ICGC Data Portal
Saturday, August 25, 2012
Clinical Oncology News - The Paradox of Increased Efficacy and End-of-Life Care
Clinical Oncology News - The Paradox of Increased Efficacy and End-of-Life Care
This commentary focuses on the complex and often emotionally charged conflict between a patient’s desire to “fight the cancer” and his or her unquestionably valid need to focus on end-of-life issues at some point in time.
Clinical Oncology News - Randomized Phase II trials: A Pragmatic Way To Inform Clinical Practice
Clinical Oncology News - Randomized Phase II trials: A Pragmatic Way To Inform Clinical Practice
.....
Consider, for example, the recent report on the biological activity of single-agent, nanoparticle albumin-bound paclitaxel in the second-line treatment of epithelial ovarian cancer.1 This nonrandomized study, conducted by the Gynecologic Oncology Group, revealed an objective response rate of 23%, similar to that previously reported with the far less expensive generic paclitaxel.2,3
But is it possible that this agent is actually superior to paclitaxel in that treatment with nanoparticle albumin-bound paclitaxel achieves a similar degree of objective clinical benefit (e.g., degree of tumor shrinkage and delay in time to progression) but with a measurably more favorable toxicity profile that includes a substantially reduced risk for peripheral neuropathy?
Unfortunately, in the complete absence of data from a randomized trial, the answer to this specific question will simply be unknown because any suggested “superior” outcomes may solely reflect the inadvertent selection bias resulting from the favorable baseline clinical features inherent in all nonrandomized studies........
Ten-Year Relative Survival for Epithelial ovarian cancer
Ten-Year Relative Survival for Epithelial Ovarian Cancer Gynecol. 2012 Sep;120(3):612-618.
OBJECTIVE: Most patients with epithelial ovarian cancer who are alive at 5 years have active disease. Thus, 10-year survival rather than 5-year survival may be a more appropriate endpoint. Relative survival adjusts for the general survival of the United States population for that race, sex, age, and date at which the diagnosis was coded. Our objective was to estimate relative survival in epithelial ovarian cancer over the course of 10 years.
METHODS: Using the Surveillance, Epidemiology and End Results 1995-2007 database, epithelial ovarian cancer cases were identified. Using the actuarial life table method, relative survival over the course of 10 years was calculated, stratified by stage, classification of residence, surgery as the first course of treatment, race, and age.
RESULTS: There were 40,692 patients who met inclusion criteria. The overall relative survival was 65%, 44%, and 36% at 2, 5, and 10 years, respectively. The slope of decline in relative survival was reduced for years 5-10 as compared with years 1-5 after diagnosis. Relative survival at 5 years was 89%, 70%, 36%, and 17%, and at 10 years relative survival was 84%, 59%, 23%, and 8% for stages I, II III, and IV, respectively. At all stages, patients with nonsurgical primary treatment and those with advanced age had reduced relative survival.
CONCLUSIONS: The 10-year relative survival for stage III is higher than expected. This information provides the physician and the patient with more accurate prognostic information.
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FDA MedWatch - CareFusion Alaris Pump Module Model 8100: Class I Recall - Motor Stalls During Infusion
From: "U.S. Food & Drug Administration (FDA)" <fda@service.govdelivery.com>
Date: 25 August, 2012 8:42:31 AM EDT
Subject: U.S. Food & Drug Administration (FDA) Daily Digest Bulletin
Subject: FDA MedWatch - CareFusion Alaris Pump Module Model 8100: Class I Recall - Motor Stalls During Infusion
Friday, August 24, 2012
Detection of urothelial tumors: comparison of urothelial phase with excretory phase CT urography--a prospective study.
Detection of urothelial tumors: comparison of urothelial phase with excretory phase CT urography--a prospective study.
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Thursday, August 23, 2012
ScienceDirect.com - European Journal of Cancer - Prognostic impact of the time interval between surgery and chemotherapy in advanced ovarian cancer: Analysis of prospective randomised phase III trials
Prognostic impact of the time interval between surgery and chemotherapy in advanced ovarian cancer: Analysis of prospective randomised phase III trials
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Safety Alerts for Human Medical Products > CareFusion 303, Alaris Pump Module, Model 8100: Class I Recall - Potential for Pump Malfunction To Stop Infusion
...BACKGROUND: The pump module is intended for healthcare facilities that use infusion for the delivery of fluids, drugs, blood, and blood products using continuous or intermittent delivery through intravenous, intra-arterial, subcutaneous, epidural, enteral, or irrigation of fluid spaces routes of administration. The pump module is used for adults, children, and newborns...
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm316637.htm?source=govdelivery
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Search Ovarian cancer: role of ultrasound in preoperative diagnosis and population screening.
Ovarian cancer: role of ultrasound in preoperative diagnosis and population screening.
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Risk of epithelial ovarian cancer in asymptomatic women with ultrasound-detected ovarian masses: a prospective cohort study within the UK collaborative trial of ovarian cancer screening (UKCTOCS).
Risk of epithelial ovarian cancer in asymptomatic women with ultrasound-detected ovarian masses: a prospective cohort study within the UK collaborative trial of ovarian cancer screening (UKCTOCS).
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Blog: truth, hope and communication...
....,Patients want us to be truthful, compassionate, and clear about their prognosis and want to know that we will be there with them every step of the way. Rather than taking away hope, being honest with our patients provides them with the necessary information to help them redefine hope, even if cure is not possible.
http://www.google.ca/reader/i/?source=mog&hl=en&gl=ca
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Ovarian cancer study to look at lifestyle | The Australian
....More than 1000 newly diagnosed Australian women will participate in the five-year study.
"We are trying to answer the question that almost every woman with ovarian cancer asks - what can I do to help beat this disease?" said Associate Professor Penny Webb from the institute's gynaecological cancers group.....
http://m.theaustralian.com.au/news/breaking-news/ovarian-cancer-study-to-look-at-lifestyle/story-fn3dxiwe-1226456389727
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LRP1B Deletion in High-Grade Serous Ova - PubMed Mobile
LRP1B Deletion in High-Grade Serous Ovarian Cancers Is Associated with Acquired Chemotherapy Resistance to Liposomal Doxorubicin.
Wednesday, August 22, 2012
Head of Education and Supportive Services with Target Ovarian Cancer | 348339 (job posting UK)
- Location: Islington, London
- Contract type: Permanent
- Salary: £30,400 for 30 hours per week (£38,000 pro rata)
- Date posted: 22 August 2012
- Recruiter: Target Ovarian Cancer
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Taxanes for Ovarian Cancer during Pregn - PubMed Mobile
Taxanes for Ovarian Cancer during Pregnancy: A Systematic Review.
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Adnexal masses suspected to be benign treated with laparoscopy
Adnexal masses suspected to be benign treated with laparoscopy.
Tuesday, August 21, 2012
Many Americans see specialists for primary care: study
Many Americans see specialists for primary care: study
http://www.reuters.com/article/idUSBRE87K13W20120821
A qualitative study on the term CAM: is there a need to reinvent the wheel?
Conclusions: CAM and other related terms could be used more effectively, provided they are used in the proper context. It appears difficult for the time being to reach a consensus on the definition of the term CAM due to the uncertainty of the positioning of CAM in the contemporary healthcare systems. While umbrella terms such as CAM and IHC are useful in the context of research, policy making and education, relevant stakeholders should limit the use of those
As complementary and alternative medicine (CAM) has developed extensively, uncertainty about the appropriateness of the terms CAM and other CAM-related terms has grown both in the research and practice communities. Various terms and definitions have been proposed over the last three decades, highlighting how little agreement exits in the field. Contextual use of current terms and their respective definitions needs to be discussed and addressed.
Methods:
Relying upon the results of a large international Delphi survey on the adequacy of the term CAM, a focus group of 13 international experts in the field of CAM was held. A forum was also set up for 28 international experts to discuss and refine proposed definitions of both CAM and integrative healthcare (IHC) terms. Audio recordings of the meeting and forum discussion threads were analyzed using interpretive description.
Results:
Multiple terms to describe the therapies, products, and disciplines often referred to as CAM, were considered. Even though participants generally agreed there is a lack of optimal definitions for popular CAM-related umbrella terms and that all terms that have so far been introduced are to some extent problematic, CAM and IHC remained the most popular and accepted terms by far. The names of the specific disciplines were also deemed adequate in certain contexts. Focus group participants clarified the context in which those three terms are appropriate. Existing and emergent definitions of both CAM and integrative healthcare terms were discussed.
A qualitative study on the term CAM: is there a need to reinvent the wheel?
Background:As complementary and alternative medicine (CAM) has developed extensively, uncertainty about the appropriateness of the terms CAM and other CAM-related terms has grown both in the research and practice communities. Various terms and definitions have been proposed over the last three decades, highlighting how little agreement exits in the field. Contextual use of current terms and their respective definitions needs to be discussed and addressed.
Methods:
Relying upon the results of a large international Delphi survey on the adequacy of the term CAM, a focus group of 13 international experts in the field of CAM was held. A forum was also set up for 28 international experts to discuss and refine proposed definitions of both CAM and integrative healthcare (IHC) terms. Audio recordings of the meeting and forum discussion threads were analyzed using interpretive description.
Results:
Multiple terms to describe the therapies, products, and disciplines often referred to as CAM, were considered. Even though participants generally agreed there is a lack of optimal definitions for popular CAM-related umbrella terms and that all terms that have so far been introduced are to some extent problematic, CAM and IHC remained the most popular and accepted terms by far. The names of the specific disciplines were also deemed adequate in certain contexts. Focus group participants clarified the context in which those three terms are appropriate. Existing and emergent definitions of both CAM and integrative healthcare terms were discussed.
Conclusions:
CAM and other related terms could be used more effectively, provided they are used in the proper context. It appears difficult for the time being to reach a consensus on the definition of the term CAM due to the uncertainty of the positioning of CAM in the contemporary healthcare systems. While umbrella terms such as CAM and IHC are useful in the context of research, policy making and education, relevant stakeholders should limit the use of those terms.
Lynch syndrome - review of patient testing
Discussion
Family history of colon cancer is documented for the majority of individuals although this varies by site. Very few individuals are tested for LS at any site, representing a potential under diagnosis of this hereditary condition in patients and their families. When testing is performed, there does not seem to be a preference for immunohistochemistry or microsatellite instability testing for any site.
http://www.google.ca/reader/i/?source=mog&hl=en&gl=ca#stream/user%2F16646332178603240200%2Fstate%2Fcom.google%2Freading-list
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Monday, August 20, 2012
Nearly half of U.S. doctors struggle with burnout: study
Nearly half of U.S. doctors struggle with burnout: study
http://www.reuters.com/article/idUSBRE87J0RJ20120821
Body composition changes in females treated for breast cancer: a review of the evidence
Body composition changes in females treated for breast cancer: a review of the evidence
Abstract
Body composition changes cannot be precisely captured using body weight or body mass index measures. Therefore, the primary
purpose of this review was to characterize the patterns of body composition change in females treated for breast cancer including
only studies that utilize imaging technologies to quantify adipose tissue and lean body mass (LBM). We reviewed PubMed for
studies published between 1971 and 2012 involving females diagnosed with breast cancer where computed axial tomography , dual-energy
X-ray absorptiometry, or magnetic resonance imaging were employed for body composition assessment. Of the initial 440 studies,
106 papers were evaluated and 36 papers met all eligibility criteria (15 observational and 21 intervention trials). Results
of these studies revealed that body weight did not consistently increase. Importantly, studies also showed that body weight
did not accurately depict changes in lean or adipose tissues. Further findings included that sarcopenic obesity as a consequence
of breast cancer treatment was not definitive, as menopausal status may be a substantial moderator of body composition. Overall,
the behavioral interventions did not exhibit consistent or profound effects on body composition outcomes; approximately half
showed favorable influence on adiposity while the effects on LBM were not apparent. The use of tamoxifen had a clear negative
impact on body composition. The majority of studies were conducted in predominantly white survivors, highlighting the need
for trials in minority populations. Collectively, these studies were limited by age, race, and/or menopause status matched
control groups, overall size, and statistical power. Very few studies simultaneously collected diet and exercise data—two
potential factors that impact body composition. Future breast cancer trials should prioritize precise body composition methodologies
to elucidate how these changes impact recurrence, prognosis, and mortality, and to provide clinicians with appropriate advice
regarding lifestyle recommendations in this growing sector of the population.
purpose of this review was to characterize the patterns of body composition change in females treated for breast cancer including
only studies that utilize imaging technologies to quantify adipose tissue and lean body mass (LBM). We reviewed PubMed for
studies published between 1971 and 2012 involving females diagnosed with breast cancer where computed axial tomography , dual-energy
X-ray absorptiometry, or magnetic resonance imaging were employed for body composition assessment. Of the initial 440 studies,
106 papers were evaluated and 36 papers met all eligibility criteria (15 observational and 21 intervention trials). Results
of these studies revealed that body weight did not consistently increase. Importantly, studies also showed that body weight
did not accurately depict changes in lean or adipose tissues. Further findings included that sarcopenic obesity as a consequence
of breast cancer treatment was not definitive, as menopausal status may be a substantial moderator of body composition. Overall,
the behavioral interventions did not exhibit consistent or profound effects on body composition outcomes; approximately half
showed favorable influence on adiposity while the effects on LBM were not apparent. The use of tamoxifen had a clear negative
impact on body composition. The majority of studies were conducted in predominantly white survivors, highlighting the need
for trials in minority populations. Collectively, these studies were limited by age, race, and/or menopause status matched
control groups, overall size, and statistical power. Very few studies simultaneously collected diet and exercise data—two
potential factors that impact body composition. Future breast cancer trials should prioritize precise body composition methodologies
to elucidate how these changes impact recurrence, prognosis, and mortality, and to provide clinicians with appropriate advice
regarding lifestyle recommendations in this growing sector of the population.
Sunday, August 19, 2012
A Nonsynonymous Polymorphism inIRS1 Modifies Risk of Developing Breast and Ovarian Cancers inBRCA1 and Ovarian Cancer
A Nonsynonymous Polymorphism inIRS1 Modifies Risk of Developing Breast and Ovarian Cancers inBRCA1 and Ovarian Cancer inBRCA2 Mutation Carriers
Abstract
Background: We previously reported significant associations between genetic variants in insulin receptor substrate 1 (IRS1) and breast cancer risk in women carrying BRCA1 mutations. The objectives of this study were to investigate whether the IRS1 variants modified ovarian cancer risk and were associated with breast cancer risk in a larger cohort of BRCA1 and BRCA2mutation carriers......
.....impact of ovarian cancer screening
Abstract
Ongoing ovarian cancer screening trials are investigating the efficacy of a two-step screening strategy using currently available blood and imaging tests [CA125 and transvaginal sonography (TVS)]. Concurrently, efforts to develop new biomarkers and imaging tests seek to improve screening performance beyond its current limits. This study estimates the mortality reduction, years of life saved, and cost-effectiveness achievable by annual multimodal screening using increasing CA125 to select women for TVS, and predicts improvements achievable by replacing currently available screening tests with hypothetical counterparts with better performance characteristics. An existing stochastic microsimulation model is refined and used to screen a virtual cohort of 1 million women from ages 45 to 85 years. Each woman is assigned a detailed disease course and screening results timeline. The preclinical behavior of CA125 and TVS is simulated using empirical data derived from clinical trials. Simulations in which the disease incidence and performance characteristics of the screening tests are independently varied are conducted to evaluate the impact of these factors on overall screening performance and costs. Our results show that when applied to women at average risk, annual screening using increasing CA125 to select women for TVS achieves modest mortality reduction (∼13%) and meets currently accepted cost-effectiveness guidelines. Screening outcomes are relatively insensitive to second-line test performance and costs. Identification of a first-line test that does substantially better than CA125 and has similar costs is required for screening to reduce ovarian mortality by at least 25% and be reasonably cost-effective.Cancer Prev Res; 5(8); 1015–24. ©2012 AACR.
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ScienceDirect.com - Gynecologic Oncology Case Reports - Management of a skin metastasis in a patient with advanced ovarian cancer
Management of a skin metastasis in a patient with advanced ovarian cancer
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Saturday, August 18, 2012
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