Ovarian Cancer

SAN FRANCISCO-Five-year survival was significantly better for women with advanced-stage ovarian cancer diagnosed from 1988 to 1994 than for those diagnosed from 1983 to 1987, according to research presented at the 30th Annual Meeting of the Society of Gynecologic Oncologists. This improvement is thought to be due to increased use of surgical debulking and adjuvant platinum/paclitaxel (Taxol).

Because most patients now want to know the truth about their diagnosis and prognosis, the ability to discuss the cancer diagnosis, disease recurrence, or treatment failure, and to solicit patients’ views about resuscitation

Brain metastases are the most common type of brain tumor in adults and are an increasingly important cause of morbidity and mortality in cancer patients. In recent years, important advances have been made in the diagnosis

PHILADELPHIA-To be effective, the time interval for ovarian cancer screening should be no more than a year, a screening trial of 22,000 postmenopausal women suggests. In this study, 67 women were identified with ovarian cancer. For 28 of these women, ovarian cancer was detected within 1 year of their last CA 125 blood test.

WASHINGTON-Accumulating evidence shows that the additional cost of treating cancer patients in clinical trials vs that of providing standard care is essentially negligible, and, in some instances, treatment on protocol is significantly less expensive, experts said at a congressional briefing sponsored by the National Coalition for Cancer Research.

Laparoscopy dates back to 1901 when Kelling inspected a dog’s abdominal cavity with a cystoscope introduced transcutaneously. This technique was subsequently applied to humans in 1923.[1] Jacobaeus, in 1910, developed instruments

Minimally invasive surgery is simply the use of small incisions with specialized equipment to accomplish surgical objectives that would otherwise be completed through larger incisions with conventional equipment. A priority of gyne-cologic oncologists

One of the cornerstones of gynecologic cancer surgery is the assessment and removal of the retroperitoneal lymph nodes. Numerous reports have demonstrated that, when performed by highly skilled individuals, laparoscopic

ALEXANDRIA, Virginia-Genetic alterations very early in the disease process lie at the root of every cancer. Functional genomics, the study of which genes are actually functioning at a given time or stage, affords a “new approach” to fighting cancer, reported Kristina Cole, MD, PhD, a cancer research training fellow at the National Cancer Institute, Bethesda, Maryland.

Pain is the most common symptom of advanced cancer. For most cancer patients, pain can be controlled with

HOUSTON-A multimodal strategy for screening asymptomatic postmenopausal women for ovarian cancer shows promise of being able to find the disease early and improve survival. Researchers for the Ovarian Cancer Screening Project (OCSP) at St. Bartholomew’s Hospital, London, are testing a strategy combining the tumor marker CA 125 with transvaginal ultrasound and a mathematical instrument called the Risk for Ovarian Cancer Algorithm (ROCA).

HOUSTON-Stress is an immediate reaction to cancer that generally becomes more intensified during the course of the disease. Barbara L. Andersen, PhD, Department of Psychology, Ohio State University, Columbus, and her colleagues are conducting a study to examine the effects of stress on the immune system in cancer patients.

HOUSTON-The severity of sexual and fertility problems experienced by women after treatment for ovarian cancer is as diverse as the patient population, Leslie Schover, PhD, said at the First Annual International Conference for Ovarian Cancer, co-sponsored by M.D. Anderson Cancer Center and Memorial Sloan-Kettering Cancer Center.

NEW YORK-Last year, more than 20,000 people took part in the 5-kilometer Revlon Run/Walk for Women in New York City, raising more than $700,000 to fight women’s cancers. This year’s event will take place on Saturday, May 1, following a route that runs from Times Square to Central Park. The event is produced by Rehage Entertainment, Inc. and the New York Road Runners Club in cooperation with the City of New York.

ANAHEIM, California-Bringing together scientists and activists involved in understanding and controlling environmental pollutants associated with cancer can create powerful new research synergies, Sandra Steingraber, PhD, said at a symposium on mixed environmental hazards and cancer at the Annual Meeting of the American Association for the Advancement of Science (AAAS).

There are several million breast cancer survivors worldwide. In the United States, 180,000 women were diagnosed with breast cancer in 1997, and approximately 97,000 of these women have an extremely low chance of a suffering a recurrence of their cancer. With an average age at diagnosis of 60 years and a 25-year expected duration of survival, the current number of breast cancer survivors in the United States may approach 2.5 million women. Since breast cancer is now being detected at an earlier stage than previously and since adjuvant chemotherapy may cause ovarian failure, an increasing number of women are becoming postmenopausal at a younger age after breast cancer treatment. This conference was convened in September 1997 to consider how menopausal breast cancer survivors should be treated at the present time and what future studies are needed to develop improved therapeutic strategies. A total of 47 breast cancer experts and 13 patient advocates participated. The proceedings of the conference are being published in six installments in successive issues of oncology. This third part focuses on the prevention of osteoporosis and the cardiovascular effects of estrogens and antiestrogens. [ONCOLOGY 13(3):397-432, 1999]

NEW YORK-Although IV topo-tecan (Hycamtin) has been in use for several years and has shown activity in a number of different malignancies, oncologists now are turning their attention to delivering this camptothecin analog orally to maximize its effectiveness.

NEW YORK-Developing and implementing cancer outreach programs for African-Americans takes planning and sensitivity, said Robin L. Hurdle, CSW, a social worker in charge of the African-American Outreach Program at Cancer Care, Inc., the New York-based program that provides emotional support, information, and practical help to people with cancer and their loved ones free of charge.

MONTREAL-Paraneoplastic syndromes are increasingly being recognized as the earliest warning signs of some cancers, according to presentations at the Presidential Symposium of the 123rd Annual Meeting of the American Neurological Association (ANA).

CHICAGO-Much of cancer treatment rightly relies on evidence from randomized clinical trials. However, definitive clinical trials have not been done on some problem diagnoses, such as ductal carcinoma in situ (DCIS).

PHOENIX-A matched case-control study from Yale University suggests that early-stage breast cancer patients with deleterious BRCA1 or 2 mutations are at greater risk of late recurrences after breast-conserving surgery and radiation therapy than those without a mutation. Further, many of these late recurrences appear to be new primary breast cancers.

PHILADELPHIA-SmithKline Beecham’s topoisomerase I inhibitor Hycamtin (topotecan HCl for injection) has received FDA approval for the treatment of small-cell lung cancer (SCLC) after failure of first-line chemotherapy. The agent was previously approved for use in ovarian cancer after failure of initial or subsequent chemotherapy.

Amifostine (Ethyol) is an analog of cysteamine that selectively protects normal tissues in multiple organ systems against the toxic effects of radiation and various cytotoxic drugs while preserving the antitumor effects of these

This two-part series provides an up-to-date summary of the various chemopreventive agents currently in development and testing. Part 1, published in last month’s issue, focused on the retinoids, such as all-trans-

Researchers at Duke University Medical Center report animal studies that may explain, for the first time, why oral contraceptives offer protection against ovarian cancer. Their findings suggest that the progestin in birth control pills induces

WASHINGTON--Genetic research has produced a growing body of information about the mutations related to breast cancer, but, so far, "no clear algorithm" to help clinicians decide how to use the new findings in the interests of patients, reported Francis S. Collins, MD, PhD, director of the National Human Genome Research Institute.

Researchers at Duke University Medical Center report animal studies that may explain, for the first time, why oral contraceptives offer protection against ovarian cancer. Their findings suggest that the progestin in birth control pills induces damaged ovarian cells to die before they turn malignant.

After an almost 40-year search for a primary regulatory of platelet production, thrombopoietin has recently been purified and cloned. Thrombopoietin regulates all stages in the production of platelets by promoting both the

Cancer chemoprevention is the use of specific natural or synthetic substances with the objective of reversing, suppressing, or preventing carcinogenic progression to invasive cancer. Currently, numerous chemopreventive agents are in various stages of development and testing. Part 1 of this two-part series provides an overview of issues unique to chemoprevention trials, including the use of surrogate biomarkers as end points. This is followed by a discussion of the retinoids, such as all-trans-retinoic acid (ATRA [Vesanoid]), 9-cis-retinoic acid (9cRA), and isotretinoin (Accutane), and the carotenoids (eg, beta-carotene and lycopene) and other "classic" antioxidants (eg, vitamins E and C and selenium). Research on these agents will be delineated by disease site when applicable. Part 2, which will appear in next month’s issue, will focus on hormonally mediated chemopreventive agents, such as tamoxifen (Nolvadex), finasteride (Proscar), oral contraceptives, and dehydroepiandrosterone (DHEA). Part 2 also will cover nonantioxidant natural agents, such as calcium, the polyphenols, the isothiocyanates, and genistein; nonsteroidal anti-inflammatory drugs (NSAIDS), such as celecoxib, sulindac sulfone, and aspirin; difluro-methylornithine (DFMO [Eflornithine]); oltipraz; and N-acetylcysteine. [ONCOLOGY(11):1643-1658, 1998]

ATLANTA--Cancer programs and hospitals wishing to expand their services to include genetic counseling and testing should be aware that the staff and resource needs are intense, Constance Roche, MSN, RN, CS, said at a conference sponsored by the National Consortium of Breast Centers. Ms. Roche and Kevin Hughes, MD, who were instrumental in establishing the Lahey Clinic Risk Assessment Program, Peabody, Massachusetts, offered advice on establishing and operating such a program.