original (unsanitized/unpublished version)

Survivors’ Debate: The Past Decade in Ovarian Cancer

Tuesday, September 04, 2007

Authored by: Sandi Pniauskas

                      Carolyn Benivegna

                      Tracy Gorden

http://ovariancancerdebate.blogspot.com/

Where have we been and where are we going? Ovarian Cancer is not a new disease and in fact has been traced back to Egyptian times. The efforts of research, education, awareness, and access to care have gained some momentum, but they have taken a predictable path and hit many a roadblock for several reasons. With the benefits of international grassroots level survivorship amongst us, we consistently discuss where this disease has been and where it is going. Therefore, we feel it is time for open public discussion about this disease and the importance, including those of genetic predispositions - men and women. So, the question is simply this: as survivors, how can we move these behind-the-scenes discussions to open forums?

While preparing research for inclusion in a presentation concerning cancer patients’ voices in healthcare, Sandi Pniauskas took special notice of a paper published by an expert panel that included the statement, "Patients or their representatives should not attend the MCC to ensure unbiased case review." (Multidisciplinary Cancer Conference report dated June 2006 ^1.)  While it would be inexcusable to take this singular quote as the ‘rule du jour’, this philosophy and others similar to it are prevalent themes in both private perception and in published literature. We can be thankful for more enlightened views such as those published in the journal of Health and Social Policy, Buffalo, New York ³ that state:  “The activists' efforts wrested control of “authoritative knowledge” that had once been the sole domain of the “experts” with advanced medical training. They used this knowledge to empower “average” people with medical information…to promote self help and engage in civil disobedience, which led to changes in healthcare delivery.”

Fancy words, but what does this mean to you and me?  At first glance, it seems these statements are being critical of the importance and of the relationships that cancer patients, their families, and friends have with respect to the care they receive from their healthcare professionals. Nothing is further from the truth, in fact. It is simply that by being informed and proactive, women with ovarian cancer along with their families and caregivers have recognized the value and importance of conducting their own critical analysis.  Most importantly, it shifts the focus onto the human elements and burdens of suffering that we experience each day in our communities.  We have learned much over the years.  Average, everyday citizens are taking active roles in their treatments and educating themselves about this disease.  In our view, and through the course of bringing light to this disease and those living with it, it has become obvious that there are no “average” ovarian cancer women. “Average”, in fact, is only a temporary state.

As those living with this disease, we dream of what the future holds in terms of early detection, education, research, treatment, and a cure. When you have a dream - and in the face of typical power barriers - what then? The answer is that you change tactics to whatever means necessary to fulfill that dream.

 

This dream has evolved in the form of two ovarian cancer conferences:  one in Novi, Michigan and another in Toronto, Canada entitled “Survivors’ Debate: the Past Decade in Ovarian Cancer” ^2. It is an effort by proactive and knowledgeable ovarian cancer survivors, coupled with supporting oncology nurses. It is with the understanding, that the conferences are fully inclusive, but the focus is cancer patients and survivors, their families and friends. There are two locations in two countries because our issues are the same: access to care, awareness, early detection, survival rates and genetics. The directive and focus is to offer a place to exchange of ideas honestly and openly without judgment or bias.

Patients need an environment where they feel encouraged to discuss the many difficulties they face. Sometimes, it is very difficult to find that place - a place without fear of retribution, criticism, or dismissive attitudes. Patient-to-patient discussion/counseling offers this environment. It allows for discussion of such topics as things that work and things that do not. As a result of looking for this arena of discussion, the Survivors’ Debate has been born - how exciting! Healthcare settings just do not currently lend themselves to the dialogue that is needed. Albeit, we would all hope to appreciate and accept this unmet need. In fact, these forums already exist extensively, but not typically in a public and open format.

Our truth is simple, but for some, the message is difficult. The message has not and is not being heard, so what does this say about the past decade in ovarian cancer? It says that the past has been about consensus building and what does or does not work for us. Today, and for the future, it is about patients speaking for themselves and not by themselves. It is not about ‘empowering’ patients, but it is about personal permission to obtain that power. It is about giving recognition to the power, the intellect and the abilities of the individual. It is with a focus on creating a public force to expedite change, all which starts with communication. It is always interesting to note that through years of survivourship in our own networks, a lack of effective communication has never existed. While women with ovarian cancer and their families are doing the best that they can to survive, a plethora of funds is being recirculated each day, so how can we move forward?    

Our ovarian cancer survivor connections and bonds have formed through the years by enduring extreme challenges and personal losses. The only bias is the bias to endure and to survive to the best of our abilities, not only as individuals but importantly also as a community. To be very blunt, this includes much silent suffering. The fulfillment of this dream is now taking place - the dream of our patients’ voices in healthcare and in a public forum is coming to fruition. We are on the cusp of being able to highlight our international ovarian cancer community with its 8 and 9 years survivorship and explain why it works. We are going to be able to explore the variety of reasons why what is needed does not get translated into caregiving. It should in fact, show those problems are healthcare system malfunctions as opposed to, in our view, system issues. It is long past due that we take our real issues into a public forum and we encourage everyone to participate. We plan to make some long overdue noise at these debates about ovarian cancer, and we envision that these two scheduled events are only the beginning of a completely new trend in ovarian cancer activism.

 

We have encouraged participation and inclusion of all. The authors of this article think back to the play ‘Wit’ and how medical professionals, in some cases, felt ostracized by the message of that particular art form. We hope, in hindsight, that we have, by today, learned the lesson that ‘Wit’ was about the patient journey as a whole and its shortcomings from both patient and professional perspectives.

At the time of this publication, very little funding support for these conferences has been available. Virtually all of the funding is being provided solely by the survivours.

¹.  F. Wright^, C. De Vito, B. Langer, A. Hunter, and the Expert Panel on the Multidisciplinary Cancer Conference Standards, Special Report, Program in Evidenced Based Care  - a Cancer Care Ontario Program  http://www.cancercare.on.ca/pdf/pebcmccf.pdf

^2.  Survivors’ Debate: The Past Decade in Ovarian Cancer (registration/information/poll): http://ovariancancerdebate.blogspot.com/

^3. J Health Soc Policy. 2006;21(3):55-69, School of Social Work, Buffalo, NY Keefe RH, Lane SD, Swarts HJ. 2006 From the bottom up: tracing the impact of four health-based social movements on health and social policies.

 

Giving VOICE to ovarian cancer survivors - authors: Carolyn Benivegna, Tracy Gorden, Sandi Pniauskas

Giving VOICE to ovarian cancer survivors ©

Survivors debate the issues

Authors:  Carolyn Benivegna*, Tracy Gorden*,  Sandi Pniauskas

*In Memorandum

 

During her research for a presentation concerning cancer patients’ voices in healthcare, Sandi Pniauskas took special notice of a paper published by an expert panel that included the following statement: "Patients or their representatives should not attend the Multidisciplinary Cancer Conference to ensure unbiased case review"  (Report dated June 2006, www.cancercare.on.ca/pdf/pebcmccf.pdf). 

While it would be imprudent to take this singular and remarkable quote as the “rule du jour,” this philosophy, and others similar to it, are prevalent in both private perception and in published literature on cancer survival/survivorship.

We can be thankful for more enlightened views, such as this example from the Journal of Health and Social Policy that, instead, celebrates the voices and contributions of (non-medical) health educators and activists:  

            The activists' efforts wrested control of “authoritative knowledge” that had once been the sole domain of the “experts” with advanced medical training. They used this knowledge to empower “average” people with medical information…to

promote self help and engage in civil disobedience, which led to changes in healthcare delivery (2006;21(3):55-69).

As ovarian cancer survivors we have learned much over the years.  Average, everyday citizens are taking active roles in their treatments and educating themselves about this deadly disease.  Yet in our view, and through the course of shedding light on this disease and the experiences of those living with it, it has become obvious that there is no such thing as an “average” survivor.

Ovarian cancer is not a new disease; in fact, it has been traced back as far as Egyptian times.  Advancements in research, education, awareness and access to care have gained some momentum, but they have also hit many roadblocks.  As ovarian cancer survivors  with international grassroots connections to, and support from, other survivors  we regularly discuss where this disease has been, and where it is going.  We now feel it is time to move these behind-the-scenes discussions to open forums. 

By being informed and proactive women with ovarian cancer, we have recognized the value and importance of conducting our own critical analysis.  Most importantly, we have learned to shift the focus onto the human elements and burdens of suffering that we experience each day in our communities.  

Creating a public forum for ovarian cancer survivors

As those living with this disease, we dream of what the future holds in terms of early detection, education, research, treatment and a cure. This dream has evolved in the form of organizing two ovarian cancer conferences for October 2007 -- one to be held in Novi, Michigan (US) and another in Toronto, Ontario (Canada) --  both entitled, “Survivors’ Debate: The Past Decade in Ovarian Cancer.” 

These public meetings are the result of a collaborative effort by proactive and knowledgeable ovarian cancer survivors with supporting oncology nurses. They will take place with the understanding that they will be fully inclusive – everyone is welcome -- but that the focus will remain on the experiences, needs and concerns of cancer patients and survivors, their families and friends.

The conferences will take place in two locations in two countries because our issues are the same: access to care, awareness, early detection, survival rates and genetics. The directive and focus of both conferences is to offer a place to exchange ideas honestly and openly without judgment or bias.

Patients need an environment where they feel encouraged to discuss the many difficulties they face.  Sometimes it is very difficult to find that space -- a place without fear of retribution, criticism or dismissive attitudes. Patient-to-patient discussion and counseling offers this environment. It allows for in-depth dialogue on a variety of topics that detail what strategies work for survivors and their families and what is not effective. Healthcare settings just do not currently lend themselves to foster the dialogue that is needed for survivors that this new forum provides.

However, the conferences will also focus on creating a public force to expedite change, which can only start with communication.  Born from need – an arena for discussion for ovarian cancer survivors by survivors -- the “Survivors’ Debate” has taken form. 

But while the conferences are about patients speaking for themselves they are not speaking by themselves. With this new forum for dialogue, debate and discussion, we can highlight the detailed knowledge and expertise of our international ovarian cancer community with almost a decade of experience behind us, and explain why, as a community, we work. But we will also be able to explore the variety of reasons why what is needed by survivors and their friends and families is not currently being translated into caregiving.

Our ovarian cancer survivor connections and bonds have formed through the years by enduring extreme challenges and personal losses. The only bias we have as survivors is the bias to endure and to survive to the best of our abilities, not only as individuals but, importantly, as a community. To be very blunt, previously this has included much silent suffering.

It is long past due that we take our real issues into a public forum and encourage everyone to participate. We plan to make some long overdue noise at these debates about ovarian cancer, and we envision that these two scheduled events are only the beginning of a completely new trend in ovarian cancer activism.

For more information on the Survivors’ Debate: The Past Decade in Ovarian Cancer, visit: http://ovariancancerdebate.blogspot.com

 

Side-bar:

Ovarian cancer

Ovarian cancer is a serious and under-recognized threat to women's health which kills more women than all of the gynecologic cancers combined.  The lifetime risk of contracting ovarian cancer is one in seventy~.  Ovarian cancer is very treatable when caught early, but the vast majority of cases are not diagnosed until too late, which means that while it is not as common as some other cancers, it remains a woman’s cancer with a poor survival rate.

Unfortunately, an early detection test still remains elusive and contrary to public perception, the PAP test is not a screening test for ovarian cancer. Efforts to diagnose ovarian cancer is through a combination of: tumor marker test (called the CA125), a bimanual pelvic/rectal exam and transvaginal ultrasound. Actual confirmation of the diagnosis of ovarian cancer is confirmed with surgery and pathology reports (eg. Laboratory tests on tissue/s specimen). When ovarian cancer is caught before it has spread beyond the ovaries 80-90%~ of women will survive five years. When diagnosed after the disease has spread, the chance of five-year survival drops to approximately 20-30%~ or less.

Signs and symptoms

Symptoms of ovarian cancer are nonspecific and mimic those of many other more common conditions, including other cancers.  However, as a result of the original work in 1999 of Cindy Melancon, RN (who died of ovarian cancer in 2003) and Dr Barbara Goff, it has now been established that both early and advanced stage ovarian cancer do have  recognizable symptoms. This debate continues -semantics.

A consensus expert panel convened earlier this year concluded that the following four symptoms are much more likely to occur in women with ovarian cancer than women in the general population:

* Bloating;

* Pelvic or abdominal pain;

* Difficulty eating or feeling full quickly;

* Urinary symptoms (urgency or frequency).

Several other symptoms have been commonly reported by women with ovarian cancer, as well; these symptoms include fatigue, indigestion, back pain, pain with intercourse, constipation and menstrual irregularities.  A woman should consult with a health care professional if any of these symptoms persist or feel abnormal.

What you can do

* Understand your family history (e.g., ovarian, breast, colorectal cancer (organs/cancers of the gastrointestinal tract),endometrial cancers);

*  Educate yourself and understand ovarian cancer as it relates to your specific diagnosis;

*  Communicate your concerns with your healthcare professional;

*  Recognize and support other ovarian cancer women/families in your community;

* learn and appreciate the lived experience of your fellow survivors;

*  Join a social networking support group and/or face-to-face support group;

*  Join a cancer organization or a program in your community and/or hospital. 

Ovarian cancer is not a silent disease – speak up and speak out - it is only a silent disease when 'we' are not listening

Note: this blog and others maintain searchable databases of information for help

A good morning

Breast, ovarian cancer vaccine trials open - Plus commentary

http://communities.canada.com/vancouversun/blogs/medicinematters/archive/2011/08/22/breast-cancer-vaccine-trial-opens-a-reality-check-response.aspx

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PLoS Medicine: Being the Ghost in the Machine: A Medical Ghostwriter's Personal View

"Introduction

Ethical concerns about medical ghostwriting have been directed primarily at “guest” authors and the pharmaceutical companies that pay them. One voice that is largely missing is that of the ghostwriters themselves who, after all, create the documents that are in the ethical and legal crosshairs. Without them, one could argue, there can be no fraud, because it is they who create the fraudulent product.
For almost 11 years, I worked as a medical writer, creating a variety of pieces including the occasional ghostwritten article. For the most part, I never saw the finished paper, nor did I care to. This article describes what I did, why I did it, why I stopped doing it, and what I think might be done about the problem of fraud in authorship......"cont'd

full free access: PLoS Medicine: How Industry Uses the ICMJE Guidelines to Manipulate Authorship—And How They Should Be Revised

"The ICMJE guidelines will always be a work in progress, but the adjustments proposed here have the potential to end the self-concealment and authorial misrepresentations that mar industry's contributions to the literature. Furthermore, they have the potential to help industry achieve the enhanced respect its beneficial contributions to medicine deserve. Industry publications will always have a commercial valence alongside their scientific and medical content: this should henceforth be truthfully displayed, and no longer downplayed or concealed."

free full access: Variants of Uncertain Significance in Breast Cancer–Related Genes: Real-World Implications for a Clinical Conundrum. Part One: Clinical Genetics Recommendations

Variants of Uncertain Significance in Breast Cancer–Related Genes: Real-World Implications for a Clinical Conundrum. Part One: Clinical Genetics Recommendations

• Full Text
• PDF

Article Outline

• Positive BRCA1 or BRCA2
• Negative BRCA1 and BRCA2
• Variant of Uncertain Clinical Significance
• Case No. 1: BRCA1 VUS
  • Clinical Discussion Points
• Case No. 2: BRCA2 VUS
• Case No. 3: BRCA2 VUS Favoring Polymorphism
• Clinical Discussion Points (Cases No. 2 and 3)
• Clinical Geneticists' Opinions
• Cancer Geneticists' Opinions
• Clinical Geneticists' Opinions
• Discussion
• References
• Copyright

Pilot Program to Personalize Care & Improve Quality of Life for Women With Recurrent Ovarian Cancer - Full Text View - ClinicalTrials.gov (CAM)

 This study is currently recruiting participants.

Verified on August 2011

First Received on August 16, 2011.   Last Updated on August 17, 2011
Purpose

The purpose of this study is to find out if complementary and alternative medicines (CAM) should be included with traditional therapy for women with recurrent ovarian cancer. Some of the alternative medicines include non-traditional drug and herbal therapies along with dietary and nutritional strategies. Only a few of these alternative medicines have been tested with women with ovarian cancer.

abstract : The effect of sleep disturbance on quality of life in women with ovarian cancer

"PSQI was not correlated with age, time since diagnosis, number of previous chemotherapy regimens. PSQI score did not differ by current disease or chemotherapy status."

Highlights

► Ovarian cancer patients have a high prevalence of sleep disturbances and poor sleep quality.
► Sleep disturbances are associated with decreased quality of life and increased depression.

abstract: Meta-analysis of gene expression profiles associated with histological classification and survival in 829 ovarian cancer samples

abstract: Therapy-related myeloid leukemia after treatment for epithelial ovarian carcinoma: An epidemiological analysis

Note: this adverse effect has been known for many years (risk vs benefit)

 Highlights

► Secondary myeloid leukemia after epithelial ovarian cancer is a rare event.
► It is highly lethal. ► Its incidence has decreased since use of platinum/taxane-based regimens.

abstract: Lymphadenectomy in ovarian cancer: standard of care or unne... : Current Opinion in Oncology

Abstract

Purpose of review: The clinical significance of lymphadenectomy in ovarian cancer is controversial. In early ovarian cancer (EOC), it is the extent of the procedure that is the main focus of debate. In advanced disease [advanced ovarian cancer (AOC)], the issue is whether or not lymphadenectomy independently impacts survival. This review summarizes the current standard of care as it relates to the role of lymphadenectomy in ovarian cancer.

Recent findings: Lymphadenectomy in EOC is a diagnostic procedure in as much as it is an integral and mandatory part of a complete surgical staging. The required extent of the procedure, however, remains uncertain. It has been suggested that at least 10 nodes from different, predefined retroperitoneal sites should be the minimum number removed. Lymphadenectomy in AOC is of potential therapeutic value. The only published randomized clinical trial (RCT) showed no overall survival benefit after radical/systematic lymphadenectomy, although there was an impact on 6-month disease-free survival. Conversely, retrospective studies, a meta-analysis and a re-analysis of three RCTs in AOC do suggest an overall survival benefit for radical/systematic lymphadenectomy.

Summary: This review concludes with the recommendation that lymphadenectomy in EOC is a mandatory part of surgical staging and that a minimum of 10 nodes should be harvested from different retroperitoneal sites. In AOC, lymphadenectomy can be considered when intraperitoneal cytoreduction has been complete or when there are bulky nodes.

abstract: Olaparib in patients with recurrent high-grade serous or poorly differentiated ovarian carcinoma or triple-negative breast cancer: a phase 2, multicentre, open-label, non-randomised study : The Lancet Oncology (with/without brca mutation/s)

The Lancet Oncology, Early Online Publication, 22 August 2011

doi:10.1016/S1470-2045(11)70214-5Cite or Link Using DOI

Olaparib in patients with recurrent high-grade serous or poorly differentiated ovarian carcinoma or triple-negative breast cancer: a phase 2, multicentre, open-label, non-randomised study

 "...

Findings

91 patients were enrolled (65 with ovarian cancer and 26 breast cancer) and 90 were treated between July 8, 2008, and Sept 24, 2009. In the ovarian cancer cohorts, 64 patients received treatment. 63 patients had target lesions and therefore were evaluable for objective response as per RECIST. In these patients, confirmed objective responses were seen in seven (41%; 95% CI 22—64) of 17 patients with BRCA1 or BRCA2 mutations and 11 (24%; 14—38) of 46 without mutations. No confirmed objective responses were reported in patients with breast cancer. The most common adverse events were fatigue (45 [70%] of patients with ovarian cancer, 13 [50%] of patients with breast cancer), nausea (42 [66%] and 16 [62%]), vomiting (25 [39%] and nine [35%]), and decreased appetite (23 [36%] and seven [27%])...."

CytRx President and CEO Steven Kriegsman and CMO Dr. Daniel Levitt Discuss Company Advantages and Oncology Clinical Pipeline Attributes in OncLive Interview - MarketWatch (INNO-206)

Note: in research

"Previous studies have shown INNO-206 efficacy in tumor models of breast, ovarian, small cell lung cancer, renal cell cancer and pancreatic cancers. Additionally, a recently announced study showed that low doses of INNO-206 and doxorubicin combined achieved complete remission in aggressively growing in vivo ovarian cancer tumors. Several other chemotherapy agents have been attached to the linker used for INNO-206, including paclitaxel, camptothecin, cisplatin and methotrexate, and may be incorporated into future clinical development by the Company."

Canadian medical report card - press release

http://cnwtelbec.com/en/releases/archive/August2011/22/c5157.html

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Expert: Drug shortage global issue - Front - TheChronicleHerald.ca

http://thechronicleherald.ca/Front/1259187.html

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24-hour shifts are a prescription for medical errors - The Globe and Mail

From The Globe and Mail:
24-hour shifts are a prescription for medical errors

Via The Globe and Mail's iPhone app

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press release: Mayo Clinic receives FDA approval for ovarian and breast cancer vaccines

ROCHESTER, Minn. — Mayo Clinic has received investigational new drug approval (http://www.fda.gov/BiologicsBloodVaccines/DevelopmentApprovalProcess/InvestigationalNewDrugINDorDeviceExemptionIDEProcess/default.htm) from the Food and Drug Administration (http://www.fda.gov/) for two new cancer vaccines that mobilize the body's defense mechanisms to destroy malignant cells. The vaccines are among the first aimed at preventing cancer recurrence. The approval clears the way for Phase I clinical trials with women treated for ovarian or breast cancer.

VIDEO ALERT: Additional audio and video resources, including comments by Dr. Keith Knutson are available at the Mayo Clinic News Blog (http://dev.newsblog.mayoclinic.org/2011/08/17/mayo-clinic-studies-cancer-vaccines/).
"People who've had cancer are at high risk for relapse, and later rounds of treatment can become more difficult," says Mayo Clinic immunologist Keith Knutson, Ph.D., (http://mayoresearch.mayo.edu/mayo/research/staff/Knutson_KL.cfm) who developed the vaccines with colleagues at Mayo Clinic. While most cancer vaccines to date have been developed to fight patients' tumors, Knutson's group is interested in immunizing patients immediately after therapy, when they're healthy, to protect against relapse.

One new vaccine targets a protein that exists in abundance in breast and ovarian cancer cells. Containing fragments of the folate receptor alpha protein, the vaccine teaches the body's immune system to detect and eliminate diseased cells. Because the protein is typical of nearly all breast and ovarian tumors, the vaccine is the first that may be applicable to the majority of patients, instead of sub-populations with distinct types of cancer.
"I'm quite optimistic that if we can combine early detection, effective conventional therapies and vaccination, we can reduce recurrence and long-term morbidity associated with breast and ovarian cancer," Knutson says. Ultimately, the vaccine may be useful as a preventive strategy for all women.

The second vaccine to receive FDA approval is designed to be administered after breast cancer patients receive conventional chemotherapy. It targets the highly aggressive Her2/neu molecule, a protein that promotes the growth of cancer cells.
"One of the greatest fears for women who've been treated for breast cancer is that the cancer will return," Knutson says. "Our hope is that the vaccine will boost the cancer-fighting capabilities of the immune system and will be a leg up on this aggressive cancer after conventional treatment is complete."

Clinical Oncology News - The Concept of ‘Unrealistic Optimism’ In Early-Phase Trials (Markman) - Aug issue

"Oncologists may not be fully aware of a relatively new term introduced by ethicists to describe certain patients who agree to participate in early-phase cancer clinical trials. Some researchers believe that these individuals express unrealistic optimism, which apparently means that despite understanding the limited statistical probability of experiencing clinical benefit from a particular management plan, they have a strong belief regarding their own favorable outcome.1 These researchers apparently feel such optimism poses a serious problem, with one member of this community of scholars being quoted as remarking, “We just need to realize that not all optimism is ethically benign.”2...............For it would appear that those who support the concept of unrealistic optimism, or its sister term therapeutic misconception, have not kept up with the oncology literature dealing with early-phase clinical trials........cont'd

Heated, Harrowing Chemotherapy Bath May Be Only Hope for Some - NYTimes.com

Note: discusses different cancers

press release: Critical Outcome Technologies Inc. Announces Definitive Proof of COTI-2's Target and Single Agent Effectiveness from Critical Study

COTI-2's specific cellular targeting, low toxicity, and proven efficacy support a potentially dramatic change in the treatment of susceptible cancers consistent with the views expressed at ASCO. Over expression of Akt/Akt2 is common in a broad range of human cancers, including ovarian, endometrial, pancreatic, breast, colorectal and lung. The percent of tumors with active Akt/Akt2 range from 20% to 100% depending on the cancer type.

About Critical Outcome Technologies Inc. (COTI)
COTI is a leading-edge company specializing in accelerating the discovery of small molecules to enable new drugs to be brought to market in a more cost effective, efficient and timely manner. COTI'S proprietary artificial intelligence system, CHEMSAS®, utilizes a series of predictive computer models to identify compounds most likely to be successfully incorporated in disease-specific drug discovery, as well as subsequent optimization and preclinical development. These compounds are targeted for a variety of diseases, particularly those for which current treatments are either lacking or ineffective.

Rush researchers discover antibody that may help detect ovarian cancer in earliest stages - press release (mesothelin antibodies)

Note: in research

".....In the study at Rush, researchers tested for mesothelin antibodies in the bloodstream of 109 women who were infertile, 28 women diagnosed with ovarian cancer, 24 women with benign ovarian tumors or cysts, and 152 healthy women. Infertility was due to endometriosis, ovulatory dysfunction or premature ovarian failure or was unexplained.
Significant levels of mesothelin antibodies were found in women with premature ovarian failure, ovulatory dysfunction and unexplained infertility, as well as in women with ovarian cancer, although not in women with endometriosis and not in healthy women or women with benign disease. Endometriosis is generally associated with a different kind of ovarian carcinoma (blogger's note - cell types: endometrioid/clear cell)  than other types of infertility, which may explain why mesothelin antibodies were not found in these cases.
Why the presence of mesothelin antibodies in the bloodstream should be linked with ovarian cancer is not clear.
"It has been hypothesized that an autoimmune response precedes or somehow contributes to the development and progression of malignant tumors," Luborsky said. "We think that antibodies may arise in response to very early abnormal changes in ovarian tissue that may or may not progress to malignancy, depending on additional triggering events. Or, alternatively, antibodies may bind to normal cells in the ovary, causing dysfunction and leading to infertility -- and, in a subpopulation of women, to the development of ovarian cancer.".....cont'd

Cancer’s Secrets Come Into Sharper Focus - Readers' Comments - NYTimes.com

free full access (pdf file) Cell - Hallmarks of Cancer: The Next Generation (published Mar 2011)

Hallmarks of Cancer: The Next Generation

• Summary
• Main Text
• References
• Supplemental Information
• Comments (2)

• PDF 2.07 MB
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Cell, Volume 144, Issue 5, 646-674, 4 March 2011
Copyright © 2011 Elsevier Inc. All rights reserved.
10.1016/j.cell.2011.02.013

Authors

Douglas Hanahan, Robert A. Weinberg See Affiliations

Summary

The hallmarks of cancer comprise six biological capabilities acquired during the multistep development of human tumors. The hallmarks constitute an organizing principle for rationalizing the complexities of neoplastic disease. They include sustaining proliferative signaling, evading growth suppressors, resisting cell death, enabling replicative immortality, inducing angiogenesis, and activating invasion and metastasis. Underlying these hallmarks are genome instability, which generates the genetic diversity that expedites their acquisition, and inflammation, which fosters multiple hallmark functions. Conceptual progress in the last decade has added two emerging hallmarks of potential generality to this list—reprogramming of energy metabolism and evading immune destruction. In addition to cancer cells, tumors exhibit another dimension of complexity: they contain a repertoire of recruited, ostensibly normal cells that contribute to the acquisition of hallmark traits by creating the “tumor microenvironment.” Recognition of the widespread applicability of these concepts will increasingly affect the development of new means to treat human cancer

full free text: (pdf file) Cell - A ceRNA Hypothesis: The Rosetta Stone of a Hidden RNA Language?

A ceRNA Hypothesis: The Rosetta Stone of a Hidden RNA Language?

• Summary
• Main Text
• References
• Comments (0)

Main Text

The Noncoding Revolution

The ceRNA Protagonists

MicroRNAs

The Transcriptome

The ceRNA Hypothesis

RNA Transcripts Communicate through the ceRNA Language

Logic and Regulation of the ceRNA Network

Experimental Evidence Supporting the ceRNA Hypothesis

ceRNAs in the Etiology of Cancer

Conclusions

Acknowledgments

full free access: ScienceDirect - Cell : The Hallmarks of Cancer published Sept 2000

Volume 100, Issue 1, 7 January 2000, Pages 57-70

---

doi:10.1016/S0092-8674(00)81683-9 | How to Cite or Link Using DOI	Cited By in Scopus (8962)
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Review

The Hallmarks of Cancer

Douglas Hanahan ¹ and Robert A. Weinberg ²

¹ Department of Biochemistry and Biophysics and, Hormone Research Institute, University of California at San Francisco, San Francisco, California 94143, USA
² Whitehead Institute for Biomedical Research and, Department of Biology, Massachusetts Institute of Technology, Cambridge, Massachusetts 02142, USA

Available online 27 September 2000.

Article Outline

• An Enumeration of the Traits

• Acquired Capability: Self-Sufficiency in Growth Signals

• Acquired Capability: Insensitivity to Antigrowth Signals

• Acquired Capability: Evading Apoptosis

• Acquired Capability: Limitless Replicative Potential

• Acquired Capability: Sustained Angiogenesis

• Acquired Capability: Tissue Invasion and Metastasis

• An Enabling Characteristic: Genome Instability

• Alternative Pathways to Cancer

• Synthesis

• Acknowledgements

• References

Beyond the Genome, Cancer’s Secrets Come Into Sharper Focus - NYTimes.com

Understanding how cancer begins and then grows is fundamental to one day preventing the disease. Here, we explain three new theories for how cancer may form.....

HealthNewsReview.org: Hot Chemotherapy Bath: Patients See Hope, Critics Hold Doubtsies | Holding Health and Medical Journalism Accountable

"Our Review Summary

This story opens readers' eyes to a debate that flared up before attendees of a recent meeting of the American Society of Clinical Oncology - but a debate that most of us wouldn't know about......"

Holding Health/Medical Journalism Accountable: Gene Therapy Cures Adult Leukemia

Note: some media reports reference 'possible' future role for ovarian cancer and therefore this link and again reminders of what is still in research/harms of hype.....

Gene Therapy Cures Adult Leukemia

August 10, 2011

RATING:

Somebody at WebMD must take responsibility for a headline that says "cure" after one year's experience in 3 patients. Cure used to be defined in 5 year terms. Is WebMD redefining the term?

Platinum Sensitivity–Related Germline Polymorphism Discovered via a Cell-Based Approach and Analysis of Its Association with Outcome in Ovarian Cancer Patients

Conclusion:
This study shows the potential of cell-based, genome-wide approaches to identify germline predictors of treatment outcome and highlights the need for extensive validation in patients to assess their clinical effect.

media: There’s no clowning when couple create cartoons - KansasCity.com Robert and Donna (ovarian cancer survivor/author/writer) Trussell

press release (financial) - ENMD-2076 - EntreMed Reports Second Quarter 2011 Financial Results

About ENMD-2076
ENMD-2076 is an orally-active, Aurora A/angiogenic kinase inhibitor with a unique kinase selectivity profile and multiple mechanisms of action. ENMD-2076 has been shown to inhibit a distinct profile of angiogenic tyrosine kinase targets in addition to the Aurora A kinase. Aurora kinases are key regulators of mitosis (cell division), and are often over-expressed in human cancers. ENMD-2076 also targets the VEGFR, Flt-3 and FGFR3 kinases which have been shown to play important roles in the pathology of several cancers. ENMD-2076 has shown promising activity in Phase 1 clinical trials in solid tumor cancers, leukemia, and multiple myeloma. ENMD-2076 is currently in a Phase 2 trial for ovarian cancer, and preclinical and clinical activities are ongoing in assessing the compound's applicability for other forms of cancer.

Quitting My Job And Living In Costa Rica

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abstract: Circulating free DNA and p53 antibodies in plasma of patients with ovarian epithelial cancers (serous/mucinous)

Blogger's Note: the connection between KRAS mutations/mucinous may be due to GI (particularly colorectal cancer eg. common denominator = KRAS mutation/mucinous cell type), see also mucinous article - to be posted subsequent to this item

BACKGROUND:
This study was conducted in order to evaluate the significance of circulating free DNA (CFDNA), blood plasma p53 antibodies (p53-Ab) and mutations of KRAS gene in the prognosis of ovarian epithelial cancers.

PATIENTS AND METHODS:

A total of 126 patients were included in this study. KRAS mutations and CFDNA were detected by means of the PCR-restriction fragment length polymorphism (PCR-RFLP) and enriched by the PCR-RFLP method. Enzyme-linked immunosorbent assay was used to analyze plasma p53-Ab.

RESULTS:

KRAS mutations were detected in 27 (21.4%) of examined tumors. The frequency of KRAS mutations was especially high in mucinous cancers (P < 0.001). CFDNA and p53-Ab were frequently detected in patients with serous cancers in high grade (P < 0.001). The overall survival rate was significantly lower for patients with serous tumors and CFDNA and p53-Ab-positive than negative tumors (P = 0.022 and P < 0.001, respectively). In mucinous ovarian cancer, a worse overall survival was correlated with the KRAS mutations (P = 0.03).

CONCLUSIONS:

The results of the present study suggested that a presence of KRAS mutations in mucinous ovarian cancer and CFDNA and p53-Ab in serous tumors was correlated with the highest risk of cancer progression.

abstract: Mucinous tumor of low malignant potential ("borderline" or "atypical proliferative" tumor) of the ovary: a study of 171 cases with the asses

Abstract

Mucinous tumors of the ovary are a continuing source of controversy in the field of gynecologic pathology. We examined a series of 171 intestinal-type mucinous tumors of low malignant potential ("borderline" or "atypical proliferative" tumors) to clarify the clinical significance of intraepithelial carcinoma (IECA) and microinvasion (area ≤ 10 mm²). The diagnosis of IECA was based on the presence of marked nuclear atypia (grade 3). Stromal microinvasion was classified as low grade and high grade (with nuclear grade 3). IECA was observed in 67 of 171 cases (39.2%). Microinvasion was identified in 31 (18.1%) cases, low grade in 22 (12.9%) cases, and high grade in 9 (5.3%) cases. Follow-up status was known in 144 cases and tumor recurrence was observed in 6 patients (4.2%). The risk factors for recurrence included International Federation of Gynecology and Obstetrics stage ≥ IC (P=0.002), microinvasion (P=0.013), age less than 45 years (P=0.032), and IECA (P=0.042). The amount of IECA ≥ 10% was also associated with the risk of recurrence (P=0.007). Among tumors with microinvasion, there was no significant association between the clinicopathologic variables and recurrence. When considering tumors with stage ≥ IC, tumor recurrence was significantly associated with IECA ≥ 10% (P=0.031) and age less than 45 years (P=0.047). It is important that mucinous tumors of low malignant potential should be staged and be optimally sampled for pathologic examination to document the status of the external surface or peritoneal involvement and to identify the worst degree of epithelial proliferation. Tumor stage ≥ IC, IECA ≥ 10%, microinvasion, and age less than 45 years were the features that were associated with tumor recurrence.
The study results also support the use of nuclear grade 3 as the sole criterion of IECA.

abstract: (small study) Cancer-Related Sources of Stress for Children With Cancer and Their Parents

Note: note differences in participation between mothers and fathers (n); abstract only info does not detail this variance


Objectives
The current study examines reports and correlates of cancer-specific stressors in children with cancer and their parents. Measures
Mothers (n = 191) and fathers (n = 95) reported on their own and their child’s stressors, general perceived stress, and posttraumatic stress symptoms. Children (n = 106) completed self-reports of their own stressors and posttraumatic stress symptoms.

Cancers | Free Full-Text | Assessment of the Evolution of Cancer Treatment Therapies

Note: numerous references to ovarian cancer

Conclusions

This review has tried to summarize the history and evolution of the most common types of cancer

treatments available today, but also new therapies under study in the last years. In addition to surgery,

chemotherapy, radiation therapy, hyperthermia, photodynamic therapy or immunotherapy, new

therapies are now at different stages of development trying to decrease drug toxicity in health tissues

and increase efficacy by targeting tumor angiogenesis, by exploring cell and gene therapy, or by using

new nanostructures for diagnosis or therapeutic purposes. Nanotechnology is offering new products,

which either used alone, due to their intrinsic properties, or in combination with other biomolecules

(anti-tumoral drugs, folic acid, albumin, antibodies, aptamers) could be used to target cancer cells.

However, the history tells us that the fight against cancer is not an easy task. Many types of cancers

are able to resist to conventional therapies, and different combinations of drugs and therapies

(e.g., surgery together with radiotherapy and chemotherapy) are usually the only way to destroy

tumoral cells. This may be also true for the new therapies arriving now to the clinic. Much more

studies are required but these new ways of treatment are opening doors to hope for many patients

waiting for a successful therapy

AHRQ: Su medicamento: Infórmese. Evite riesgos. (Incluye tarjeta de bolsillo) Spanish/English

AHRQ Releases a Spanish-Language Tool to Help Consumers Reduce Medication Errors

AHRQ has released a revised Spanish-language medication safety booklet, “Su medicamento: Infórmese. Evite riesgos” (“Your Medicine: Be Smart. Be Safe.”) to help Spanish-speaking patients learn more about how to take medicines safely. The booklet includes a detachable, wallet-size card that can help patients keep track of medicines they are taking, including vitamins and herbal and other dietary supplements. Select to download a copy of the guide in Spanish. Print copies are available by sending an e-mail to AHRQPubs@ahrq.hhs.gov. The guide is also available in English.

a request: survivors stories for interviews (per Women's Oncology Research & Dialogue Newsletter)

WORD is looking for new women to be interviewed about their journey and fight against gynecologic cancers.  If you would be willing to work with us - please contact us soon!