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Monday, February 08, 2016

Understanding inherited genetic risk of adult glioma – a review



open access

 ..... In this paper, we review current knowledge about inherited risk for primary adult glioma, specifically, glioblastoma, and grade II/III astrocytoma, oligodendroglioma, and oligoastrocytoma. We also discuss how inherited risk varies by histology and molecular subtypes characterized by acquired mutations. An information sheet is appended to help patients and their families understand these important concepts.....That several rare hereditary cancer syndromes greatly increase risk of glioma has been known for many years. These familial syndromes include neurofibromatosis, tuberous sclerosis, Lynch syndrome, Li-Fraumeni syndrome, melanoma-neural system tumor syndrome, and Ollier disease (Table 1).14

 It is very important to understand that inherited genetic risk variants, whether common or rare, with low or high penetrance, are neither necessary nor sufficient for glioma formation – rather, they contribute to risk. Even for people with familial syndromes, additional acquired mutations are required for tumorigenesis. Moreover, not everyone who inherits the same mutation necessarily develops cancer or the same type of cancer.
 Understanding inherited genetic risk of adult glioma – a review

Supplementary Data

Supplementary Data



Table 1.
Rare hereditary cancer syndromes that increase risk of glioma

Impact of Age at Primary Breast Cancer on Contralateral Breast Cancer Risk in BRCA1/2 Mutation Carriers



open access

Is Cancer Pain Control Improved by a Simple WHO Pain Analgesic Ladder Approach Combined With Tumor-Directed Treatment?



open access
 
The practical use of the WHO analgesic ladder has evolved over time; is there a need for a formal change? Taking into consideration that pain is the symptom most feared by patients and families, and that studies have demonstrated that 90% of patients with cancer experience pain1 and only 50% receive adequate pain control in unselected cancer cohorts,2 there is an urgent need for improvement. The solutions are clearly more complex than simply changing the WHO analgesic ladder. Systematic pain diagnosis during oncology consultations should be incorporated as a minimum requirement into standard inpatient and outpatient consultations. However, it is debatable how to address symptom management in general and pain management specifically in consultations where the primary focus is often how to treat the tumor and prolong life. Cancer pain is affected by many variables, such as tumor type and site, the extent of the disease, cancer therapy, and host factors (sex, genomics, and psychologic and social factors, among others), which challenge a simple solution to pain diagnosis. Is it possible to simplify both pain classification and management, with improved overall pain control as a result?
In the article that accompanies this editorial, Bandieri et al3 challenge the concept of the WHO analgesic ladder.....
 
  • See accompanying article on page 436

Gene family turns cancer cells into aggressive stem cells that keep growing



medical news (in research)

Journal Reference:
  1. Linlin Luo, Peter Mcgarvey, Subha Madhavan, Rakesh Kumar, Yuriy Gusev, Geeta Upadhyay. Distinct lymphocyte antigens 6 (Ly6) family members Ly6D, Ly6E, Ly6K and Ly6H drive tumorigenesis and clinical outcome. Oncotarget, 2016 DOI: 10.18632/oncotarget.7163

Satisfaction with cancer care among underserved racial-ethnic minorities and lower-income patients receiving patient navigation



abstract

Sunday, February 07, 2016

Contemporary Evaluation and Management of Upper Tract Urothelial Cancer



abstract

 Radical nephroureterectomy with en bloc bladder cuff excision and regional lymphadenectomy is the gold standard for the management of high-grade and high-risk upper tract urothelial carcinomas (UTUC). There are few prospective randomized controlled studies in this uncommon and often aggressive disease to support level-1 management guidelines. However, recent developments in imaging, minimally invasive techniques, lymphatic dissemination, and bladder cancer prevention raise the hope for improved risk stratification and treatments without compromising, and hopefully improving, oncological outcomes. Multi-modality approaches in terms of neoadjuvant, adjuvant topical and systemic chemotherapeutic regimens are promising, with 2 prospective trials either open or in development.

Polyphenols (EUFIC)



Polyphenols (EUFIC)
 
What are polyphenols?
The antioxidant hypothesis
Polyphenols and health 
Conclusion

Inhibitory Effects of the Four Main Theaflavin Derivatives Found in Black Tea on Ovarian Cancer Cells



abstract

BACKGROUND:

Some polyphenols induce apoptosis and inhibit angiogenesis. Consumption of black tea, rich in polyphenols, has been found to reduce ovarian cancer risk. Theaflavin (TF1), theaflavin-3-gallate (TF2a), theaflavin-3'-gallate (TF2b) and theaflavin-3, 3'-digallate (TF3) are four main theaflavin derivatives found in black tea.

MATERIALS AND METHODS:

Cell proliferation assay, Hoechst 33342 staining assay, Caspase-Glo Assay, western blot, human umbilical vein endothelial cell tube formation assay and vascular endothelial growth factor (VEGF) enzyme-linked immunosorbent assay were performed.

RESULTS:

All four theaflavin derivatives reduced viability of ovarian cancer cells at lower concentrations than with normal ovarian cells. TF1 mainly mediated apoptosis via the intrinsic pathway, while the others via the intrinsic and extrinsic pathways. TF1 inhibited tube formation via reducing VEGF secretion in a hypoxia-inducible factor 1α-independent manner, while the others in a HIF1α-dependent way.

CONCLUSION:

All four theaflavin derivatives inhibited ovarian cancer cells. Some of the effects and mechanisms of TF1 are different from those of the other three theaflavin derivatives.

Oral mucosal stigmata in hereditary-cancer syndromes: From germline mutations to distinctive clinical phenotypes and tailored therapies



abstract
 

Highlights

Several familial-cancer syndromes include distinctive oral mucosal lesions.
Their genetic background involve germline mutations in tumor suppressor genes.
A multidisciplinary approach is crucial for management of the gene-carriers probands.
An early onset of oral disease may lead to genetic testing in suspected probands.
The advancements in this field lead to the development of targeted therapies.


Abstract
Numerous familial tumor syndromes are associated with distinctive oral mucosal findings, which may make possible an early diagnosis as an efficacious marker for the risk of developing visceral malignancies. In detail, Familial Adenomatous Polyposis (FAP), Gardner syndrome, Peutz-Jeghers syndrome, Cowden Syndrome, Gorlin Syndrome, Lynch/Muir-Torre Syndrome and Multiple Endocrine Neoplasia show specific lesions of the oral mucosa and other distinct clinical and molecular features. The common genetic background of the above mentioned syndromes involve germline mutations in tumor suppressor genes, such as APC, PTEN, PTCH1, STK11, RET, clearly implied in both ectodermal and mesodermal differentiation, being the oral mucosal and dental stigmata frequently associated in the specific clinical phenotypes. The oral and maxillofacial manifestations of these syndromes may become visible several years before the intestinal lesions,

Sensitivity of ovarian cancer cells to acetaminophen reveals biological pathways that affect patient survival



technical - in research - open access (abstract & pdf)

Received February 11, 2015; Accepted November 16, 2015

Genetic testing for Lynch syndrome: family communication and motivation



open access (pdf)

.....In the Netherlands the communication regarding presence of a LS gene mutation within a family occurs by means of the family-mediated approach. When a pathogenic mutation is detected the counselee is asked to inform all at risk relatives. During the counselling process, communication strategies to inform relatives are discussed with the counselee. Furthermore a letter to inform relatives is supplied. This approach implies that family members are responsible to inform their relatives on the diagnosis of LS and the possibility of genetic testing. Currently, little is known about patients’ experiences with andattitudes towards this family-mediated approach.....

clinical trials search: ovarian cancer AND "Fallopian Tube Cancer"



Search of: Open Studies | Exclude Unknown | ovarian cancer AND "Fallopian Tube Cancer" | Adult, Senior | received from 09/01/2015 to 02/07/2016 - List Results - ClinicalTrials.gov

 14 studies found for:    Open Studies | Exclude Unknown | ovarian cancer AND "Fallopian Tube Cancer" | Adult, Senior | received from 09/01/2015 to 02/07/2016

clinical trials: ovarian cancer - received 09/01/2015 - 02/07/2016



Search of: Open Studies | Exclude Unknown | ovarian cancer | Adult, Senior | received from 09/01/2015 to 02/07/2016 - List Results - ClinicalTrials.gov


73 studies found for:    Open Studies | Exclude Unknown | ovarian cancer | Adult, Senior | received from 09/01/2015 to 02/07/2016

(Canada) Playing fast and loose with logic at the assisted death hearings



ipolitics Canada

 By | Feb 2, 2016 8:56 pm |  comments |

Who needs shock TV when we can tune into telecasts of Parliament’s Special Joint Committee on Physician-Assisted Dying hearings?
Listening to certain MPs and witnesses creates the impression that Canada stands on the brink of the wholesale slaughter of the innocent, the undesirable and the vulnerable. Given the level of debate, viewers are often left wondering whether some Parliamentarians and witnesses have even read the Supreme Court of Canada’s Carter et.al. v Attorney General of Canada ruling......

NCCN Clinical Practice Guidelines: Genetic/Familial High-Risk Assessment: Breast and Ovarian + link Colorectal Genetics



 Blogger's Note: odd the inclusion of Cowden/LFS but not Lynch Syndrome reference, see link below (Colorectal)

NCCN Guidelines

Genetic/Familial High-Risk Assessment: Breast and Ovarian   

Genetic/Familial High-Risk Assessment: Colorectal   

NCCN Guidelines: (2015) Ovarian Cancer Including Fallopian Tube Cancer and Primary Peritoneal Cancer



ovarian.pdf
 
Ovarian Cancer      20th Annual Edition!
 

NCCN.org
Version 2.2015, 06/22/15 © National Comprehensive Cancer Network, Inc. 2015
NCCN Guidelines for Patients
® available at
www.nccn.org/patient

Saturday, February 06, 2016

Genetic/Familial High-Risk Assessment: Breast and Ovarian, Version 2.2015



Version 2.2015 

 This Article
  1. J Natl Compr Canc Netw 14:153-162
 Abstract

The NCCN Guidelines for Genetic/Familial High-Risk Assessment: Breast and Ovarian provide recommendations for genetic testing and counseling and risk assessment and management for hereditary cancer syndromes. Guidelines focus on syndromes associated with an increased risk of breast and/or ovarian cancer and are intended to assist with clinical and shared decision-making. These NCCN Guidelines Insights summarize major discussion points of the 2015 NCCN Genetic/Familial High-Risk Assessment: Breast and Ovarian panel meeting. Major discussion topics this year included multigene testing, risk management recommendations for less common genetic mutations, and salpingectomy for ovarian cancer risk reduction. The panel also discussed revisions to genetic testing criteria that take into account ovarian cancer histology and personal history of pancreatic cancer.

ANN KOLKER Obituary - Washington, DC | The Washington Post Feb 3, 2016



ANN KOLKER Obituary


Risk-Reduction Surgery in Pediatric Surgical Oncology: A Perspective



abstract

Objective
A small percentage of pediatric solid cancers arise as a result of clearly identified inherited predisposition syndromes and nongenetic lesions. Evidence supports pre-emptive surgery for children with genetic [multiple endocrine neoplasia type 2 (MEN2), familial adenomatous polyposis syndrome (FAP), hereditary nonpolyposis colorectal cancer (HNPCC), and hereditary diffuse gastric cancer (HDGC) and nongenetic [thyroglossal duct cysts (TGDC), congenital pulmonary airway malformations (CPAM), alimentary tract duplication cysts (ATDC), and congenital choledochal cysts (CCC)] developmental anomalies. Our aim was to explore the utility of risk reduction surgery to treat and prevent cancer in children........

Impact of FOXL2 mutations on signaling in ovarian granulosa cell tumors



abstract


Highlights

FOXL2 is the key player in granulosa cell differentiation and its expression is critical in maintaining ovarian phenotype.
Although more than 260 mutations identified in FOXL2 result in Blepharophimosis–Ptosis–Epicanthus inversus syndrome, only the FOXL2 C134W mutation is unique to granulosa cell tumors of the ovary.
Mutant FOXL2 has been found to alter hormone production, apoptotis and proliferation in vitro.
Further insights into FOXL2 signaling can be found at http://www.cancerindex.org/geneweb//FOXL2.htm.

 Granulosa cell tumors (GCT) are unique sex-cord stromal tumors which account for ∼8% of all ovarian malignancies. They exhibit morphological, biochemical and hormonal features similar to proliferating granulosa cells of the preovulatory follicle, including estrogen and inhibin synthesis. A somatic missense mutation in the forkhead box L2 (FOXL2) gene (C134W) is unique to adult GCT, and absent in other ovarian cancers. FOXL2 is a transcription factor that plays a critical role in ovarian function, in particular, proliferation and differentiation of granulosa cells. The molecular mechanisms underlying the pathogenicity of the mutant FOXL2 remain unresolved. Here we review the molecular alterations known to be associated with mutant FOXL2 and the potential signaling implications. Several studies suggest that dysregulated FOXL2 function may alter cell cycle progression and apoptosis. Further insights into the molecular mechanism of GCT pathophysiology may identify therapeutic targets for the treatment of these tumors.

Ruptured clear cell carcinoma of the ovary presenting as acute abdomen



open access

Highlights

This is the first report of spontaneous rupture of clear cell ovarian carcinoma.
Ruptured tumors should remain in the differential diagnosis of acute abdomen.
Stage 1 due to rupture has a better prognosis than ascites and surface involvement.

Here we present the first documented case of a ruptured ovarian clear cell carcinoma presenting as an acute abdomen.

Case

......The patient is a 54 year old G1P1001, postmenopausal woman who presented to the emergency department complaining of severe abdominal pain for the past 24 h. She reported that the pain was diffuse and constant; review of systems was otherwise negative. Past gynecological history was remarkable for endometriosis. Past medical, surgical, family, and social histories were non-contributory. On presentation, her vital signs were remarkable for tachycardia with a pulse of 105. The remainder of her vital signs was within normal limits. On physical exam, her abdomen was distended, diffusely tender, dull to percussion, and positive for both rebound and guarding........
 
.......This case is novel in that spontaneous rupture of a clear cell ovarian tumor had occurred, and the patient presented with peritoneal signs and an acute abdomen, which is a surgical emergency. Gynecologists often see patients with ovarian malignancies presenting subacutely with constitutional and abdominal and pelvic signs and symptoms in an outpatient setting. However, epithelial ovarian carcinomas, and in particular ovarian clear cell cancer, ought to remain in the differential diagnosis in patients presenting with an acute abdomen with imaging suspicious for malignancy.

Friday, February 05, 2016

The FDA (U.S.) Wants To Hear Your Opinion - genetic testing/results



Your Opinion

 The FDA Wants To Hear Your Opinion
If you have an opinion about genetic testing and the best way to return those results, the U.S. Food and Drug Administration (FDA) wants to hear it at a daylong workshop scheduled for March 2nd.
The meeting offers the FDA a chance to get perspectives from the public and medical professionals on how best to convey genetic test results in a way that meets the needs of both patients and practitioners.The meeting comes on the heels of the ambitious Precision Medicine Initiative, announced during last year’s State of the Union address. Genetic testing and patient access and engagement are key components of the initiative. As such the FDA is “considering new approaches in its regulation” of certain types of genetic testing, according to the Federal Register.
What: Patient and Medical Professional Perspectives on the Return of Genetic Test Results
When: March 2, 2016 from 8 a.m. to 4 p.m.
Where: FDA’s White Oak Campus
10903 New Hampshire Ave., Bldg. 31
Conference Center, the Great Room (Rm. 1503)
Silver Spring, MD 20993For more information go here.
As part of the run-up to the meeting, the agency has offered up several case studies with different scenarios involving genetic testing. For instance, how to handle reporting on variants associated with different levels of risks for Alzheimer’s disease, or how to report on results that might include conflicting information or that have limited evidence. The FDA wants to hear opinions on how best health care professionals should handle this kind of information.
You have three ways to participate:
  1. Attend. People who want to attend and give their comments in person must register for the event, which has limited seating. The workshop is scheduled to begin at 8 a.m. ET March 2nd at the FDA’s White Oak Campus in Silver Springs, Maryland.
  2. Watch Webcast. The meeting will also be Webcast. Comments can be sent in the mail addressed to Division of Dockets Management (HFA-305), FDA, 5630 Fishers Lane, and Rm. 1061, Rockville, MD 20852.
  3. Submit comments online. Comments can also be submitted online by March 31st. All submissions, whether done through the mail or online must include reference to: “Docket No.  FDA-2015-N-4809 for `Patient and Medical Professional Perspectives on the Return of Genetic Test Results; Public Workshop; Request for Comments.’”

 

EvidenceUpdates: Hyperbaric oxygen for patients with chronic bowel dysfunction after pelvic radiotherapy



1) New Articles -- EvidenceUpdates
2) open access full text

 Abstract
BACKGROUND: Hyperbaric oxygen has been used as a therapy for patients experiencing chronic intestinal syndromes after pelvic radiotherapy for decades, yet the evidence to support the use of this therapy is based almost exclusively on non-randomised studies. We aimed to provide conclusive results for the clinical benefits of hyperbaric oxygen in patients with chronic bowel dysfunction after radiotherapy for pelvic malignancies.
 INTERPRETATION: We found no evidence that patients with radiation-induced chronic gastrointestinal symptoms, including those patients with rectal bleeding, benefit from hyperbaric oxygen therapy. These findings contrast with evidence used to justify current practices, and more level 1 evidence is urgently needed.


Glover M, Smerdon GR, Andreyev HJ, et al. Hyperbaric oxygen for patients with chronic bowel dysfunction after pelvic radiotherapy (HOT2): a randomised, double-blind, sham-controlled phase 3 trial. Lancet Oncol. 2015 Dec 15. pii: S1470-2045(15)00461-1. doi: 10.1016/S1470-2045(15)00461-1. (Original) PMID: 26703894
Read Abstract Read Comments

Screening for Pancreatic Adenocarcinoma in BRCA2 Mutation Carriers: Results of a Disease Simulation Model



abstract

FDR = first degree relatives

FINDINGS:

One-time screening at age 50 resulted in a LE gain of 3.9 days for the primary BRCA2 cohort, and a gain of 5.8 days for those with BRCA2 and one FDR. Annual screening resulted in LE loss of 12.9 days for the primary cohort and 1.3 days for BRCA2 carriers with 1 FDR, but resulted in 20.6 days gained for carriers with 2 FDRs and 260 days gained for those with 3 FDRs. For patients with ≥ 3 FDRs, annual screening starting at an earlier age (i.e. 35-40) was optimal.

INTERPRETATION:

Among BRCA2 mutation carriers, aggressive screening regimens may be ineffective unless additional indicators of elevated risk (e.g., 2 or more FDRs) are present. More clinical studies are needed to confirm these findings.

Thursday, February 04, 2016

Patient and caregiver perspectives on managing pain in advanced cancer



Patient and caregiver perspectives (abstract)
 Patient and caregiver perspectives on managing pain in advanced cancer: A qualitative longitudinal study (UK)

Background: Despite advances in treatment of pain in advanced cancer, it remains a major source of suffering with adverse effects on patients’ life quality. There is increasing understanding of its multi-dimensional nature and the variable responsiveness of medication to complex pain. Less clear is how patients and their caregivers respond to and manage pain complexity. 

Aim: To explore patients’ and carers’ experiences of advanced cancer pain and the processes that they engage in to manage pain. 

Design: Qualitative study employing face-to-face interviews at two time points and audio diaries. Data were analysed using grounded theory strategies. 

Setting/participants: Purposive sample of 21 advanced cancer patients and 16 carers from oncology outpatients in a tertiary cancer centre and a hospice. 

Results: Three distinct patterns of pain were discerned in patients’ accounts, distinguishable in terms of complexity, severity, transiency and degree of perceived control over pain. Pain was dynamic reflecting changes in the disease process, access to and effectiveness of pain relief. For patients and carers, neither pain relief nor expertise in pain management is secured once and for all. The main drivers of help-seeking and action by patients to manage pain were the sensory experiences of pain and meaning attached to it, not beliefs about analgesia

Conclusion: The complex and dynamic nature of pain and how it was understood shaped help-seeking and pain management. Variable effectiveness of pain relief for different pain types were challenging for patients and professionals in achieving relief.

HBOC: Tier 1 Genomic Applications Toolkit for Public Health Departments



HBOC (hereditary breast and ovarian cancer)

Tier 1 Genomic Applications Toolkit for Public Health Departments Lynch Syndrome



Toolkit 

Women Survivors Alliance: CALL FOR STAGE SHOW AUDITIONS: My 2nd Act: Survivor Stories



CALL FOR STAGE SHOW AUDITIONS

 Women Survivors Alliance


My 2nd Act:  Survivor Stories from the Stage LIVE Stage Show Production
Call for Auditions in Atlanta and Nashville
The 2016 My 2nd Act: Survivor Stories from the Stage shows are coming to Atlanta and Nashville in April 2016 and we are currently casting for our survivor story-tellers!
Produced by the Women Survivors Alliance, My 2nd Act: Survivor Stories from the Stage is a professionally produced stage show hosted at theaters around the country.  These shows are unique as they feature 10 women from the cities in which the stage show is hosted reading their 7 minute stories about what they are doing with their life after a cancer diagnosis – THEIR 2nd Acts!  The result?  A celebratory, inspiring and empowering stage show full of emotions – both for the survivors and non-survivors in the audience.   The members of the audience are, in turn, inspired to create their own 2nd Acts, which in turn inspire others, regardless of their life challenge. And so on, and so on ….....

GenomeFIRST awarded $400K grant to bring genomic information into patients' care FORTY FORT, Pa



PRNewswire-USNewswire

 ....The GenomeFIRST Medicine program takes a comprehensive approach to care that includes genomic screening, interpretation and managing results — essentially changing health care by expanding providers' ability to care for their patients before a problem arises. With support from the Robert Wood Johnson Foundation, Geisinger will pilot a scalable model for integrating genomic results into the everyday care of 300 Geisinger patients. The project will focus on the three most common genetic conditions in Geisinger's GenomeFIRST program: Hereditary Breast and Ovarian Cancer Syndrome (HBOC), Lynch Syndrome, and Familial Hypercholesterolemia....

Clinical Cancer Advances 2016: Annual Report on Progress Against Cancer - ASCO



open access

 JCO


In 2015, researchers reported marked gains in overcoming treatment resistance in several difficult-to-treat forms of blood, ovarian, lung, and breast cancers.
 This report features examples of notable research successes achieved thanks to funding from the US National Institutes of Health (NIH), including:
  • An early clinical trial that showed that a combination of two novel targeted drugs may slow the growth of a difficult-to-treat form of ovarian cancer.
    The FDA approved two first-in-class therapies, olaparib for the treatment of advanced ovarian cancer and palbociclib for the treatment of advanced breast cancer. Each of these drugs blocks a specific molecule that fuels the growth of that cancer.
    read full text

Wednesday, February 03, 2016

Preventive surgery for women at high risk of breast and ovarian cancer



health news

 In a review article published in the Feb. 4 issue of the New England Journal of Medicine, a pair of Mayo Clinic Cancer Center researchers provide an in-depth look at the issues associated with the care of women in families with hereditary breast and ovarian cancer syndrome who have not yet developed cancer themselves. The article addresses optimal risk assessment for breast and ovarian cancers, the usefulness of risk-reducing surgery, side effects of these procedures, alternative strategies for cancer prevention and the best ways to help with the decision-making process....

Cancer survival in New South Wales, Australia: socioeconomic disparities remain despite overall improvements



open access

Background

Disparities in cancer survival by socioeconomic status have been reported previously in Australia. We investigated whether those disparities have changed over time.
 

Methods

We used population-based cancer registry data for 377,493 patients diagnosed with one of 10 major cancers in New South Wales (NSW), Australia. Patients were assigned to an area-based measure of socioeconomic status. Five-year relative survival was estimated for each socioeconomic quintile in each ‘at risk’ period (1996–2000 and 2004–2008) for the 10 individual cancers. Poisson-regression modelling was used to adjust for several prognostic factors. The relative excess risk of death by socioeconomic quintile derived from this modelling was compared over time.
 

Conclusion

While recent health and social policies in NSW have accompanied an increase in cancer survival overall, they have not been associated with a reduction in socioeconomic inequalities.

  Liver, breast, ovarian and prostate cancers saw higher case numbers in the less disadvantaged SES groups, whereas the opposite trend occurred for lung cancer.
 No significant variation in RER was found for melanoma, ovarian, cervix or uterine cancers.
 Melanoma and ovarian cancer again showed no significant variation in RER of death by SES in 2004–2008.
 Previous studies of ovarian cancer survival have also found no association with SES [6, 32]. The non-specific nature of symptoms and lack of a definitive screening-diagnostic test could explain this finding, as the majority of diagnoses in all socioeconomic groups in NSW in both periods occurred at an unknown or already advanced stage (Additional file 2: Table S2), by which point effective treatment options are limited [33].

added section to Ovarian Cancer and Us blog (pubmed feed)



Image result for arrow clip artSee right hand side column of blog

Massively Parallel Sequencing-Based Clonality Analysis of Synchronous Endometrioid Endometrial and Ovarian Carcinomas (3)



Massively Parallel Sequencing-Based Clonality Analysis of Synchronous Endometrioid Endometrial and Ovarian Carcinomas


Massively Parallel Sequencing-Based Clonality Analysis of Synchronous Endometrioid Endometrial and Ovarian Carcinomas

Abstract

Synchronous early-stage endometrioid endometrial carcinomas (EECs) and endometrioid ovarian carcinomas (EOCs) are associated with a favorable prognosis and have been suggested to represent independent primary tumors rather than metastatic disease. We subjected sporadic synchronous EECs/EOCs from five patients to whole-exome massively parallel sequencing, which revealed that the EEC and EOC of each case displayed strikingly similar repertoires of somatic mutations and gene copy number alterations. Despite the presence of mutations restricted to the EEC or EOC in each case, we observed that the mutational processes that shaped their respective genomes were consistent. High-depth targeted massively parallel sequencing of sporadic synchronous EECs/EOCs from 17 additional patients confirmed that these lesions are clonally related. In an additional Lynch Syndrome case, however, the EEC and EOC were found to constitute independent cancers lacking somatic mutations in common. Taken together, sporadic synchronous EECs/EOCs are clonally related and likely constitute dissemination from one site to the other.

Canadian Doctors for Medicare: January February 2016 Newsletter



January February 2016 Newsletter

 Unfortunately, advocacy groups were not invited to observe the meeting.

Access 30 Highly Cited Articles from Nutrition and Cancer: An Intl Journal



An International Journal 

 You’ll find 30 HIGHLY-CITED ARTICLES from the CURRENT 2015-2013 volume years. Just click on each article title to download in PDF format or to view in HTML format. FREE ACCESS is available through to year end 2016.

8th Annual Asian Oncology Summit - download programme



option 1: Conference Programme 
option 2: (pdf)

 AOS 2016

Liquid cancer biopsy: the future of cancer detection? - The Lancet Oncology



Editorial

new journal: ESMO Open



Home | ESMO Open


BMJ is pleased to announce the launch of ESMO Open, the Open Access journal from the European Society for Medical Oncology. To find out more about the journal’s vision, please watch the video from the Editor-in-Chief, Professor Christoph Zielinski

Delivering 'Bad' vs 'Serious' News to Patients/patient's perception (includes comments)



medscape

Ovarian Cancer Pictures: Cysts, Symptoms, Tests, Stages, and Treatments



webmd

EvidenceUpdates: Postoperative Showering for Clean and Clean-contaminated Wounds: A Prospective, Randomized, Controlled Trial



New Articles (includes professional commentaries)

 OBJECTIVE: To evaluate wound infection rates, pain scores, satisfaction with wound care, and wound care costs starting 48 hours after surgery.

 CONCLUSIONS: Clean and clean-contaminated wounds can be safely showered 48 hours after surgery. Postoperative showering does not increase the risk of surgical site complications. It may increase patients' satisfaction and lower the cost of wound care.

Tuesday, February 02, 2016

Getting to the bottom of financial disclosure issues in the not-for-profit sector - Ottawa



Ottawa Telfer School of Management

 Professor Qiu Chen has just published research examining a key transparency issue in the nonprofit sector: to increase opportunities for donations, some managers misreport fundraising and/or administrative expenses as program expenses.....

 abstract link: Director Monitoring of Expense Misreporting in Nonprofit Organizations: The Effects of Expense Disclosure Transparency, Donor Evaluation Focus and Organization Performance

The next steps on Zika : Nature News & Comment



Nature News & Comment

 The World Health Organization this week declared that clusters of birth defects suspected of being linked to an epidemic of Zika virus in the Americas constituted a “public health emergency of international concern”. Beyond the practical imperative to better control the mosquitoes that spread Zika and other diseases, the most urgent priority on the ground is research to answer basic, but crucial, questions, including whether the birth defects are caused by the virus, and if so, how frequently......

NCI-MATCH: A Status Report and Future Directions Feb 1st



NCI

We will also be opening 12 to 14 additional treatment arms, with the expectation of having as many as 22 to 24 arms open by May 2016.
....Because our experience to date is leading to some modifications in the trial, the pause in enrollment to the screening step is expected to continue until all of these changes are implemented. We expect to resume enrollment of new patients by May 2016.
The ongoing interim analysis, results from which will be publicly presented in early spring, will include data on:
  • the diversity of cancer types (common and rare) among patients who have enrolled in the trial
  • patients with a mutation that matches to one of the 10 available treatments versus those with no match
  • the estimated proportion of patients who may have a mutation that matches to one of the 22 to 24 treatment arms, once all arms become available
  • the type and quality of tumor samples submitted by the institutions enrolling patients in the trial
  • the performance and turnaround time of the four laboratories supporting the trial with sample processing and genomic testing
The interim analysis will provide a snapshot of how this ambitious trial unfolded and will help the trial leadership make necessary refinements. Already we are making important changes to NCI-MATCH....

Editorial: Does cancer research focus on areas of importance to patients?



Editorials (UK)

Abstract

The majority of research ideas are proposed by clinicians or scientists and little is currently known about which areas of research patients feel are important. We performed a 4 week pilot patient survey at the Royal Marsden (a specialist cancer centre) to investigate patients’ views on priorities for cancer research. A total of 780 patients completed the survey and the top research priorities were identified as: detection and prevention of cancer, scientific understanding, curative treatment and personalised treatment. The top research priorities were remarkably consistent across age, gender and a variety of tumour types. We believe that patients’ views should be considered alongside those of clinicians and researchers when devising research proposals and strategies.

Results and discussion

We had a total of 780 respondents, of whom 55% were female. The majority of patients were between 46–75 years of age: 119 patients (15%) were less than 45 years, 234 patients (30%) were 46–60 years, 326 (42%) were 61–75 years and 85 (11%) were >75 years. A large number of different tumour types were represented (see Table 1), with the most common being breast, prostate and gynaecological malignancies. Not all patients answered every question, however 396 (51%) patients stated they were being treated with curative intent and 296 (38%) patients were treated with palliative intent. Some patients had not yet started treatment or were having supportive care only, but 397 (51%) of patients were currently undergoing treatment and 229 (29%) were in follow-up/remission.....

 Table 1. Tumour types of respondents to the PACER survey.
 

Utility of endometrial sampling prior to risk-reducing hysterectomy in a patient with Lynch syndrome



open access
 Introduction
Women with Lynch syndrome have an autosomal dominant mutation in one of the DNA mismatch repair genes resulting in an increased lifetime risk for colorectal and endometrial cancer in addition to cancers of the ovary, stomach, hepatobiliary tract, pancreas, small bowel, urinary tract, and central nervous system. The current National Comprehensive Cancer Network (NCCN) guidelines recommend that individuals with Lynch syndrome undergo colorectal cancer screening with colonoscopy [1]. There is less data to support gynaecologic screening. However, because of high lifetime risk of endometrial cancer in women with Lynch syndrome the NCCN and other consensus guidelines recommend annual or biennial endometrial sampling beginning at age 30–35 years and risk-reducing hysterectomy and bilateral salpingo-oophorectomy in women who have completed childbearing [1, 2].....

Case presentation

A 50-year-old, gravida zero, Ashkenazi Jewish woman underwent screening for Lynch syndrome. Her paternal grandfather was diagnosed with colon cancer at age 80, paternal uncle diagnosed with colon cancer at age 50, and two paternal second cousins diagnosed with premenopausal endometrial cancer. Both the patient and her father were found to have the Lynch syndrome mutation MSH6 3959del4, which results in premature truncation of the MSH6 protein at amino acid position 1325 [3]. Following this screening result, the patient was immediately referred for risk-reducing gynaecologic surgery.
The patient had no personal history of cancer or gynaecologic pathology....
 

Discussion

Women with Lynch syndrome undergoing risk-reducing hysterectomy are at risk for having an occult endometrial cancer, however the magnitude of risk remains unknown. The estimated cumulative lifetime risk for endometrial cancer in Lynch syndrome varies by report and mutation, ranging from 21–71%. The MSH6 3959del4 mutation (as in the current case) is associated with the greatest risk of endometrial cancer, affecting 71% of women by age 70 [3]. Prior case reports have described occult endometrial cancer discovered in patients with Lynch syndrome undergoing risk-reducing surgery [4, 5]. Lachiewicz et al [6] recently published the first study to explore the prevalence of occult gynaecologic malignancy at the time of risk-reducing surgery in patients with Lynch syndrome......

World Cancer Day 2014 Part I: Talking About Cancer



OncoLink Cancer Blogs

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Ethical and Societal Questions Loom Large as Gene Editing Moves Closer to the Clinic



JAMA 

Evidence! New S4PM Survey Shows People Want to Collaborate with Their Doctors and Co-Produce Their Clinical Data



e-Patients.net
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  A fundamental precept of participatory medicine is that health care should not be a spectator sport—it’s best practiced in a participatory manner. This requires engagement from both the patient and the clinician.....So it was quite gratifying to see the results of a new Society for Participatory Medicine survey. The survey, fielded by ORC International, a professional survey firm, asked 1000 adults five questions. We’re publishing the results in this downloadable PDF infographic.