Twitter: Amid election woes, Canadians are telling America it's great

Twitter - Amid election woes, Canadians are telling America it's great
  

An online Canadian campaign is trying to make Americans feel a bit better about the current state of political affairs by reminding them why we like their country in the first place.

The hashtag #TellAmericaItsGreat, created by Toronto ad agency The Garden, is being used on Twitter to remind our American neighbours about their best qualities as they go through an election season that is more rancorous and divisive by the day.

 America has a big decision to make. Before they do, we want to remind them they’re already pretty great.

SWOG: The Front Line re: ESMO conference

The Front Line
 

... the U.S. had the top number of delegates outside of Europe. I’m glad the worth of ESMO is increasingly being recognized here at home.

Myriad Will Present New Data on Its Variant Classification Program ASHG Annual Meeting

News Release 

Should Patients Read Their Progress Notes? (Mass General)

Proto Magazine

The Canada Revenue Agency's online consultation on charities' political activities

The Canada Revenue Agency's online consultation on charities' political activities

 How to comment
Closing date: All comments are requested by November 25, 2016.
Who may respond:
These consultations are open to everyone. Please email your comments to: consultation-policy-politique@cra-arc.gc.ca.

Cancer Genetics Risk Assessment and Counseling — NCI Updated: Oct 13, 2016

Cancer Genetics Risk Assessment and Counseling (PDQ®)

This summary describes current approaches to assessing and counseling people about their chance of having an inherited susceptibility to cancer. Genetic counseling is defined by the National Society of Genetic CounselorsExit Disclaimer as the process of helping people understand and adapt to the medical, psychological, and familial implications of genetic contributions to disease. Several reviews present overviews of the cancer risk assessment, counseling, and genetic testing process.[1-3] 

Individuals are considered to be candidates for cancer risk assessment if they have a personal and/or family history (maternal or paternal lineage) with features suggestive of hereditary cancer.[3] These features vary by type of cancer and specific hereditary syndrome. Criteria have been published to help identify individuals who may benefit from genetic counseling.[3,4] The PDQ cancer genetics information summaries on breast, ovarian, endometrial, colorectal, prostate, kidney, and skin cancers and endocrine and neuroendocrine neoplasias describe the clinical features of hereditary syndromes associated with these conditions.

The following are features that suggest hereditary cancer:

• Unusually early age of cancer onset (e.g., premenopausal breast cancer).
• Multiple primary cancers in a single individual (e.g., colorectal and endometrial cancer).
• Bilateral cancer in paired organs or multifocal disease (e.g., bilateral breast cancer or multifocal renal cancer).
• Clustering of the same type of cancer in close relatives (e.g., mother, daughter, and sisters with breast cancer).
• Cancers occurring in multiple generations of a family (i.e., autosomal dominant inheritance).
• Occurrence of rare tumors (e.g., retinoblastoma, adrenocortical carcinoma, granulosa cell tumor of the ovary, ocular melanoma, or duodenal cancer).
• Unusual presentation of cancer (e.g., male breast cancer).
• Uncommon tumor histology (e.g., medullary thyroid carcinoma).
• Rare cancers associated with birth defects (e.g., Wilms tumor and genitourinary abnormalities).
• Geographic or ethnic populations known to be at high risk of hereditary cancers. Genetic testing candidates may be identified based solely on ethnicity when a strong founder effect is present in a given population (e.g., Ashkenazi heritage and BRCA1/BRCA2 pathogenic variants).[5,6]

As part of the process of genetic education and counseling, genetic testing may be considered when the following factors are present:

• An individual's personal history (including ethnicity) and/or family history are suspicious for a genetic predisposition to cancer.
• The genetic test has sufficient sensitivity and specificity to be interpreted.
• The test will impact the individual's diagnosis, cancer management or cancer risk management, and/or help clarify risk in family members.[7-9]

It is important that individuals who are candidates for genetic testing undergo genetic education and counseling before testing to facilitate informed decision making and adaptation to the risk or condition.[3] Genetic education and counseling allows individuals to consider the various medical uncertainties, diagnosis, or medical management based on varied test results, and the risks, benefits, and limitations of genetic testing.

News Organizations' Overall Grades (see drop down menu)

HealthNewsReview.org

eg.

PARP inhibitors: STAT's look at new ovarian cancer drugs should have established why we need more on the market

HealthNewsReview.org

A banner week for CDA (Celebrity Disease Awareness): More stars shill health products (Canada/U.S.)

healthnewsreview

 The following post is by Alan Cassels, a pharmaceutical policy researcher at the University of Victoria, British Columbia, a journalist, and author of the The Cochrane Collaboration: Medicine’s Best-Kept Secret.

Index: Jnl Minimally Invasive Gynecology Supplement (November–December 2016)

abstracts:
Journal of Minimally Invasive Gynecology | Vol 23, Iss 7, Supplement, Pgs A1-A14, S1-S262, (November–December 2016)

Post-resection outcomes for pediatric ovarian neoplasm: is ovarian-preserving surgery a good option? (Tennessee)

 dys·men·or·rhe·a ˌdismenəˈrēə/

noun Medicine noun: dysmenorrhoea; noun: dysmenorrhea

1. painful menstruation, typically involving abdominal cramps.

                   ~~~~~~~~~~~~~~~~~~~~~~~~~~~

abstract
 

PURPOSE:

Pediatric surgeons often care for children with ovarian tumors. Few studies report long-term outcomes for these patients. This study characterizes intermediate-term results for patients who underwent surgical resection of ovarian neoplasms as children.

METHODS:

Patients who underwent surgery for ovarian neoplasms at a children's hospital were identified. They were invited to participate in a telephone-based survey assessing post-surgical recurrence, dysmenorrhea, quality of life, and fertility.

RESULTS:

188 patients were identified; 79 met criteria. 31 patients had ovarian-sparing tumor resection; 48 had oophorectomy; five had recurrences. 56 were successfully interviewed at a median follow-up of 4.6 years. Dysmenorrhea rates of 52 and 78 % were reported (p = 0.07), respectively. Two patients suffered from infertility. Quality of life was generally reported as good.

CONCLUSION:

Intermediate outcomes are good for patients who underwent ovarian-sparing tumor resection or oophorectomy for pediatric ovarian tumors. Additional long-term monitoring would be beneficial to better assess fertility and dysmenorrhea outcomes.

Utah Cancer Survivors: A Comprehensive Comparison of Health-Related Outcomes Between Survivors and Individuals Without a History of Cancer | SpringerLink

abstract:
Utah Cancer Survivors: A Comprehensive Comparison of Health-Related Outcomes Between Survivors and Individuals Without a History of Cancer 

 Assessments of cancer survivors’ health-related needs are often limited to national estimates. State-specific information is vital to inform state comprehensive cancer control efforts developed to support patients and providers. We investigated demographics, health status/quality of life, health behaviors, and health care characteristics of long-term Utah cancer survivors compared to Utahans without a history of cancer. Utah Behavioral Risk Factor Surveillance System (BRFSS) 2009 and 2010 data were used. Individuals diagnosed with cancer within the past 5 years were excluded........ A total of 11,320 eligible individuals (727 cancer survivors, 10,593 controls) were included. Respondents were primarily non-Hispanic White (95.3 % of survivors, 84.1 % of controls). Survivors were older (85 % of survivors ≥40 years of age vs. 47 % of controls). Survivors reported the majority of their cancer survivorship care was managed by primary care physicians or non-cancer specialists (93.5 %, 95 % CI = 87.9–99.1). Furthermore, 71.1 % (95 % CI = 59.2–82.9) of survivors reported that they did not receive a cancer treatment summary. In multivariable estimates, fair/poor general health was more common among survivors compared to controls (17.8 %, 95 % CI = 12.5–23.1 vs. 14.2 %, 95 % CI = 12.4–16.0). Few survivors in Utah receive follow-up care from a cancer specialist. Provider educational efforts are needed to promote knowledge of cancer survivor issues. Efforts should be made to improve continuity in follow-up care that addresses the known issues of long-term survivors that preclude optimal quality of life, resulting in a patient-centered approach to survivorship.

(Oregon) Cancer Fatalism and Preferred Sources of Cancer Information

abstract

 Cancer fatalism is associated with lower participation in cancer screening, nonadherence to cancer screening guidelines, and avoidance of medical care. Few studies, however, have examined the relationship between cancer fatalism and health information seeking. The purpose of this study was to examine the relationship between endorsement of fatalistic beliefs regarding cancer and preferred sources of cancer information. We analyzed data from the Health Information National Trends Survey 4 Cycle 2, which were collected in late 2012 and early 2013 (N = 3630). When weighted, the data are representative of the non-institutionalized US population aged 18 or older. In bivariate and multivariate analyses, we assessed three cancer fatalism beliefs as predictors of preferred use of healthcare provider versus preferred use of the Internet for cancer information. Results indicate the majority of US adults endorse one or more fatalistic beliefs about cancer. Unadjusted results indicate endorsing the fatalistic belief that “there’s not much you can do to lower your chances of getting cancer” was significantly associated with lower odds of preferring the Internet (versus healthcare providers) as the source of cancer information (OR: 0.70; CI: 0.50, 0.98). In the adjusted model, however, none of the three cancer fatalism measures were significantly associated with preferred source of cancer information. In conclusion, fatalistic beliefs about cancer are common, and further research is warranted to understand cancer fatalism and whether and how it may impact health information-seeking behaviors.

(Mayo) Living with Cancer: an Educational Intervention in Cancer Patients Can Improve Patient-Reported Knowledge Deficit | SpringerLink

abstract:
Living with Cancer: an Educational Intervention in Cancer Patients Can Improve Patient-Reported Knowledge Deficit

 A cancer diagnosis requires significant information to facilitate health care decision making, understand management options, and health care system navigation. Patient knowledge deficit can decrease quality of life and health care compliance. Surveys were distributed to attendees of the Mayo Clinic “Living with and Surviving Cancer” patient symposium January 2015. Follow-up survey was sent to participants 3 months after the symposium. Surveys included demographic data and patient-reported disease comprehension, symptom burden, desired information, and quality-of-life assessment.

Demographics: 113 patients completed the pre-intervention survey. Average age was 64.7 years. Disease types included hematologic (N = 50) and solid malignancies (N = 77). Most patients self-reported adequate baseline understanding of their disease (80 %), screening tests (74 %), and monitoring tools (72 %). Lowest knowledge topics were legal issues (13 %) and pain management (35 %).  



Pre- and post-analysis: 79 of the initial 113 participants completed both surveys. In the post-symposium setting, durable knowledge impact was noted in disease understanding (pre 80 % vs post 92 %), treatment options (pre 60 % vs post 76 %), nutrition (pre 68 % vs post 84 %), and legal issues (pre 15 % vs post 32 %). Most patients desired increased understanding regarding disease, screening tests, nutrition, and stress and fatigue management. The level of desired information for these topics decreased in the post-symposium setting, statistically significant decrease noted in 4 of 5 topics assessed. Knowledge needs and deficit in cancer care range from disease-specific topics, social stressors, and health care navigation. A cancer patient-centered symposium can improve patient-reported knowledge deficit, with durable responses at 3 months, but patient needs persist.

Learning Needs of Gynecologic Cancer Survivors (Turkey)

abstract

 To define the learning needs of patients with gynecological oncology. The study was performed as a descriptive study. A total of 92 patients were participated. Data were collected using Patient Learning Needs Scale (PLNS)........ The mean age of women’s was 50.37 ± 12.20 years. The women’s diagnoses were cervical (45.7 %), ovarian (27.2 %), and endometrial (19.6 %) cancers. The most frequently stated learning needs topics were coping with pain (47.8 %), daily living activities (46.2 %), and psychological support (44.6 %)...... Women who graduated from elementary school needed more education than the women with higher education (p < 0.001). Learning needs level of the women are high and related to increase quality of life, medicine usage, complications of treatment, skin problems, pain management, and supportive care. As a healthcare professional, we should plan and develop educational programs in order to adequately inform patients about their learning needs.

stats: Ovarian Cancer and Us- what you have been reading (top 10)/totals

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The association between reproductive and hormonal factors and ovarian cancer by estrogen-α and progesterone receptor status

abstract:
The association between reproductive and hormonal factors and ovarian cancer by estrogen-α and progesterone receptor status
 

Highlights

• •Ovarian tumor development through hormonal pathways may differ from breast cancer.
• •Postmenopausal women were more likely to develop PR(–) ovarian tumors.
• •Women with a tubal ligation tended to develop ERα(–) ovarian tumors.

Objective

We assessed the association between reproductive and hormonal factors and ovarian cancer incidence characterized by estrogen receptor-α (ERα) and progesterone receptor (PR) status.

Methods

Tissue microarrays were used to assess ERα and PR expression among 197 Nurses' Health Study (NHS), 42 NHSII and 76 New England Case-Control Study (NECC) ovarian cancer cases. NHS/NHSII cases were matched to up to 4 controls (n = 954) on diagnosis date and birth year. NECC controls (n = 725) were frequency matched on age. Cases were considered receptor positive if ≥1% of tumor cells stained positive. Associations by ERα and PR status were assessed using polytomous logistic regression. p-Value for heterogeneity was calculated using a likelihood ratio test.

Results

45% of ovarian tumors were PR(+), 78% were ERα(+) and 45% were ERα(+)/PR(+), while 22% were ERα(–)/PR(–). Postmenopausal status was associated with an increased risk of PR(–) tumors (OR: 2.07; 95%CI: 1.15–3.75; p-heterogeneity = 0.01) and age at natural menopause was inversely associated with PR(–) tumors (OR, per 5 years: 0.77; 95%CI: 0.61–0.96; p-het = 0.01). Increasing duration of postmenopause was differentially associated by PR status (p-het = 0.0009). Number of children and tubal ligation were more strongly associated with ERα(–) versus ERα(+) tumors (p-het = 0.002 and 0.05, respectively). No differential associations were observed for oral contraceptive or hormone therapy use.

Conclusions

Postmenopausal women have an increased risk of developing PR(–) ovarian tumors compared to premenopausal women. The associations observed for ovarian cancer differ from those seen for breast cancer suggesting that the biology for tumor development through ERα and PR pathways may differ.

Role of paroxetine in the management of hot flashes in gyn cancer survivors (randomized single-center controlled trial)

 Pronunciation

Generic Name: paroxetine (pa ROX a teen)
Brand Names: Brisdelle, Paxil, Paxil CR, Pexeva

 Paroxetine, also known by the trade names Paxil and Seroxat among others

                              ~~~~~~~~~~~~~~~~~~~~~~~
abstract:
Role of paroxetine in the management of hot flashes in gynecological cancer survivors: Results of the first randomized single-center controlled trial
  

Highlights

• •To examine the effects of paroxetine supplementation on hot flashes and sleep in gynecological cancer survivors
• •We compared 7.5 mg oral paroxetine or placebo daily for 16 weeks in gynecological cancer survivors.
• •Paroxetine 7.5 mg significantly reduces hot flashes in weekly frequency and severity in gynecological cancer survivors.

Mismatch Repair Polymorphisms as Markers of Breast Cancer Prevalence in the Breast Cancer Family Registry (NY)

open access

Materials and Methods

Study population. We selected participants enrolled in the New York site of the BCFR with available DNA (8-18). Enrollment eligibility for participants in the parent study included having to meet one of the following criteria: i) A female relative who had been diagnosed with either breast or ovarian cancer prior to the age of 45; ii) A female relative who has been diagnosed with breast and ovarian cancer at any age; iii) Two or more female relatives who had been diagnosed with breast or ovarian cancer after the age of 45; iv) A male relative diagnosed with breast cancer at any age; v) A known carrier of BRCA1 or 2 mutation. We used data collected at baseline through epidemiologic and family history questionnaires on demographics, ethnicity, history of all cancers, smoking, alcohol consumption, reproductive history, hormone use, height, weight, physical activity and dietary intake. Blood was collected at the time of recruitment, on average 5 years after diagnosis of cases (19). The current study includes 313 sister-sets (n=744) consisting of sisters discordant for breast cancer.

 In conclusion, in our family-based case-control study, we observe an increase in breast cancer risk due to alleles typically associated with Lynch syndrome cancers. These findings suggest that, while polymorphisms in MMR have, thus far, not been associated with sporadic breast cancer, deficiencies in this pathway may be relevant in familial breast cancer.

Ovarian clear cell carcinoma with plasma cell-rich inflammatory stroma: Cytological Findings of a Case

abstract

 We report a case of clear cell carcinoma (CCC) of the ovary with plasma cell-rich inflammatory stroma, a recently proposed subtype of CCC, and present the cytological findings. The patient was a 48-year-old woman, who was incidentally found to have a right ovarian tumor during the preoperative work-up for an early-stage adenocarcinoma of the uterine cervix. Cytological examination of an imprint smear of the ovarian tumor and peritoneal washing revealed solid cell clusters of irregular, often dendritic shapes, which were intermingled with many inflammatory cells. "Raspberry bodies" were not found. Histopathological examination of the extirpated ovarian tumor showed the features of CCC with plasma cell-rich inflammatory stroma. This subtype of ovarian CCC poses cytological and histological diagnostic problems, and its differentiation from dysgerminoma is often difficult, because it mostly lacks the hyaline or mucoid stroma. Irregularly shaped clusters of large polyhedral cells, coarsely clumped nuclear chromatin, and plasma cell-rich inflammatory infiltrates suggest CCC, but the cytological differences between dysgerminoma and CCC are often subtle, and immunohistochemical examinations for cytokeratin 7 or epithelial membrane antigen may be necessary. Diagn. Cytopathol, 2016.

PARP inhibitors for BRCA1/2-mutated and sporadic ovarian cancer: current practice and future directions

British Journal of Cancer - open access

FROM:

PARP inhibitors for BRCA1/2-mutated and sporadic ovarian cancer: current practice and future directions

G E Konecny and R S Kristeleit

BACK TO ARTICLE

Figure 1.

Role of PARP in DNA repair and main effects of PARP inhibitors. (A) Main DNA repair mechanisms, key pathway components and role of PARP1 for each pathway. (B) DNA single strand break repair by base excision repair. (C) Effect of PARP inhibition on DNA single and double strand break repair. AP, apurinic/apyrimidinic; ATM, ataxia telangiectasia; BER, base excision repair; DNA-PKcs, DNA-dependent protein kinase, catalytic subunit; DSB, double-strand break; FA, Fanconi anemia; FEN1, flap sructure-specific endonuclease 1; HR, homologous recombination; KU70 and KU80, make up the Ku heterodimer; MMEJ, microhomologymediated end joining; MRN, MRE11–RAD50–NBS1 protein complex; NBN, Nibrin; NHEJ, non-homologous end joining; PARP, poly (ADP-ribose) polymerase; PALB2, partner and localiser of BRC; PARPi, PARP inhibitor; RAD51, eukaryote gene of RAD51 protein family; SSB, single-strand break.
Full figure and legend (402K)

Table 1 - PARP inhibitors under development.

Full table

Table 2 - Most common AEs (any grade and grade 3) with olaparib treatment based on data from 2 large olaparib clinical trials. Shown are any grade AEs reported in at least 15% of patients or grade 3 AEs reported in at least 5% of patients.

Full table

Table 3 - Clinical Trials of PARP inhibitors in ovarian cancer.

Full table