OVARIAN CANCER and US

Monday, October 21, 2013

Is Cancer a Metabolic Disease?

open access

" Elevated LDH levels have been discovered in Burkitt’s lymphoma⁴⁸ and non-small cell lung cancer,⁷² whereas increased MCT levels have been detected in ovarian,⁷³ prostate,⁵² gastric,⁷⁴ and cervical⁷⁵ carcinomas."

Review

Open Access

Although cancer has historically been viewed as a disorder of proliferation, recent evidence has suggested that it should also be considered a metabolic disease. Growing tumors rewire the metabolic programs to meet and even exceed the bioenergetic and biosynthetic demands of continuous cell growth. The metabolic profile observed in cancer cells often includes increased consumption of glucose and glutamine, increased glycolysis, changes in the use of metabolic enzyme isoforms, and increased secretion of lactate. Oncogenes and tumor suppressors have been discovered to have roles in cancer-associated changes in metabolism as well. The metabolic profile of tumor cells has been suggested to reflect the rapid proliferative rate. Cancer-associated metabolic changes may also reveal the importance of protection against reactive oxygen species or a role for secreted lactate in the tumor microenvironment. This article reviews recent research in the field of cancer metabolism, raising the following questions: Why do cancer cells shift the metabolism in this way? Are the changes in metabolism in cancer cells a consequence of the changes in proliferation or a driver of cancer progression? Can cancer metabolism be targeted to benefit patients?.........

Saturday, October 19, 2013

Noteworthy, October 2013 newsletter College of Physicians and Surgeons of Ontario

Blogger's Note: the Supreme Court of Canada's recent decision should have an impact on this issue and responses

October 2013

College of Physicians and Surgeons of Ontario

The Decision-making for the End of Life policy is currently open for consultation.

You are invited to provide your feedback.

Please consider the following questions.

Do you think a physician’s presence in the home at the time of death provides a level of comfort?
What role do you think doctors can play in end-of-life care?

Find out more and provide your feedback here.

Preventing ovarian cancer by salpingectomy - Author Description of the Error and Correction

Preventing ovarian cancer by salpingectomy | Foulkes | Current Oncology

Curr Oncol 2013;20:139–42.

(doi: http://dx.doi.org/10.3747/co.20.1613)

Author Description of the Error and Correction

An error was made in the text of the paper (p. 139, col. 1, under the subheading The Origins of High-Grade Ovarian Carcinoma). The sentence

Further studies have confirmed that in situ serous tubal carcinomas are present in between 60% and 100% of preventive oophorectomy specimens from women with BRCA1 or BRCA2 mutations, but also that such disease is seen in the excised fallopian tubes of 30%–60% of women with high-grade serous carcinomas who do not carry BRCA1 / 2 mutations.

should read

Further studies have confirmed that in situ serous tubal carcinomas are present in approximately 8%–12% of preventive salpingo-oophorectomy specimens from women with BRCA1 or BRCA2 mutations, but also that such disease is seen in the excised fallopian tubes of 30%–60% of women with high-grade serous carcinomas who do not carry BRCA1 / 2 mutations.

I thank Dr. T. Colgan for bringing this error to my attention.

Equivocal or Ambiguous Terminologies in Pathology: Focus of Continuous Quality Improvement?

abstract

Ambiguous terminologies introduce uncertainty into pathology reports and may be misinterpreted by clinicians. Although absolute diagnostic certainty in all cases is not attainable, nevertheless, unbridled use of equivocal or ambiguous terminologies may lead to additional, sometimes unnecessary, tests and/or procedures directly or indirectly leading to increase in health care costs, as well as patient and clinician dissatisfaction. We evaluated the degree of certainty attributed to the commonly used ambiguous terminologies (“consistent with,” “compatible with,” “indicative of,” “favor,” “suggestive of,” “suspicious for,” “not excluded,” “cannot exclude,” “not ruled out,” “not definite for,” “not specific for,” “indeterminate,” “not identified”) used in pathology reports by groups of attending physicians and their respective trainees using an online survey. There is no statistical difference in the interpretation of each terminology between attending pathologists and pathology trainees. There is also no significant difference between pathology and other attending groups for majority of the terminologies. However, there are significant differences between at least 2 of the 4 attending physician categories in the following pathology terminologies: “consistent with” (overall P=0.01), “compatible with” (P=0.02), “not excluded” (P=0.008), and “cannot exclude” (P=0.01). The pairwise comparisons among the 4 specialties show that there is significant difference in the interpretation of the degree of certainty between pathology and medicine in terms of “not excluded” (P=0.007) and “cannot exclude” (P=0.03). Focused peer review or monitoring of pathology reports with ambiguous terminologies may reduce their use and represent a worthwhile and achievable goal.

Prognostic role of early versus late onset of bone metastasis in patients with carcinoma of the ovary, peritoneum and fallopian tube

abstract

Background Bone metastases are a rare manifestation in the management of ovarian cancer and thought to be associated with a poor prognosis as sign of distant spread. Only few data exist on this rare condition. The present study aimed to more information on this very distinct patient collective.

Patients and methods A retrospective chart review was carried out including all patients who had been treated from 1994 to 2009 for histologically confirmed ovarian, peritoneal and fallopian tube cancer. Overall, 1717 cases were detected and screened. Patients with bone metastasis were identified and analyzed regarding survival as well as various clinical variables.

Results A total of 26 women who had been diagnosed with bone metastases ante mortem could be identified, resulting in an incidence of 1.50%. The majority of patients presented multiple bone lesions (80.8%) and bone spread was symptomatic in 62.5% of the cases. Mean overall survival from primary diagnosis of EOC was 50.5 months (range: 2.5–142.5 months). Median overall survival after diagnosis of bone metastases was 7.2 months. When divided into two subsets depending on timepoint diagnosis of bone metastases, there was a significant difference in overall survival. The mean overall survival from primary diagnosis of EOC in the early-onset group (n = 8), defined as occurence of bone manifestation within 12 months, was 11.2 months. The mean overall survival in the late-onset group (n = 15) was 78.4 months (P = 0.000001).

Conclusions The time interval from diagnosis to appearance of bone metastases is a prognostic factor in ovarian cancer. While early onset bone spread has a strong negative prognostic impact, late-onset bone diagnosis of bone metastases hardly influences the prognosis at all. This finding should be considered in the management of patients with bone metastases from ovarian cancer.

New research shows 'DNA tags' could guide treatment for advanced ovarian cancer. ecancer

ecancer

15 Oct 2013

A Cancer Research UK study has identified chemical ‘tags’ on DNA in patients’ tumours that could help doctors decide the type of chemotherapy women with advanced ovarian cancer should receive, according to a new paper published in the journal Clinical Cancer Research. (Promoter CpG Island Methylation of Genes in Key Cancer Pathways Associates with Clinical Outcome in High-Grade Serous Ovarian Cancer)
The DNA tags could be used to assess whether patients will benefit from their current treatment or if other drugs should be tried, as well as indicating whether their cancer is likely to come back.....

Clinical Cancer Research
Conclusions: A three loci model of DNA methylation could identify two distinct prognostic groups of patients with ovarian cancer (PFS: HR = 2.29, P = 3.34 × 10⁻⁵; overall survival: HR = 1.87, P = 0.007) and patients more likely to have poor response to chemotherapy (OR = 3.45, P = 0.012). Clin Cancer Res; 19(20); 5788–97. ©2013 AACR.

A Unifying Vision of Cancer Therapy for the 21st Century - open access

Journal of Clinical Oncology, Vol 17, No 11S (November Supplement), 1999: 13-21
© 1999 American Society for Clinical Oncology

A Unifying Vision of Cancer Therapy for the 21st Century

Tuesday, October 15, 2013

ASCO: Familial Gastric and Pancreatic Cancers: Diagnosis and Screening (note: brca/lynch syndrome/genetics/familial predisposition...)

open access (see also Table 1)

CONCLUSION

Although the vast majority of gastric and pancreatic cancers
are believed to be sporadic, up to 10% of cases are diagnosed
in individuals with a family history. Family history assessment,
including review of cancer diagnoses in fırst- and
second-degree relatives, should be a part of the evaluation
of every patient diagnosed with cancer. Although gastric
and pancreatic cancers can be seen in association with various
hereditary cancer syndromes, the yield of genetic testing
in patients without a family history remains low. In contrast
to screening for colorectal cancer, screening for gastric
and pancreatic cancers is not currently recommended
for most asymptomatic individuals. Although there is currently
insuffıcient evidence that screening reduces morbidity
or mortality from gastric or pancreatic cancers, it may be a
consideration for selected individuals who meet high-risk
criteria.

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Monday, October 21, 2013

Saturday, October 19, 2013

Author Description of the Error and Correction

CONTENTS

Friday, October 18, 2013

Editorial

News & Views

Clinical Trial Commentary

Preliminary Communication

Research Article

Review

Acknowledgements

Wednesday, October 16, 2013

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

Background

Methods

Results

Conclusions

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

Tuesday, October 15, 2013

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