Thursday, March 17, 2011
Wednesday, March 16, 2011
Alberta health board CEO lobbies doctors for patients' help
"....But more doctors are coming forward to discuss how the system hasn't let them speak freely because they face intimidation and punishment, says Independent legislative member Raj Sherman......."cont'd
Read more: http://www.edmontonjournal.com/Alberta+health+board+lobbies+doctors+patients+help/4452643/story.html#ixzz1GoiC9B2m
Tuesday, March 15, 2011
Doctors 2.0 conference Paris 2011 - Speakers (includes Gilles Frydman/ACOR)
Speakers include:
Gilles Frydman is the head of ACOR, the Association of Cancer Online Resources, founded in 1995 in New York, and the largest online cancer patient community with 65 000 patients and caregivers. ACOR’s 159 electronic lists deliver approximately 1.5 million email messages weekly. The ACOR community has demonstrated its ability to accelerate the distribution of quality information regarding trials, treatments, pharmacovigilance.
Acta Oncologica - summary - Standardized FDG uptake as a prognostic variable and as a predictor of incomplete cytoreduction in primary advanced ovaria
Discussion. FDG uptake (SUVmax) in the primary tumor of patients with advanced ovarian cancer was not a prognostic variable and the FDG uptake did not predict complete cytoreduction after primary surgery. Future prospective clinical trials will need to clarify if other PET tracers can serve as prognostic variables in ovarian cancer.
Monday, March 14, 2011
Health Advocacy Organizations and the Pharmaceutical Industry: An Analysis of Disclosure Practices -- American Journal of Public Health selected articles
Note: this journal is by subscription ($$$)
AJPH First Look, published online ahead of print Jan 13, 2011
© 2011 American Public Health Association
DOI: 10.2105/AJPH.2010.300027
GOVERNMENT, POLITICS, AND LAW |
Sheila M. Rothman is with the Division of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, and the Center for the Study of Society and Medicine,
College of Physicians and Surgeons, Columbia University. Victoria H. Raveis is with the Psychosocial Unit on Health, Ageing, and Community, New York University College of Dentistry, New
York. At the time of the study Anne Friedman was with the Center on Medicine as a Profession, College of Physicians and Surgeons, Columbia University. David J. Rothman is with the College
of Physicians and Surgeons, Columbia University.
Correspondence: Correspondence should be sent to Sheila M. Rothman, Center for the Study of Society and Medicine, College of Physicians and Surgeons, Columbia University,
630 West 168th St, PH 15-25, New York, NY 10032 (e-mail: smr4@columbia.edu). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" button.
Health advocacy organizations (HAOs) are influential stakeholders in health policy. Although their advocacy tends to closely correspond with the pharmaceutical industry's
marketing aims, the financial relationships between HAOs and the pharmaceutical industry have rarely been analyzed.
We used Eli Lilly and Company's grant registry to examine its grant-giving policies. We also examined HAO Web sites to determine their grant-disclosure patterns.
Only 25% of HAOs that received Lilly grants acknowledged Lilly's contributions on their Web sites, and only 10% acknowledged Lilly as a grant event sponsor.
No HAO disclosed the exact amount of a Lilly grant.
As highly trusted organizations, HAOs should disclose all corporate grants, including the purpose and the amount. Absent this disclosure, legislators, regulators,
and the public cannot evaluate possible conflicts of interest or biases in HAO advocacy.
This article has been cited by other articles:
 | |  | |   M. Weinberg Patient Advocacy Organizations and Corporate Relationships Am J Public Health, April 1, 2011; 101(4): 582 - 583. [Full Text] [PDF] | |
eLetters:
Read all eLetters- Health Advocacy Organizations: Transparency is important and so is evidence
- Frances M Visco
- AJPH Online, 17 Jan 2011 [Full text]
- Patient Advocacy Organizations are Committed to Transparency
- Myrl Weinberg
- AJPH Online, 20 Jan 2011 [Full text]
- Re: Health Advocacy Organizations and the Pharmaceutical Industry: An Analysis
- Jack Harris, et al.
- AJPH Online, 24 Jan 2011 [Full text]
abstract: Patient Advocacy Organizations and Corporate Relationships -- Weinberg 101 (4): 582 -- American Journal of Public Health
April 2011, Vol 101, No. 4 | American Journal of Public Health 582-583
© 2011 American Public Health Association
DOI: 10.2105/AJPH.2011.300087
LETTERS |
Myrl Weinberg is president of the National Health Council, Washington, DC.
Correspondence: Correspondence should be sent to Myrl Weinberg, National Health Council, 1730 M Street, NW, Suite 500, Washington, DC 20036-4561 (e-mail: mweinberg@nhcouncil.org). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link.
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The NHC agrees with Rothman et al. about the need for transparency.1 For this reason, any patient advocacy organization that wishes to join or retain its membership in the NHC must disclose funding received from corporations and present the information in an easily accessible manner within 6 months of the close
(NCCN) Updated Ovarian Cancer Guidelines Offer a New Treatment Choice
Note: this refers to the Japanese study published 2010 of weekly Taxol - search blog for the original study and additional commentaries
March 14, 2011 — The updated 2011 National Comprehensive Cancer Network (NCCN) Ovarian Cancer Guidelines have added a new treatment option — dose-dense paclitaxel — for the first-line treatment of stage II, III, or IV epithelial ovarian cancer.
The category 1 recommendation comes from data from the Japanese Gynecologic Oncology Group, said panel chair Robert J. Morgan, MD, professor of medicine at the City of Hope Comprehensive Cancer Center in Duarte, California, here at the NCCN 16th Annual Conference.
In a phase 3 open-label randomized controlled trial published in the Lancet (2009; 374:1331-1338), Noriyuki Katsumata and colleagues reported that dose-dense paclitaxel once a week in combination with carboplatin every 3 weeks for advanced ovarian cancer resulted in a significant survival advantage. The study concluded that paclitaxel and carboplatin given every 3 weeks is standard treatment for advanced ovarian carcinoma.
"This was an important addition," Dr. Morgan told Medscape Medical News........"
PharmaLive: Topotarget Announces Updates on Belinostat in Two Clinical Trials - NSCLC and Ovarian Cancer (negative study ovarian/Belinostat/Carboplatin)
Ovarian cancer – GOG 0126-T (NCI-driven study)
Preliminary analysis of GOG 0126-T trial has not shown enough activity to enter into second stage. Consequently the study will be ended.
The study
The study is an open-label single-arm phase II trial with belinostat in combination with carboplatin given to patients with ovarian cancer who progress during or shortly after first-line treatment with platinum containing chemotherapy. The trial is sponsored by the GOG with support from the NCI. Belinostat is administered as a 30-minute daily IV infusion on day one through five with carboplatin being administered on day three. Treatment is given every third week and is repeated until disease progression......
Gastroenterology & Endoscopy News - Gastros Outperform Oncologists in Recognition of Inherited CRC (Lynch Syndrome/PJS/FAP....extracolonic tumors)
Note: access is free/requires registration
"......Overall, physicians benefited from the educational intervention, scoring significantly higher on exams about genetic testing for Lynch syndrome, FAP and Peutz-Jeghers syndrome post-test than at baseline. The education session also significantly improved physicians’ recognition of Lynch syndrome family pedigrees and surveillance of the disease, but did not effectively enhance awareness of extra-colonic manifestations.
Although the educational intervention improved the ability of physicians to identify families with multiple members affected by CRC, it did not help them spot extra-colonic cancers in families with Lynch syndrome. Identifying extra-colonic cancers is important because Lynch syndrome increases a person’s risk for endometrial cancer and is associated with cancers of the stomach (6%-9%); ovaries (6%-12%); and ureter and renal pelvis (3%-8%) (and others), according to the Colon Cancer Alliance for Research and Education for Lynch Syndrome...........cont'd
"Ms. (Kate) Murphy has survived ovarian and breast cancer as well as three episodes of colon cancer."
abstract: Revised Bethesda Guidelines: compliance in identifying HNPCC affected families (Lynch Syndrome)
Conclusion
Based on these results, there is a marked incompliance with revised Bethesda guidelines when assessing patients with colorectal cancer. This has a significant impact on clinical pathways for the management of HNPCC (Lynch Syndrome) families.
Sunday, March 13, 2011
ABC News - Japan Earthquake: before and after photos (google earth)
Sun Mar 13, 2011 3:00pm AEDT
Aerial photos taken over Japan have revealed the scale of devastation across dozens of suburbs and tens of thousands of homes and businesses.Hover over each satellite photo to view the devastation caused by the earthquake and tsunami.
abstract: Pregnancy after adolescent and adult cancer: A population-based matched cohort study
"In summary, fertility-preserving attempts have succeeded in patients with ovarian or testicular cancer and in males with Hodgkin lymphoma."
abstract: Ovarian cancer linked to lynch syndrome typically presents as early-onset, non-serous epithelial tumors (endometrioid/clear cell cell types) MSH2 MSH6 MLH1
Ovarian cancer linked to lynch syndrome typically presents as early-onset, non-serous epithelial tumors.
Abstract
OBJECTIVE: Heredity is a major cause of ovarian cancer and during recent years the contribution from germline mismatch repair (MMR) gene mutations linked to Lynch syndrome has gradually been recognized.METHODS: We characterized clinical features, tumor morphology and mismatch repair defects in all ovarian cancers identified in Swedish and Danish Lynch syndrome families.
RESULTS: In total, 63 epithelial ovarian cancers developed at mean 48 (range 30-79) years of age with 47% being early stage (FIGO stage I). Histologically, endometrioid (35%) and clear cell (17%) tumors were overrepresented. The underlying MMR gene mutations in these families affected MSH2 in 49%, MSH6 in 33% and MLH1 in 17%. Immunohistochemical loss of the corresponding MMR protein was demonstrated in 33/36 (92%) tumors analyzed.
CONCLUSION: The combined data from our cohorts demonstrate that ovarian cancer associated with Lynch syndrome typically presents at young age as early-stage, non-serous tumors, which implicates that a family history of colorectal and endometrial cancer should be specifically considered in such cases.
abstract: Development and Validation of 11 Symptom Indexes to Evaluate Response to Chemotherapy for Advanced Cancer
Abstract
Recent guidance from the FDA discusses patient-reported outcomes as end points in clinical trials. Using methods consistent with this guidance, the authors developed symptom indexes for patients with advanced cancer. Input on the most important symptoms was obtained from 533 patients recruited from NCCN Member Institutions and 4 nonprofit social service organizations. Diagnoses included bladder, brain, breast, colorectal, head and neck, hepatobiliary/pancreatic, kidney, lung, ovarian, and prostate cancers and lymphoma. Physician experts in each of these diseases were also surveyed to differentiate symptoms that were predominantly disease-based from those that were predominantly treatment-induced. Results are evaluated alongside previously published indexes for 9 of these 11 advanced cancers that were created based on expert provider surveys, also implemented at NCCN Member Institutions. Final results are 11 symptom indexes that reflect the highest priorities of people affected by these 11 advanced cancers and the experienced perspective of the people who provide their medical treatment. Beyond the clinical value of such indexes, they may also contribute significantly to satisfying regulatory requirements for a standardized tool to evaluate drug efficacy with respect to symptomatology.
Saturday, March 12, 2011
Penetrance (mutations) - Wikipedia, the free encyclopedia
Associated terminology
- complete penetrance. The allele is said to have complete penetrance if all individuals who have the disease-causing mutation have clinical symptoms of the disease.
- highly penetrant. If an allele is highly penetrant, then the trait it produces will almost always be apparent in an individual carrying the allele.
- incomplete penetrance or reduced penetrance. Penetrance is said to be reduced or incomplete when some individuals fail to express the trait, even though they carry the allele.
- low penetrance. An allele with low penetrance will only sometimes produce the symptom or trait with which it has been associated at a detectable level. In cases of low penetrance, it is difficult to distinguish environmental from genetic factors.
Thursday, March 10, 2011
News - Penn State Biochemistry and Molecular Biology Colorectal Cancer month/Lynch Syndrome excerpt
"Lynch syndrome, previously referred to as hereditary non-polyposis colorectal cancer or HNPCC, represents the most common hereditary cause of colorectal cancer.
Approximately 1 in 400 to 1 in 500 individuals in the general population are estimated to have Lynch syndrome.
Knowledge, as they say, in this condition, is power. Not only should individuals with Lynch syndrome start their colonoscopies earlier (at 20-25 years of age) and have them more frequently (every 1-2 years), they should also be screened for stomach and small intestine cancer, urinary tract cancers involving the kidneys and ureters, and the hepatobiliary tract, including the gallbladder, bile duct, pancreas and liver.
Further, women with Lynch syndrome should be aware of the increased risk for both endometrial and ovarian cancer and offered the option of prophylactic surgery following childbearing."
March 2011: Hereditary Cancer in Clinical Practice | Full text | Lynch Syndrome - is breast cancer a feature?
Background
The debate on whether or not breast cancer is in the tumor spectrum for Lynch syndrome produces a conundrum for healthcare providers.
The classic tumor spectrum for Lynch Syndrome (LS) includes colon, endometrial, ovarian, stomach, small intestine, hepatobiliary, urinary tract and brain/central nervous system cancers. Muir-Torre Syndrome (MTS) is a variant of LS that is associated with additional skin lesions including sebaceous gland tumors and keratoacanthomas. MTS was observed in 28% of LS families when assessing for MTS skin lesions [1]. It has also been reported that 10-14% of individuals with MTS present initially with breast cancer [2,3]. An extensive study published in 2002 excluded breast cancer as part of the tumor spectrum associated with LS [4].
However, more recently it was reported that DNA mismatch repair (MMR) gene deficiencies were identified in 51% of breast cancers arising in MMR mutation carriers [5]. Another study reported a male with an MLH1 mutation who had both colon and breast cancer. The breast cancer exhibited somatic reduction to homozygosity for the MLH1 mutation [6].
Here we report two unrelated families in which the proband has a germline MMR gene mutation and bilateral breast cancer, and one family in which the proband had ovarian and renal cancer and her daughter, maternal aunt and cousin had breast cancer at age 47, 59, and 48 respectively.
This raises the question are these breast cancers associated with the MMR mutations or a breast cancer susceptibility gene and what testing should be offered?
Conclusion
Our findings indicate that breast cancer is part of the spectrum of tumors in LS families in which the breast cancer segregates with the other LS associated tumors.Additional hereditary breast cancer gene testing may not be warranted in these circumstances. A future research goal is to perform IHC on the breast tumors from these families to determine if they show loss of expression of the MMR gene that is known to be altered.
....cont'd (full free access)
Doctor and Patient - When Doctors Make Mistakes - NYTimes.com
Note: forwarded from patient safety community, sad situation/s really
Number of U.S. Cancer Survivors Grows to Nearly 12 Million
Number of U.S. Cancer Survivors Grows to Nearly 12 Million
The number of cancer survivors in the United States increased from 3 million in 1971 to 11.7 million in 2007, according to a new study by CDC and the National Cancer Institute.
A cancer survivor is defined as anyone who has been diagnosed with cancer, from the time of diagnosis through the balance of his or her life. Cancer survivors largely consist of people who are 65 years of age or older and women. Many people with cancer live a long time after diagnosis; more than a million people were alive in 2007 after being diagnosed with cancer 25 years or more earlier.
Of the 11.7 million people living with cancer in 2007—
- 7 million were 65 years of age or older.
- 6.3 million were women.
- 4.7 million were diagnosed 10 years earlier or more.
- Breast cancer survivors (22%).
- Prostate cancer survivors (19%).
- Colorectal cancer survivors (10%).
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6009a1.htm
TABLE. Estimated number of living persons ever diagnosed with cancer, by age group and cancer type --- United States, January 1, 2007 | |||||||
|---|---|---|---|---|---|---|---|
Cancer type | Age group (yrs) | Overall | |||||
0--19 | 20--39 | 40--64 | 65--84 | ≥85 | No. | (%) | |
Ovary | 1,033 | 10,357 | 79,225 | 73,230 | 13,315 | 177,162 | (1.5) |
Wednesday, March 09, 2011
Linus Pauling Institute at Oregon State University (research institute vitamins/micronutriends/phytochemicals)
Researchers at the Linus Pauling Institute investigate the role that vitamins and essential minerals (micronutrients) and chemicals from plants (phytochemicals) play in human aging, immune function, and chronic diseases, especially heart disease, cancer, and neurodegenerative diseases. A major emphasis is to understand the role of oxidative stress and inflammation in disease etiology, and the preventive effects of dietary constituents with antioxidant or anti-inflammatory properties.
The goal of these studies is to understand the mechanisms by which diet, micronutrients, and dietary supplements affect disease initiation and progression and can be used in the prevention or treatment of human diseases, thereby enhancing lifespan and healthspan......cont'd
NIH/NCCAM
Center of Excellence
The Linus Pauling Institute is one of the nation's first two Centers of Excellence for Research on Complementary and Alternative Medicine designated by the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (NIH).
ELC : Imedex e-learning center March 8th, 2011 video (30 min) interviews from SGO
Note: requires password/registration to view videos (free), risk factors, hereditary, KRAS mutation/variant (in many other cancers as well), MiRnA, ICON7 (Avastin).....
Featured Activity:
Best of the Day: 2011 Society of Gynecologic Oncologists Annual Meeting on Women’s Cancer
Dr Bradley Monk interviews 6 nationally recognized experts in GYN oncology about their interpretations of clinically relevant data presented at the annual meeting. Drs Deborah Armstrong, Barbara Goff, Tom Herzog, Warner Huh, Robert Coleman, and Robert Burger comprise the esteemed faculty.
update on ovariancancerandus blog stats - just for fun
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2011 journal issues - current content listings Jan/March 2011 including supplement (SGO meeting)
Articles in Press | Volume 120 (2011) | |
| Volume 120, Issue 3 - selected pp. 317-492 (March 2011) Technologic Innovations and Novel Surgical Approaches for Patients with Gynecologic Malignancies | |
| Volume 120, Issue 2 pp. 165-316 (February 2011) | |
 | Volume 120, Issue 1 pp. 1-164 (January 2011) | |
| Volume 120, Supplement 1 pp. S1-S150 (March 2011) ABSTRACTS PRESENTED FOR THE 42ND ANNUAL MEETING OF THE SOCIETY OF GYNECOLOGIC ONCOLOGISTS, ABSTRACTS PRESENTED FOR THE 42ND ANNUAL MEETING OF THE SOCIETY OF GYNECOLOGIC ONCOLOGISTS | |
Journal Gynecologic Oncology, Volume 120, Supplement 1, Pages S1-S150 (March 2011) abstracts to be presented at 2011 annual SGO meeting
Note: this journal is by subscription ($$$) for full access, the actual abstracts via this indexed list are not available - titles of presentations only - abstracts either have been previously published or to come
Volume 120, Supplement 1, Pages S1-S150 (March 2011)
ABSTRACTS PRESENTED FOR THE 42ND ANNUAL MEETING OF THE SOCIETY OF GYNECOLOGIC ONCOLOGISTS
Orlando, FL USA
March 2011
financial news: Healthcare Stock on Watch; Vermillion (OVA1) climbs on Poster Presentation | Beacon Equity: Penny Stocks, Stock Alerts
Healthcare Stock on Watch; Vermillion climbs on Poster Presentation
Vermillion Inc. (NASDAQ: VRML) shares are up nearly 2.5% to $4.99 mid-day on word of the company’s poster presentation of its preliminary results from its collaboration with John Hopkins University School of Medicine to identify biomarkers that improve the identification of malignant ovarian tumors.
The poster evaluated more than 20 candidate biomarkers for their ability to complement the company’s CA125 in distinguishing benign ovarian tumors from malignant ones.
The poster evaluated more than 20 candidate biomarkers for their ability to complement the company’s CA125 in distinguishing benign ovarian tumors from malignant ones.
Medical News: Bevacizumab Value in Ovarian Cancer Questioned - in Clinical Context, Ovarian Cancer from MedPage Today
Note: the actual study including those related to Avastin/breast cancer were previously posted (on this blog) but this particular Medscape article may be easier to read.
Search blog (top left hand column or sidebar) via key word Avastin.
NCI Cancer Bulletin Mar 2011: Ovarian Cancer Study Raises Questions about Developing Markers for Early Detection
IMPORTANT/Blogger's Note: longterm ovarian cancer survivours and caregivers will recall the historical 'hype' on new early detection tests - caution advised and confirming this as per the NCI Bulletin below (LPA would be one example only)
"A long-awaited assessment of potential biomarkers for detecting early ovarian cancer shows that blood levels of the CA-125 protein remain the best predictor of the disease. But if there is to be any hope that screening will reduce deaths from this disease, then more accurate markers would have to be developed, researchers concluded in the March Cancer Prevention Research. (note: also see blog postings for related abstracts)
None of the 28 potential serum markers tested in the study outperformed CA-125. But for screening, the researchers noted, doctors would need a test that could detect a signal from tumors more than 6 months before diagnosis; CA-125 had its strongest signal within 6 months of diagnosis.
Although the results may seem disappointing, the findings can inform future efforts to detect the disease early, the study authors wrote. This idea was echoed by several biomarker experts who were not involved in the work but who stressed the importance of the findings......."cont'd
2011 March Cancer Prevention Research articles/references: Ovarian Cancer Biomarker Performance in Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial Specimens — Cancer Prev Res
Tuesday, March 08, 2011
SGO: MicroRNA May Help Predict Ovarian Ca Response - in Meeting Coverage, SGO from MedPage Today
"Changes in expression of a microRNA showed potential for predicting response to the angiogenesis inhibitor bevacizumab (Avastin) in recurrent serous ovarian cancer, according to results of a small study reported here..........."
worth reading - Medical News: SGO: PARP Inhibitor Active in Ovarian Cancer - in Meeting Coverage, SGO from MedPage Today
......"Antitumor activity was observed in heavily pretreated BRCA1 and BRCA2 mutation carriers, and preliminary antitumor activity was seen in patients with sporadic cancers," said Robert Wenham, MD, of the H. Lee Moffitt Cancer Center in Tampa, Fla...........During the initial dose-escalation phase, the patient population was enriched with BRCA1/2 mutation carriers. In the dose-expansion phase of the trial, investigators enrolled patients with sporadic platinum-resistant high-grade serous ovarian cancer......cont'd
Cancer Clinical Trial: Existential Issues in Elderly People With Cancer [Conditions: Cancer] (aged people with cancer)
Detailed Clinical Trial Description
Existential and spiritual issues in elderly people with cancer are scarcely investigated with respect to the content and importance of these aspects to this patient group in terms of living with their disease and benefit from specialist health treatment and care. The present study is an independent doctoral study that also has an initial function for an intended multidisciplinary research project with the working title "Aged people with cancer".
Arms, Groups and Cohorts in this Clinical Trial
: Cancer in elderly peopleData Points Publication Series - Series Overview | AHRQ Effective Health Care Program
Planned Data Points Publications:
Utilization of erythropoietin-stimulating agentsUtilization of anti-cancer biologic products
Utilization of anti-cancer biologic products by diagnosis
Medicare reimbursements by recurrent ICD-9 categories
abstract: Health-related quality of life and cancer clinical trials (University of British Columbia)
Note: consider values? whose?
".....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."
Review - EvidenceUpdates: Congestive heart failure risk in patients with breast cancer treated with bevacizumab/Avastin (including professional commentary)
Monday, March 07, 2011
(references SGO presentation) PCPs less likely to refer patients to gynecologic oncologists | HemOncToday
"..........Just 39.3% of family physicians and 51% of internists reported that they would refer the patient to the gynecologic oncologist. They were much more likely to refer their patients to obstetrician-gynecologists. Among obstetrician-gynecologists, however, two-thirds reported that they would refer a patient with abdominal pain and a suspicious ovarian mass to a gynecologic oncologist.........One-third of the obstetrician-gynecologists reported that they would operate on the patient themselves.........."
Goff B. #10. Presented at: the 42nd Annual Meeting of the Society of Gynecologic Oncologists; March 6-9, 2011, Orlando, Fla.
(OVA1) Vermillion Attends 42nd Annual Meeting of the SGO March 7, 2011 /PRNewswire/ --
Note: see press release for more details "OVA1 improves the sensitivity of the ACOG referral guidelines for an ovarian mass" "OVA1 Has High Sensitivity in Identifying Ovarian Malignancy Compared to Preoperative Assessment and CA125" | |||
abstract: JCO - Natural History of (Taxol) Paclitaxel-Associated Acute Pain Syndrome: Prospective Cohort Study NCCTG N08C1
Abstract
Purpose The characteristics and natural history of the
paclitaxel–acute pain syndrome (P-APS) and paclitaxel's
more chronic neuropathy have not been well delineated.
paclitaxel–acute pain syndrome (P-APS) and paclitaxel's
more chronic neuropathy have not been well delineated.
Methods Patients receiving weekly paclitaxel (70 to 90 mg/m2) completed daily questionnaires and weekly European
Organisation for Research and Treatment of Cancer (EORTC) Chemotherapy-Induced Peripheral Neuropathy (CIPN) –20
instruments during the entire course of therapy.
Organisation for Research and Treatment of Cancer (EORTC) Chemotherapy-Induced Peripheral Neuropathy (CIPN) –20
instruments during the entire course of therapy.
Results P-APS symptoms peaked 3 days after chemotherapy.
Twenty percent of patients had pain scores of 5 to 10 of 10 with
the first dose of paclitaxel. Sensory neuropathy symptoms wer
e more prominent than were motor or autonomic neuropathy
symptoms. Of the sensory neuropathy symptoms, numbness and
tingling were more prominent than was shooting or burning pain. Patients with higher P-APS pain scores with the first dose of
paclitaxel appeared to have more chronic neuropathy.
Twenty percent of patients had pain scores of 5 to 10 of 10 with
the first dose of paclitaxel. Sensory neuropathy symptoms wer
e more prominent than were motor or autonomic neuropathy
symptoms. Of the sensory neuropathy symptoms, numbness and
tingling were more prominent than was shooting or burning pain. Patients with higher P-APS pain scores with the first dose of
paclitaxel appeared to have more chronic neuropathy.
Conclusion These data support that the P-APS is related to nerve pathology as opposed to being arthralgias and/or myalgias.
Numbness and tingling are more prominent chronic neuropathic symptoms than is shooting or burning pain.
Numbness and tingling are more prominent chronic neuropathic symptoms than is shooting or burning pain.
define: arthralgias: Aches or pains in joints, without obvious
swelling, warmth, or redness.
vasculitis.med.jhu.edu/whatis/glossary.html
swelling, warmth, or redness.
vasculitis.med.jhu.edu/whatis/glossary.html
define: myalgias: pain in a muscle or group of muscles
wordnetweb.princeton.edu/perl/webwn
wordnetweb.princeton.edu/perl/webwn
abstract JCO: At What Cost Does a Potential Survival Advantage of Bevacizumab Make Sense for the Primary Treatment of Ovarian Cancer? A Cost-Effectiveness Analysis
Abstract
Purpose
To determine whether the addition of bevacizumab to paclitaxel and carboplatin for the primary treatment of advanced ovarian cancer can be cost effective.
Conclusion:
The addition of bevacizumab to standard chemotherapy in patients with advanced ovarian cancer is not cost effective. Treatment with maintenance bevacizumab leads to improved PFS but is associated with both direct and indirect costs. The cost effectiveness of bevacizumab in the adjuvant treatment of ovarian cancer is primarily dependent on drug costs.
JCO Editorial + abstract/podcast: Bevacizumab (Avastin) for Advanced Breast Cancer: All Tied Up With a RIBBON? (the Ribbon-1 trial)
- [PDF]
- [JCO Podcast]
- Breast Cancer RIBBON-1: Randomized, Double-Blind, Placebo-Controlled, Phase III Trial of Chemotherapy With or Without Bevacizumab for First-Line Treatment of Human Epidermal Growth Factor Receptor 2–Negative, Locally Recurrent or Metastatic Breast Cancer
- [Abstract]
- [JCO Podcast]
Ohio State study: Targeted ovarian cancer therapy not cost-effective (Bevacizumab/Avastin)
Note: read the whole article
------------------------------------------------------------------------------------
Ohio State study: Targeted ovarian cancer therapy not cost-effective
COLUMBUS, Ohio – An analysis conducted by Ohio State University cancer researchers has found that adding the targeted therapy bevacizumab to the treatment of patients with advanced ovarian cancer is not cost effective.
The findings comparing the relative value of various clinical strategies will be published online March 7 in the Journal of Clinical Oncology (see blog)................ cont'd
"Although a discussion regarding cost-effectiveness of a potentially life-extending intervention invariably suggests the rationing of limited health care resources, the intent of this study was to provide a framework with which to evaluate the pending results of a clinical trial of three different interventions for ovarian cancer, said Cohn."............... cont'd
Medical News: SGO: Ovarian Ca Patients Shortchanged by Medicare - in Meeting Coverage, SGO from MedPage Today
Action Points
- Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
- Explain that an analysis of NCI and Medicare databases found that less than 40% of patients over age 65 with advanced ovarian cancer received care that measures up to national standards.
- Note that this study found demographic factors -- including race, marital status, geographic location, and socioeconomic status -- affected whether patients over 65 received optimal treatment.
Sunday, March 06, 2011
still recruiting: Quality of Life Associated With a Low-Risk Screening Program for Ovarian Cancer - Full Text View - ClinicalTrials.gov
Purpose
The goal of this research study is to learn more about how women feel about an ovarian cancer screening program that involves getting a blood test to measure CA 125 levels. This includes finding out about women's quality of life and whether they are concerned or worried about their risk of developing cancer. This study also seeks to find out whether elevated CA 125 levels affect participants in terms of cancer worries or concerns.
Therapeutic Targeting of Stress Factors in Ovarian Cancer Patients - Full Text View - ClinicalTrials.gov
Note Exclusion criteria:
Exclusion Criteria: a. Patients who receive neoadjuvant chemotherapy for their ovarian, primary peritoneal, or fallopian tube cancer are excluded....
Purpose
This research is looking at the effect of biobehavioral factors such as stress and whether these factors alter how the body responds to chemotherapy, one of the purposes of this study is to determine if the addition of a beta-blocker such as Propranolol (Inderal) is tolerable when given with chemotherapy in the treatment of newly diagnosed ovarian, fallopian tube, or primary peritoneal cancer. An additional purpose of the study is to understand if behavioral factors such as depression and anxiety can alter different blood markers that affect tumor vascularity. The Investigator wishes to determine whether the use of beta-blocker drugs such as Inderal, might alter these behavioral factors by drawing blood prior to and after the administration of Inderal as well as giving behavioral questionaires at different time points. Beta-blockers are commonly used for the treatment of hypertension, protection of the heart after a heart attack, and irregularities in heartbeats. Altering these factors might boost the immune system and affect other areas of cancer biology, thereby allowing the chemotherapy to be more effective. The significance of this research is that it may help improve our treatments of this disease in the future.
10-year analysis of the ATAC trial: wrong conclusion? : The Lancet Oncology
"The 10-year analysis of the Arimidex, Tamoxifen, Alone or in Combination (ATAC) trial1 continues to show a difference in its primary endpoint of disease-free survival, which favours anastrozole as adjuvant treatment for postmenopausal women with hormone-responsive breast cancer. Ultimately, however, clinical trials have two aims: either to show improvement in survival, or in its quality.
Anastrozole has failed to meet these criteria when compared with tamoxifen."
Incidence and mortality in epithelial ovarian cancer by family history of any cancer - 2011
define: sororal
Of or pertaining to a sister; Related through someone's sister
Abstract
BACKGROUND:
Practically all data on familial risk in ovarian and other cancers are based on incident cancer, whereas familiality in cancer mortality is largely unknown. If fatal forms of cancer are a highly familial subtype, then familial risk for mortality may exceed that of incidence, which is relevant for clinical decision making and counseling.
METHODS:
Ovarian cancer patients in the nationwide Swedish Family Cancer Database were classified according to fatal and nonfatal (incident) family history. Familial risks for incident and fatal ovarian cancer were calculated for offspring based on their parental or sibling family history of any cancer using standardized incidence ratios (SIRs) for incidence and standardized mortality ratios (SMRs) for mortality. Offspring without family history were referents.
RESULTS:
The database included 24,757 mothers and 8138 daughters with ovarian cancer. When a mother had ovarian cancer, the SIR for incident ovarian cancer in daughters was 2.69, and when a sister had ovarian cancer it was 3.49. The SMRs for fatal cancer by fatal cancer in probands were 3.39 and 5.80, respectively. For fatal serous cancers among siblings, the SMR was 6.16, compared with 10.01 for the endometrioid type. Ovarian cancer was associated with maternal (SIR, 1.22; SMR, 1.56) and sororal breast cancer (SIR, 1.27). Another discordant association was between ovarian and paternal prostate cancer (SIR, 1.12; SMR, 1.66).
CONCLUSIONS:
Fatal familial risks were higher for concordant ovarian, ovarian-breast, and ovarian-prostate cancers than the corresponding incident risks. This may suggest that highly fatal subtypes exist for these cancers, calling for genetic dissection. Cancer 2011
Postmenopausal hormone use and incident ovarian cancer: Associations differ by regimen- Intl Journal of Cancer
"......Neither current nor former E + P use was associated with ovarian cancer risk (RR 1.08, 95% CI 0.86–1.35; RR 1.08, 95% CI 0.68–1.71, respectively, per 5-year increment). These findings suggest that progestins may mitigate some of the detrimental effects of estrogen on the ovarian epithelium."
Timing of administration of bevacizumab (Avastin) chemotherapy affects wound healing after chest wall port placement - Cancer
Definition: dehiscence - Separation of wound edges.
Abstract
BACKGROUND:
The authors investigated how the timing of administration of bevacizumab, a targeted vascular endothelial growth factor-inhibiting chemotherapeutic agent, affected the risk of wound healing in patients undergoing chest wall port placement.
CONCLUSIONS:
The risk of a wound dehiscence requiring chest wall port explant in patients treated with bevacizumab was inversely proportional to the interval between bevacizumab administration and port placement, with significantly higher risk seen when the interval is less than 14 days.
March 2011 (Cancer) The use of recombinant erythropoietin for the treatment of chemotherapy-induced anemia in patients with ovarian cancer does not affect progression-free or overall survival
Abstract
BACKGROUND.
Studies have suggested that erythropoietin-stimulating agents (ESAs) may affect progression-free survival (PFS) and overall survival (OS) in a variety of cancer types. Because this finding had not been explored previously in ovarian or primary peritoneal carcinoma, the authors of this report analyzed their ovarian cancer population to determine whether ESA treatment for chemotherapy-induced anemia affected PFS or OS.
CONCLUSIONS.
The current results indicated that there was no difference in cancer-related PFS or OS with use of ESA in this cohort of women treated for ovarian cancer.
Saturday, March 05, 2011
Paper: Analysis of Quality of Life in Cancer Patients by Structural Equation Model (technical)
Note: see Table 1 for criteria/index of variables
Expression Compilation of Several Putative Cancer Stem Cell Markers by Primary Ovarian Carcinoma Open Access
Note: see Table 1 for cell types/stage included in study
".......None of the stem cell markers was expressed by all patients’ cells. No correlation with tumor type was demonstrated. The complexity of expression challenges the isolation of cancer stem cell."
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