From The Globe and Mail:
24-hour shifts are a prescription for medical errors
Via The Globe and Mail's iPhone app
24-hour shifts are a prescription for medical errors
Via The Globe and Mail's iPhone app
Sent from my iPhone
Thursday, August 18, 2011
Wednesday, August 17, 2011
press release: Mayo Clinic receives FDA approval for ovarian and breast cancer vaccines
ROCHESTER, Minn. — Mayo Clinic has received investigational new drug approval (http://www.fda.gov/BiologicsBloodVaccines/DevelopmentApprovalProcess/InvestigationalNewDrugINDorDeviceExemptionIDEProcess/default.htm) from the Food and Drug Administration (http://www.fda.gov/) for two new cancer vaccines that mobilize the body's defense mechanisms to destroy malignant cells. The vaccines are among the first aimed at preventing cancer recurrence. The approval clears the way for Phase I clinical trials with women treated for ovarian or breast cancer.
VIDEO ALERT: Additional audio and video resources, including comments by Dr. Keith Knutson are available at the Mayo Clinic News Blog (http://dev.newsblog.mayoclinic.org/2011/08/17/mayo-clinic-studies-cancer-vaccines/).
"People who've had cancer are at high risk for relapse, and later rounds of treatment can become more difficult," says Mayo Clinic immunologist Keith Knutson, Ph.D., (http://mayoresearch.mayo.edu/mayo/research/staff/Knutson_KL.cfm) who developed the vaccines with colleagues at Mayo Clinic. While most cancer vaccines to date have been developed to fight patients' tumors, Knutson's group is interested in immunizing patients immediately after therapy, when they're healthy, to protect against relapse.
One new vaccine targets a protein that exists in abundance in breast and ovarian cancer cells. Containing fragments of the folate receptor alpha protein, the vaccine teaches the body's immune system to detect and eliminate diseased cells. Because the protein is typical of nearly all breast and ovarian tumors, the vaccine is the first that may be applicable to the majority of patients, instead of sub-populations with distinct types of cancer.
"I'm quite optimistic that if we can combine early detection, effective conventional therapies and vaccination, we can reduce recurrence and long-term morbidity associated with breast and ovarian cancer," Knutson says. Ultimately, the vaccine may be useful as a preventive strategy for all women.
The second vaccine to receive FDA approval is designed to be administered after breast cancer patients receive conventional chemotherapy. It targets the highly aggressive Her2/neu molecule, a protein that promotes the growth of cancer cells.
"One of the greatest fears for women who've been treated for breast cancer is that the cancer will return," Knutson says. "Our hope is that the vaccine will boost the cancer-fighting capabilities of the immune system and will be a leg up on this aggressive cancer after conventional treatment is complete."
Clinical Oncology News - The Concept of ‘Unrealistic Optimism’ In Early-Phase Trials (Markman) - Aug issue
"Oncologists may not be fully aware of a relatively new term introduced by ethicists to describe certain patients who agree to participate in early-phase cancer clinical trials. Some researchers believe that these individuals express unrealistic optimism, which apparently means that despite understanding the limited statistical probability of experiencing clinical benefit from a particular management plan, they have a strong belief regarding their own favorable outcome.1 These researchers apparently feel such optimism poses a serious problem, with one member of this community of scholars being quoted as remarking, “We just need to realize that not all optimism is ethically benign.”2...............For it would appear that those who support the concept of unrealistic optimism, or its sister term therapeutic misconception, have not kept up with the oncology literature dealing with early-phase clinical trials........cont'd
Heated, Harrowing Chemotherapy Bath May Be Only Hope for Some - NYTimes.com
Note: discusses different cancers
press release: Critical Outcome Technologies Inc. Announces Definitive Proof of COTI-2's Target and Single Agent Effectiveness from Critical Study
COTI-2's specific cellular targeting, low toxicity, and proven efficacy support a potentially dramatic change in the treatment of susceptible cancers consistent with the views expressed at ASCO. Over expression of Akt/Akt2 is common in a broad range of human cancers, including ovarian, endometrial, pancreatic, breast, colorectal and lung. The percent of tumors with active Akt/Akt2 range from 20% to 100% depending on the cancer type.
About Critical Outcome Technologies Inc. (COTI)
COTI is a leading-edge company specializing in accelerating the discovery of small molecules to enable new drugs to be brought to market in a more cost effective, efficient and timely manner. COTI'S proprietary artificial intelligence system, CHEMSAS®, utilizes a series of predictive computer models to identify compounds most likely to be successfully incorporated in disease-specific drug discovery, as well as subsequent optimization and preclinical development. These compounds are targeted for a variety of diseases, particularly those for which current treatments are either lacking or ineffective.
Tuesday, August 16, 2011
Rush researchers discover antibody that may help detect ovarian cancer in earliest stages - press release (mesothelin antibodies)
Note: in research
".....In the study at Rush, researchers tested for mesothelin antibodies in the bloodstream of 109 women who were infertile, 28 women diagnosed with ovarian cancer, 24 women with benign ovarian tumors or cysts, and 152 healthy women. Infertility was due to endometriosis, ovulatory dysfunction or premature ovarian failure or was unexplained.
Significant levels of mesothelin antibodies were found in women with premature ovarian failure, ovulatory dysfunction and unexplained infertility, as well as in women with ovarian cancer, although not in women with endometriosis and not in healthy women or women with benign disease. Endometriosis is generally associated with a different kind of ovarian carcinoma (blogger's note - cell types: endometrioid/clear cell) than other types of infertility, which may explain why mesothelin antibodies were not found in these cases.
Why the presence of mesothelin antibodies in the bloodstream should be linked with ovarian cancer is not clear.
"It has been hypothesized that an autoimmune response precedes or somehow contributes to the development and progression of malignant tumors," Luborsky said. "We think that antibodies may arise in response to very early abnormal changes in ovarian tissue that may or may not progress to malignancy, depending on additional triggering events. Or, alternatively, antibodies may bind to normal cells in the ovary, causing dysfunction and leading to infertility -- and, in a subpopulation of women, to the development of ovarian cancer.".....cont'd
free full access (pdf file) Cell - Hallmarks of Cancer: The Next Generation (published Mar 2011)
Hallmarks of Cancer: The Next Generation
Permissions
Cell, Volume 144, Issue 5, 646-674, 4 March 2011
Copyright © 2011 Elsevier Inc. All rights reserved.
10.1016/j.cell.2011.02.013
Copyright © 2011 Elsevier Inc. All rights reserved.
10.1016/j.cell.2011.02.013
Authors
Summary
The hallmarks of cancer comprise six biological capabilities acquired during the multistep development of human tumors. The hallmarks constitute an organizing principle for rationalizing the complexities of neoplastic disease. They include sustaining proliferative signaling, evading growth suppressors, resisting cell death, enabling replicative immortality, inducing angiogenesis, and activating invasion and metastasis. Underlying these hallmarks are genome instability, which generates the genetic diversity that expedites their acquisition, and inflammation, which fosters multiple hallmark functions. Conceptual progress in the last decade has added two emerging hallmarks of potential generality to this list—reprogramming of energy metabolism and evading immune destruction. In addition to cancer cells, tumors exhibit another dimension of complexity: they contain a repertoire of recruited, ostensibly normal cells that contribute to the acquisition of hallmark traits by creating the “tumor microenvironment.” Recognition of the widespread applicability of these concepts will increasingly affect the development of new means to treat human cancerfull free text: (pdf file) Cell - A ceRNA Hypothesis: The Rosetta Stone of a Hidden RNA Language?
A ceRNA Hypothesis: The Rosetta Stone of a Hidden RNA Language?
- Main Text
- The Noncoding Revolution
- The ceRNA Protagonists
- MicroRNAs
- The Transcriptome
- The ceRNA Hypothesis
- RNA Transcripts Communicate through the ceRNA Language
- Logic and Regulation of the ceRNA Network
- Experimental Evidence Supporting the ceRNA Hypothesis
- ceRNAs in the Etiology of Cancer
- Conclusions
- Acknowledgments
full free access: ScienceDirect - Cell : The Hallmarks of Cancer published Sept 2000
 |  |
 doi:10.1016/S0092-8674(00)81683-9 | How to Cite or Link Using DOI | |
| Permissions & Reprints |
Review
The Hallmarks of Cancer
Douglas Hanahan 1 and Robert A. Weinberg 2Available online 27 September 2000.
Article Outline
Monday, August 15, 2011
HealthNewsReview.org: Hot Chemotherapy Bath: Patients See Hope, Critics Hold Doubtsies | Holding Health and Medical Journalism Accountable
"Our Review Summary
This story opens readers' eyes to a debate that flared up before attendees of a recent meeting of the American Society of Clinical Oncology - but a debate that most of us wouldn't know about......"
Holding Health/Medical Journalism Accountable: Gene Therapy Cures Adult Leukemia
Note: some media reports reference 'possible' future role for ovarian cancer and therefore this link and again reminders of what is still in research/harms of hype.....
Gene Therapy Cures Adult Leukemia
August 10, 2011
Platinum Sensitivity–Related Germline Polymorphism Discovered via a Cell-Based Approach and Analysis of Its Association with Outcome in Ovarian Cancer Patients
Conclusion:
This study shows the potential of cell-based, genome-wide approaches to identify germline predictors of treatment outcome and highlights the need for extensive validation in patients to assess their clinical effect.
press release (financial) - ENMD-2076 - EntreMed Reports Second Quarter 2011 Financial Results
About ENMD-2076
ENMD-2076 is an orally-active, Aurora A/angiogenic kinase inhibitor with a unique kinase selectivity profile and multiple mechanisms of action. ENMD-2076 has been shown to inhibit a distinct profile of angiogenic tyrosine kinase targets in addition to the Aurora A kinase. Aurora kinases are key regulators of mitosis (cell division), and are often over-expressed in human cancers. ENMD-2076 also targets the VEGFR, Flt-3 and FGFR3 kinases which have been shown to play important roles in the pathology of several cancers. ENMD-2076 has shown promising activity in Phase 1 clinical trials in solid tumor cancers, leukemia, and multiple myeloma. ENMD-2076 is currently in a Phase 2 trial for ovarian cancer, and preclinical and clinical activities are ongoing in assessing the compound's applicability for other forms of cancer.
Sunday, August 14, 2011
abstract: Circulating free DNA and p53 antibodies in plasma of patients with ovarian epithelial cancers (serous/mucinous)
Blogger's Note: the connection between KRAS mutations/mucinous may be due to GI (particularly colorectal cancer eg. common denominator = KRAS mutation/mucinous cell type), see also mucinous article - to be posted subsequent to this item
BACKGROUND:
This study was conducted in order to evaluate the significance of circulating free DNA (CFDNA), blood plasma p53 antibodies (p53-Ab) and mutations of KRAS gene in the prognosis of ovarian epithelial cancers.
PATIENTS AND METHODS:
A total of 126 patients were included in this study. KRAS mutations and CFDNA were detected by means of the PCR-restriction fragment length polymorphism (PCR-RFLP) and enriched by the PCR-RFLP method. Enzyme-linked immunosorbent assay was used to analyze plasma p53-Ab.RESULTS:
KRAS mutations were detected in 27 (21.4%) of examined tumors. The frequency of KRAS mutations was especially high in mucinous cancers (P < 0.001). CFDNA and p53-Ab were frequently detected in patients with serous cancers in high grade (P < 0.001). The overall survival rate was significantly lower for patients with serous tumors and CFDNA and p53-Ab-positive than negative tumors (P = 0.022 and P < 0.001, respectively). In mucinous ovarian cancer, a worse overall survival was correlated with the KRAS mutations (P = 0.03).CONCLUSIONS:
The results of the present study suggested that a presence of KRAS mutations in mucinous ovarian cancer and CFDNA and p53-Ab in serous tumors was correlated with the highest risk of cancer progression.abstract: Mucinous tumor of low malignant potential ("borderline" or "atypical proliferative" tumor) of the ovary: a study of 171 cases with the asses
Abstract
Mucinous tumors of the ovary are a continuing source of controversy in the field of gynecologic pathology. We examined a series of 171 intestinal-type mucinous tumors of low malignant potential ("borderline" or "atypical proliferative" tumors) to clarify the clinical significance of intraepithelial carcinoma (IECA) and microinvasion (area ≤ 10 mm²). The diagnosis of IECA was based on the presence of marked nuclear atypia (grade 3). Stromal microinvasion was classified as low grade and high grade (with nuclear grade 3). IECA was observed in 67 of 171 cases (39.2%). Microinvasion was identified in 31 (18.1%) cases, low grade in 22 (12.9%) cases, and high grade in 9 (5.3%) cases. Follow-up status was known in 144 cases and tumor recurrence was observed in 6 patients (4.2%). The risk factors for recurrence included International Federation of Gynecology and Obstetrics stage ≥ IC (P=0.002), microinvasion (P=0.013), age less than 45 years (P=0.032), and IECA (P=0.042). The amount of IECA ≥ 10% was also associated with the risk of recurrence (P=0.007). Among tumors with microinvasion, there was no significant association between the clinicopathologic variables and recurrence. When considering tumors with stage ≥ IC, tumor recurrence was significantly associated with IECA ≥ 10% (P=0.031) and age less than 45 years (P=0.047). It is important that mucinous tumors of low malignant potential should be staged and be optimally sampled for pathologic examination to document the status of the external surface or peritoneal involvement and to identify the worst degree of epithelial proliferation. Tumor stage ≥ IC, IECA ≥ 10%, microinvasion, and age less than 45 years were the features that were associated with tumor recurrence.The study results also support the use of nuclear grade 3 as the sole criterion of IECA.
abstract: (small study) Cancer-Related Sources of Stress for Children With Cancer and Their Parents
Note: note differences in participation between mothers and fathers (n); abstract only info does not detail this variance
Objectives
The current study examines reports and correlates of cancer-specific stressors in children with cancer and their parents. Measures
Mothers (n = 191) and fathers (n = 95) reported on their own and their child’s stressors, general perceived stress, and posttraumatic stress symptoms. Children (n = 106) completed self-reports of their own stressors and posttraumatic stress symptoms.
Cancers | Free Full-Text | Assessment of the Evolution of Cancer Treatment Therapies
Note: numerous references to ovarian cancer
Conclusions
This review has tried to summarize the history and evolution of the most common types of cancer
treatments available today, but also new therapies under study in the last years. In addition to surgery,
chemotherapy, radiation therapy, hyperthermia, photodynamic therapy or immunotherapy, new
therapies are now at different stages of development trying to decrease drug toxicity in health tissues
and increase efficacy by targeting tumor angiogenesis, by exploring cell and gene therapy, or by using
new nanostructures for diagnosis or therapeutic purposes. Nanotechnology is offering new products,
which either used alone, due to their intrinsic properties, or in combination with other biomolecules
(anti-tumoral drugs, folic acid, albumin, antibodies, aptamers) could be used to target cancer cells.
However, the history tells us that the fight against cancer is not an easy task. Many types of cancers
are able to resist to conventional therapies, and different combinations of drugs and therapies
(e.g., surgery together with radiotherapy and chemotherapy) are usually the only way to destroy
tumoral cells. This may be also true for the new therapies arriving now to the clinic. Much more
studies are required but these new ways of treatment are opening doors to hope for many patients
waiting for a successful therapy
AHRQ: Su medicamento: Infórmese. Evite riesgos. (Incluye tarjeta de bolsillo) Spanish/English
AHRQ Releases a Spanish-Language Tool to Help Consumers Reduce Medication Errors
AHRQ has released a revised Spanish-language medication safety booklet, “Su medicamento: Infórmese. Evite riesgos” (“Your Medicine: Be Smart. Be Safe.”) to help Spanish-speaking patients learn more about how to take medicines safely. The booklet includes a detachable, wallet-size card that can help patients keep track of medicines they are taking, including vitamins and herbal and other dietary supplements. Select to download a copy of the guide in Spanish. Print copies are available by sending an e-mail to AHRQPubs@ahrq.hhs.gov. The guide is also available in English.
a request: survivors stories for interviews (per Women's Oncology Research & Dialogue Newsletter)
WORD is looking for new women to be interviewed about their journey and fight against gynecologic cancers. If you would be willing to work with us - please contact us soon!
Saturday, August 13, 2011
abstract: Cochrane review - Optimal primary surgical treatment for advanced epithelial ovarian cancer
Abstract
BACKGROUND:
Ovarian cancer is the sixth most common cancer among women. In addition to diagnosis and staging, primary surgery is performed to achieve optimal cytoreduction (surgical efforts aimed at removing the bulk of the tumour) as the amount of residual tumour is one of the most important prognostic factors for survival of women with epithelial ovarian cancer. An optimal outcome of cytoreductive surgery remains a subject of controversy to many practising gynae-oncologists. The Gynaecologic Oncology group (GOG) currently defines 'optimal' as having residual tumour nodules each measuring 1 cm or less in maximum diameter, with complete cytoreduction (microscopic disease) being the ideal surgical outcome. Although the size of residual tumour masses after surgery has been shown to be an important prognostic factor for advanced ovarian cancer, it is unclear whether it is the surgical procedure that is directly responsible for the superior outcome that is associated with less residual disease.OBJECTIVES:
To evaluate the effectiveness and safety of optimal primary cytoreductive surgery for women with surgically staged advanced epithelial ovarian cancer (stages III and IV).To assess the impact of various residual tumour sizes, over a range between zero and 2 cm, on overall survival.MAIN RESULTS:
There were no RCTs or prospective non-RCTs identified that were designed to evaluate the effectiveness of surgery when performed as a primary procedure in advanced stage ovarian cancer.We found 11 retrospective studies that included a multivariate analysis that met our inclusion criteria. Analyses showed the prognostic importance of complete cytoreduction, where the residual disease was microscopic that is no visible disease, as overall (OS) and progression-free survival (PFS) were significantly prolonged in these groups of women. PFS was not reported in all of the studies but was sufficiently documented to allow firm conclusions to be drawn.When we compared suboptimal (> 1 cm) versus optimal (< 1 cm) cytoreduction the survival estimates were attenuated but remained statistically significant in favour of the lower volume disease group There was no significant difference in OS and only a borderline difference in PFS when residual disease of > 2 cm and < 2 cm were compared (hazard ratio (HR) 1.65, 95% CI 0.82 to 3.31; and HR 1.27, 95% CI 1.00 to 1.61, P = 0.05 for OS and PFS respectively).There was a high risk of bias due to the retrospective nature of these studies where, despite statistical adjustment for important prognostic factors, selection bias was still likely to be of particular concern. Adverse events, quality of life (QoL) and cost-effectiveness were not reported by treatment arm or to a satisfactory level in any of the studies.AUTHORS' CONCLUSIONS:
During primary surgery for advanced stage epithelial ovarian cancer all attempts should be made to achieve complete cytoreduction. When this is not achievable, the surgical goal should be optimal (< 1 cm) residual disease. Due to the high risk of bias in the current evidence, randomised controlled trials should be performed to determine whether it is the surgical intervention or patient-related and disease-related factors that are associated with the improved survival in these groups of women. The findings of this review that women with residual disease < 1 cm still do better than women with residual disease > 1 cm should prompt the surgical community to retain this category and consider re-defining it as 'near optimal' cytoreduction, reserving the term 'suboptimal' cytoreduction to cases where the residual disease is > 1 cm (optimal/near optimal/suboptimal instead of complete/optimal/suboptimaMissing link: inflammation and ovarian cancer : The Lancet Oncology (commentary) - note photo in article
Note: view excellent photo (in blue/not teal) at the end of the article
LIFE Before Death : The Lancet Oncology - documentary/commentary
Genesis of the LIFE Before Death project lay in remarks from WHO. “The project co-producer Mike Hill and I read a 2009 WHO statement saying that 600 million people worldwide were going to suffer in their lifetime from untreated pain due to a lack of access to medicinal opiates”, explains Australian documentary maker Sue Collins. “We found that a very alarming statistic”, she added. Here are three more alarming statistics: more than 5 billion people worldwide have no access to essential pain medicines; this year 3·6 million people will die with untreated severe pain from cancer and AIDS; and 99·9% of these deaths will be in low-income and middle-income countries.
US physician whistleblowers face intimidation and retaliation : The Lancet Oncology
Note: partial summary/pay-per-view article "Reporting of billing fraud or drug company kickbacks is safe, and sometimes even lucrative, for US clinicians. But according to clinicians and advocates, physicians who voice concern about patient care routinely face institutional retaliation. “Blacklisting is more aggressive in the medical profession than any other industry”, says Tom Devine (Government Accountability Project, Washington, DC, USA). Although the Whistleblower Protection Act should protect federal physicians and other government ...
The predicted truncation from a (ovarian) cancer-associated variant of the MSH2 initiation codon alters activity of the MSH2-MSH6 mismatch repair complex
Abstract
Lynch syndrome (LS) is caused by germline mutations in DNA mismatch repair (MMR) genes. MMR recognizes and repairs DNA mismatches and small insertion/deletion loops. Carriers of MMR gene variants have a high risk of developing colorectal, endometrial, ovarian, and other extracolonic carcinomas. We report on an ovarian cancer patient who carries a germline MSH2 c.1A>C variant which alters the translation initiation codon. Mutations affecting the MSH2 start codon have been described previously for LS-related malignancies. However, the patients often lack a clear family history indicative of LS and their tumors often fail to display microsatellite instability, a hallmark feature of LS...."(technical)Friday, August 12, 2011
Editorial: Slow Progress in Cancer Care Disparities: HIPAA, PPACA, and CHEWBACCA… But We're Still not There! - the Oncologist
Note: full access may require registration/fee
Several factors (Table 1) appear to contribute to these differences in cancer outcomes, and these must become part of our medical consciousness as deficits that require urgent attention and/or resolution.
View this table:
Table 1.
Factors associated with disparities of cancer care
Prognostic Role of Vitamin D Status and Efficacy of Vitamin D Supplementation in Cancer Patients: A Systematic Review - the Oncologist
Abstract
Background. Whether or not hypovitaminosis D can influence the prognosis of cancer patients and whether or not vitamin D (vitD) supplementation improves outcome remain controversial.
Conclusion. Hypovitaminosis D seems to be associated with a worse prognosis in some cancers, but vitD supplementation failed to demonstrate a benefit in prostate cancer patients. The currently available evidence is insufficient to recommend vitD supplementation in cancer patients in clinical practice.
Note: per reference, one study included - ovarian cancer
(Tamez S, Norizoe C, Ochiai K et al. Vitamin D receptor polymorphisms and prognosis of patients with epithelial ovarian cancer. Br J Cancer 2009; 101:1957–1960.)
Thursday, August 11, 2011
(Canadian Medical Assoc) CMA got flood of feedback during its dialogue with Canadians
"The CMA's 2011 campaign to gather Canadians' input on their health care system was a marriage of old and new methods - town hall meetings, the Internet and social media - and it produced an unprecedented amount of feedback.
That becomes clear quickly in Voices into Action, a report that provides a synopsis of the information gathered by the CMA since the launch of its National Dialogue on Health Care Transformation last year......"
Editorial: Redirecting T Cells — NEJM
Note: while not related to ovarian cancer, this 3-patient (leukemia/T-cell) study has received widespread publicity;
very early stage research; safety concerns
Wednesday, August 10, 2011
EvidenceUpdates - Strategies to identify the lynch syndrome among patients with colorectal cancer: a cost-effectiveness analysis. (focus on women/risk reduction strategies) - abstract
"..... At current rates of germline testing, screening, and prophylactic surgery, the strategies reduced deaths from colorectal cancer by 7% to 42% and deaths from endometrial and ovarian cancer by 1% to 6%....."
CONCLUSION: Widespread colorectal tumor testing to identify families with the Lynch syndrome could yield substantial benefits at acceptable costs, particularly for women with a mutation associated with the Lynch syndrome who begin regular screening and have risk-reducing surgery. The cost-effectiveness of such testing depends on the participation rate among relatives at risk for the Lynch syndrome.
Ratings (on article/professionals) pending – login (free) to http://plus.mcmaster.ca/evidenceupdates in a few days if interested.
Dresser appointed to NIH (U.S.) advisory committee | Newsroom | Washington University in St. Louis
"...Dresser, an expert in biomedical ethics, holds a joint appointment at the law school and at Washington University School of Medicine in St. Louis, teaching law and medical students about legal and ethical issues in end-of-life care, biomedical research, genetics, assisted reproduction and related topics......She has written extensively in her field and is the co-author of a casebook on bioethics and law and a book on the ethical treatment of animals. She also is the author of a book on patient advocacy and research ethics......Dresser also is a prolific speaker and panelist at national and international symposia, conferences and workshops on such topics as bioethics and cancer; advance treatment directives; stem cell research; biomedical research policy; and human cloning."
abstract: Comparing diagnostic delay in cancer: a cross-sectional study in three European countries with primary care-led health care systems (UK, Netherlands, Sweden)
Conclusions. A large-scale study comparing cancer delays in European countries and based on primary care-held records is feasible but would require supplementary sources of data in order to maximize information on demographic variables, the cancer stage at diagnosis and treatment details. Such a large-scale study is timely and desirable since our findings suggest systematic differences in the way cancer is managed in the three countries.
Monday, August 08, 2011
abstract: Attitudes to reproductive genetic testing in women who had a positive BRCA test before having children: a qualitative analysis
"Awareness of reproductive testing options was very variable among the cohort. The findings highlight the complexities of reproductive decision making for young women who knowingly carry a BRCA mutation, and the dilemmas inherent to reproductive genetic testing when the condition being tested for also affects a prospective parent."
full free access: Evidence for the Complexity of MicroRNA-Mediated Regulation in Ovarian Cancer: A Systems Approach (technical/in research)
"Our findings underscore the complexities of miRNA-mediated regulation in vivo and the necessity of understanding the basis of these complexities in cancer cells before the therapeutic potential of miRNAs can be fully realized."
full free access: Survival of patients with ovarian cancer in central and northern Denmark, 1998–2009
Objective
To examine time trends of survival and mortality of ovarian cancer in the central and northern Denmark regions during the period 1998–2009.
Conclusion
The survival of ovarian cancer patients did not improve during the study period. This lack of improvement contrasts with the national cancer strategies implemented during this last decade, focusing on improving the survival of ovarian cancer patients.
full free access: Hormonal Contraception—What Kind, When, and for Whom?
Continuing Medical Education
Abstract
Method
Selective review of the literature.
Results
COCs suppress gonadotropin secretion and thereby inhibit follicular maturation and ovulation. Their correct use is associated with 0.3 pregnancies per 100 women per year, their typical use, with 1 pregnancy per 100 women per year (Pearl index). COCs have effects on the cardiovascular and hemostatic systems as well as on lipid and carbohydrate metabolism. When given in the presence of specific risk factors, they significantly increase the likelihood of cardiovascular disease and thromboembolism. Women with persistent human papilloma virus (HPV) infection who take COCs are at increased risk of developing invasive cervical cancer. On the other hand, COCs lower the cumulative incidence of endometrial and ovarian cancer by 30% to 50%, and that of colorectal cancer by 20% to 30%. Other malignancies seem to be unaffected by COC use.
Conclusion
As long as personal and familial risk factors are carefully considered, COCs constitute a safe, reversible, and well-tolerated method of contraception.
MicroRNA Processing and Binding Site Polymorphisms Are Not Replicated in the Ovarian Cancer Association Consortium
Background: Single nucleotide polymorphisms (SNP) in microRNA-related genes have been associated with epithelial ovarian cancer (EOC) risk in two reports, yet associated alleles may be inconsistent across studies.
Results: After adjustment for European ancestry, no overall association was observed between any of the analyzed SNPs and EOC risk.
Conclusions: Common variants in these evaluated genes do not seem to be strongly associated with EOC risk.
Impact: This analysis suggests earlier associations between EOC risk and SNPs in these genes may have been chance findings, possibly confounded by population admixture. To more adequately evaluate the relationship between genetic variants and cancer risk, large sample sizes are needed, adjustment for population stratification should be carried out, and use of imputed SNP data should be consideredCombination of two drugs (carboplatin/decitabine) 'can treat ovarian cancer' | International Federation of Gynecology and Obstetrics
Decitabine (duh-sye-tuh-bean)
Trade/other name(s): Dacogen"...Experts from Indiana University (IU) noted that carboplatin and decitabine, when combined, has a positive effect on the majority of late-stage ovarian cancer patients, even if they had previously developed a resistance to carbolplatin....Further studies will now be conducted to determine whether the drug combination can be rolled out on a wide scale."
Sunday, August 07, 2011
Landmark ovarian cancer discovery as scientists unveil high risk gene (RAD51D) : Cancer Research UK
Sunday 7 August 2011
Cancer Research UK Press Release
Cancer Research UK-funded scientists have discovered that women who carry a faulty copy of a gene called RAD51D have almost a one in 11 chance of developing ovarian cancer, the most significant ovarian cancer gene discovery for more than a decade, reveals a study in Nature Genetics1 today (Sunday).Saturday, August 06, 2011
A weekly topotecan and biweekly bevacizumab combination demonstrates acceptable toxicity and encouraging efficacy in patients with platinum-resistant
Note: pay particular attention to the side effects/adverse events
RANZCOG College Statement on prophylactic oophorectomy in older women undergoing hysterectomy for benign disease: Is the evidence sufficient to change practice?
Conclusion: A survey of gynaecologists revealed that few currently appear to adhere to the College Statement regarding prophylactic oophorectomy at the time of hysterectomy for benign disease. High quality evidence regarding either harm or benefit following retention of ovaries after menopause is lacking. Nevertheless, dialogue between clinicians and patients on this topic is important.
Advocates Partnership Program Opportunities | Genetic Alliance - deadline to apply Aug 26th - Montreal conference
Advocates Partnership Program
at the International Congress of Human Genetics
October 11-15, 2011 ● Montreal, Canada
www.ichg2011.org
Deadline to Apply: August 26, 2011
conference notice: Welcome to the 12th International Congress of Human Genetics annual meeting (Montreal)
On behalf of The American Society of Human Genetics (ASHG) and the International Federation of Human Genetics Societies (IFHGS), it gives us great pleasure to invite human geneticists from all around the world to attend and participate in the 12th International Congress of Human Genetics (ICHG) and the 61st ASHG Annual Meeting. The Congress will be held at the Le Palais des Congrès (Convention Center) in Montreal (Quebec), Canada from Tuesday, October 11th through Saturday, October 15th 2011, coinciding with the ASHG meeting.
The ICHG is the foremost meeting of the world human genetics community and is held every five years. The first Congress was held in 1956 in Copenhagen and subsequent venues have included Berlin, Washington, DC, Rio de Janeiro, Vienna and most recently Brisbane. The anticipated attendance is 7,000 delegates from over 60 countries around the world.
National Patient Safety Foundation: ASPPS - info/membership (fee based membership)
Membership in the American Society of Professionals in Patient Safety is open to professionals whose primary responsibility is patient safety, as well as to individuals across other healthcare disciplines, medical students, providers, risk managment and quality leaders, patient safety advocates and all those committed to safe patient care. Individual membership is the newest addition to NPSF’s portfolio, which includes continuing education credits through the Professional Learning Series, the NPSF Annual Patient Safety Congress, and other high-value programs. S
Friday, August 05, 2011
Thursday, August 04, 2011
Cancer Genome Atlas (press release July 2011) TCGA Completes Ovarian Cancer (serous) Analysis - TCGA plus link to video discussion
To view a video of Dr. Spellman discussing TCGA and the ovarian cancer findings, please go to http://www.youtube.com/watch?v=TK_CIGEUHxU
Wednesday, August 03, 2011
Bionomics - News - new trials phase 1/11 announced - BNC105 (combo)
Ovarian cancer trial planned:
- Randomised Phase I/II trial of BNC105 in combination with carboplatin and gemcitabine
- Preclinical data support use of BNC105 in combination with platinum (cisplatin; carboplatin) based therapeutic regimens
Quantitative and Functional Alterations of Plasmacytoid Dendritic Cells Contribute to Immune Tolerance in Ovarian Cancer
Note: in research/technical
Abstract
"In ovarian cancer, the immune system fails to eradicate established tumors partly due to the induction of immune tolerance within tumor microenvironment.....cont'd
Modification of BRCA1-Associated Breast and Ovarian Cancer Risk by BRCA1 Interacting Genes
"Overall, the data suggest that genomic variation at multiple loci that encode proteins that interact biologically with BRCA1 are associated with modified breast cancer and ovarian cancer risk in women who carry BRCA1 mutations."
Use of SAND Balloon Catheter for Laparoscopic Management of Extremely Large Ovarian Cysts (intraperitoneal spillage)
"With proper patient selection, the SAND balloon catheter can be extremely useful in laparoscopic removal of very large adnexal masses, without intraperitoneal spillage."
Use of metformin and the risk of ovarian cancer: A case-control analysis
OBJECTIVE:
To explore the association between use of metformin or other antidiabetic drugs and the risk of ovarian cancer.CONCLUSION:
In this large epidemiological study long-term use of metformin, but not of sulfonylureas, was associated with a tendency towards a decreased risk of ovarian cancer. Long-term use of insulin was associated with an increased risk of ovarian cancer.Sunday, July 31, 2011
Saturday, July 30, 2011
(recap-dated July 29, 2011) Gynecologic Cancers Update from the 2011 Annual Oncology Meeting « OncoFacts
Gynecologic Cancers Update from the 2011 Annual Oncology Meeting
Reviewed by Bradley Monk, MD, FACS, FACOG
abstract - European Journal of Obstetrics & Gynecology and Reproductive Biology : Ovarian cancer risk assessment: a tool for preoperative assessment
DIA Patient Organization/ Advocate Track - Drug Information Association - conference notice Rare Diseases/Orphan Products Oct 11-13th Washington, Dc
Patient Organization/ Advocate Track | ||||||||
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ELC : Interactive Case: Ovarian Cancer: Symptomatic Stage IV Disease Dr Thomas Herzo
Note: requires registration (free)
Interactive Case: Ovarian Cancer: Symptomatic Stage IV Disease Dr Thomas Herzog presents a provocative discussion focusing on options for treatment of a patient presenting with stage IV disease. His discussion incorporates the contemporary option of neo-adjuvant chemotherapy as well as the addition of an anti-angiogenic agent into the initial treatment regimen.FDA Warns of Serious Drug Interactions in Patients Taking Psychiatric Drugs « news@JAMA (Linezolid/Zyvox/Methylene blue)
"Patients taking certain psychiatric drugs may experience serious neurological problems if they are given the antibacterial medication linezolid (sold under the brand name Zyvox) or methylene blue, a drug that is also used as a dye in some diagnostic procedures and for certain other uses, such as treating cyanide poisoning, according to a pair of warnings issued yesterday by the US Food and Drug Administration (FDA)."
Wiki Methylene blue resource:
http://en.wikipedia.org/wiki/Methylene_blue
Friday, July 29, 2011
Breast density 'linked to specific types of breast cancer' | International Federation of Gynecology and Obstetrics
"Given that the magnitude of the association with breast density is strong across all breast cancer subtypes and particularly for [oestrogen receptor]-negative disease, breast density should be included in risk prediction models across tumour subtypes," the researchers said.
Thursday, July 28, 2011
Cancer Causes and Control - Dietary calcium and magnesium intake in relation to cancer incidence and mortality in a German prospective cohort
"This prospective cohort study provides no strong evidence to support that high dietary calcium and magnesium intake in the intake range observed in a German population may reduce cancer incidence or mortality."
Effect of dignity therapy on distress and end-of-life experience in terminally ill patients: a randomised controlled trial : The Lancet Oncology
Background
Dignity therapy is a unique, individualised, short-term psychotherapy that was developed for patients (and their families) living with life-threatening or life-limiting illness. We investigated whether dignity therapy could mitigate distress or bolster the experience in patients nearing the end of their lives.
abstract: Quantity, Design, and Scope of the Palliative Oncology Literature
"...Comparing 2004 with 2009, we found an increase in the proportion of original studies among all palliative oncology publications but no significant difference in study design or research topic. We identified significant deficiencies in the quantity, design, and scope of the palliative oncology literature...."
abstract: Pegylated liposomal doxorubicin: appraisal of its current role in the management of epithelial ovarian cancer.
Markman M.
Source
Cancer Treatment Centers of America, Eastern Regional Medical Center, Philadelphia, PA, USA.
Abstract
Pegylated liposomal doxorubicin (PLD) has become a major component in the routine management of epithelial ovarian cancer. The drug is frequently employed as a single agent in the platinum-resistant setting, and recently reported data reveal the superiority of the combination of PLD plus carboplatin, compared with the platinum drug plus paclitaxel, in delaying the time to disease progression in women with recurrent (potentially platinum-sensitive) disease. Current research efforts involving PLD in ovarian cancer are focusing on adding novel targeted drugs to this cytotoxic agent. The utility of such approaches in the platinum-resistant population, compared with the sequential administration of single agents active in this setting, remains to be determined.
abstract - Ovarian cancer risk assessment (OCRA): a tool for preoperative assessment
Objectives
The objective of this pilot study was to determine if the combination of CA 125, menopausal status and prealbumin can be used to accurately predict ovarian cancer in women with pelvic masses.Highlights
► Correct pre-operative diagnosis of ovarian cancer is key to referral.
► Surgery by gynecologic oncologist helps survival.
► Combination of age, prealbumin, CA 125 helps proper referral.
abstract: Secondary Somatic Mutations Restoring BRCA1/2 Predict Chemotherapy Resistance in Hereditary Ovarian Carcinomas
Conclusion: Secondary somatic mutations that restore BRCA1/2 in carcinomas from women with germline BRCA1/2 mutations predict resistance to platinum chemotherapy and may also predict resistance to PARP inhibitors. These mutations were detectable only in ovarian carcinomas of women whom have had previous chemotherapy, either for ovarian or breast carcinoma.
Wednesday, July 27, 2011
Pink makes women donate less to breast-cancer causes: study (ovarian) - media
From The Globe and Mail:
Pink makes women donate less to breast-cancer causes: study
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Pink makes women donate less to breast-cancer causes: study
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Sent from my iPhone
McGuinty says loss of Ontario health records very serious issue - The Globe and Mail
From The Globe and Mail:
McGuinty says loss of Ontario health records very serious issue
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McGuinty says loss of Ontario health records very serious issue
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Contemporary Approaches in Targeting Angiogenesis | prIME Oncology
Topics
- Module One: Concepts in Angiogenesis Inhibition
- Module Two: Biomarkers in Angiogenesis
- Module Three: Optimizing Outcomes with Antiangiogenic Therapy in Non-Small Cell Lung Cancer
- Module Four: Optimizing Outcomes with Antiangiogenic Therapy in Colorectal Cancer
- Module Five: Optimizing Outcomes with Antiangiogenic Therapy in Glioblastoma
- Module Six: Practical Considerations in Patient Management Involving Antiangiogenic Therapy
Tuesday, July 26, 2011
Frank words about breast screening - Open Medicine - Analysis and Comment
"......As recently observed in the New England Journal of Medicine, we should “work to prevent vested interests from being granted the loudest voices in health care.”2 The vested interests in what has been termed “the mammography wars”2 are clearly those in the imaging industry, those involved directly in screening programs, and even those in the not-for-profit sector, whose fundraising capacity is enhanced by a public committed to fighting breast cancer.
It is reasonable for women to choose to be screened, but only if they are completely informed about the probability of benefit versus the probability of harm. For 2000 women aged 40–49 who undergo screening for 10 years, the benefit is much smaller in terms of avoiding death from breast cancer than is the harm arising from over-diagnosis and unnecessary treatment for breast cancer, to say nothing of the increased rates of mastectomy associated with screening.22,23 These issues are not widely known to the general public. After over 20 years of involvement in the screening controversy I can only conclude that this is information few want to hear and many want to suppress."
CDC Home Healthcare-associated Infections (HAIs) checklist
Infection Prevention Guide
Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care
This summary guide of infection prevention recommendations for outpatient (ambulatory care) settings.
Infection Prevention Checklist
The Infection Prevention Checklist for Outpatient Settings: Minimum Expectations for Safe Care is a companion to the Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care.
Monday, July 25, 2011
Reported referral for genetic counseling or BRCA 1/2 testing among United States physicians - journal Cancer 2011 - abstract
CONCLUSION:
Physicians reported that they would refer many average-risk women and would not refer many high-risk women for genetic counseling/testing. Intervention efforts, including promotion of accurate risk assessment, are needed.Saturday, July 23, 2011
Fwd: My doctor threatened to fire me for going to a walk-in clinic. Why? - The Globe and Mail
Sent from my iPhone
Begin forwarded message:
From: Sandi Pniauskas <sandipn@sympatico.ca>
Date: 23 July, 2011 7:06:58 AM EDT
To: Sandi Pniauskas <sandipn@sympatico.ca>
Subject: My doctor threatened to fire me for going to a walk-in clinic. Why? - The Globe and Mail
From The Globe and Mail:
My doctor threatened to fire me for going to a walk-in clinic. Why?
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Sent from my iPhone
Friday, July 22, 2011
Glossary | The Cochrane Collaboration (worth bookmarking)
- examples:
- Adverse effect search for term
- An adverse event for which the causal relation between the drug/intervention and the event is at least a reasonable possibility. The term ‘adverse effect’ applies to all interventions, while ‘adverse drug reaction’ (ADR) is used only with drugs. In the case of drugs an adverse effect tends to be seen from the point of view of the drug and an adverse reaction is seen from the point of view of the patient. Also called: Adverse reaction
- Baseline characteristics search for term
- Values of demographic, clinical and other variables collected for each participant at the beginning of a trial, before the intervention is administered.
- Causal effect search for term
- An association between two characteristics that can be demonstrated to be due to cause and effect, i.e. a change in one causes the change in the other. Causality can be demonstrated by experimental studies such as controlled trials (for example, that an experimental intervention causes a reduction in mortality). However, causality can often not be determined from an observational study.
Molecular Test Aids in Identifying Cancers of Unknown Origin - Medscape (pathology/molecular diagnostic test - 15 different cancer types...)
".....The identity of most tumors can be determined "with confidence" by clinicians with histologic, clinical, and radiographic findings, say the study authors, led by James P. Grenert, MD, from the Department of Pathology at UCSF. "However, when tumors are poorly differentiated or metastatic with no clear primary, identifying the tissue of origin is difficult," they write.
Immunohistochemical stains may or may not be helpful in identifying the tumor origin. Molecular testing of tumors is an additional means of characterizing these tumors, the authors say.
TOO is the only molecular diagnostic test for cancer tissue of origin cleared by the US Food and Drug Association, the manufacturer notes. It is limited to identifying 15 types of tumor tissues: bladder, breast, colorectal, gastric, testicular germ cell, kidney, hepatocellular, nonsmall-cell lung, non-Hodgkin's lymphoma, melanoma, ovarian, pancreas, prostate, thyroid, and sarcoma. These 15 tumor types represent 90% of all cancers, the company points out....."cont'd
The study was funded in part by a grant from Pathwork Diagnostics.
Clin Chim Acta. 2011;412:1462–1464. Abstract
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