Thursday, November 27, 2008
Ovarian cancer detection and treatment: current situation and future prospects - abstract
Ovarian cancer detection and treatment: current si...[Anticancer Res. 2008 Sep-Oct] - PubMed Result: "Ovarian cancer detection and treatment: current situation and future prospects.
Argento M, Hoffman P, Gauchez AS.
Pôle de Biologie, CHU Grenoble, BP217 38043 Grenoble cedex 9, France.
Between 70 and 75% of ovarian carcinomas are not discovered until they have reached an advanced stage III or later. Efforts should therefore be concentrated on earlier diagnosis. Ovarian cancer is not an entirely silent disease. Today, it is known that there are key symptoms which, depending on their frequency and intensity, can serve as warning signs to clinicians and patients. Mass screening for ovarian cancer is not currently possible because of a lack of specific markers for use in biological and imaging techniques, although new markers are now being developed. Screening every six or twelve months with the CA 125 blood test plus a transvaginal ultrasound is restricted to women at risk. Certain teams have proposed preventive bilateral adnexectomy for such women. The ovary is a complex organ subjected to a hormonal environment and affected by immune system dysfunctions. There now appears to be consensus on the influence of hormones in ovarian cancer, namely the beneficial role of pregnancy, breast feeding and in particular oral contraception, as well as the deleterious role of hormone replacement therapy(HRT).
However, the two main arguments put forward, incessant ovulation and exposure to gonadotropins, do not explain all the epidemiological data. It is through a better understanding of the etiology of ovarian cancer that new therapies can be developed. The theory of cancer immune surveillance, whereby lymphocytes have a sentinel role of recognizing and constantly suppressing malignant cells, provided a starting point for research into antitumoral immunotherapy. The first trials of vaccination by direct injection of tumor antigens or "loaded" dendritic cells today offer considerable hope for patients.
How Peer Review Failed at Redding Medical Center, Why It Is Failing Across the Country and What Can Be Done About It
While this is not specific to ovarian cancer, I expect it will be value for many:
redding-failure.pdf (application/pdf Object)
Wednesday, November 26, 2008
The withdrawal from oncogenetic counselling and testing for hereditary and familial breast and ovarian cancers
The withdrawal from oncogenetic counselling and te...[J Exp Clin Cancer Res. 2008] - PubMed Result
"CONCLUSIONS: The study revealed the importance to pay attention to the whole persona and their family system as well as provide information highlighting usefulness of early diagnosis."
Aggressive and complex surgery for advanced ovarian cancer: an economic analysis
Aggressive and complex surgery for advanced ovaria...[Gynecol Oncol. 2008] - PubMed Result
"CONCLUSIONS: Complex surgery for ovarian cancer cytoreduction carries a survival benefit at increased direct medical cost. However, preliminary cost-effectiveness results suggest complex surgery provides good value for money spent. Future research on the cost and quality of life implications of surgical morbidity during follow-up is warranted to formally assess the cost-effectiveness of complex vs. simple surgical procedures."
Cause-Specific Survival for Women Diagnosed With Cancer During Pregnancy or Lactation: A Registry-Based Cohort Study
Cause-Specific Survival for Women Diagnosed With C...[J Clin Oncol. 2008] - PubMed Result
"CONCLUSION: In general, the diagnosis of most cancer types during pregnancy or lactation does not increase the risk of cause-specific death. Breast and ovarian cancer diagnosed during lactation represents an exception."
Tuesday, November 25, 2008
Monday, November 24, 2008
news item regarding Commonwealth Fund publication Nov 2008
excerpts:
Only one-quarter (26%) of U.S. and Canadian patients reported same-day access to doctors when they were sick—and one-fourth or more reported long waits. In contrast, about half or more of Dutch (60%), New Zealand (54%), and U.K. (48%) patients were able to get a same-day appointment.
In the past two years, 59 percent of U.S. patients visited an emergency room; only Canada had higher rates (64%). In both countries, one in five said they went to the ER for a condition that could have been cared for by a regular doctor if one had been available.
Interval debulking surgery for advanced epithelial...[Gynecol Oncol. 2008] - PubMed Result
Interval debulking surgery for advanced epithelial...[Gynecol Oncol. 2008] - PubMed Result
"CONCLUSIONS: Our review could not conclude whether IDS would improve the survival of women with advanced EOC compared with conventional treatment. IDS appeared to yield benefit only in the patients whose primary surgery was not performed by expert surgeons."
Oophorectomy as a risk factor for coronary heart disease
Conclusion
The existing evidence is inconclusive to determine the effect of BSO on risk of CHD.
Sunday, November 23, 2008
The Role of Antioxidants and Vitamin A in Ovarian Cancer: Results From the Women's Health Initiative - Nutrition and Cancer
The Role of Antioxidants and Vitamin A in Ovarian Cancer: Results From the Women's Health Initiative - Nutrition and Cancer
"The results from this prospective study of well-nourished, postmenopausal women suggest that intake of dietary antioxidants, carotenoids, and vitamin A are not associated with a reduction in ovarian cancer risk."
Uptake of clinical genetic testing for ovarian cancer in Ontario: a population based study
Uptake of clinical genetic testing for ovarian can...[Gynecol Oncol. 2008] - PubMed Result:
"CONCLUSIONS: Genetic testing is available in Ontario to all women with invasive ovarian cancer. However, only a small proportion of women are being referred for testing. This study suggests that increased public awareness directed at physicians and at women with cancer may expand the use of genetic testing."
ICES - search results "ovarian"
| 1 | Health care delivery in Canada and the United States: are there relevant differences in health care outcomes? | 5% | Investigative Reports | September, 2003 |
| At a Glance | ||||
| 2 | At A Glance - October 2008 | 39% | At a Glance | October, 2008 |
| Journal Publications | ||||
| 3 | Outcomes in surgery for ovarian cancer | 12% | Journal Publications | September, 2003 |
| 4 | Surgical outcomes in women with ovarian cancer | 10% | Journal Publications | October, 2008 |
| Other | ||||
| 5 | Chapter 7: Surgery for Ovarian Cancer | 100% | Other | November, 2008 |
| 6 | Egg race | 16% | Other | April, 2006 |
| 7 | More than skin deep | 12% | Other | December, 2003 |
| 8 | Overview | 3% | Other | November, 2008 |
| 9 | Technical Appendix (abbreviated version) | 2% | Other | November, 2008 |
| 10 | Chapter 1: Introduction | 2% | Other | November, 2008 |
| 11 | Chapter 10: Reflections and Recommendations | 2% | Other | November, 2008 |
| 12 | HC 2008 - Urbach - Cancer surgery services | 2% | Other | February, 2008 |
Cancer Surgery in Ontario, Chapter 7, Surgery for Ovarian Cancer 2008 December report
Cancer Surgery in Ontario, Chapter 7, Surgery for Ovarian Cancer.pdf (application/pdf Object)
Implications:
More research is needed to better
understand why the use of cancer
staging procedures—such as
omentectomy and lymph node
excision—varied among women in
the study cohort who underwent
surgery for ovarian cancer.
Plans for expanding surgical services
related to the treatment of ovarian
cancer in Ontario should factor in the
existing referral patterns among Local
Health Integration Networks (LHINs).
There are relatively few gynecologic
oncologists in Ontario; these subspecialists
provide care to a large
number of women with ovarian cancer.
Further evaluation is required—both
in terms of the role of gynecologic
oncologists in treating women with
ovarian cancer, and also whether the
supply of these specialists will be
sufficient to meet future demand.
Findings
• While the incidence of ovarian cancer among Ontario women increased with age in 2003/04, the probability of surgical treatment decreased. About three-quarters (73 percent) of women in the Overall Ovarian Cancer Cohort underwent a surgical procedure related to the diagnosis and treatment of their disease.
• There was no clear relationship between women’s socioeconomic status and whether they had surgery for ovarian cancer. However, those living in regions with the lowest neighbourhood income were less likely than all others to have ovarian cancer-related surgery. (duh?)
• Rates of ovarian cancer-related surgery ranged across Local Health Integration Networks (LHINs) of patient residence—from a low of 58 percent among women living in the North West LHIN to a high of 88 percent among those residing in the Erie St. Clair LHIN.
Lymph node excision was done in just eight percent of women with ovarian cancer
During the study period, gynecologic oncologists comprised about seven percent of all physicians performing ovarian cancer
surgery in Ontario. Yet these sub-specialists performed nearly half (49) percent of all the surgeries among women in the
Ovarian Cancer Surgery Cohort.
Obstetrician/gynecologists performed 40 percent of surgeries on women in this study cohort; the remaining 12 percent of
procedures were done by physicians with other specialties.
Gynecologic oncologists were more likely than obstetrician/gynecologists to perform omentectomy (70 percent vs. 44 percent respectively) and lymph node excision (13 percent vs. six percent
Canadian Medicine: New study adds weight to call for boys to get HPV vaccine too
Canadian Medicine: New study adds weight to call for boys to get HPV vaccine too
"The study’s failure to demonstrate the vaccine’s effect on cancer is a function of the same problem that some critics of the HPV vaccine identified in the trials on girls: the trials’ follow-up periods aren’t long enough to determine whether there will actually be a drop in cancers, and, if so, how long the vaccine’s protection will last."
Note: nor long-term side effects
Commentary: Hormone Receptor Testing in Breast Cancer: A Distress Signal from Canada
Commentary: Hormone Receptor Testing in Breast Cancer: A Distress Signal from Canada -- Allred 13 (11): 1134 -- The Oncologist
Note: this response addresses the clinical aspects but not the political landscape and lack of transparency.
original article:
Breast Cancer Testing Scandal Shines Spotlight on Black Box of Clinical Laboratory Testing
http://jnci.oxfordjournals.org/cgi/content/full/100/12/836?ijkey=bfa78dfa42fd694d7cd597c944b59f7b421076d4&keytype2=tf_ipsecshaFriday, November 21, 2008
Macleans.ca - The angry breast cancer survivors
Macleans.ca - The angry breast cancer survivors
Women with post-treatment maladies find no one really wants to hear ‘downbeat’ stories
Thursday, November 20, 2008
AFP: European patent office restores breast cancer gene patent
AFP: European patent office restores breast cancer gene patent
"Only a handful of countries -- including Brazil and Chile -- do not allow patents on genes in any form."
Wednesday, November 19, 2008
The impact of positron emission tomography (PET) on expected management during cancer treatment: findings of the National Oncologic PET Registry.
http://www.ncbi.nlm.nih.gov/pubmed/19016303?dopt=AbstractPlus"
Tuesday, November 18, 2008
[Bowel Perforation Associated with Bevacizumab Therapy in Recurrent Ovarian Cancers without Bowel Obstruction or Bowel Involvement
http://www.ncbi.nlm.nih.gov/pubmed/19011357?dopt=AbstractPlus
Rare Appendix Tumor - Pseudomyxoma Peritonei (PMP)
http://www.cancerwise.org/april_2007/display.cfm?id=119563e8-6f93-48bd-9c3f22598df717dc&method=displayfull&color=green
"How is PMP diagnosed?
The disease is challenging to diagnose. A lot can be hidden inside the abdomen, and it develops slowly over time. Many patients are originally misdiagnosed with ovarian cancer (women) or metatastatic colon cancer."
Monday, November 17, 2008
Family history can trump breast cancer gene test - Yahoo! News
http://news.yahoo.com/s/ap/20081117/ap_on_he_me/med_breast_cancer_3
Family history can trump breast cancer gene test
By LAURAN NEERGAARD, AP Medical Writer Lauran Neergaard, Ap Medical Writer Mon Nov 17, 3:28 pm ET
WASHINGTON – If breast cancer runs in the family, women can be at high risk even if they test free of the disease's most common gene mutations, sobering new research shows. The genes BRCA1 and BRCA2 are linked with particularly aggressive hereditary breast cancer, and an increased risk of ovarian cancer, too.
When a breast cancer patient is found to carry one of those gene mutations, her relatives tend to breathe a sigh of relief if they test gene-free.
But those headline-grabbing genes account for only about 15 percent of all breast cancer cases. Even in families riddled with breast cancer, a BRCA gene is the culprit only in roughly one family of every five that gets tested, said University of Toronto cancer specialist Dr. Steven Narod.
So clearly members of those families remain at risk from other yet-to-be-found genes, but how much risk?
Narod tracked nearly 1,500 women from 365 breast cancer-prone families, who tested negative for BRCA1 and BRCA2 mutations.
After five years, those women had a fourfold higher risk than average women of developing breast cancer, Narod reported Monday at a meeting of the American Association for Cancer Research.
This is crucial information for women considering gene testing, said Georgetown University genetics counselor Beth Peshkin, who wasn't part of the study.
"This is contrary to what I think the common perception is," Peshkin said. "Unless a mutation is identified in the family, a negative test result doesn't provide reassurance."
The good news: Narod's study showed these women didn't have an increased risk of ovarian cancer, like BRCA1- and BRCA2-carriers do.
While the $3,000 BRCA tests are well-accepted, newer tests for other genes linked to breast cancer are coming on the market.
But "the family history is a much stronger predictor," stressed Narod. He recommends that such women take the anti-cancer drug tamoxifen and undergo MRI cancer checkups instead of easier mammograms "regardless of what other gene tests showed."
Oncology: percentage of visits for patients, regardless of age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy ....
http://www.qualitymeasures.ahrq.gov/summary/summary.aspx?ss=1&doc_id=12046
Oncology: percentage of visits for patients, regardless of age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy who report having pain with a documented plan of care to address pain.
Cancer in Canada in 2008 -- Marrett et al. 179 (11): 1163 -- Canadian Medical Association Journal
http://www.cmaj.ca/cgi/content/full/179/11/1163?etoc#T122
Pandora's box: ethics of PGD for inherited risk of late-onset disorders
http://www.ncbi.nlm.nih.gov/pubmed/18983739?ordinalpos=8&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
Metabolic syndrome after risk-reducing salpingo-oophorectomy in women at high risk of hereditary breast ovarian cancer
A controlled observational study:
http://www.ncbi.nlm.nih.gov/pubmed/19008092?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
A serum based analysis of ovarian epithelial tumorigenesis
http://www.ncbi.nlm.nih.gov/pubmed/19007974?dopt=Abstract
Helping Doctors and Patients Make Sense of Health Statistics
http://www.psychologicalscience.org/journals/pspi/pspi_8_2_article.pdf">pspi_8_2_article.pdf
SUMMARY
We show that information pamphlets,
Web sites, leaflets distributed to doctors by the pharmaceutical
industry, and even medical journals often report
evidence in nontransparent forms that suggest big benefits
of featured interventions and small harms. Without understanding
the numbers involved, the public is susceptible
to political and commercial manipulation of their anxieties
and hopes, which undermines the goals of informed consent
and shared decision making.
Methods of consumer involvement in developing healthcare policy and research, clinical practice guidelines and patient information material -Cochrane
http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD004563/frame.html
"Two studies, which compared using consumer interviewers with staff interviewers as data collectors for patient satisfaction surveys, found small differences in satisfaction survey results, with less favourable results obtained when consumers were the interviewers."
Laparoscopy versus laparotomy for FIGO Stage I ovarian cancer - Cochrane Review
http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD005344/frame.html
The Canadian Press: Surgeons aren't following all guidelines to lower infection risks: survey
http://www.google.com/hostednews/canadianpress/article/ALeqM5g0WNRYszHEFxjZugztFqtiNXi-wg"
Fighting cancer with the internet and social networking : The Lancet Oncology
http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(08)70275-4/fulltext
Very rapidly, social networking applications, such as Wikipedia, FaceBook, YouTube, and MySpace, have risen to be in the top-ten most-used sites on the Web, reshaping how we communicate, learn, and live.
Note: there was no specific mention of one of the original online cancer sites: Association of Online Cancer Resources:
http://www.acor.org
Sunday, November 16, 2008
Why have evidence if it's really money that matters?
http://www.ncbi.nlm.nih.gov/pubmed/18822549?dopt=AbstractPlus
Friday, November 14, 2008
Does patient knowledge improve treatment outcome?
[Does patient knowledge improve treatment outcome?] [Z Evid Fortbild Qual Gesundhwes. 2008] - PubMed Result
Non-compliance in patients is rarely provoked by intention or laziness. Thus, patients should not be the first to be blamed for lack of therapeutic success. Non-compliance from health care providers to supply patients with necessary information and skills, though, is an important cause of insufficient treatment outcomes. Patient knowledge can improve health outcomes. But this knowledge must be evidence-based and relevant for the patient. In addition, knowledge must enable patients to assume an important part in disease control and treatment. Evaluation of patient information or self-management programmes should consider that knowledge is just one component of a complex intervention..... cont'd
abstract: The Role of Antioxidants and Vitamin A in Ovarian Cancer: Results from the Women's Health Initiative (WHI)
The Role of Antioxidants and Vitamin A in Ovarian ...[Nutr Cancer. 2008] - PubMed Result:
"The results from this prospective study of well-nourished, postmenopausal women suggest that intake of dietary antioxidants, carotenoids, and vitamin A are not associated with a reduction in ovarian cancer risk."
Improved survival for fallopian tube cancer: a comparison of clinical characteristics and outcome for primary fallopian tube and ovarian cancer.
http://www.ncbi.nlm.nih.gov/pubmed/19006196?dopt=AbstractPlus
Joint Declaration and Statement of Commitment on Palliative Care and Pain Treatment as Human Rights
Palliative Care and Pain Treatment as Human Rights
There have been several requests and publications calling for palliative care and pain treatment to be recognized as human rights but not an international Declaration joining palliative care, pain, cancer, AIDS and other related organizations for this same purpose. The IAHPC and the Worldwide Palliative Care Alliance (WPCA) joined efforts and worked together to develop a Joint Declaration and Statement of Commitment which unites all organizations working in this field.
Thursday, November 13, 2008
Monday, November 10, 2008
abstract: Symptoms of ovarian cancer in young patients 2 years before diagnosis
IngentaConnect Symptoms of ovarian cancer in young patients 2years before diagno...: "complained of at least one symptom up to 2 years before diagnosis"
Highlights on an Invitational Exchange Fall 2008 The Change Foundation
Lessons & Confessions from the Regional Health-care Front: Where can they lead Ontario?
May 2008
Confessions_Web.pdf (application/pdf Object)
Advice and admonitions for Ontario:
Support leaders who stand alone, take the heat, bear
the pain, and tell the truth.
A statement for extensive primary cytoreductive surgery in advanced ovarian cancer (references CHORUS trial)
Wiley InterScience :: Article :: HTML Full Text
The support that this trial and its European counterpart received suggests to us that there are many like-minded gynaecological oncologists who wish to see our management strategies for ovarian cancer based on evidence and not historical practice.
Virtual Posters: Health-Related Quality of Life in Ovarian Cancer: methodological issues in Randomised Controlled Trials
Virtual Posters
Conclusions
Lack of clear reporting of trial withdrawals and inappropriate statistical methods for handling missing data and informative censoring are predominant in the ovarian cancer trial literature. This may bias results and limit information in understanding disease impact and any therapeutic treatment benefits. Future trials should focus on these methodological limitations and a priori definitions of minimally important differences in HRQOL outcomes.
Sunday, November 09, 2008
e-Health: educating, enlightening, or exasperating the American patient with cancer? (NCCN 2008)
e-Health: educating, enlightening, or exasperating the American patient with cancer? (NCCN 2008): "“One of the problems is that cancer is not a sound bite,” argued Al B. Benson III, MD, of the Robert H. Lurie Comprehensive Cancer Center. “It is a complex collection of diseases with very complex biology. And it’s impossible for a lay population to fully grasp all of those nuances.”"
We Fought Cancer…And Cancer Won
We Fought Cancer…And Cancer Won
"....Stop us if you've heard that before. Hope springs eternal that such findings will not join the long list of those that are interesting but irrelevant to patients."
Tuesday, November 04, 2008
Monday, November 03, 2008
Information exchange among physicians caring for the same patient in the community - Canadian Medical Association Journal
Information exchange among physicians caring for the same patient in the community -- van Walraven et al. 179 (10): 1013 -- Canadian Medical Association Journal:
"Conclusion
Our study has revealed poor exchange of information between physicians who treat the same patient in the community. If continuity of patient care is to be increased, interventions and systemic modifications will be needed to improve information exchange.
UICC - Sign the World Cancer Declaration 2008
uicc | international union against cancer - A call to action from the global cancer community
Together we can eliminate cancer as a major threat for future generations
Sign the World Cancer Declaration 2008
Let your voice be heard!
Your endorsement will show the world's leaders that the global cancer community stands united behind this for call for action to reduce the global cancer burden significantly by 2020.
- Click here to sign the declaration online as an individual and here to see the individual signatories
- Click here to endorse the declaration online as an organization and here to see the organizational signatories
- Click here to read the call to action or here to download the pdf
The World Cancer Declaration 2008 is a tool to help cancer advocates bring the growing cancer crisis to the attention of health policymakers at national, regional and global levels.
It represents a consensus between foundations, national and international non-governmental and governmental organizations, professional bodies, the private sector, academia and civil society from all continents that are committed to the vision of eliminating cancer as a major threat for future generations.The UICC encourages partnership within the framework of the World Cancer Declaration. By working together, we can more easily implement the priority actions and achieve the 2020 targets.
Note: Organizations should endorse the call only once
abstract: I am doing the best that i can!
Editorial commentary (mine): interesting the small cap "i":
I am doing the best that i can!
"The qualitative nature of this study provides the 'voice' of women who have a GI disorder, which is often lacking in the literature, thus providing healthcare professionals with insight into the feelings and experiences of these women. The inability to understand the experiences of individuals with chronic conditions can act as a barrier in the treatment and interaction/rapport between healthcare professional and client."
The antidepressant debate and the balanced placebo trial design: An ethical analysis
The antidepressant debate and the balanced placebo...[Int J Law Psychiatry. 2008] - PubMed Result
abstract: Int J Law Psychiatry. 2008 Oct 25
The antidepressant debate and the balanced placebo trial design: An ethical analysis.
Waring DR.
York University, Toronto, Canada.
"...My focal question is whether the BPTD is ethically defensible. I will explore two objections that can be raised against it: 1) lying to BPTD research subjects violates their autonomy and exploits their illness and 2) the BPTD may not enable us to test the additivity thesis with accuracy, i.e., it may contribute to the masking of drug effects that it aims to avoid. I argue that these objections support the conclusion that the BPTD is ethically indefensible."
abstract: The Potential of PARP Inhibitors in Genetic Breast and Ovarian Cancers
Wiley InterScience :: JOURNALS :: Annals of the New York Academy of Sciences: "The Potential of PARP Inhibitors in Genetic Breast and Ovarian Cancers"
Sunday, November 02, 2008
Informed Consent Revisited: A Doctrine in the Service of Cancer Care - The Oncologist
Informed Consent Revisited: A Doctrine in the Service of Cancer Care -- Schachter and Fins 13 (10): 1109 -- The Oncologist
Empathetic and attentive interest in patients facilitates an understanding about patients' physiological and psychological needs. Significantly, it enables the physician to contextualize the patient's decision within the patient's moral and values framework. If there is a paradox in all of this, it is that the ideal of informed consent rests as much in the physician educating the patient as it does in the patient educating the physician.
The Edmonton symptom assessment system-what do patients think? [Support Care Cancer. 2008]
The Edmonton symptom assessment system-what do pat...[Support Care Cancer. 2008] - PubMed Result
"Patients expressed a need to emphasize the timeframe as 'now'."
Interval debulking surgery for advanced epithelial ovarian cancer
Interval debulking surgery for advanced epithelial ovarian cancer
Plain language summary
Interval debulking surgery for advanced epithelial ovarian cancer
"Ovarian cancer frequently presents at an advanced stage so it may not be possible to surgically remove all the tumours. Several cycles of chemotherapy are generally given after primary surgery. Secondary surgery, performed after a few cycles of chemotherapy before proceeding to further cycles of chemotherapy, is called interval debulking surgery (IDS). This review compared the survival of patients with advanced epithelial ovarian cancer, who had IDS performed between cycles of chemotherapy after primary surgery with survival of patients who had conventional treatment (primary debulking surgery and adjuvant chemotherapy). It found similar survival in patients who did and did not receive IDS. No adequate information regarding adverse effects was available. Data on quality of life (QOL) of the patients were also inconclusive."
The American Journal of Surgical Pathology - Abstract: Volume 32(11) November 2008 p 1667-1674 Subdividing Ovarian and Peritoneal Serous Carcinoma Into Moderately Differentiated and Poorly Differentiated
Subdividing Ovarian and Peritoneal Serous Carcinoma Into Moderately Differentiated and Poorly Differentiated Does not Have Biologic Validity Based on Molecular Genetic and In Vitro Drug Resistance Data.
free full text: Loss of DNA Mismatch Repair Protein hMSH6 (one Lynch Syndrome gene) in Ovarian Cancer is Histotype-Specific
Loss of DNA Mismatch Repair Protein hMSH6 in Ovarian Cancer is Histotype-Specific
Conclusions:
These results underscore the importance of identifying the correct HNPCC-associated tumors and genes toward the recognition of affected families that may develop ovarian carcinoma as well as appropriate clinical surveillance. We found negative hMSH6 protein expression in several histologic subtypes of ovarian carcinoma, particularly in clear cell, endometrioid, and mucinous carcinoma, suggesting that loss of hMSH6 function may participate in the genesis of these subtypes of cancer. However, loss of hMSH6 protein expression did not predict overall survival, and it was not associated with disease stage, tumor grade, patient age or family history of cancer.
Wednesday, October 29, 2008
Tuesday, October 28, 2008
Monday, October 27, 2008
U.S. *NEW* Social Security Online - Compassionate Allowances
main page:
http://www.socialsecurity.gov/compassionateallowances/
list of conditions:
Social Security Online - Compassionate Allowances
Compassionate Allowances
| Social Security has an obligation to provide benefits quickly to applicants whose medical conditions are so serious that their conditions obviously meet disability standards. Compassionate allowances are a way of quickly identifying diseases and other medical conditions that invariably qualify under the Listing of Impairments based on minimal objective medical information. Compassionate allowances will allow Social Security to quickly target the most obviously disabled individuals for allowances based on objective medical information that we can obtain quickly. Commissioner Astrue has held two Compassionate Allowance public outreach hearings. The first was on rare diseases and the second was on cancers. A third hearing on brain injuries is planned for November 18, 2008. The initial list of Compassionate Allowance conditions was developed as a result of information received at public outreach hearings, public comment on an Advance Notice of Proposed Rulemaking, comments received from the Social Security and Disability Determination Service communities, and the counsel of medical and scientific experts. Also, we considered which conditions are most likely to meet our current definition of disability. A modest 50 conditions have been selected for the initiative's rollout. The list which follows may expand over time. Initial List of Compassionate Allowance Conditions Additional information about how compassionate allowances are processed |
2008 full free text: Informed Consent Revisited: A Doctrine in the Service of Cancer Care --the Oncologist
Informed Consent Revisited: A Doctrine in the Service of Cancer Care -- Schachter and Fins 13 (10): 1109 -- The Oncologist: "CONCLUSION
Empathetic and attentive interest in patients facilitates an understanding about patients' physiological and psychological needs. Significantly, it enables the physician to contextualize the patient's decision within the patient's moral and values framework. If there is a paradox in all of this, it is that the ideal of informed consent rests as much in the physician educating the patient as it does in the patient educating the physician.
2008 full free text: multinational study - Hormone Therapy and the Risk of Breast Cancer in BRCA1 Mutation Carriers - JNCI
Hormone Therapy and the Risk of Breast Cancer in BRCA1 Mutation Carriers -- Eisen et al. 100 (19): 1361 -- JNCI Journal of the National Cancer Institute
"In conclusion, these data are reassuring in suggesting that HT is probably not contraindicated in women with a BRCA1 mutation. Although the data cannot yet be considered definitive, we observed a statistically significant reduction in the risk of breast cancer following HT use, in both the unadjusted and adjusted analyses. It is important that these findings be replicated. The observed associations were not different for women who used estrogen alone or estrogen plus progesterone. There was little difference in the observed ORs associated with less than 3 years and 3 or more years of exposure, and therefore it is not possible for us to recommend an optimum duration of use. We did not include patients with BRCA2 mutations in this study because the sample size was small. It is important that these data be confirmed in other populations, including in women with BRCA2 mutations. It is also important to evaluate the other risks and benefits associated with HT use in women at high risk for breast cancer."
CONTEXT AND CAVEATS
Prior knowledge:
Use of hormone therapy (HT) after menopause may increase the risk of breast cancer in the general population. The effects of HT in women with mutations in the BRCA1 gene, however, are not known.
Study design:
Case–control study of postmenopausal women who carry a BRCA1 mutation to compare the risks of breast cancer among those who used HT and those who did not.
Contribution:
In this study of BRCA1 mutation carriers, a decrease in breast cancer risk was observed among those who took HT compared with those who did not.
Implications:
HT use does not appear to be associated with an increased risk for breast cancer among postmenopausal women who carry a BRCA1 mutation. Indeed, in this study, it was associated with a decreased risk among such women.
Limitations:
The study was relatively small, women who had undergone preventive mastectomy or used tamoxifen were excluded, and the results depended on the participants’ recall of HT use. An average of approximately 5.6 years had elapsed between breast cancer diagnosis and the completion of the questionnaire, so if BRCA1 mutation carriers who previously took HT have shorter survival after breast cancer diagnosis than those who did not take HT, this would have skewed the results in the negative direction that was observed.
From the Editors
2008 Talking About Charities - full report
TAC2008-03-CompleteReport.pdf (application/pdf Object)
The Board of Directors of The Muttart Foundation is pleased to release the fourth
iteration of Talking About Charities. This report outlines the results of almost 3,900
phone interviews in which respondents were asked for their views about charities and
issues affecting charities.
Charities can take pride that they continue to enjoy significant levels of trust.
Trust is a critical component of the relationship that beneficiaries and donors must have
with those community organizations working to improve the quality of life.
Two years ago, when the last report was released, we said the study had important messages for the sector. Those messages are reiterated, sometimes even more strongly, in the results from this year’s interviews.
Clearly, respondents say they think charities can and should do a better job at
providing information about their activities, particularly in the area of fundraising.
The charitable sector ignores these messages at its peril. Respondents say they
want the sector to become better at telling its story – not only about the values that
underline its work and the value of its work to communities across the country, but also
about how it accomplishes its work.
We hope that this report can help make charities more aware of the public’s
interest in having a more complete understanding, since that can do little but to
strengthen support.
We commend this report to the sector, to policymakers at all levels of government
and to the public at large. May it help guide our discussions and our efforts.
Multianalyte Profiling of Serum Antigens and Autoimmune and Infectious Disease Molecules to Identify Biomarkers Dysregulated in Epithelial Ovarian Cancer -- Bertenshaw et al. 17 (10): 2872 -- Cancer
Multianalyte Profiling of Serum Antigens and Autoimmune and Infectious Disease Molecules to Identify Biomarkers Dysregulated in Epithelial Ovarian Cancer -- Bertenshaw et al. 17 (10): 2872 -- Cancer
When analyzed by cancer subtype and stage, there were differences in the relative value of biomarkers.
Correction: Article on Diagnostic Markers for Early Detection of Ovarian Cancer
1078-0432.CCR-14-22-CORv1.pdf (application/pdf Object)
Correction: Article on Diagnostic Markers for Early
Detection of Ovarian Cancer
In the article on diagnostic markers for early detection of ovarian cancer in the February
15, 2008, issue of Clinical Cancer Research, the authors indicated that the novel blood test
described has a PPV for the general population above the suggested 0.10 necessary to be
used as a screening test. However, data were not provided to support this claim. The PPV
of this test for the general population is 6.5%, or 0.065. Therefore, it was incorrect to
suggest that this test may be used for screening the general population, and the authors
do not support the use of this test for screening the general population.
Visintin I, Feng Z, Longton G, Ward DC, Alvero AB, Lai Y, Tenthorey J, Leiser A,
Flores-Saaib R, Yu H, Azori M, Rutherford T, Schwartz PE, Mor G. Diagnostic markers
for early detection of ovarian cancer.
Clin Cancer Res 2008;14:1065–72.
Sunday, October 26, 2008
click here to view: Recap of 4 related items - Ovarian Cancer Screening/Diagnostic Markers
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