016/j.jss.2010.11.585

Scientists peer into the future of stem cell biology (microRNAs)




Biological diversity of ovarian cancer lessens value of screening




abstract: Laparoscopic Excision of Ovarian Remnants: Retrospective Cohort Study with Long-term Follow-up



media: Letter to the Editor (Darlene Gray/OCATS) Refreshing leadership




Promoting genetic literacy: cancer control in the BRCA era - Cutting Edge - Cancer World (including Lynch Syndrome/spectrum of cancers)



Note: worth reading; covers a variety of concerns
 
IN BRIEF
  • Accounting for around 5%–10% of all breast cancers, harmful mutations in BRCA1 or BRCA2 increase a woman’s chance of developing breast cancer over their lifetime by approximately five times compared to the normal population.
  • Carriers of the harmful BRCA1/2 mutations are also approximately 10–30 times more likely to develop ovarian cancer, with these mutations accounting for around 10% of all ovarian cancers.
  • There is no single BRCA mutation, but a wide variety of mutations on these two genes, many of which have yet to be recorded. Only some have been demonstrated to be harmful.
  • BRCA mutations can also raise the risk of other cancers, including gastric, pancreatic, colon and prostate cancer, as well as melanoma and male breast cancer.
  • Other ‘cancer genes’ include mutated APC genes, responsible for familial adenomatous polyposis, which lead to colon cancer, and mutated MLH1, MSH2 MSH6, or PMS2 genes, which are associated with hereditary non-polyposis colon cancer (HNPCC) (Lynch Syndrome), a syndrome that also raises the risk of endometrial (uterine), stomach, ovarian, small bowel (intestinal), urinary tract, liver, and bile duct cancers.

(2010) Slipstream - When Patients Meet Online, Are There Side Effects? - NYTimes.com (patient exploitation)





"...raises important questions about the trade-off between the benefits of information sharing and the risk of patient exploitation."

Seth's Blog: Pleasing




Ovariancancerandus Blog: top 5 most recently read articles















Thursday, February 03, 2011

MSKCC (Memorial Sloan Kettering) Winter 2011 newsletter Molecular Medicine for Ovarian and Endometrial Cancer - Douglas A Levine



Note: includes reference to PARP inhibitors

Download Article - Update in Gynecologic Oncology, Winter 2011






Using Quality of Life Measures in Breast Cancer Clinical Trials — J. Natl. Cancer Inst. (and all cancers)



"Both the World Health Organization and the U.S. Food and Drug Administration have endorsed quality of life, but they are not always incorporated into trials because of the additional resources needed for data collection."

Cancer Awareness A Must For Women February is Ovarian Cancer month in Australia




abstract: Cancer survival among Latinos and the Hispanic Paradox.



CONCLUSIONS: No evidence of a Hispanic advantage was found in cancer survival. Improvement in mortality follow-up procedures for Latinos, especially for those without a valid social security number, is critical. By considering Hispanics as a whole rather than by subgroup, existing survival disparities are being missed.

abstract: Healthy eating index and ovarian cancer risk. [Cancer Causes Control. 2011] - PubMed result




The evidence for a role of diet on ovarian cancer prevention remains inconclusive.
While many studies have evaluated individual foods and food groups, the evaluation of a comprehensive dietary quality index for predicting cancer risk has received little attention.
This study investigates the association between the Healthy Eating Index (HEI), which reflects adherence to the current USDA Dietary Guidelines for Americans and ovarian cancer risk in a population-based case-control study in New Jersey. A total of 205 cases and 390 controls completed the Block 98.2 food frequency questionnaire (FFQ) in addition to reporting on potential risk factors for ovarian cancer. FFQ data were then utilized to calculate the HEI score, and cup, ounce, gram, or caloric equivalents for the 12 different food groups comprising the index. In multivariate models, the OR for the highest tertile of the HEI score compared with the lowest (reflecting a better diet compared with a worse diet) was 0.90 (95% CI: 0.55-1.47).
There was limited evidence for a statistically significant association between any of the 12 individual food components and ovarian cancer risk. Based on this study's results, neither individual food groups nor dietary quality showed potential for preventing ovarian cancer.

abstract: A non-BRCA1/2 hereditary breast cancer sub-group defined by aCGH profiling of genetically related patients (BRCAx)



Germline mutations in BRCA1 and BRCA2 explain approximately 25% of all familial breast cancers.

Despite intense efforts to find additional high-risk breast cancer genes (BRCAx) using linkage analysis, none have been reported thus far.

Here we explore the hypothesis that BRCAx breast tumors from genetically related patients share a somatic genetic etiology that might be revealed by array comparative genomic hybridization (aCGH) profiling.

As BRCA1 and BRCA2 tumors can be identified on the basis of specific genomic profiles, the same may be true for a subset of BRCAx families. Analyses used aCGH to compare 58 non-BRCA1/2 familial breast tumors (designated BRCAx) to sporadic (non-familiar) controls, BRCA1 and BRCA2 tumors. The selection criteria for BRCAx families included at least three cases of breast cancer diagnosed before the age of 60 in the family, and the absence of ovarian or male breast cancer.

Hierarchical cluster analysis was performed to determine sub-groups within the BRCAx tumor class and family heterogeneity. Analysis of aCGH profiles of BRCAx tumors indicated that they constitute a heterogeneous class, but are distinct from both sporadic and BRCA1/2 tumors. The BRCAx class could be divided into sub-groups. One subgroup was characterized by a gain of chromosome 22. Tumors from family members were classified within the same sub-group in agreement with the hypothesis that tumors from the same family would harbor a similar genetic background. This approach provides a method to target a sub-group of BRCAx families for further linkage analysis studies.

full free acPhase II Trial of Trastuzumab in Women with Advanced or Recurrent, HER2-Positive Endometrial Carcinoma: a Gynecologic Oncology Group Study




abstract: Clear cell carcinoma of the ovary: A report from the first Ovarian Clear Cell Symposium, June 24th, 2010 (plus blogger's commentary)



Blogger's Notes: with the exception of the 2 mutations mentioned, there is nothing new in this abstract;  social media can overcome past issues with patient accrual


OBJECTIVES: Recent literature has highlighted histological types of ovarian carcinoma as distinct diseases, each with unique clinical and molecular features. Historically, the diagnosis of ovarian clear cell carcinoma (CCC) has been of concern to both patients and physicians due to reports that CCC is associated with a worse prognosis than the more common serous type of ovarian carcinoma (HGSC). This review discusses the unique features of ovarian CCC.

METHODS: In June of 2010, a group of researchers and clinicians convened in Vancouver to review and discuss the clinical, pathological, molecular, and treatment-related features of CCC.

RESULTS: CCC is the second most common type of ovarian epithelial cancer, representing 5-25% of ovarian carcinomas. It is characterised by its association with endometriosis, and frequent mutations of ARID1A and PIK3CA. Low-stage CCC appears to have a better outcome than stage matched HGSC, while the opposite is true for high-stage disease, suggesting that the current standard treatments applied to HGSC (high grade serous) are ineffective for CCC.

CONCLUSIONS: Ovarian CCC is highly distinct from HGSC, and a clearer understanding of the basic biology of this disease is needed. Alternative therapies should be explored: irradiation and targeting disease-specific molecular markers should be examined in greater detail. Finally, novel approaches to clinical trial design are needed due to the smaller numbers of patients affected.

abstract: Surgical staging of early stage epithelial ovarian... [Gynecol Oncol. 2011] - PubMed result



Note: positive lymph node findings upgrade staging from early stage to advanced stage; full access is by subscription ($$$)


OBJECTIVES: The objectives of this study were to determine the adequacy of surgical staging performed on surgically treated epithelial ovarian cancer (EOC) patients with apparent early stage disease and to determine if receipt of surgical staging had an influence on survival.
METHODS: Detailed surgical staging information was collected from medical records for 721 patients diagnosed between 1998 and 2000 with EOC. Patients resided in California or New York and were identified through population-based cancer registries.
RESULTSNearly 90% of patients had removal of the omentum and evaluation of bowel serosa and mesentery but only 72% had assessment of retroperitoneal lymph nodes and the majority of patients did not receive biopsies of other peritoneal locations. Only lymph node assessment (as well as node assessment combined with washings and omentectomy) had a statistically significant association with improved survival. The 5-year survival for women with node sampling was 84.2% versus 69.6% for those without this surgical procedure, and patients who did not have lymph node assessment had nearly twice the risk of death as those who did. When patients were stratified by receipt of chemotherapy, lack of node sampling had an effect only on patients who also had no chemotherapy (adjusted HR=2.2, CI=1.0-4.5).
CONCLUSIONS: The results of this population-based study confirm the prognostic importance of surgical staging for women with EOC, and the important role of gynecologic oncologists in treating these patients. Adjuvant chemotherapy does not appear to further improve survival for those women who receive adequate surgical staging.

sanibel island photo (testing android app)



Published with Blogger-droid v1.6.7

abstract: Ovarian serous surface papillary borderline tumors form sea anemone-like masses



PURPOSE: To clarify the imaging characteristics of ovarian serous surface papillary borderline tumor (SSPBT), whose prognosis is far better than that of serous surface papillary adenocarcinoma (SSPC).

in research: (miR-335) Running A Cancer Roadblock - Science News breast/ovarian



"The function of miR-335 in controlling whether escaped cancer cells can form a new tumor may also be important in ovarian cancer. Women with ovarian cancer who later had a relapse were more likely to be missing a copy of miR-335 in their original tumors than women who did not relapse, the team found."

in research: (miR-429) Discovery may lead to turning back the clock on ovarian cancer | Science Blog




Imedex: Great Debates & Updates in Gynecologic Malignancies April 9, 2011 New York, New York conference notice




Wednesday, February 02, 2011

New study alters long-held beliefs about shingles (herpes zoster virus)




in research: Generic drug (Losartan) may improve the effectiveness of cancer nanotherapies



"Low doses of an inexpensive, FDA-approved hypertension medication may improve the results of nanotherapeutic approaches to cancer treatment. In a report in the early edition of Proceedings of the National Academy of Sciences, Massachusetts General Hospital (MGH) investigators describe experiments showing that the generic drug losartan, by modifying the network of collagen fibers that characterizes most solid tumors, improved the effectiveness of two nanotherapeutics against several types of cancer....."

"....Experiments with two nanotherapeutics – liposomes containing the chemotherapy drug doxorubicin and a virus designed to infect and destroy – showed that combining each treatment with losartan significantly reduced the size or delayed the growth of implanted tumors...."

Podcasts (numerous) - the Art of Oncology (ASCO)



ASCO Expert Corner: Young Adults With Cancer Q & A (+ most common types of cancers in YA)



Q: What are the most common types of cancer that are diagnosed in young adults?
A: Among young adults (defined here as those ages 15 to 39), the ten most common types of cancer, in order of frequency, are breast cancer, lymphoma (non-Hodgkin and Hodgkin), melanoma, sarcoma, gynecologic cancers of the ovary and cervix, thyroid cancer, testicular cancer, colorectal cancer, leukemia, and brain tumors. These types account for 90% of the cancers in this age group.

abstract: Anthropometric factors and ovarian cancer risk in the Malmö Diet and Cancer Study



define: anthropometry - The field that involves the measurement of the dimensions and other physical characteristics of people and the application of this information to the design of things they use.
www.fda.gov/medicaldevices/deviceregulationandguidance/guidancedocuments/ucm095024.htm

"....Neither height, weight, BMI, body fat percentage, waist- or hip circumference were associated with overall risk, nor with risk for different subtypes, differentiation grade or stage.
Conclusions: These results demonstrate that a high WHR (waist hip ratio) is associated with a decreased risk of EOC. Other anthropometric factors were not associated with EOC risk."

abstract: Racial disparities in ovarian cancer surgical care: A population-based analysis



Conclusions Among women undergoing initial surgery for ovarian cancer, African-American patients are significantly less likely to be operated on by a high-volume surgeon and to undergo important ovarian cancer-specific surgical procedures compared to White patients.

case report: Simultaneous breast and ovarian metastasis from gallbladder carcinoma



CONCLUSION: This is an unusual case of carcinoma of the gallbladder with metastasis to the breast and ovary, which has not been documented before.

Tuesday, February 01, 2011

abstract: The PREMM(1,2,6) model predicts risk of MLH1, MSH2, and MSH6 germline mutations based on cancer history (Lynch Syndrome)




full free access: Effect of Direct-to-Consumer Genomewide Profiling to Assess Disease Risk — NEJM




CPSI (Canadian Patient Safety Institute) Bulletin



Improving Care Bulletin

This report is written about you – our partners, stakeholders, policy makers and advocates.
We want this document to speak to you and value any feedback you have as we work together to make a patient safety ripple in our healthcare system.
If you would like paper copies of this report please contact Jody White at jwhite@cpsi-icsp.ca.

NIH summit to focus on management of radiation dose in computerized tomography, Tuesday, February 1, 2011 News Release - National Institutes of Health (NIH)




Cancer - Volume 117, Issue 3 - 1 February 2011 - Wiley Online Library (subscription required to view full text)



Note: this is the index of the most current volume with abstracts only without a subscription; numerous references to ovarian cancer

Commentary: Early versus delayed treatment of relapsed ovarian cancer : The Lancet (re: Rustin trial early vs delayed treatments/survival)



Polymorphism in the GALNT1 Gene and Epithelial Ovarian Cancer in Non-Hispanic White Women: The Ovarian Cancer Association Consortium



"In summary, the present analysis fails to replicate an earlier reported association of a GALNT1 variant with risk of ovarian cancer. This study highlights the need to replicate putative findings in genetic association studies."

Ovarian Metastases of Pancreaticobiliary Tract Adenocarcinomas: Analysis of 35 Cases, With Emphasis on the Ability of Metastases to Simulate Primary Ovarian Mucinous Tumors



New clinical trial to determine ovarian cancer risks in African-American women



Loss of protein could contribute to early breast and ovarian cancer deaths (protein MCPH1)



FDA review indicates possible association between breast implants and a rare cancer anaplastic large cell lymphoma (ALCL) - lymphoma



Advance Directive Language and Laws May Interfere With Patient Wishes - RWJF



The guidelines created to protect patients making end-of-life decisions may have the opposite effect. A Robert Wood Johnson Foundation Physician Faculty Scholar identifies problems and offers solutions

Saturday, January 29, 2011

Medical News: Implant Focus Shifts to Rarity of Implant-Related Cancer - in Product Alert, Devices and Vaccines from MedPage Today



Lancet (abstract) Retraction: validation of gene signatures that predict the response of breast cancer to neoadjuvant chemotherapy: a substudy of the EORTC 10994/BIG 00-01 clinical trial



Note: full details available to subscribers ($$$)

 Comment

Retraction—validation of gene signatures that predict the response of breast cancer to neoadjuvant chemotherapy: a substudy of the EORTC 10994/BIG 00-01 clinical trial

abstract: Is surgical restaging indicated in apparent stage IA pure ovarian dysgerminoma?



Objective

Conservative surgery followed by platinum-based chemotherapy is considered the standard approach for pure ovarian dysgerminoma (POD), except for correctly staged IA patients. The aim of study was to evaluate the outcome of IA POD patients with incomplete surgical staging in order to define the proper management.

Friday, January 28, 2011

abstract: Validation of a Self-Concept Scale for Lynch Syndrome in Different Nationalities (multinational study) Denmark, Sweden, Canada



J Genet Couns. 2011 Jan 26. [Epub ahead of print]
"Learning about hereditary cancer may influence an individual's self-concept, which otherwise represents a complex but stable cognitive structure. Recently, a 20-statement self-concept scale, with subscales related to stigma-vulnerability and bowel symptom-related anxiety, was developed for Lynch syndrome. We compared the performance of this scale in 591 mutation carriers from Denmark, Sweden and Canada. Principal component analysis identified two sets of linked statements-the first related to feeling different, isolated and labeled, and the second to concern and worry about bowel changes. The scale performed consistently in the three countries. Minor differences were identified, with guilt about passing on a defective gene and feelings of losing one's privacy being more pronounced among Canadians, whereas Danes more often expressed worries about cancer. Validation of the Lynch syndrome self-concept scale supports its basic structure, identifies dependence between the statements in the subscales and demonstrates its applicability in different Western populations."

CIHI report 2011: Multiple chronic conditions, not age, main driver of health system use by seniors - debunking the myth




abstract: Hormone replacement therapy and breast cancer



Hormone replacement therapy and breast cancer.

Genesis Prevention Centre, University Hospital of South Manchester, Manchester, M23 9LT, UK, anthony.howell@christie.nhs.uk.

Abstract

There is evidence that hormone replacement therapy (HRT) may both stimulate and inhibit breast cancers, giving rise to a spectrum of activities, which are frequently hard to understand. Here we summarise the evidence for these paradoxical effects and, given the current data, attempt to give an indication where it may or may not be appropriate to prescribe HRT.It is clear that administration of oestrogen-progestin (E-P) and oestrogen alone (E) HRT is sufficient to stimulate the growth of overt breast tumours in women since withdrawal of HRT results in reduction of proliferation of primary tumours and withdrawal responses in metastatic tumours. E-P, E including tibolone are associated with increased local and distant relapse when given after surgery for breast cancer. For women given HRT who do not have breast cancer the only large randomised trial (WHI) of E-P or E versus placebo has produced some expected and also paradoxical results. E-P increases breast cancer risk as previously shown in observational studies. Risk is increased, particularly in women known to be compliant. Conversely, E either has no effect or reduces breast cancer risk consistent with some but not all observational studies. Two observational studies report a decrease or at least no increase in risk when E-P or E are given after oophorectomy in young women with BRCA1/2 mutations. Early oophorectomy increases death rates from cardiovascular and other conditions and there is evidence that this may be reversed by the use of E post-oophorectomy. HRT may thus reduce the risk of breast cancer and other diseases (e.g., cardiovascular) in young women and increase or decrease them in older women.

Thursday, January 27, 2011

press release/media: For the Treatment of Second-Line Platinum Sensitive Advanced Ovarian Cancer, One-Third of Surveyed Oncologists Indicate That Paclitaxel/Carboplatin Has the Best Overall Clinical Profile When Compared to Other Currently Available Therapies



CCR Clinical Trials at NIH: Clinical Research: results - 22 solid tumor (adult)



Search for Clinical Trials at NIH
The NCI Center for Cancer Research (CCR) conducts more than 150 cancer clinical trials at theNational Institutes of Health (NIH) Clinical Center in Bethesda, Maryland. Cancer clinical trialsthat take place at the NIH Clinical Center are open to patients with cancer, regardless of where they live in the United States.

There are 22 clinical trials at NIH that match your search criteria
*Cancer by type/disease: Solid Tumor (Adult)

in research: Scientists Work on New System to Capture Ovarian Cancer Cells Using Magnetic Nanoparticles




Editorial (referencing Lancet article/sleep deprivation): Canadian Journal of Surgery [February 2011]



Staff surgeon competence
E.J. Harvey
[full text in PDF]
La compétence des chirurgiens en titre
E.J. Harvey
[full text in PDF]

Wednesday, January 26, 2011

The "integration" of pseudoscience into medicine continues apace : Respectful Insolence (refers to CAM + discussions)




clinical trial: Internet-based System for Cancer Patients to Self-report Toxicity - Full Text View



Purpose
Cancer patients may develop side effects during treatment, such as nausea, pain, fatigue, diarrhea, constipation, or shortness of breath. These symptoms may be due to the cancer itself, or due to treatments like chemotherapy drugs or radiation therapy. Doctors and nurses often ask patients about their symptoms, because an important part of cancer treatment is to make patients feel as well as possible. If patients do not feel well, the investigators may need to change the way the investigators are treating you or prescribe therapies that will decrease your symptoms. The best way to find out how you are feeling is to ask you directly.
However, during your time between appointments the investigators may not be able to ask you how you are feeling on a regular basis. In addition, even at an appointment, there may be symptoms that the investigators do not have a chance to discuss.
The investigators are interested in developing new ways to ask patients about how they are feeling, using the Internet. A special new website called STAR ("Symptom Tracking and Reporting for Patients") has been developed to help patients record this information, so that their doctors and nurses can review it during clinic appointments. This study is designed to help us see if STAR is a helpful way for us to keep track of information about patients' symptoms and quality of life.

clinical trial: Pathway to Diagnosis of Ovarian Cancer - Full Text View



Purpose
The purpose of this study is to describe the prediagnostic symptoms and the events along the pathway to diagnosis of women with ovarian cancer, referred for first-line chemotherapy.

clinical trial: Primary Tumor Harvest for the Purpose of Possible Use in a Future Clinical Trial in Patients With Ovarian, Fallopian Tube or Primary Peritoneal Cancer



Purpose
The purpose of this research study is to collect tumor samples at the time of surgery and store them for possible use as part of an experimental vaccine study for the participants cancer in the future.

clinical trial: Pancreatic Cancer Genetics ClinicalTrials.gov



Purpose

The aim of this study is to determine the frequency of the three most common BRCA1 and BRCA2 genetic mutations that are commonly found in Ashkenazi Jewish patients with pancreatic cancer. Testing for BRCA1 and BRCA2 mutations in relatives of hereditary pancreatic cancer patients may have a significant impact; allowing for early screening, treatment, and resection of pre-malignant tissue or malignant lesions.

clinical trial: Anonymous Testing of Pathology Specimens for BRCA (and Lynch Syndrome MSH2) Mutations in Ashkenazi Jewish Individuals Who Have Cancer



Purpose
The intent of the proposed study is to describe the prevalence of the most common recurring mutations
in BRCA1 and BRCA2, blmAsh , and the A636P MSH2  (Lynch Syndrome) mutation among Ashkenazi Jewish individuals with a variety of cancer diagnoses. If a substantial proportion of these samples contain such mutations, future patients presenting with these diseases may wish to undergo genetic counseling and, if appropriate, formal genetic testing. The benefit from such a process would pertain mainly to the families of these individuals.

Condition
Extrahepatic Bile Duct Cancer
Gallbladder Cancer
Gastric Cancer
Lung Cancer
Melanoma
Non-Hodgkin's Lymphoma
Uterine Cancer
CORPUS UTERI,ENDOMETRIUM
LUNG
OVARY

free full access: Chemosensitivity and outcome of BRCA1- and BRCA2-associated ovarian cancer patients after first-line chemotherapy compared with sporadic ovarian cancer patients — Ann Oncol




this week's partial stats - blog views this week ranked by country



Ranking by country (most frequent first):
United States

France

Germany

South Korea

Canada

Russia

United Kingdom

Netherlands

Chin
a
Philippines

free full access: WHO/PLoS Collection “No Health Without Research”



"It seems astonishing that in the 21st century decisions on health care can still be made without a solid grounding in research evidence. This is true even in clinical research, whether for simple or complex interventions [1], where systematic reviews time and time again conclude that the evidence base is inadequate [2]. It is even more true in the areas of health policy and health systems, where quality research is hampered further by a lack of shared definitions, a lack of consensus on guiding principles, poor capacity (especially in low-resource regions), and methodological challenges [3],[4].
The World Health Report (WHR) for 2012 will be on the theme of “No Health without Research”. This flagship report from WHO will, for the first time in its history, focus on research for better health. The primary target audience of the report will be ministers of health in the WHO member states, and the goal of the report is to provide new ideas, innovative thinking, and pragmatic advice for member states on how to strengthen their own health research systems. The report will have the three following aims.
  1. To show that research is important for meeting health needs and improving health outcomes;
  2. To encourage countries to therefore invest more resources in developing and strengthening their national health research systems;
  3. To argue that countries should not see research as an expense or as an afterthought, but as an investment for a better, healthier future.....cont'd

Women of Teal: The World of Cancer Bloggers




Thirty-day mortality rate in women with cancer and venous thromboembolism. Findings from the RIETE Registry (abstract)



Note: different adverse events depending on cancer site

Comeback Cancers by Ann F. Chambers - Project Syndicate



(FB friend) Stop the Traditional Herbal Medicinal Products Directive Petition




Kuwaiti patients, Canadian care: Hospital executives seek revenue in foreign lands - The Globe and Mail




FDA review indicates possible association between breast implants and a rare cancer (see Blogger's Notes on this issue)



Blogger's Notes: for background information regarding the long standing health issues concerning breast implants do a 'litigation' search. Past research on
the issue of risk/breast implants (noncancer/cancer issues) includes many
lawsuits, the latter of which were settled by some of the manufacturers without admission of fault (guilt). The past lawsuits (class action suits) were based on the older forms of implants.

Dietary Phytoestrogens/Risk of Ovarian Cancer in the Women's Lifestyle and Health Cohort Study



Takeda Pharma, Millennium commence (AMG386) TRINOVA-1 Phase III cancer (ovarian) trial



Takeda Pharmaceutical and the Takeda Oncology Company: Millennium, have commenced TRINOVA-1 Phase III clinical trial on anti-cancer agent AMG 386 in Japan

DICER1 Mutations in Familial Multinodular Goiter (thyroid) With/Without Ovarian Sertoli-Leydig Cell Tumors



AVANT Says No Avastin Benefit in Stage III Colon Cancer - Colorectal Cancer Coalition



American Society of Clinical Oncology Statement: Toward Individualized Care for Patients With Advanced Cancer — JCO



Addition of Bevacizumab to Chemotherapy for Treatment of Solid Tumors: Similar Results but Different Conclusions



Table 1. Randomized Phase III Studies Comparing Chemotherapy With or Without Bevacizumab As First-Line Chemotherapy for Advanced Epithelial Cancers

Tuesday, January 25, 2011

Readers' Photos - Picture Your Life After Cancer - Interactive Feature - NYTimes.com



Involving the public in healthcare policy: An update of the research evidence and proposed evaluation framework | RAND



Blogger's Note: worth reading if not, critically, somewhat old news

IAPO calls on WHO member states to involve patients at all levels to meet the health related MDGs (Millennium Development Goals)| A global voice for patients



"To do this effectively, patients must be involved in both the design and delivery of their care."

Cost recovery (handouts) trumps concerns about conflicted interest -- Canadian Medical Association Journal



Although there's widespread variation in the policies that Canadian medical schools have toward pharmaceutical and medical devices industry handouts for medical education and in some cases, seemingly no policies at all, administrators say there is no need for restrictive guidelines ....cont'd

Association Between a Name Change from Palliative to Supportive Care and the Timing of Patient Referrals -- The Oncologist



"....Because of the nature of our institution as a comprehensive cancer center
with a large patient volume, the results might not be generalizable to smaller cancer centers and oncology programs in other areas. However, the findings 
of our study regarding a higher overall number of referrals and earlier
referrals in the outpatient setting confirm the findings of our previous
survey study on the attitudes and beliefs of medical oncologists and
midlevel providers regarding the term palliative care. We believe
that these findings and the difference in referral pattern after the
name change are not center specific but rather reflect perceptions
among health care professionals in the U.S. regarding the strong
associations among palliative care, hospice, and end of life."


Conclusion The name change to supportive care was associated with more inpatient referrals and earlier referrals in the outpatient setting. The outpatient setting facilitates earlier access to supportive/palliative care and should be established in more centers.

Contagious Cancer - The Oncologist



Of interest: note reference to organ transplant (not new news but under-recognized??)

"INTRODUCTION 
In the cancer clinic, physicians and other oncology caregivers are
occasionally asked whether cancer can ever be passed along from
one individual to another. One example is the wife who asks whether
she could ever "catch" cancer from her husband with prostate cancer.
Although the answer to that one is no, the question of a man "catching"
cancer from a partner with cervical cancer is not unrealistic since
various strains of human papilloma virus are known causes of cervical
cancer as well as penile cancer. Pathogens including certain viruses,
bacteria, and parasites represent major causes of cancer in developing
parts of the world. In fact, an estimated 1.5 million cases per year or
15% of all cancers worldwide can be attributed to infectious
etiologies, mostly due to viral infections...."cont'd

Laparoscopic Institute for Gynecologic Oncology 2011 conference April 14-16 San Francisco




Society of Gynecologic Oncologists to Host 42nd Annual Meeting on Women's Cancer --March Orlando, Florida




Monday, January 24, 2011

2nd annual event: (call for participants) tHE ART of the Matter - OCATS (Ovarian Cancer Awareness & Treatment in Sask




On Saturday May 21st OCATS (Ovarian Cancer Awareness & Treatment in Sask) will host its 2nd Annual “tHE ART of the Matter” art show, the theme being all things feminine, related to the creativity of feminine, all matters of interest or important to women – whether as the artist, or as the subject matter of her work.

The goals of the event is to honour women and our joy and our struggles, and to create awareness for gynecologic cancers for all women and men who care about us.  

If you are an artist and would like to participate please let us know by February 15th.  Please know that your participation and support will be very much appreciated by women and their support people who are dealing with a gynecologic cancer.  If you know an artist please forward this notice on.  And if you are just interested in art, please plan on attending the show!

Thank you, 

Darlene Gray 

OCATS

Ovarian Cancer Awareness & Treatment in Saskatchewan

Find us on Facebook too!


Atlas of Genetics and Cytogenetics in Oncology and Haematology - Ovarian tumours : an overview







full free access: 2011 The Risk of Urothelial Bladder Cancer in Lynch syndrome is increased, in particular among MSH2 mutation carriers



See Box 1 for surveillance recommendations

Attached file list to this document:



PEER_stage2_10.1136%2Fjmg.2010.076992.pdf(1.5 MB)


further information:  
Atlas Genetics Oncology: Bladder: Urothelial carcinomas


Not Enough Progress Against Cancer?. In the Pipeline: (clinical trials, drugs etc) - blog discussion




Premature Menopause: The Unexpected Symptoms of Cancer Treatment - Chicago event Feb 2nd (surgical menopoause....)



The Institute for Women’s Health Research is hosting an event with a panel of experts and pre-screening of the documentary on Wednesday, February 2nd in Chicago

Unrealistic optimism appears common in early cancer trials (patient version HOPE ??)



Blogger Comment: patients call optimism also as "HOPE"

Cochrane Collaboration awarded seat on World Health Assembly




(Geneva, Switzerland – January 24, 2011) On
January 24, 2011, the
World Health Organization (WHO) awarded
The Cochrane Collaboration a seat on the World Health Assembly allowing the Collaboration to provide input on WHO health resolutions.

The Cochrane Collaboration was accepted as a Non-Governmental Organization in Official Relations
with the WHO at the WHO’s Executive Board meeting, establishing a partnership with formalized communication
between the two organizations.

You can read more in the official press release announcing this story on www.cochrane.org. It is available in Arabic, Standard Chinese, German, English, French, Russian and Spanish.

call for Nominations - deadline Feb. 11, 2011 Top 25 Women in Healthcare - Modern Healthcare



Do you know a female executive making a positive difference in the healthcare industry? A leader at the forefront of healthcare reform, policy, education, research or advocacy? A woman who is using her power or abilities to successfully effect change?
Nominate her for Modern Healthcare's 4th biennial Top 25 Women in Healthcare recognition program!
For entry criteria, submission details and FAQs,
visit ModernHealthcare.com/topwomenexecs

Research and Markets: Ovarian Cancer Therapeutics - Pipeline Assessment and Market Forecasts to 2017



Business

Research and Markets: Ovarian Cancer Therapeutics - Pipeline Assessment

and Market Forecasts to 2017


© Business Wire 2011
2011-01-20 16:11:16 -


OCATS - Ovarian Cancer Awareness & Treatment in Saskatchewan



For Medical Professionals

Because ovarian cancer has no screening tools, blood tests and the symptoms
often are mistaken for other conditions, misdiagnosed and even ignored OCATS has developed an OCATS Physician Guide (available to anyone). This guide
was developed to help medical professionals and women recognize the
symptoms, be aware of symptoms andcombinations of symptoms, the diagnostic tools available to every physician, proper referral practices for women
with the possibility of a gynecologic cancer. We will soon be sending this
guide to every medical clinic and medical
professional in Saskatchewan.
These guides are available in Australia and in the United States.
To view these documents:

OCATS Guide for Medical Professionals
Australia
GP Guide for Australia
CPO Guidelines for Ovarian Cancer, Australian Government
United States
2009.10.1-Symptons document

New Events | Sandy S. Eddinger Ovarian Cancer Research Foundation




Saturday, January 22, 2011

short (very) commentary: EORTC 55971: Does it apply to all patients with advanced state ovarian cancer?



Research Highlights
► Within this randomized trial a statistical benefit was seen with primary
surgery among patients with less than 5 cm of upper abdominal
disease (HR 0.64).
► Across different countries in this study there was significant
heterogeneity of the benefit of primary cytoreductive surgery.

refers to:
EORTC Newsletter Results of the EORTC 55971 trial: Neoadjuvant 
chemotherapy followed by interval debulking surgery is not inferior to 
primary debulking surgery followed by chemotherapy as a treatment 
option for patients with stage IIIC or IV ovarian carcinoma

Comparison of gene expression patterns between avian and human ovarian cancers



Conclusions

Gene expression of spontaneous ovarian cancer in the chicken is comparable
to gene expression patterns of human ovarian cancer.

Research Highlights

► Avian tubal cancer and ovarian cancer gene expression patterns
are different.
► Chicken ovarian cancer expression predicts expression patterns
in human ovarian cancer.

low-grade serous ovarian cancer part of the tumor spectrum of Hereditary Breast and Ovarian Cancer?



Research Highlights

► Low-grade ovarian cancer patients have less family history of breast/ovarian cancer.
► Ovarian cancer grade may be an important factor in hereditary cancer risk assessment.
► Offer BRCA testing to patients with strong family history, regardless of tumor grade.

abstract: Low-dose abdominal radiation as a docetaxel chemosensitizer for recurrent epithelial ovarian cancer: A phase I study GOG



Research Highlights

►Radiotherapy is a chemosensitizer to docetaxel in the treatment of ovarian cancer. ►Chemoradiation resulted in stable disease in women with recurrent ovarian cancer. ►Radiotherapy with docetaxel is tolerable in women with recurrent ovarian cancer.

abstract: A new index of priority symptoms in advanced ovarian cancer



abstract: Ovarian cancer patient surveillance after curative-intent initial treatment



Objective

Patient surveillance after potentially curative treatment of ovarian carcinoma has important clinical and financial implications for patients and society. The optimal intensity of surveillance for these patients is unknown. We aimed to document the current follow-up practice patterns of gynecologic oncologists.

Methods

We created four idealized vignettes describing patients with stages I–III ovarian cancer. We mailed a custom-designed survey instrument based on the vignettes to the members of the Society of Gynecologic Oncologists (SGO). SGO members were asked, via this instrument, how often they requested 11 discrete follow-up evaluations for their patients for the first 10 postoperative years after treatment with curative intent.

Results

We received 283 evaluable responses (30%) from the 943 SGO members and candidate members. The most frequently performed items for each year were office visit, pelvic examination, and serum CA-125 level. Imaging studies such as chest X-ray, abdominal–pelvic CT, chest CT, abdominal–pelvic MRI, and transvaginal ultrasound were rarely recommended. There was marked variation in the frequency of use of most tests. There was a decrease in the frequency of testing over time for all modalities.

Conclusion

This dataset provides detailed documentation of the self-reported surveillance practices of highly credentialed experts who manage patients with ovarian cancer in the 21st century. The optimal follow-up strategy remains unknown and controversial. Our survey showed marked variation in surveillance intensity. Identifying the sources of this variation warrants further research.

Research Highlights

►Optimal follow-up for women with ovarian cancer remains unknown and controversial. ►Specialists were asked about follow-up practice patterns for this patient population. ►Results showed exams/CA125 levels are performed more often than imaging studies.

OWHN: Echo: Women's Health Leadership Program Ontario - retreat/training application note deadline dates



Women's Health Leadership Program

Upcoming Women's Health Leadership 101 Retreats:

 Retreat Date: March 7 - 9, 2011 ~ Application Deadline: January 26, 2011

 Retreat Date: March 23 - 25, 2011 ~ 

Application Deadline: February 2, 2011

The Ontario Women's Health Network (OWHN) is currently accepting
applications for the upcoming Women's Health Leadership 101 training
retreats scheduled for March 7-9, 2011 and March 23-25, 2011,
respectively, at the Nottawasaga Inn in Alliston. Women's Health
Leadership 101 is the first of three graduated training levels that
make up the Women's Health Leadership Program. This is an ongoing
program and further upcoming retreat dates and information will be
announced in the near future.

The program, funded by Echo: Improving Women's Health in Ontario,
seeks to amplify women's voices in the development of health policy,
research and services.

Women's Health Leadership 101 addresses leadership and sex and
gender based analysis in the context of women's health and health
systems in a participatory and supportive environment. It explores
women's own sense of leadership and application of skills, while
enhancing their leadership skills and community networks.

This program is designed for women who are motivated and
interested in women's health issues and who are already actively
engaged in their communities. The program seeks to recruit women
who are committed to being active in women's health issues in their
communities following the retreat.

More information about the program as well as the application package
is available on the OWHN website at: http://www.owhn.on.ca/Women%27s_Health_Leadership.htm

Women who are interested in applying to participate in the Women's
Health Leadership Program should complete application and return
it to OWHN by the appropriate application deadline date (shown above).

We welcome you to share this email widely.

Please do not hesitate to contact OWHN with questions about the
program or application process.

OWHN: 416-408-4840 or toll-free 1-877-860-4545
email: owhn@owhn.on.ca.

Friday, January 21, 2011

2010 full free access: The Antioxidant Debate



Article Outline

Key Concepts

Classes of Antioxidants

Antioxidants for the Treatment of Cancer

Single Antioxidant Supplements

Mixtures of Antioxidant Supplements

Antioxidants for Supportive Care

Cancer-Related Cachexia

Cardiotoxicity

Neurotoxicity

Ototoxicity

General Chemotherapy-Related Toxicities

Radiation-Induced Side Effects

Conclusion

References

Copyright

Cochrane CAM Reviews Commentary: Is There More to Quality Than the Research Method Itself?




Explore: The Journal of Science and Healing - Current Issue




Advances in Mind Body Medicine - Journal




CAM Journals and Databases



IN-CAM website

One of the information resources that we provide on the IN-CAM website is a list of research journals that publish research on CAM and Integrative Health Care. As this field of inquiry continues to develop and expand, this list continues to grow. 

CAM Journals and Databases list

Determinants of geographic patterns of diseases: interaction of lactose/lactase status and sunshine exposure - Jnl Med Hypotheses



".........The patterns related to sunshine (Vitamin D) reflect that obtained with national lactase status proportions and also corroborate a literature review. However, correlations are weak to moderate and only ovarian cancer reached conventional statistical significance. Because these comparisons are based on modest number of national data firm conclusions cannot be made....."

PLoS Medicine: The Impact of eHealth on the Quality and Safety of Health Care: A Systematic Overview




blog: Women of Teal: Sharing a Cancer Diagnosis - Sometimes It Takes Time




abstract: Bleeding events in (Avastin) bevacizumab-treated cancer patients who received full-dose anticoagulation and remained on study



Conclusions:
These data suggest that bevacizumab did not increase the risk of severe bleeding in cancer patients who received

abstract: Aromatase inhibitor therapy: toxicities and management strategies in the treatment of postmenopausal women with hormone-sensitive early brea



"Diagnosis" - The Woman Who Was Wasting Away - NYTimes.com



Lisa Sanders is the author of “Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis.”

full free access: Preventable adverse drug events and their causes and contributing factors: the analysis of register data — Int J Qual Health Care (patient safety)



"In recent years, the number of patient complaints has also increased, probably because patients are more aware of their rights and more attention has been paid to patient safety [18]. These complaints contain detailed narratives about the case, and these data can be used to understand which factors contribute to errors in health care [1].

The purpose of this study was to evaluate the nature of preventable ADEs based on data from national supervisory authority. In particular, the study focuses on the potential causes and contributing factors of preventable ADEs from the information management point of view.
The study aims to answer the following questions:
1. What are the causes of ADEs, and in which phase of the medication management process are the causes for ADEs present?
2. How does information management affect the origin of ADEs?
3. What are the contributing factors for ADEs in information management?

Expression of TGFß1 and its receptors is associated with biological features of ovarian cancer and sensitivity to paclitaxel/carboplatin



Abstract ....... It is suggested that TGFß1 mRNA expression is an indicator of tumor sensitivity to standard therapy with PTX (Taxol) and CBDCA (Carboplatin), that it can identify biologically aggressive and highly malignant tumors and that it can predict the prognosis of patients with ovarian cancer."

Webinar Series | Ovarian Cancer National Alliance (register/dates/times)




Register for our webinar series online! If you've already registered, you'll be sent a reminder the day before this presentation.

The Webinar Series schedule is as follows:

Tuesday, January 25, 2011 at 2:00pm EST
Are Clinical Trials the Answer?
Dr. Ronnie Alvarez, Professor Ob/Gyn, University of Alabama

Thursday, February 10, 2011 at 1:00pm EST
Young Survivors Rock!
Lindsay Avner, Founder and Executive Director, Bright Pink
Chana Garcia, advocate, blogger and ovarian cancer survivor

Thursday, February 17, 2011 at 1:00pm EST
Ovarian Cancer – What’s Basic? What’s New?
Dr. Robert Coleman, Professor, Department of Gynecologic Oncology, MD Anderson Cancer Center

Wednesday, March 2, 2011 at 1:00pm EST
Getting Involved with Partner Members
Robin Cohen, OCNA Board member and Partner Member
Sue Ellen Moore, OCNA Board member and Partner Member

abstract: Value of FDG PET/CT in Patients with Treated Ovarian Cancer and Raised CA125 Serum Levels



CONCLUSION:
PET/CT was able to detect active disease at relatively low levels of CA125, thereby facilitating the early diagnosis of recurrence or residual disease. Also in patients with low CA125 levels (<30).

magazine: Women’s Health Headlines UT Medical Center’s “Frontiers” Magazine | Tennessee Today



This issue of Frontiers is available in print and online (pdf).
To request a printed copy, contact the UT Graduate School of Medicine at 865-305-9190 or click here.

Cantech Letter interviews Brad Thompson President and CEO of Oncolytics Biotech (Reolysin, GOG, clinical trials)




Hereditary Colorectal Cancer: eMedicine Gastroenterology



Background

Hereditary nonpolyposis colorectal cancer (HNPCC), an autosomal-dominant syndrome, accounts for 2-5% of all colorectal carcinomas. Colorectal cancer in patients with hereditary nonpolyposis colorectal cancer (HNPCC) presents at an earlier age than in the general population and is characterized by an increased risk of other cancers, such as endometrial cancer and, to a lesser extent, cancers of the ovary, stomach, small intestine, hepatobiliary tract, pancreas, upper urinary tract, prostrate, brain, and skin.



Table 1. Seven different genes are known to be associated with HNPCC, 
and all of them are involved with DNA mismatch repair, identified with
the frequencies below.

Mismatch Excision Repaired MMRChromosome LocationFrequency of HNPCC Cases
MSH2

2p1645-50%
MLH1

3p22.3/A>20%
MSH6

2p1610%
PMS2

7p22.11%
PMS1

2q32.2Rare
MSH3

5q14.1Rare
EXO1

1q43Rare
Other genes not yet discovered


Table 2.
Incidence of different types of cancers between individuals with Lynch syndrome and those in the general population.

Table
Type of Cancer General Population Risk (by age 70 y) Lynch Syndrome Risk (by age 70 y)
 
Endometrial1.5%40-50%
Ovarian1%9-12%
Upper Urinary TractLess than 1%4-10%
StomachLess than 1%13% (higher in Asians)
Small BowelLess than 1%1-3%
BrainLess than 1%1-4%
Biliary TractLess than 1%1-5%

























20-25%

abstract: Health-related quality of life and cancer clinical trials — Therapeutic Advances in Medical Oncology



"The overall outlook for the routine assessment of patient-reported outcomes in clinical trials is assured and, eventually, it is likely to become a standard part of clinical practice. However, there is still a need for a clear method for determining the clinical meaningfulness of changes in scores. The answer will probably come from the greater use of patient-reported outcomes and the consequent growth of experience that is necessary to make such judgements"