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Friday, August 10, 2012

Humanities aren’t a science. Stop treating them like one. | Literally Psyched, Scientific American Blog Network



.....The tools of mathematical and statistical and scientific analysis are invaluable. But their quantifiable certainty is all too easy to see as the only "real" way of doing things when really, it is but one tool and one approach—and not one that is translatable or applicable to all matters of qualitative phenomena. That's one basic fact we'd do well not to forget."


http://blogs.scientificamerican.com/literally-psyched/2012/08/10/humanities-arent-a-science-stop-treating-them-like-one/


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Individualized care best for lymphedema patients, MU researcher says



http://www.eurekalert.org/pub_releases/2012-08/uom-icb081012.php

Management of a suspicious adnexal mass - PubMed Mobile





Management of a suspicious adnexal mass: a clinical practice guideline.

Authors

Dodge JE, et al. Show all

Journal

Curr Oncol. 2012 Aug;19(4):e244-e257.

Affiliation

Division of Gynaecologic Oncology, Princess Margaret Hospital, University Health Network, Department of Obstetrics and Gynaecology, Toronto, ON.

Abstract

QUESTIONS: What is the optimal strategy for preoperative identification of the adnexal mass suspicious for ovarian cancer? What is the most appropriate surgical procedure for a woman who presents with an adnexal mass suspicious for malignancy?....

July 18th, 2012: Uncertain Genetic Test Results for Lynch Syndrome - Full Text View - ClinicalTrials.gov



Uncertain Genetic Test Results for Lynch Syndrome - Full Text View - ClinicalTrials.gov

This study is currently recruiting participants.
Verified April 2012 by National Institutes of Health Clinical Center (CC)

First Received on July 18, 2012.   No Changes Posted
Sponsor: National Human Genome Research Institute (NHGRI)
Information provided by: National Institutes of Health Clinical Center (CC)
ClinicalTrials.gov Identifier: NCT01646112
  Purpose
Background:
  • Individuals have varying tolerances for receiving ambiguous information. However, not much is known about how ambiguous genetic testing information is received. Also, not much is known about how at-risk individuals internalize and process these results. More information is needed about how this information affects a person's life.
  • Lynch Syndrome is a genetic condition that carries a high risk of colon cancer and other cancers. Individuals at risk for Lynch Syndrome can have genetic testing for it. The test may confirm a diagnosis and determine actions that can be taken. Results from genetic testing can also affect the perspectives of relatives who might also be affected. However, genetic testing can also produce variants of unknown significance (VUS). VUS are data that may not provide enough information to make decisions. Researchers want to study people who have received a VUS result for genetic testing for Lynch Syndrome.
Objectives:
- To learn more about the impact and experience of receiving a VUS for Lynch Syndrome genetic testing.
Eligibility:
- Individuals at least 18 years of age who have recently had a VUS result on a genetic test for Lynch Syndrome.
Design:
  • Participants will be asked to answer demographic questions. They will also have a 45- to 60-minute phone interview.
  • During the phone interview, participants will be asked a series of questions about their diagnosis. They will be asked about how they received the result and how they felt right after receiving it. They will also discuss who they have spoken to about the result.

Thursday, August 09, 2012

ongoing: Anonymous Testing of Pathology Specimens for BRCA Mutations in Ashkenazi Jewish Individuals Who Have Cancer - Full Text View - ClinicalTrials.gov



Anonymous Testing of Pathology Specimens for BRCA Mutations in Ashkenazi Jewish Individuals Who Have Cancer - Full Text View - ClinicalTrials.gov

Anonymous Testing of Pathology Specimens for BRCA Mutations in Ashkenazi Jewish Individuals Who Have Cancer
This study is currently recruiting participants.
Verified July 2012 by Memorial Sloan-Kettering Cancer Center

First Received on December 22, 2007.   Last Updated on July 23, 2012   History of Changes
Sponsor: Memorial Sloan-Kettering Cancer Center
Information provided by (Responsible Party): Memorial Sloan-Kettering Cancer Center
ClinicalTrials.gov Identifier: NCT00588263
  Purpose
The intent of the proposed study is to describe the prevalence of the most common recurring mutations in BRCA1 and BRCA2, blmAsh , and the A636P MSH2 mutation among Ashkenazi Jewish individuals with a variety of cancer diagnoses. If a substantial proportion of these samples contain such mutations, future patients presenting with these diseases may wish to undergo genetic counseling and, if appropriate, formal genetic testing. The benefit from such a process would pertain mainly to the families of these individuals.

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

Study Type: Observational
Study Design: Observational Model: Cohort
Time Perspective: Prospective
Official Title: Anonymous Testing of Pathology Specimens for BRCA Mutations in Ashkenazi Jewish Individual With Cancer

Are Opinions Based on Science: Modelling Social Response to Scientific Facts



Are Opinions Based on Science: Modelling Social Response to Scientific Facts:

by Gerardo Iñiguez, Julia Tagüeña-Martínez, Kimmo K. Kaski, Rafael A. Barrio

As scientists we like to think that modern societies and their members base their views, opinions and behaviour on scientific facts. This is not necessarily the case, even though we are all (over-) exposed to information flow through various channels of media, i.e. newspapers, television, radio, internet, and web. It is thought that this is mainly due to the conflicting information on the mass media and to the individual attitude (formed by cultural, educational and environmental factors), that is, one external factor and another personal factor. In this paper we will investigate the dynamical development of opinion in a small population of agents by means of a computational model of opinion formation in a co-evolving network of socially linked agents. The personal and external factors are taken into account by assigning an individual attitude parameter to each agent, and by subjecting all to an external but homogeneous field to simulate the effect of the media. We then adjust the field strength in the model by using actual data on scientific perception surveys carried out in two different populations, which allow us to compare two different societies. We interpret the model findings with the aid of simple mean field calculations. Our results suggest that scientifically sound concepts are more difficult to acquire than concepts not validated by science, since opposing individuals organize themselves in close communities that prevent opinion consensus.................

Putting respect to work : The Lancet



Putting respect to work : The Lancet

The Lancet, Volume 380, Issue 9841, Page 564, 11 August 2012
doi:10.1016/S0140-6736(12)61330-0Cite or Link Using DOI

Putting respect to work

There is an aspect of dignity that Charles Foster (June 2, p 2044)1 does not address. I found the term vague and unhelpful until I heard Gordon Lishman, former Director-General of Age Concern England, remark how whereas professionals often used the term “dignity”, the word older people themselves used was usually “respect”. In Latin the word dignus means “worthy”. Surely, our obligation is to show people the respect, whether in word or deed, that gives them dignity—the subjective experience of their own worth.
We can explore the implications for this in the scenarios Foster describes. In the case of the patient in the vegetative state undergoing vaginal examinations we could reasonably assume that her sense of worth would be impaired if she were aware of what was going on; for the brain-damaged teenager we have the difficult choice of whether to presume that her standards are ours—or accept her apparent behaviour that she does not mind; but the owner of the skull used as a drinking vessel can have no sense of worth—although we might regard the behaviour as in poor taste.
 
I declare that I have no onflicts of interest.

Reference

1 Foster C. Putting dignity to work. Lancet 2012; 379: 2044-2045. Full Text | PDF(150KB) | CrossRef | PubMed

European Journal of Human Genetics - Genetic testing and common disorders in a public health framework: how to assess relevance and possibilities



http://www.nature.com/ejhg/journal/v19/n1s/full/ejhg2010249a.html

Cancer care services don't differ by neighborhood



http://reut.rs/S3ffBr

HIN-1 clear cell ovarian cancer



CONCLUSIONS: Methylation of HIN-1 and CACNA1A promoters are two novel epigenetic biomarkers associated with poor outcomes in OCCA patients. Ectopic expression of the HIN-1 gene increased paclitaxel sensitivity through Akt pathway

http://www.google.ca/reader/i/?source=mog&hl=en&gl=ca#stream/search%2FOvarian


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A Retrospective Study Evaluating Frequency and Risk Factors of Osteonecrosis of the Jaw in 576 Cancer Patients Receiving Intravenous Bisphosphonates




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A Retrospective Study Evaluating Frequency and Risk Factors of Osteonecrosis of the Jaw in 576 Cancer Patients Receiving Intravenous Bisphosphonates

Retrospective analysis of 576 cancer patients treated with intravenous bisphosphonates found that 3.1% developed osteonecrosis of the jaw, 59% of which followed tooth extraction. Diabetes, hypothyroidism,...



Patterns of Gene Expression That Characterize Long-term Survival in Advanced Stage Serous Ovarian Cancers




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Patterns of Gene Expression That Characterize Long-term Survival in Advanced Stage Serous Ovarian Cancers

Clinical Cancer Research In Clinical Cancer Research, Vol. 11, No. 10. (15 May 2005), pp. 3686-3696, doi:10.1158/1078-0432.CCR-04-2398

Purpose: A better understanding of the underlying biology of invasive serous ovarian cancer is critical for the development of early detection strategies and new therapeutics. The objective of this study was to define gene expression patterns associated with favorable survival.
Andrew Berchuck, Edwin Iversen, Johnathan Lancaster, Jennifer Pittman, Jingqin Luo, Paula Lee, Susan Murphy, Holly Dressman, Phillip Febbo, Mike West, Joseph Nevins, Jeffrey Marks



Komen founder to leave CEO role but stay on in management



http://reut.rs/OUnMWY

State of the Science in Ovarian Cancer Quality of Life Research: A Systematic Review



State of the Science in Ovarian Cancer Quality of Life Research: A Systematic Review

Hess, Lisa M. PhD; Stehman, Frederick B. MD

International Journal of Gynecological Cancer . POST AUTHOR CORRECTIONS, 6 August 2012

doi: 10.1097/IGC.0b013e318263f02e

Abstract

Introduction: Health-related quality of life (HRQOL) has become an increasingly important focus of outcomes in cancer care with the movement toward more patient-oriented research. Quality-of-life outcomes are important in ovarian cancer, which has not yet benefitted from improved survival outcomes as have other diseases. This study was designed to systematically assess and summarize HRQOL in ovarian cancer.

Methods: A systematic search strategy was initiated to identify published literature measuring HRQOL of women with a diagnosis of ovarian cancer (OC). Data were synthesized to evaluate HRQOL and patient-reported outcome data at various time points: before, during, and after chemotherapy. Data were pooled and summary statistics compared across published studies. Comparisons of means were conducted using analysis of variance.

Results: There were 170 publications meeting all eligibility criteria, representing 139 unique studies of patients with ovarian cancer, where QOL data were collected. Within this literature, more than 90 different patient-reported outcome (PRO) instruments were administered. The most common HRQOL instruments included the European Organisation for Research and Treatment of Cancer QLQ-C30 and the Functional Assessment of Cancer Therapy. Few studies alone demonstrated significant differences in QOL between the experimental and comparison arm or throughout the treatment period. Pooled data, however, show that baseline QOL may significantly improve, particularly after completion of chemotherapy treatment.

Discussion: Despite the increase in assessment and reporting of QOL in ovarian cancer research studies during the past 15 years, there remains little consistency in the types and format of data collected. There is a need to enhance the standardized collection and reporting of HRQOL data from research involving women with ovarian cancer so that research can build on the cumulative knowledge base to improve outcomes in this patient population.



No Proven Benefit For PET And PET/CT In Ovarian Cancer



Ann_Oncology: Maternal and fetal outcomes of taxane chemotherapy in breast and ovarian cancer during pregnancy: case series and review of the literature



http://m.annonc.oxfordjournals.org/content/early/2012/08/07/annonc.mds170.short?rss=1?rss=1?rss=1

Health IT for You - Giving You Access to Your Medical Records (3:00 min) | Patients & Families | HealthIT.gov



Health IT for You - Giving You Access to Your Medical Records (3:00 min)

August 7, 2012 | 3:00

Health Information Technology, or Health IT for short, is upgrading our healthcare system for the 21st Century. Today's technology is converting the information in our paper records into an electronic format which allows you and your doctors to have access to your health information when and where it's needed. Learn more about the benefits of health IT and how online, secure access to your health record can help make sure you get the best care.

View the 60-second version of this video.




Recurrences of ovarian cancer can be detected earlier and more accurately with PET/CT



Recurrences of ovarian cancer can be detected earlier and more accurately with PET/CT

Due to the lack of studies, there is currently no proof that patients with ovarian cancer can benefit from positron emission tomography (PET) alone or in combination with computed tomography (CT). As regards diagnostic accuracy, in certain cases, recurrences can be detected earlier and more accurately with PET or PET/CT than with conventional imaging techniques. This is the conclusion of the final report by the German Institute for Quality and Efficiency in Health Care (IQWiG) in Cologne that was published on 23 May 2012.

More reliable diagnosis is supposed to improve treatment

Ovarian cancer is the fifth most common malignant tumour in women. Every year 15.9 women in every 100,000 are diagnosed with the disease in Germany and it claims the lives of 8 in 100,000 women per year. Since the ovaries lie deep in the abdomen and an ovarian tumour normally causes no symptoms for a long time, it is often only discovered at a late stage.

Many experts hope that an investigation using PET or PET/CT alone or in combination with other methods would be better able to distinguish between benign and malignant tumours when ovarian cancer is suspected. It could also help classify cancerous tumours into the correct stage, make it easier to assess whether they respond to treatment and to show earlier and with greater certainty whether a recurrence or secondary tumour (metastasis) has occurred. This information should then enable patients to be given better treatment recommendations.

Benefit for patients is crucial

IQWiG therefore searched the international literature for studies investigating the effects of diagnosis using PET or PET/CT on health aspects of direct relevance to patients. For example, the results of this research - and an appropriately tailored treatment - could contribute to patients having better chances of survival, spare them unnecessary operations or other diagnostic procedures, or improve their quality of life. However, the search for such studies was unsuccessful, so the question as to the patient-relevant benefit of PET or PET/CT had to remain unanswered.

PET can better detect recurrences in certain cases

In addition, IQWiG searched for studies in which the diagnostic accuracy and prognostic power of PET or PET/CT were compared with other diagnostic methods. The basic question is how often a PET investigation gives a correct result. On the one hand, it should overlook true, cancerous tumours as rarely as possible, but on the other, it should not awake any false suspicions.

A review of hospital characteristics associated



http://www.ncbi.nlm.nih.gov/m/pubmed/22871420/


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Trends in telehealth versus on-site clinical genetics appointments in Manitoba: a comparative study



Trends in telehealth versus on-site clinical genetics appointments in Manitoba: a comparative study

J Genet Couns. 2012 

Abstract

Telehealth involves the use of information and communications technology to deliver health services to patients over distance. Canada is well suited to benefit from telehealth since many individuals live in remote, rural and isolated locations. Manitoba is the easternmost prairie province and MBTelehealth is an active Canadian program that currently has 105 sites in 73 communities. Although studies of patient satisfaction comparing telehealth to on-site clinical visits have been conducted, a comparative study of the types of genetics patients seen via these two modalities has not been performed previously. In this study we: (1) examined the uptake of telehealth in Genetics in Manitoba; (2) contrasted telehealth usage in Genetics with other clinical programs; and (3) performed a comparative study of the types of Genetics referrals seen in 2008 on-site versus via telehealth. Results indicate the uptake of telehealth is increasing and has made genetics outreach clinics unnecessary. The Program of Genetics and Metabolism is consistently one of the top ten utilizers of telehealth within the province. With respect to discipline, chi square analysis revealed the trends were not significantly different for on-site and telehealth encounters, with prenatal referrals being the most common and Hereditary Breast and Ovarian Cancer referrals being the least common. Referrals within each discipline varied depending on the need for fetal assessment and physical examination. Telehealth was utilized regularly for test results sessions across all disciplines.




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Trends in telehealth versus on-site cli - PubMed Mobile



Trends in telehealth versus on-site clinical genetics appointments in Manitoba: a comparative study.

Authors

Elliott AM, et al. Show all

Journal

J Genet Couns. 2012 Apr;21(2):337-44. Epub 2011 Oct 15.

Affiliation

WRHA Program of Genetics and Metabolism, University of Manitoba, Winnipeg, MB, Canada. aelliott@hsc.mb.ca

Abstract

Telehealth involves the use of information and communications technology to deliver health services to patients over distance. Canada is well suited to benefit from telehealth since many individuals live in remote, rural and isolated locations. Manitoba is the easternmost prairie province and MBTelehealth is an active Canadian program that currently has 105 sites in 73 communities. Although studies of patient satisfaction comparing telehealth to on-site clinical visits have been conducted, a comparative study of the types of genetics patients seen via these two modalities has not been performed previously. In this study we: (1) examined the uptake of telehealth in Genetics in Manitoba; (2) contrasted telehealth usage in Genetics with other clinical programs; and (3) performed a comparative study of the types of Genetics referrals seen in 2008 on-site versus via telehealth. Results indicate the uptake of telehealth is increasing and has made genetics outreach clinics unnecessary. The Program of Genetics and Metabolism is consistently one of the top ten utilizers of telehealth within the province. With respect to discipline, chi square analysis revealed the trends were not significantly different for on-site and telehealth encounters, with prenatal referrals being the most common and Hereditary Breast and Ovarian Cancer referrals being the least common. Referrals within each discipline varied depending on the need for fetal assessment and physical examination. Telehealth was utilized regularly for test results sessions across all disciplines.





Wednesday, August 08, 2012

PBS Documentary Climb for Life: A Legacy at REI Salt Lake City



PBS Documentary Climb For Life: A Legacy

Join the HERA Women's Cancer Foundation as they celebrate their 10th anniversary! Learn about the life and work of HERA's founder, Sean Patrick, through KUED's PBS documentary , Climb for Life: A Legacy. In establishing HERA, she gathered a community, became a catalyst for change, and even after her death, inspires the critical quest for ovarian cancer research and awareness. Also hear from survivors and meet others dedicated to the cause. Light refreshments will be served. HERA's largest national event, Climb4Life Utah, offers an incredible weekend of climbing, hiking and shooting photos in the majestic Wasatch Mountains to raise funds for ovarian cancer research and awareness.

Date: Aug 8, 2012 Time: 7 pmPhone: 801-486-2100Address: 3285 East 3300 South, Salt Lake City, 84124Where: REI Salt Lake City



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Tuesday, August 07, 2012

Chemotherapy May Co-opt Healthy Cells to Support Tumors « news@JAMA



Chemotherapy May Co-opt Healthy Cells to Support Tumors « news@JAMA

Why People Stick with Cancer Screening, Even When It Causes Harm (media)



http://healthland.time.com/2012/05/25/why-people-cling-to-cancer-screening-and-other-questionable-medical-interventions-even-when-they-cause-harm/

Families should not be allowed to veto dead relatives' organ donation wishes



http://www.eurekalert.org/pub_releases/2012-08/bmj-fsn080612.php

Ovarian Cancer National Alliance- Help Us Shape Future Ovarian Cancer Research by Answering a Brief Survey (2nd link)



Check out this post: http://www.ovariancancer.org/2012/08/07/help-us-shape-future-ovarian-cancer-research-by-answering-a-brief-survey/


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Survey-Ovarian cancer survivors - SGO / Ovarian Cancer National Alliance




Do you want a say in how ovarian cancer drugs are evaluated, approved and covered? We pleased to announce that the Ovarian Cancer National Alliance is partnering with the Society of Gynecologic Oncology (SGO) on a first-of-its-kind survey for women with ovarian cancer. Your input will help the Alliance and SGO better understand the patient perspective on outcomes from clinical research–and could shape future research.

We urge all ovarian cancer survivors to click this link and complete our short survey. We want to know which endpoints are meaningful to you, and what impact various side effects have on your quality of life.

We're all used to seeing the outcomes of clinical trials reported in terms of progression-free survival, overall survival and adverse events. Those measures are the basis for whether drugs are approved by the FDA and covered by major health insurers. But what do these outcomes really mean for women with ovarian cancer?

Please help us by completing the survey and sharing it with other women with ovarian cancer. Your responses are completely anonymous. The results from this survey will be used to draft a white paper guiding future research on ovarian cancer.

If you have any questions about this survey, feel free to contact the Alliance at ocna@ovariancancer.org or (202) 331-1332.




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: Venous thromboembolism is a relevant and underestimated adverse event in cancer patients treated in phase I studiesBritish Journal of Cancer




Clinical Study

British Journal of Cancer 107, 612-616 (7 August 2012) |doi:10.1038/bjc.2012.325

Venous thromboembolism is a relevant and underestimated adverse event in cancer patients treated in phase I studies

Background:

To investigate, retrospectively, the role of tumour histotype and antiangiogenic drugs for venous thromboembolism (VTE) development in advanced cancer patients treated in phase I studies.

Methods:

Patients enrolled and treated in phase I studies conducted by SENDO (Southern Europe New Drugs Organisation) were considered.

Results:

Data of 1415 patients were included in the analysis: 526 (37.2%) patients were males, median age was 57.3 years (range: 13–85). Fifty-six (3.96%) patients developed a VTE. At multivariate analysis gynaecologic (hazard ratio (HR): 2.8, 95%confidence interval (CI): 1.29–6.23, P=0.009) and gastrointestinal tumours (HR: 3.23, 95% CI: 1.18–8.87, P=0.023) as well as combination regimens of cytotoxic and antiangiogenic agents (HR: 2.6, 95%CI: 1.11–6.30, P=0.028), white blood cell >11000μl−1 (HR: 2.59, 95% CI: 1.10–6.09, P=0.028) and haemoglobin<10gdl−1 (HR: 3.1, 95%CI: 1.07–8.94, P=0.037) were statistically correlated with VTE development. Venous thromboembolism was the fourth most common cause of drug discontinuation. The median time from first drug administration to discontinuation was 1.4 for VTE and 2.3 months for the other adverse events (P=0.02).

Conclusion:

Venous thromboembolism is a relatively common complication among patients treated in the context of phase I studies, and may lead to early drug discontinuation. A greater risk of developing VTE is associated with the diagnosis of gynaecologic and gastrointestinal tumours and the combined use of chemotherapy and antiangiogenic drugs.




Foundation Medicine and Clovis Oncology form alliance - Mass High Tech Business News



Foundation Medicine and Clovis Oncology form alliance - Mass High Tech Business News

Oxigene Announces Phase 2 Ovarian Cancer Trial of Zybrestat Plus Bevacizumab Achieves Important Interim Safety Objective



http://pharmalive.com/News/Index.cfm?articleid=851802

What is symptom burden: a qualitative exploration of patient definitions.



What is symptom burden: a qualitative exploration of patient definitions.


J Palliat Care. 2012 Summer

Abstract

Current definitions of "symptom burden" are largely derived from clinicians, and there are many variations in the way the term is used, defined, and operationalized. The aim of this study was to explore patient perceptions of symptom burden in the context of advanced and incurable disease. A group of 58 cancer patients followed by a palliative care team answered a single open-ended question: "Please define 'symptom burden'". Three authors independently coded and analyzed patient responses using a grounded theory approach. They identified six themes, the most frequently coded of which were: "can't do usual activities", "psychological suffering" and "specific severe symptoms". Our findings indicate that the concept of symptom burden is complex and extends beyond numerical symptom-scoring systems. In addition to inquiring about specific symptoms, it may be important to directly ask patients about their overall burden or experience of symptoms.





Ovarian cancer and smoking





Reply to "How to improve cytoreductive surgery for advanced ovarian cancer and talk about it in a common language" pay walled



http://www.ncbi.nlm.nih.gov/m/pubmed/22864110/?i=12&from=ovarian%20cancer

Metformin Targets Ovarian Cancer Stem ...



Abstract

PURPOSE: Studies in non-gynecologic tumors indicate metformin inhibits growth of cancer stem cells (CSC). Diabetic patients with ovarian cancer who are taking metformin have better outcomes than those not taking metformin. The purpose of this study was to directly address the impact of metformin on ovarian CSC.

METHODS: The impact of metformin on ovarian cancer cell line growth and viability was assessed ......,,


Impact of Routine Follow-Up Examinations on Life Expectancy in Ovarian Cancer Patients: A Simulation Study.



Impact of Routine Follow-Up Examinations on Life Expectancy in Ovarian Cancer Patients: A Simulation Study.

 

Abstract

OBJECTIVE: The clinical benefit of routine follow-up in patients treated for ovarian cancer is subject to debate. In this study, the magnitude of the potential survival benefit of routine examinations was evaluated by Markov modeling.

METHODS: The clinical course of ovarian cancer was simulated using a 4-state nonstationary Markov model. Risk of recurrence and mortality probabilities were derived from individual patient data and Statistics Netherlands. The life expectancy was simulated for 3 follow-up scenarios: a current, withholding (all recurrences detected symptomatically), and perfect follow-up program (all recurrences detected asymptomatically). The impact of effective recurrence treatment in the future was modeled by varying the mortality ratio between patients with asymptomatically versus symptomatically detected recurrences. The model was validated using empirical data.

RESULTS: The mean life expectancy of patients, aged 58 years and in complete clinical remission after primary treatment, was 10.8 years. Varying the transition probabilities with ±25% changed the life expectancy by up to 1.1 years. The modeled life expectancy for the withholding and perfect follow-up scenarios was also 10.8 years and insensitive to model assumptions. In patients with stages IIB to IV, the life expectancy was 7.0 years, irrespective of follow-up strategy. A mortality ratio of 0.8 for patients with asymptomatically versus symptomatically detected recurrences resulted in a gain in life expectancy of 5 months for withholding versus perfect follow-up.

CONCLUSIONS: Routine follow-up in ovarian cancer patients is not expected to improve the life expectancy. The timing of detection of recurrent ovarian cancer is immaterial until markedly improved treatment options become available.




Systematic lymphadenectomy in ovarian cancer at second-look surgery: a randomised clinical trial.



http://www.ncbi.nlm.nih.gov/m/pubmed/22864456/?i=8&from=ovarian%20cancer

High frequency of BRCA1 founder mutation in Polish women with non familial breast cancer



High frequency of BRCA1 founder mutations in Polish women with nonfamilial breast cancer.

Abstract

Possession of a BRCA1/2 mutation increases risk of contralateral breast and ovarian cancer recurrence and may have an impact on health management decisions, such as imaging screening, preventive surgical interventions and systemic therapies. A hospital-based study was conducted to assess the frequency and spectrum of pathogenic germline BRCA1 and BRCA2 mutations in Polish women with familial and nonfamilial breast cancer. Genomic DNA was extracted from 1581 women with breast cancer and from 2225 healthy individuals. For genotyping BRCA1 (5382insC, T300G, 3819del5, 185delAG, C5370T, 3875del4, 3896delT, 4153delA, 4184del4, 4160delAG, G5332A) mutations and BRCA2 (G1408T, 5467insT, 6174delT, 6192delAT, 6675delTA, 8138del5, 9152delT, C9610T, 9630delC) mutations, a Custom TaqMan (Applied Biosystems) PCR-based technology was adopted. A BRCA1 mutation was found in 26 and 12.5 % of women with familial breast cancer and in 13 and 8.3 % nonfamilial (sporadic) breast cancer, diagnosed before or after 50 years of age, respectively. A much lower frequency of BRCA2 mutation was observed. The predominance of seven BRCA1 mutations (5382insC, T300G, 3819del5, 185delAG, C5370T, 3875del4, 4153delA) studied in the Masovian voivodeship population confirmed a strong founder effect for BRCA1 mutations in the Polish population, and the results of BRCA2 testing confirmed a high diversity in the studied pathogenic mutations in BRCA2 gene. We propose offering inexpensive testing for the presence of BRCA1 founder mutations to all Polish women at the time of initial breast cancer diagnosis, regardless of the patient's family history or age of disease onset.




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The Microculture-Kinetic (MiCK) Assay: The Role of a Drug-Induced Apoptosis Assay in Drug Development and Clinical Care.



http://www.ncbi.nlm.nih.gov/m/pubmed/22865459/?i=5&from=ovarian%20cancer

Sunday, August 05, 2012

Vitamins & Supplements - Sept 2012 Consumer Reports Investigates



Vitamins & Supplements - Consumer Reports Investigates

paywalled: Patients with Lynch Syndrome Mismatch Repair Gene Mutations Are at Higher Risk for Not Only Upper Tract Urothelial Cancer but Also Bladder Cancer



Patients with Lynch Syndrome Mismatch Repair Gene Mutations Are at Higher Risk for Not Only Upper Tract Urothelial Cancer but Also Bladder Cancer

Abstract

Background

Lynch syndrome (LS), or hereditary nonpolyposis colorectal cancer, is caused by mutations in mismatch repair (MMR) genes. An increased risk for upper tract urothelial carcinoma (UTUC) has been described in this population; however, data regarding the risk for bladder cancer (BCa) are sparse.

Objective

To assess the risk of BCa in MMR mutation carriers and suggest screening and management recommendations.

Design, setting, and participants

Cancer data from 1980 to 2007 were obtained from the Familial Gastrointestinal Cancer Registry in Toronto for 321 persons with known MMR mutations: mutL homolog 1, colon cancer, nonpolyposis type 2 (E. coli) (MLH1); mutS homolog 2, colon cancer, nonpolyposis type 1 (E. coli) (MSH2); mutS homolog 6 (E. coli) (MSH6); and PMS2 postmeiotic segregation increased 2 (S. cerevisiae) (PMS2).

Outcome measurements and statistical analysis

Standardized incidence ratios from the Ontario Cancer Registry, using the Surveillance Epidemiology and End Results public database, were used to compare cancer risk in patients with MMR mutations with the Canadian population. Microsatellite instability analysis and immunohistochemistry (IHC) of the MMR proteins were also performed and the results compared with matched sporadic bladder tumors.

Results and limitations

Eleven of 177 patients with MSH2 mutations (6.21%, p < 0.001 compared with the Canadian population) were found to have BCa, compared with 3 of 129 patients with MLH1 mutations (2.32%, p > 0.05). Of these 11 tumors, 81.8% lacked expression of MSH2 on IHC, compared with the matched sporadic cases, which all displayed normal expression of MSH2 and MLH1. The incidence of UTUC among MSH2 carriers was 3.95% (p < 0.001), and all tumors were found to be deficient in MSH2 expression on IHC. Mutations in the intron 5 splice site and exon 7 of the MSH2 gene increased the risk of urothelial cancer. Limitations include possible inflated risk estimates due to ascertainment bias.

Conclusions

LS patients with MSH2 mutations are at an increased risk for not only UTUC but also BCa and could be offered appropriate screening.


Figures and tables from this article:
Full-size image (105K)
Fig. 1. Tumor sections at ×200 magnification: (A) abnormal MSH2 expression—nuclear expression is lost in the tumor, with normal nuclear staining in the adjacent tissue; (B) normal MLH1 expression—normal strong nuclear expression in the tumor and normal tissue.
View Within Article
Table 1. Distribution of patients with mismatch repair mutations
View table in article
M:F = male-to-female; MLH1 = mutL homolog 1, colon cancer, nonpolyposis type 2 (E. coli); MSH2 = mutS homolog 2, colon cancer, nonpolyposis type 1 (E. coli); MSH6 = mutS homolog 6 (E. coli); PMS2 = PSM2 postmeiotic segregation increased 2 (S. cerevisiae).
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Table 2. Total incidence of urothelial cancers due to MLH1 and MSH2
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MLH1 = mutL homolog 1, colon cancer, nonpolyposis type 2 (E. coli); MSH2 = mutS homolog 2, colon cancer, nonpolyposis type 1 (E. coli); NS = not significant.
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Table 3. Urothelial cancers in patients with confirmed MSH2 mutations and comparison with matched sporadic bladder cancer patients
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− = absent expression; +  = normal expression; CR = colorectal; Dx = diagnosis; EM = endometrial; F = female; GA = gastric; HG = high grade; IHC = immunohistochemistry; LG = low grade; LS = Lynch syndrome; M = male; MSH2 = mutS homolog 2, colon cancer, nonpolyposis type 1 (E. coli); MSI = microsatellite instability; MSI-H = high microsatellite instability; MSS = microsatellite stable; OR = occupational risk; OV = ovarian; RP = renal pelvis; U = ureter.Patients H1 and H2 are related.
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Table 4. Urothelial cancers in patients with confirmed MLH1 mutations
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− = absent expression; +  = normal expression; CR = colorectal; HG = high grade; IHC = immunohistochemistry; LG = low grade; LS = Lynch syndrome; M = male; MLH1 = mutL homolog 1, colon cancer, nonpolyposis type 2 (E. coli); MSI = microsatellite instability; MSI-H = high microsatellite instability; OR = occupational risk; RP = renal pelvis.