Tuesday, March 22, 2011

abstract: Genital powder exposure and the risk of epithelial ovarian cancer Cancer Causes and Control, Online First™

Conclusions

The International Agency for Research on Cancer has designated perineal exposure to talc (via the application of genital powders) as a possible carcinogen in women. A modest association of ovarian cancer with this exposure was seen in our study and in some previous ones, but that association generally has not been consistent within or among studies. Therefore, no stronger adjective than “possible” appears warranted at this time.

Monday, March 21, 2011

blog re: NCCN conference - The Coach And The Critic: Stories Of Caregivers Where "Kill Me" Is Not An Option

The Coach And The Critic: Stories Of Caregivers Where "Kill Me" Is Not An Option

What Patients Value When Oncologists Give News of Cancer Recurrence: Commentary on Specific Moments in Audio-Recorded Conversations -- Back et al. 16 (3): 342 -- The Oncologist CME Online

fig 1

Note: full access after registration (free), study design used 'standardized' patients

Definitions of standardized patient:
A simulated patient or standardized patient (SP) (also known as a patient instructor), in health care, is an individual who is trained to act as a real patient in order to simulate a set of symptoms or problems. ...
en.wikipedia.org/wiki/Standardized_patient

Gastroenterology & Endoscopy News - Is Colonoscopy the Optimal Method for Colorectal Cancer Screening? (no specific mention of Lynch Syndrome

Note: no mention of Lynch Syndrome (biology/genetics), full free access with registration (free)

full free access: Research output on primary care in Australia, Canada, Germany, the Netherlands, the United Kingdom, and the United States: bibliometric analysis - bmj.com

What is already known on this topic

The UK Research Assessment Exercise in 2008 rated 50% of UK primary care research as world class or internationally excellent, but no direct international comparisons exist

What this study adds

In six countries with strong primary care, the United Kingdom and the Netherlands produce the most cited primary care led primary care research
Identifying research on primary care that is carried out by primary care researchers is difficult using routine bibliometric methods
Only 29% of research papers on primary care had at least one primary care researcher as author

Guest post: Absolute risk not as straightforward as you might think - Gary Schwitzer's HealthNewsReview Blog

"...As a Cochrane review pointed out this week (Persuasive health information could be misleading) (note - this link forwards to a Reuters story) relative risks are very persuasive, but they don't always serve your best interests when making health decisions....:

press release/abstract: Marshall Edwards Announces Publication of Phase II Clinical Trial Results - Phenoxodiol phase 11 ovarian cancer trial results (32 pts)

SAN DIEGO, March 21, 2011 /PRNewswire/ -- Marshall Edwards, Inc.(Nasdaq: MSHL), an oncology company focused on the clinical development of novel therapeutics targeting cancer metabolism, announced today the publication of results from a Phase II clinical trial of intravenous Phenoxodiol in combination with cisplatin in women with platinum-resistant ovarian cancer. The publication is now available on the International Journal of Gynecological Cancer website and scheduled to print in the May issue of the journal......

abstract: Int J Gynecol Cancer. 2011 Mar 15. [Epub ahead of print]

Phase II Evaluation of Phenoxodiol in Combination With Cisplatin or Paclitaxel in Women With Platinum/Taxane-Refractory/Resistant Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancers.

Clinical Cancer Research Programs Merge To Accelerate Research

The American College of Radiology's Imaging Network (ACRIN) and the Eastern Cooperative Oncology Group (ECOG), National Cancer Institute (NCI) Clinical Trials Cooperative Group members, have announced their intent to merge their clinical cancer research programs.

The groups plan to form an alliance that combines their complementary strengths. The new organization will include three areas of research emphasis: early detection and diagnosis of cancer; biomarker-driven Phase II and Phase III therapeutic studies for multiple cancer types and stages; and genetic, molecular and imaging marker research to predict and monitor treatment response........cont'd

full free access: jan 2011 Cancer and Work - A Canadian Perspective Canadian Association of Psychosocial Oncology

Limited free speech for docs | Columnists | Comment | Calgary Sun

Comments

Sandi Pniauskas
March 20th 2011, 10:16pm

"I see no mention of the Institute for Patient Safety and their role in these issues. Aside from selected physicians (the few) who choose to speak up publicly, it's rather a continuing sad situation in Canada. For those who do speak up, healthcare professionals, patients and the public, we seem to ostracize those individuals who have the tenacity to persevere in truth telling and simply trying to do the best possible under often terrible circumstances. More so, where is the peer process in this aside from political fence sitting. There is definitely a need for both federal and provincial ombudsman positions 'with teeth'- to correct these ongoing errors of judgment."

Sunday, March 20, 2011

CureToday.com: Spring 2011 Article - "Breaking Out of the Silence"

Genetics of Breast and Ovarian Cancer (PDQ®) - NCI - rare syndrome (LFS, Cowden, PJS)

Other Rare Breast and Ovarian Cancer-Associated Syndromes
Li-Fraumeni syndrome
Cowden syndrome
Peutz-Jeghers syndrome

NIH Video Casting Event Summary - Li-Fraumeni Syndrome (LFS) Workshop - 2010 scientists/physicians/families

video meeting/serves as a starting point for the creation of a LFS research consortium.

Author: NIH Office of Rare Disease and the National Cancer Institute
Runtime: 05:31:06
Download: Download Video
How to download a Videocast
CIT File ID: 16253
CIT Live ID: 9741
Permanent link: http://videocast.nih.gov/launch.asp?16253

Commentary MJA Insight: Henry Woo: Abuse of self-pay patient system widespread (ethics)

Note: sound familiar?
(to view subscribe(free)

"....Sadly, the abuse of the self-pay system is widespread in the NSW public hospital system. We may be aware that it is happening, but nothing will change unless patients complain, and this is hardly likely.

Surgeons who aren’t happy with this arrangement appear unwilling to come forward in fear of political retribution, professional isolation and stymied career progression.

If we were to abolish self-pay, would we risk throwing the baby out with the bathwater? We have to balance the risks to our professional standing, our inability to regulate this behaviour and the financial risks to those who can least afford it against the risk of removing patient choice.

I would like to see this practice abolished, but if we cannot speak out about this when it involves unethical behaviour, the balance is heavily tilted against ever eradicating the self-pay system in our public hospitals."

Validation of the Histologic Grading for Ovarian Clear Cell Adenocarcinoma: A Retrospective Multi-institutional Study by the Japan Clear Cell Carcinoma Study Group

Abstract
"Pathologic slides from 150 patients with clear cell adenocarcinoma from the collaborating institutions were reviewed independently by 2 pathologists, and each tumor was graded histologically using the Shimizu-Silverberg and International Federation of Gynecology and Obstetrics (FIGO) grading systems...................... These results suggest that the 2 tested grading systems have limited value for the prognostication of patients with clear cell adenocarcinoma, and that a more effective grading system for this tumor may be required."

Physicians as guardians of genetic knowledge : The Lancet

Intll Jnl of Oncology: Ganoderma lucidum (herbal mushrooms) exerts anti-tumor effects on ovarian cancer cells and enhances their sensitivity to cisplatin (York University Toronto)

"Ganoderma lucidum is a herbal mushroom known to have many health benefits, including the inhibition of tumor cell growth. However, the effect of Ganoderma lucidum on epithelial ovarian cancer (EOC), the most fatal gynecological malignancy, has not yet been reported...................... Taken together, these findings suggest that Ganoderma lucidum exerts multiple anti-tumor effects on ovarian cancer cells and can enhance the sensitivity of EOC cells to cisplatin."

abstract: Genomic Analysis Reveals the Molecular Heterogeneity of Ovarian Clear Cell Carcinomas

CONCLUSIONS:
OCCCs constitute a heterogeneous disease at the genomic level despite having similar histological features. The pattern of genomic aberrations in subgroups of OCCCs is of clinical significance.

abstract: Mutation and Loss of Expression of ARID1A in Uterine Low-grade Endometrioid Carcinoma

Abstract:

ARID1A is a recently identified tumor suppressor gene that is mutated in approximately 50% of ovarian clear cell and 30% of ovarian endometrioid carcinomas. The mutation is associated with loss of protein expression as assessed by immunohistochemistry.

In this study, we evaluated ARID1A immunoreactivity in a wide variety of carcinomas to determine the prevalence of ARID1A inactivation in carcinomas. Mutational analysis of ARID1A was carried out in selected cases. Immunoreactivity was not detected (corresponding to inactivation or mutation of ARID1A) in 36 (3.6%) of 995 tumors.

Uterine low-grade endometrioid carcinomas showed a relatively high-frequency loss of ARID1A expression, as 15 (26%) of 58 cases were negative. The other tumor that had a relatively high-frequency loss of ARID1A expression was gastric carcinoma (11%). Mutational analysis showed 10 (40%) of 25 uterine endometrioid carcinomas; none of 12 uterine serous carcinomas and none of 56 ovarian serous and mucinous carcinomas harbored somatic ARID1A mutations. All mutations in endometrioid carcinomas were nonsense or insertion/deletion mutations, and tumors with ARID1A mutations showed complete loss or clonal loss of ARID1A expression.

In conclusion, this study is the first large-scale analysis of a wide variety of carcinomas showing that uterine low-grade endometrioid carcinoma is the predominant tumor type harboring ARID1A mutations and frequent loss of ARID1A expression. These findings suggest that the molecular pathogenesis of low-grade uterine endometrioid carcinoma is similar to that of ovarian low-grade endometrioid and clear cell carcinoma, tumors that have previously been shown to have a high-frequency loss of expression and mutation of ARID1A.

Saturday, March 19, 2011

Medical News: SGO: Mutation Link to Ovarian Cancer Disputed - in Meeting Coverage, SGO from MedPage (KRAS mutation)

Genomic Health Says Gene Test Alters Breast Cancer Therapy - Businessweek (21 gene test)

Ovarian cancer patient ‘failed by consultant’ (The Bolton News) - case of misconduct

Blogger's note: odd that the story didn't mention how the patient is doing ??

"....The panel heard that at a later consultation, the progress of the condition was again not identified and acted on, with poor notes made.
A specialist was not consulted and clinical standards of care were not met...."

abstract: Informed consent to microsatellite instability and immunohistochemistry screening for Lynch syndrome (ethics/informed consent)

From the 1Department of Bioethics, Cleveland Clinic; 2Genomic Medicine Institute Lerner College of Medicine, Cleveland Clinic; and 3Center for Genomic Research Ethics & Law, Case Western Reserve University, Cleveland, Ohio.

Abstract

OBJECTIVE: Routine microsatellite instability (MSI) and immunohistochemistry (IHC) screening of colorectal cancers can assist in identifying a significant proportion of cancers attributable to Lynch syndrome. This article considers whether it is necessary to obtain patient informed consent for microsatellite instability and immunohistochemistry screening.

RESULTS: Although microsatellite instability screening examines genetic features of a tumor, it lacks several important characteristics that typically mandate formal informed consent to genetic testing. Microsatellite instability screening describes discrete tissue samples and does not provide information about the rest of the patient's body or germline. In contrast, immunohistochemistry screening is a proteomic test that may reveal information about the patient's germline. As such, immunohistochemistry screening can be viewed as similar to other forms of genetic testing, in which explicit patient consent is regarded as an ethical prerequisite.

CONCLUSION: There is no ethical requirement to obtain explicit informed consent for microsatellite instability screening of colorectal tumor samples for Lynch syndrome. There is support for obtaining patient consent to immunohistochemistry testing, given its similarities with other genetic analyses for which informed consent is typically deemed necessary. Regardless of which screening test is used, it is important to prepare patients and their families for the possibility of a positive screening test.

Mar 15th, 2011 - free full access - A National Registry for Healthy Volunteers in Phase 1 Clinical Trials - — JAMA

Nevada news: Nevada Cancer Institute Expands with New Oncologists (gynecologic oncologist)

Friday, March 18, 2011

March 11/2011 Dr Maurie Markman: Prophylactic Oophorectomy and BRCA1/2 Mutations

Note: full free access/requires registration

excerpt:

"Short- and Long-Term Effects of Surgical Menopause

Second, the performance of a bilateral oophorectomy in a premenopausal woman, so-called "surgical menopause," can result in very distressing menopausal symptoms, such as hot flashes, depression, sleep disturbances, vaginal dryness, painful intercourse, etc.^[7] It is important to acknowledge that these symptoms are often described as being substantially worse than those experienced following natural menopause. The impact of these symptoms on an individual woman's overall quality-of-life should not be underestimated.
Again, the point of noting this concern is not to deny the utility of this surgery in women with a substantial risk of developing ovarian cancer. Rather, it is to be certain that this issue is discussed with the individual woman prior to the performance of the procedure. In this way, she can include this information in her decision-making process....."

OCATS AGM Meeting Regina, Sask - Ovarian Cancer Awareness & Treatment in Saskatchewan (OCATS)

Time	Saturday, March 19 · 12:00pm - 2:00pm

OCATS AGM with Judy Wright, Guest Speaker

Darlene Gray invited you · Share · Public Event



Location	Knox Met United Church, Room 105 2340 Victoria Avenue Regina

Created By	Ovarian Cancer Awareness & Treatment in Saskatchewan (OCATS), Darlene Gray

More Info	Election of Board Members Presentation of financial Statement for 2010 Vote on Change to Bylaws/ARticles/Constitution (one) Guest Speaker: Gifted Counsellor Judy Wright, Judy will share with us a new endeavor of hers, working with clients and horses to help people overcome barriers and physical and emotional pain. Light Lunch by Donation Memberships can be renewed at the door. If you are a paid member, you can vote by proxy, email darlenegray@sasktel.net

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

Main page of website: HealthNewsReview.org | Independent Expert Reviews of News Stories | Holding Health and Medical Journalism Accountable

Tuesday, March 15, 2011

Faulty Gene Helps Tumors Dodge Drugs (MCL1 and FBW7)

NIH Research Matters is on Facebook
www.facebook.com/ResearchMatters,

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.

media: Help patients live while they are dying - "It's the right thing to do" (palliative care)

no abstract: Bilateral macular ischemia and severe visual loss following trastuzumab (Herceptin) therapy

Acta Oncologica - Summary - Magnetic resonance imaging of tumor necrosis

Acta Oncologica - summary - Standardized FDG uptake as a prognostic variable and as a predictor of incomplete cytoreduction in primary advanced ovaria

Discussion. FDG uptake (SUV_max) 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

April 2011, Vol 101, No. 4 | American Journal of Public Health 602-609
© 2011 American Public Health Association
DOI: 10.2105/AJPH.2010.300027

GOVERNMENT, POLITICS, AND LAW

Health Advocacy Organizations and the Pharmaceutical Industry: An Analysis of Disclosure Practices
Sheila M. Rothman, PhD, Victoria H. Raveis, PhD, Anne Friedman, BA and David J. Rothman, PhD
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 stakeholdersin health policy. Although their advocacy tends to closely correspondwith the pharmaceutical industry's
marketing aims, the financialrelationships between HAOs and the pharmaceutical industry haverarely been analyzed.
We used Eli Lilly and Company's grant registry to examine itsgrant-giving policies. We also examined HAO Web sites to determinetheir grant-disclosure patterns.

Only 25% of HAOs that receivedLilly grants acknowledged Lilly's contributions on their Websites, 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 corporategrants, including the purpose and the amount. Absent this disclosure,legislators, regulators,

and the public cannot evaluate possibleconflicts 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

Patient Advocacy Organizations and Corporate Relationships
Myrl Weinberg, MA
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.

Because this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

Since its creation in 1920, the National Health Council (NHC)has been dedicated to the values of integrity, transparency,and honesty. It is crucial that the patients we represent, thepublic, and the policy makers receive accurate information abouthow patient advocacy organizations conduct their relationshipswith corporate America.
The NHC agrees with Rothman et al. about the need for transparency.¹ For this reason, any patient advocacy organization that wishesto join or retain its membership in the NHC must disclose fundingreceived from corporations and present the information in aneasily accessible manner within 6 months of the close . . . [Full Text]

eCancer video: (Avastin) Bevacizumab and Ovarian Cancer: Results of ICON7 - interview Prof. Timothy J. Perren, MD discusses sgo presentation

(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......

(PreOvar test) Mira Dx™ Dismisses Flawed Study as “Puzzling,” and “Comparing Apples and Oranges” | Business Wire (refers to sgo presentation/KRAS mutation variant....)

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: BRCA1/2 status and clinicopathologic characteristics of patients with double primary breast and ovarian cancer (Slovenia)

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

Bevacizumab Doubles Risk of GI Adverse Events in Key Ovarian Cancer Trial : Internal Medicine News SGO/Dr Burger/O'Malley

Visual (slides): Ovarian Cancer Pictures: Cysts, Symptoms, Tests, Stages, Treatments and Risks

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

Subscribe to: Posts ( Atom )

Note: this journal is subscription based ($$$); most (free) abstracts are of limited value -------------------------------------------------------------------------- Surgical Clinics of North America
Volume 91, Issue 2, Pages 277-466 (April 2011)

Update on Surgical Palliative Care
Edited by Geoffrey P. Dunn



	page xi Full-Text PDF (21 KB)
	Foreword: Update on Surgical Palliative Care Ronald F. Martin pages xiii-xv Full Text \| Full-Text PDF (56 KB)
	Preface: Update on Surgical Palliative Care Geoffrey P. Dunn pages xvii-xviii Full Text \| Full-Text PDF (54 KB)
	Dedication Geoffrey P. Dunn page xix Full Text \| Full-Text PDF (23 KB)
	Surgical Palliative Care: Recent Trends and Developments Geoffrey P. Dunn pages 277-292 Abstract \| Full Text \| Full-Text PDF (119 KB)
	Are Surgeons Capable of Introspection? David W. Page pages 293-304 Abstract \| Full Text \| Full-Text PDF (92 KB)
	Spiritual Dimensions of Surgical Palliative Care Margaret J. Tarpley, John L. Tarpley pages 305-315 Abstract \| Full Text \| Full-Text PDF (95 KB)
	Inpatient Palliative Care Consultation: Enhancing Quality of Care for Surgical Patients by Collaboration Michael D. Adolph pages 317-324 Abstract \| Full Text \| Full-Text PDF (75 KB)
	Palliative Medicine in the Surgical Intensive Care Unit and Trauma Christine C. Toevs pages 325-331 Abstract \| Full Text \| Full-Text PDF (61 KB)
	Care of the Family in the Surgical Intensive Care Unit Leslie Steele Tyrie, Anne Charlotte Mosenthal pages 333-342 Abstract \| Full Text \| Full-Text PDF (82 KB)
	Palliative Surgical Oncology Nader N. Hanna, Emily Bellavance, Timothy Keay pages 343-353 Abstract \| Full Text \| Full-Text PDF (89 KB)
	Communication Skills in Palliative Surgery: Skill and Effort Are Key Thomas J. Miner pages 355-366 Abstract \| Full Text \| Full-Text PDF (362 KB)
	Image-Guided Palliative Care Procedures Jay Requarth pages 367-402 Abstract \| Full Text \| Full-Text PDF (1581 KB)
	Palliative Care in Lung Cancer Betty Ferrell, Marianna Koczywas, Fred Grannis, Annie Harrington pages 403-417 Abstract \| Full Text \| Full-Text PDF (428 KB)
	Palliative Care and Pediatric Surgery Julia Shelton, Gretchen Purcell Jackson pages 419-428 Abstract \| Full Text \| Full-Text PDF (170 KB)
	Palliative Care in Urology Jennifer N. Wu, Frederick J. Meyers, Christopher P. Evans pages 429-444 Abstract \| Full Text \| Full-Text PDF (561 KB)
	Surgical Palliative Care in Haiti Joan L. Huffman pages 445-457 Abstract \| Full Text \| Full-Text PDF (103 KB)
	Index pages 459-465 Full-Text PDF (45 KB)

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Tuesday, March 22, 2011

Conclusions

Monday, March 21, 2011

What is already known on this topic

What this study adds

Phase II Evaluation of Phenoxodiol in Combination With Cisplatin or Paclitaxel in Women With Platinum/Taxane-Refractory/Resistant Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancers.

Sunday, March 20, 2011

Saturday, March 19, 2011

Abstract

Friday, March 18, 2011

excerpt:

"Short- and Long-Term Effects of Surgical Menopause

OCATS AGM with Judy Wright, Guest Speaker

Thursday, March 17, 2011

WHO warns against self-medicating against radiation

Objective

Conclusion

Research Highlights

Abstract

Objective

Conclusions

Research Highlights

Research Highlights

Research Highlights

Research Highlights

Wednesday, March 16, 2011

Tuesday, March 15, 2011

Monday, March 14, 2011

GOVERNMENT, POLITICS, AND LAW

eLetters:

LETTERS

Sunday, March 13, 2011

Ovarian cancer linked to lynch syndrome typically presents as early-onset, non-serous epithelial tumors.

Abstract

Abstract

Saturday, March 12, 2011

Associated terminology

Thursday, March 10, 2011

Conclusion

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SURVIVORS' DEBATE: The Past Decade in Ovarian Cancer

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