Good news

Progress in cancer survival, mortality, and incidence in seven high-income countries 1995–2014 (ICBP SURVMARK-2): a population-based study

https://tinyurl.com/y2a7vpn3

This population-based study of cancer survival in seven countries provides information from 4 million patients comparing survival at 1 and 5 years post diagnosis. During the period 1995 to 2014 improved survival was recorded for all cancer types, especially in younger patients.

Comparison between different countries showed Australia to be the country with the best survival for every cancer type other than ovary and lung, for which Australia had the second best outcomes.  

Cancer incidence

https://tinyurl.com/y6nmmgzq

The annual review of cancer incidence in Australia shows an increase greater in remote areas, for indigenous Australians and those of lower socio-economic status.

However, the age-standardised incidence of ovarian cancer has decreased from 12.4/100,000 in 1982 to 9.8/100,000 now.

Ovary preservation? It’s OK

Fertility-sparing surgery for treatment of non-epithelial ovarian cancer: Oncological and reproductive outcomes in a prospective nationwide population-based cohort study

https://tinyurl.com/y2xjqd54

For young women with early stage ovarian cancer the decision as to the extent of surgery to undergo is difficult. Preservation of fertility is important, the concern is; does this mean an increased risk of recurrence?

This survey of the Swedish Quality Register for Gynecological Cancer identified 73 women, aged 18-40, with stage I ovarian cancer during the period 2008-2015. Most (78%) had ovary-sparing surgery, the others opted for full pelvic clearance.

The outcomes were good for both groups; the 5 years overall survival rate was 98%. There was no statistical difference in outcomes; the fertility of those women who had limited surgery was preserved, only 12% requiring IVF therapy.

Immunotherapy

How Immunotherapy Is Making an Impact in Ovarian Cancer

https://tinyurl.com/y6dvx8xb

In Australia 5 women in 1000 will develop advanced ovarian cancer by the age of 60. Progression free survival is improving, but overall survival is unchanged for the last 20 years. A need for alternate therapy has led to much clinical research. Immunotherapy is promoted as a great prospect for change.  Recently Dmitriy Zamarin, M.D. from Sloane Kettering spoke about various approaches: -

Check point inhibition; cancer develops when normal mutated cell death is prevented. Inhibition of this is good therapy in other cancers such as Keytruda for melanoma. Clinical trials have failed to show any benefit for ovarian cancer. 

Oncolytic virus therapy; vaccination with genetically modified adenovirus makes cancer cells vulnerable to killer T cells, these form in the patient’s thymus gland in response to disease. This is subject to clinical trial.

CAR T therapy; this process involves in vitro genetic modification of killer T cells. Although shown to be good for cancers of the blood, such as Kymriah for acute lymphoblastic leukaemia, no benefit is yet proved for solid tumours such as ovarian cancer. This too is subject to clinical trial.

It is early in a new field of research. What is clear is that each patient is different, the environment in which cancer exists is just as important as the tumour cell genetic type; targeted therapy is essential to change the current grim prospect.

T vs. C

Napping is OK

Cancer Survivors and the Art of Napping

https://tinyurl.com/y8xlcpvx

“Sita (my service dog) is around 14 years old. I also have a cat, named Cesar, who is 10. I tell them that we are all getting older together. 

I have been battling cancer for over eight years now. For someone with an incurable cancer on chemo, the tiredness never leaves. When the fatigue hits, I go to my bedroom. Cesar curls up between my legs, Sita lies on her bed and we all nap together.  

They obviously feel no guilt that they should be doing stuff, unlike me. Animals can be smarter than people and we can learn from them.”