Thursday, September 24, 2015
Management of Menopausal Symptoms
abstract
Most menopausal women experience vasomotor symptoms with bothersome symptoms often lasting longer than one decade. Hormone therapy (HT) represents the most effective treatment for these symptoms with oral and transdermal estrogen formulations having comparable efficacy. Findings from the Women's Health Initiative and other recent randomized clinical trials have helped to clarify the benefits and risks of combination estrogen–progestin and estrogen-alone therapy. Absolute risks observed with HT tended to be small, especially in younger women. Neither regimen increased all-cause mortality rates. Given the lower rates of adverse events on HT among women close to menopause onset and at lower baseline risk of cardiovascular disease, risk stratification and personalized risk assessment appear to represent a sound strategy for optimizing the benefit–risk profile and safety of HT. Systemic HT should not be arbitrarily stopped at age 65 years; instead treatment duration should be individualized based on patients' risk profiles and personal preferences. Genitourinary syndrome of menopause represents a common condition that adversely affects the quality of life of many menopausal women. Without treatment, symptoms worsen over time. Low-dose vaginal estrogen represents highly effective treatment for this condition. Because custom-compounded hormones have not been tested for efficacy or safety, U.S. Food and Drug Administration (FDA)–approved HT is preferred. A low-dose formulation of paroxetine mesylate currently represents the only nonhormonal medication FDA-approved to treat vasomotor symptoms. Gynecologists and other clinicians who remain abreast of data addressing the benefit–risk profile of hormonal and nonhormonal treatments can help menopausal women make sound choices regarding management of menopausal symptoms.
Economic Impact Among Family Caregivers of Patients With Advanced Ovarian Cancer (Italy)
open access
Much work has been devoted to describing the medical costs of cancer care; however, less attention has been devoted to describing the economic burden of informal caregiving for cancer patients. This economic analysis of caregiving in patients with advanced ovarian cancer reports the significant burden that cancer treatment places on both families and society.
Article Outline
Abstract
MATERIALS AND METHODS
Measures
Mood State
Social Support
Work Productivity Loss
Economic Analysis
Statistical Analysis
RESULTS
Work Productivity Loss
Economic Analysis
CONCLUSIONS
(Overview Wiki) Healthcare in Italy
Starving cancer cells of sugar could be the key to future treatment
education
....You may have seen articles or websites advocating that starving patients of sugar is crucial for getting rid of tumours or that eating less sugar reduces the risk of cancer. The story is not that simple. Cancer cells always find alternatives to fuel their tank of glucose, no matter how little sugar we ingest. There is not a direct connection between eating sugar and getting cancer and it is always advisable to talk to your doctor if you have doubt about your diet.
Tuesday, September 22, 2015
Patients the losers in doctor dispute - "The Ontario government is resorting to these bully-boy tactics...
The Globe and Mail
Patients the losers in doctor dispute - "The Ontario government is resorting to these bully-boy tactics because it wants to cut spending. And it thinks it can get away with it because “fat cat” doctors don’t garner a lot of public sympathy"
.... As Warren Winkler, the former judge who
prepared a conciliator’s report on the dispute, noted, without
fundamental system change, the government will not be able to achieve
savings, and physicians will not be able to provide adequate care.
That’s a lose-lose, with the ultimate loser being patients.
Monday, September 21, 2015
Factors Associated with Knowledge regarding ovarian cancer and ovarian cancer screening (Malaysia)
open access
FACTORS ASSOCIATED WITH KNOWLEDGE REGARDING OVARIAN CANCER
AND OVARIAN CANCER SCREENING AMONG FEMALE STAFF IN UNIVERSITI PUTRA MALAYSIA, MALAYSIA
In Malaysia, ovarian cancer ranks the 5th most frequent cancer among women causing 1098 newly diagnosed cases and more than 600 deaths annually (Al-
Naggar et al., 2013).
Sunday, September 20, 2015
Double Pathology: Malignant Epithelial Ovarian Tumor (1V) and Germ Cell Tumor (Choriocarcinoma), a Rare Coexistence
Case Report - open access
Double Pathology: Malignant Epithelial Ovarian Tumor and Germ Cell Tumor (Choriocarcinoma), a Rare Coexistence
.... Different chemotherapeutic regimens have been used in cases of mixed choriocarcinoma and carcinoma, but established chemotherapeutic regimens have not been described. Chemotherapeutic regimens that target both components have been advocated and used. The absence of choriocarcinoma in ovarian primary and its presence in the extraovarian peritoneal deposits have not been described in the English literature so far. This case is being presented for its rarity....
Saturday, September 19, 2015
MSH2 role in BRCA1-driven tumorigenesis: a preliminary study in yeast and in human tumors from BRCA1-VUS carriers
abstract
BRCA1 interacts with several proteins implicated in homologous and non homologous recombination and in mismatch repair. The aim of this study is to determine if MSH2, a well known partner of BRCA1 involved in DNA repair, may contribute to breast and ovarian cancer development and progression. To better understand the functional interaction between BRCA1 and MSH2, we studied the effect of the deletion of MSH2 gene on BRCA1-induced genome instability in yeast. Preliminary results in yeast indicated that MSH2 and BRCA1 may interact to modulate homologous recombination (HR). We also carried out a genetic and epigenetic profiling of MSH2 gene by mutational analysis and promoter methylation evaluation in 9 breast and 2 ovarian tumors from carriers of BRCA1 unknown significance variants (VUS). 2/2 ovarian and 2/9 breast tumors carried MSH2 somatic mutations possible pathogenics (4/11, 36%): a missense mutation in exon 3 (p.G162R), a duplication of exon 1 and a deletion of exon 2. In addition, two germline synonymous variants in exon 11 were identified. None of the tumors showed promoter methylation.
In conclusion, a surprisingly high frequency of MSH2 gene mutations has been found in tumor tissues from BRCA1 VUS carrier patients. This result supports the indication deriving from the yeast model that BRCA1 driven tumorigenesis may be modulated by MSH2.
Predictive value of 18F-FDG PET/CT in restaging patients affected by ovarian carcinoma: a multicentre study
abstract
CONCLUSION:
18F-FDG PET/CT has an important prognostic value in assessing the risk of disease progression and mortality rate. An efficacious therapy planning might therefore effectively rely on 18F-FDG PET/CT findings. Semiquantitative data were not proven to be an effective tool to predict disease progression.Prognostic factors modifying the treatment-free interval in recurrent ovarian cancer
abstract
OBJECTIVES:
While primary treatment for high-grade serous ovarian cancer tends to be uniform - maximal debulking and platinum/taxane adjuvant chemotherapy - there is little standardization of treatment in the recurrent setting beyond the exhaustive use of platinum therapies. Using secondary data from multiple centers participating in the Cancer Genome Atlas study (TCGA), we seek to characterize clinical features, timing and serial response data to provide empirical evidence for treatment expectations in the recurrent setting.METHODS:
We conducted a retrospective survival analysis of TCGA study primary and secondary patient chemotherapy regimens by characterizing the dynamics of 1119 lines of therapy comprising the treatment of 461 high-grade serous ovarian cancer patients. All patients with post-surgical drug therapy information from the TCGA database were included in this study.RESULTS:
A complete response to adjuvant therapy led to longer overall survival, but did not affect treatment free intervals (TFIs) after relapse of disease. A strong predictor of the TFI on the next treatment regimen was the previous TFI with a decaying effect. The number of previous treatments, of platinum treatments, and the length of time from surgery all have an exponentially decreasing effect on TFI. Re-treatment times appear to cluster at predictable times following surgery.CONCLUSIONS:
While patients experience a consistent reduction in TFI with increasing re-treatment, the initial adjuvant interval is unrelated to later interval lengths. Platinum re-treatment remained an effective option in patients typically thought to be platinum resistant and the timing of monitoring visits may drive overall re-treatment patterns.Ovarian cancer in France: Trends in incidence, mortality and survival, 1980-2012
abstract
OBJECTIVE:
The aim of this epidemiological study was to describe the incidence, mortality and survival of ovarian cancer (OC) in France, according to age, period of diagnosis, and histological type.METHODS:
Incidence and mortality were estimated from 1980 to 2012 based on data in French cancer registries and from the Centre for Epidemiology of Causes of Death (CépiDc-Inserm) up to 2009. Net survival was estimated from registry data using the Pohar-Perme method, on cases diagnosed between 1989 and 2010, with date of last follow-up set at 30 June 2013.RESULTS:
In 2012, 4615 cases of OC were diagnosed in France, and 3140 women died from OC. World population age-standardized incidence and mortality rates declined by respectively 0.6% and 1.2% per year between 1980 and 2012. Net survival at 5years increased slightly, from 40% for the period 1989-1993 to 45% for the period 2005-2010. Net survival varied considerably according to histological type. Germ cell tumors had better net survival at 10years (81%) compared to epithelial tumors (32%), sex cord-stromal tumors (40%) and tumors without biopsy (8%).CONCLUSIONS:
Our study shows a decline in incidence and mortality rates from ovarian cancer in France between 1980 and 2012, but net survival remains poor overall, and improved only slightly over the whole study period.(2014) Updates on drug discovery in ovarian cancer
Full text - Updates on drug discovery in ovarian cancer http://ovariancancerandus.blogspot.com/feeds/posts/default
Drug discovery in the ovarian cancer arena continues to launch important new clinical trials. Many biologic agents are being studied in phase II and phase III clinical trials for recurrent disease. These agents include compounds that disrupt angiogenesis through a variety of mechanisms. Other oncogenic pathways are also specifically targeted such as PARP, MEK, and topoisomerase inhibitors which are currently being studied in phase III trials. Various cytotoxic agents, as well as therapeutic vaccines, are also under investigation, and continue to demonstrate promising new data. The relevant agents in the treatment of ovarian cancer which have demonstrated positive phase II activity will be discussed......
Review: Opportunistic salpingectomy for ovarian cancer prevention
open access
Recently accumulated evidence has strongly indicated that the fallopian tube is the site of origin for the majority of high-grade serous ovarian or peritoneal carcinomas. As a result, recommendations have been made to change surgical practice in women at general population risk for ovarian cancer and perform bilateral salpingectomy at the time of hysterectomy without oophorectomy and in lieu of tubal ligation, a practice that has been termed opportunistic salpingectomy (OS). Despite suggestions that bilateral salpingectomy may be used as an interim procedure in women with BRCA1/2 mutations, enabling them to delay oophorectomy, there is insufficient evidence to support this practice as a safe alternative and risk-reducing bilateral salpingo-oophorectomy remains the recommended standard of care for high-risk women. While evidence on uptake of OS is sparse, it points toward increasing practice of OS during hysterectomy......
Friday, September 18, 2015
Urinary Tract Cancer in Lynch Syndrome; Increased Risk in Carriers of MSH2 Mutations
abstract -(Urology)
Objective
To evaluate the risk of urothelial cancer in the upper urinary tract and the bladder, determine the contribution from the different mismatch-repair genes and define clinical characteristics of urothelial cancer in Lynch syndrome.Methods
The national hereditary nonpolyposis colorectal cancer registry was used to identify all 288 Lynch syndrome families in Denmark. Urothelial cancers that developed in mutation carriers and in their first-degree relatives were identified, mismatch-repair status was assessed, clinico-pathologic variables were defined and cumulative life-time risks were determined.Results
In total, 48 cancers of the ureter, 34 cancers of the renal pelvis and 54 urinary bladder cancers developed at a mean age of 61 (24-89) years. The tumors were typically of high grade, showed loss of mismatch repair protein expression in 90% of the tumors and microsatellite instability in 23% of the tumors. Mutations in MSH2 were overrepresented (73%) and MSH2 mutation carriers were at significantly increased risk of urinary tract cancer compared individuals with mutations in MLH1/MSH6.Conclusions
Cancers of the upper urinary tract as well as the urinary bladder are included in the Lynch syndrome tumor spectrum. Urothelial cancers are predominantly linked to MSH2 mutations, which suggest that surveillance should be targeted at individuals with mutations herein.(Markman) Supplements and Cancer Resistance: A Word of Caution
Clinical Oncology News
...... It is important to note, the major issue here is not the lack of evidence-based data supporting the objective validity of claims that the supplement actually produces the desired favorable effect, but rather the potential that use of the product may cause harm.....
(Markman) Misstatements Reportedly Made by Oncology Experts in Nonmedical Press: A Cause for Concern?
Clinical Oncology News
This
commentary highlights a concern, the magnitude of which remains largely
unknown: How often do oncology opinion leaders make statements in the
nonmedical media that are factually incorrect? A corollary to this query
is the issue of whether others might be reluctant to challenge or
correct the errors simply because the statement is made by a recognized
leader within academic oncology.
For example,
consider the quote that appeared in a recent announcement of the
publication of a paper from a high-profile scientific group examining
the genomic profile of tumors from patients with “late-stage” prostate
cancer.1 In a relatively large group of men with this condition (n=150), approximately 15% were found to have a BRCA1 or BRCA2 mutation.2
Commenting
on this observation and the possible management of the condition with
olaparib (Lynparza, AstraZeneca), recently approved by the FDA in the
management of women with ovarian cancer and a BRCA mutation, or other
similar agents in this drug class, a leader of the project was reported
to state: “Prior to this no one would have entertained treating these
patients with those drugs.1”
This is a strong but stunningly incorrect statement.
- See more at:
http://www.clinicaloncology.com/ViewArticle.aspx?ses=ogst&d=Provocative+Perspectives+in+Oncology&d_id=521&i=September+2015&i_id=860&a_id=33664#sthash.U0nZLpMh.dpufFor example, consider the quote that appeared in a recent announcement of the publication of a paper from a high-profile scientific group examining the genomic profile of tumors from patients with “late-stage” prostate cancer.1 In a relatively large group of men with this condition (n=150), approximately 15% were found to have a BRCA1 or BRCA2 mutation.2
Commenting on this observation and the possible management of the condition with olaparib (Lynparza, AstraZeneca), recently approved by the FDA in the management of women with ovarian cancer and a BRCA mutation, or other similar agents in this drug class, a leader of the project was reported to state: “Prior to this no one would have entertained treating these patients with those drugs.1”
This is a strong but stunningly incorrect statement......
ACP to Jerry Brown: Veto Physician-Assisted Suicide Bill
Blogger's Note: this subject matter is in great debate both in the U.S. and Canada (with key differences)
Medpage Today
How is comorbidity lived? - The Lancet
open access
..... Research that seeks to appreciate the everyday reality of comorbidity––the contingent character of chronic, reoccurring illnesses––is faced with theoretical and methodological untidiness. The correspondence of symptom and root cause is muddled. Inside the clinic, the demand for an index disease to guide understanding and intervention is often answered only by the story or symptom presented during each clinical encounter. Outside the clinic, the daily negotiation of health and illness emerges in ways that are both precarious and pedestrian. Few would be surprised if the daily struggle with comorbidity wore a person down, eroding not only the meaning of illness but of life.....
A national population-based study provides insight in the origin of malignancies metastatic to the ovary
open access
A national population-based study provides insight in the origin of malignancies metastatic to the ovary Jolien Bruls, Michiel Simons,
Lucy I. Overbeek, Johan Bulten, Leon F. Massuger, and Iris D. NagtegaalIntroduction
Malignancies metastatic to the ovary are estimated to account for 5–30 % of all ovarian malignancies [1–8]. These most commonly originate from the colorectum, followed by endometrium, stomach, appendix, and breast [1, 2, 6–9]. Differentiating between a primary and metastatic malignancy of the ovaries can be complex as many metastatic carcinomas mimic primary ovarian carcinomas [9]. Mucinous ovarian carcinomas (MOC) are notoriously difficult to distinguish from metastatic adenocarcinomas, and as a consequence, the latter are often misdiagnosed as primary tumors [10–13].....
Side per site of origin:
Tubal ligation and ovarian cancer risk in a large cohort: Substantial variation by histological type
abstract
Histopathological and molecular studies suggest that different histological subtypes (histotypes) of ovarian cancer have different aetiologies. Few studies have been large enough to explore reliably the effect of tubal ligation (sterilization), which has been associated with a reduced overall risk of ovarian cancer, on different tumour histotypes. In a prospective study of 1.1 million UK women (Million Woman Study), 8,035 ovarian cancers occurred during mean follow-up of 13.8 years. Using a Cox proportional hazards model, we estimated adjusted relative risks of ovarian cancer associated with tubal ligation. Overall, there was substantial heterogeneity in tumour risk associated with tubal ligation for the four main histotypes, serous, endometrioid, mucinous and clear cell (heterogeneity: p<0.0001). For serous tumours, the most common histotype, risks differed significantly between high-grade and low-grade tumours ; heterogeneity: p=0.007. Relative risks were almost halved for endometrioid and clear cell tumours, but there was no association between tubal ligation and mucinous tumours . For the main tumour histotypes we found little variation of risk by timing of tubal ligation. The significant differences by tumour histotype are unlikely to be due to confounding and are consistent with hypotheses that high-grade and low-grade serous tumours have different origins, and that some endometrioid and clear cell tumours might arise from cells and/or carcinogens travelling through the Fallopian tubes.
BRCA1/2 testing in newly diagnosed breast and ovarian cancer patients without prior genetic counselling: the DNA-BONus study
open access version
Discussion
The main findings in this study are that: (1) most patients with newly diagnosed ovarian cancer accept germline BRCA1/2 testing, with significantly lower uptake among breast cancer patients; (2) there is a high prevalence of BRCA1/2 mutation carriers in the group of ovarian cancer patients; (3) all patients who were identified with a pathogenic BRCA1/2 variant fulfill our current clinical criteria for diagnostic BRCA1/2
testing; and (4) the level of anxiety and depression symptoms in the
participants at inclusion was comparable to what can be found in cancer
patients in general.28, 29
Hospitalization rates in chemo trials may be misleading
Two Types of Ovarian Cortical Inclusion Cysts: Proposed Origin and Possible Role in Ovarian Serous Carcinogenesis
open access - Response to Original Article
Article by Natalie Banet and Robert J. Kurman: Two Types of Ovarian Cortical Inclusion Cysts: Proposed Origin and Possible Role in Ovarian Serous Carcinogenesis; Int. J. Gynecol. Pathol. 2015;34:3–8.
In conclusion, the hypothesis that all high-grade serous ovarian carcinomas arise from fimbrial cells requires further studies.
abstract - Original Article
Two Types of Ovarian Cortical Inclusion Cysts: Proposed Origin and Possible Role in Ovarian Serous Carcinogenesis
Banet, Natalie M.D.; Kurman, Robert J. M.D.
Ovarian cortical inclusion cysts (CICs) have been long
regarded as a possible site of origin of epithelial ovarian carcinoma.
It has been proposed that they develop from invagination of ovarian
surface epithelium (OSE) which then undergoes metaplasia to form
mullerian-type tissue and then undergoes neoplastic transformation.
Recent studies have challenged this view, at least for high-grade serous
carcinoma, proposing that the latter arise from occult carcinomas in
the fallopian tube. Although there is compelling evidence supporting
this view, it does not account for the origin of all high-grade serous
carcinomas. We have postulated that a subset of high-grade serous
carcinoma may develop from CICs, but that they are derived from
implantation of tubal epithelium when the OSE is disrupted at ovulation.
If true, it would be expected that the number of CICs would increase
with age and that CICs would not be present before menarche. To test
this hypothesis we examined ovaries removed at autopsy for the presence
of CICs and correlated their presence with age. In addition, we used
immunohistochemistry for PAX8 (mullerian marker) and calretinin
(mesothelial marker). CICs were defined as either ciliated (tubal-type,
PAX8-positive) or flat (OSE-type, calretinin-positive). As it has been
argued that steroid hormones convert mesothelial-derived OSE to
mullerian-type tissue, we performed immunohistochemistry for estrogen
and progesterone receptors. CICs lined by tubal-type epithelium were
found only in postmenarchial women and 20/21 (95%) were PAX8-positive;
none of the 5 flat cysts expressed PAX8 but 4/5 (80%) expressed
calretinin. Estrogen receptor was expressed in 1 of 21 (5%) ciliated
CICs, whereas it was negative in all 5 flat CICs. Progesterone receptor
was expressed in 14 of 21 (66%) ciliated CICs, and in none of the 5 flat
cysts. The findings suggest that there are 2 types of CICs, 1 from OSE
and 1 from tubal epithelium that probably develop at the time of
ovulation.
Magnesium protects against cisplatin-induced acute kidney injury without compromising cisplatin-mediated killing (in mice)
abstract
... These findings demonstrate the renoprotective role of magnesium during cisplatin AKI, without compromising the chemotherapeutic efficacy of cisplatin in an ovarian tumor-bearing mouse model.
Thursday, September 17, 2015
The hMLH1 −93G>A Polymorphism and Risk of Ovarian Cancer in the Chinese Population
Open access
In conclusion, the present study indicates that in the Chinese population, carriers of the -93AA and AG genotypes have increased risk of ovarian cancer compared with GG carriers. To the best of our knowledge, this study provided the first evidence that the -93G>A polymorphism in hMLH1 is associated with a significant risk of developing ovarian cancer in the Chinese population. Further independent population-based case-control studies are warranted to validate our results in larger sample sizes, as well as in different populations.
Improved Detection of Microsatellite Instability in Early Colorectal Lesions
open access
Results
Study population and samples
Patients with a history of cancer were preferentially selected for this study resulting in 32.5% (52/160) of cases having a personal or family history of one or more 1st or 2nd degree relatives with colon or other LS-associated cancers. Most were colon cancers (43/52). The other LS-associated cancers were ovarian, uterine and gastric. About six percent (9/160) of patients had a previous colorectal carcinoma and 78% (7/9) of these had synchronous or metachronous lesions in this study. An additional 11% (18/160) had lesions previously removed. Only 3% (5/160) had both a personal and family history of colon cancer.NIH framework points the way forward for building national, large-scale research cohort, a key component of the President’s Precision Medicine Initiative
NIH
.....NIH plans to move quickly to build the infrastructure so that participants can begin enrolling in the cohort in 2016, with a goal of enrolling at least 1 million participants in three to four years.....
Shared genetics underlying epidemiological association between endometriosis and ovarian cancer.
abstract
Epidemiological studies have demonstrated associations between endometriosis and certain histotypes of ovarian cancer, including clear cell, low-grade serous and endometrioid carcinomas. We aimed to determine whether the observed associations might be due to shared genetic aetiology. To address this, we used two endometriosis datasets genotyped on common arrays with full-genome coverage (3194 cases and 7060 controls) and a large ovarian cancer dataset genotyped on the customized Illumina Infinium iSelect (iCOGS) arrays (10 065 cases and 21 663 controls). Previous work has suggested that a large number of genetic variants contribute to endometriosis and ovarian cancer (all histotypes combined) susceptibility. Here, using the iCOGS data, we confirmed polygenic architecture for most histotypes of ovarian cancer. This led us to evaluate if the polygenic effects are shared across diseases. We found evidence for shared genetic risks between endometriosis and all histotypes of ovarian cancer, except for the intestinal mucinous type. Clear cell carcinoma showed the strongest genetic correlation with endometriosis (0.51, 95% CI = 0.18-0.84). Endometrioid and low-grade serous carcinomas had similar correlation coefficients (0.48, 95% CI = 0.07-0.89 and 0.40, 95% CI = 0.05-0.75, respectively). High-grade serous carcinoma, which often arises from the fallopian tubes, showed a weaker genetic correlation with endometriosis (0.25, 95% CI = 0.11-0.39), despite the absence of a known epidemiological association. These results suggest that the epidemiological association between endometriosis and ovarian adenocarcinoma may be attributable to shared genetic susceptibility loci.
Endometriosis and ovarian cancer: potential benefits and harms of screening and risk-reducing surgery
abstract
Although endometriosis is well recognized as a benign gynecologic condition, its association with ovarian cancer (OVCA) has frequently been reported. Review articles on this topic are voluminous, yet there seems to be no consensus as to whether endometriosis is truly a precursor of OVCA and whether any screening or risk-reducing surgery should be instituted, on the basis of our current knowledge. In this review, published data are compiled and critically appraised. Through this critical appraisal, it seems clear that the strongest evidence seems to come from prevalence data. This type of data also suggests a reduced risk of certain histotypes (mainly type II) of OVCA in women with endometriosis. This may explain the rather moderate increase in risk as shown in epidemiologic studies. Even with this moderate increase in OVCA risk, caution should be exercised because of apparent bias in favor of publication of positive results, extensive heterogeneities among prevalence estimates, and inverse relationship between estimates and sizes of the studies. Many molecular studies are conflicting, and earlier studies showing molecular aberrations involved in genomic instability and mutation that enable malignant transformation are not replicated in later studies. Given the low incidence of OVCA and the rather moderate increase in risk of mostly type I tumors, screening seems to be ill-advised, and risk-reducing surgery such as salpingectomy with or without oophorectomy does not seem to yield any substantial benefit to women with endometriosis.
Pediatric and Adolescent Extracranial Germ Cell Tumors: The Road to Collaboration
Extracranial Germ Cell Tumors
.... Adolescents and young adults with GCTs often are treated by medical oncologists, urologists, or gynecologic oncologists. The therapeutic dilemma for all is how to best define disease risk so that therapy and toxicity can be appropriately reduced for some patients and intensified for others. Further clinical and biologic insights can only be achieved through collaborations that do not set limitations by age, sex, and primary tumor site. Therefore, international collaborations, spanning different cooperative groups and disciplines, have been developed to address these challenges.
Pattern of Frequent But Nontargeted Pharmacologic Thromboprophylaxis for Hospitalized Patients With Cancer at Academic Medical Centers
open access
Pattern of Frequent But Nontargeted Pharmacologic Thromboprophylaxis for Hospitalized Patients With Cancer at Academic Medical Centers: A Prospective, Cross-Sectional, Multicenter Study
Conclusion We conclude that pharmacologic thromboprophylaxis is frequently administered to hospitalized patients with cancer but that nearly one third of patients are considered to have relative contraindications for prophylactic anticoagulation. Pharmacologic thromboprophylaxis in hospitalized patients with cancer is commonly prescribed without regard to the presence or absence of concomitant risk factors for VTE.
See accompanying editorial on page 1754
Evidence-Based Medicine for Thromboprophylaxis in Hospitalized Patients With Cancer: Why Aren't We There Yet?
....Considering that 60% of venous thromboembolism cases are related to hospitalization,16 that 20% of venous thromboembolism occur in oncology patients,17 and that venous thromboembolism is associated with increased in-hospital mortality,18 it is disheartening that good quality research has not been done to address in-hospital thromboprophylaxis in patients with cancer. The lack of evidence to guide best practice in this everyday clinical setting is unacceptable. Zwicker et al4 have sounded an alarm. The oncology community needs to take action.
Epithelial ovarian cancer: Advances in model systems, microenvironmental influences, therapy, and origins | Women's Cancer
Women's Cancer
Improving outcomes for women with epithelial ovarian cancer is a major health issue worldwide as 5-year survival has not improved significantly over the last two decades.
The urgent need to increase our understanding of high grade serous ovarian cancer (HG-SOC) led to it being chosen for the pilot project of The Cancer Genome Atlas (TCGA) and the genomes of over 400 HG-SOC samples are now freely accessible for interrogation. These data are being used for the discovery of biomarkers as well as the generation of hypotheses to understand the natural history of this malignancy and develop effective targeted therapies.....
A Guide to Survivorship for Women Who Have Ovarian Cancer
Google Books 2015
A Guide to Survivorship for Women Who Have Ovarian Cancer - Robert E. Bristow, Terri L. Cornelison, F. J. Montz
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