The Falling; Ovarian Cancer Neuropathy

The Falling, Wandering and Crashing Business of Cancer Treatment Side Effects

https://tinyurl.com/tjn58ke

Neuropathy is a common and often unexpected side effect of platinum chemotherapy for ovarian cancer. Some studies suggest up to 100% of patients will develop nerve damage, sensory, autonomic and motor*. The damage is usually reversible but long lasting, frequently for several years.

The effects are little discussed, probably because they are so distressing.  This article by Sherry Hanson in “Cure” is brilliant. She talks of the “twitch” causing breakages, weakness, can’t open the wine bottle and falls, giving up roller blading at the age of 75!

The story should be compulsory reading for those about to enter the world of platinum chemo. She writes well, tells it as it is, with black humour - “But I’m still here”.

*     https://tinyurl.com/vtr86yg

Ovarian Christmas Cheer

Blue Monday? Not for Ovarian cancer

https://tinyurl.com/on3l7m8

         Do you know about Blue Monday? It was news for me; it’s an invention by advertisers (of course), aimed at selling more stuff (of course), mostly cruising in the Caribbean. The third Monday in January, Blue Monday is the day when the end of good feelings after Christmas and the reality of failure to honour New Year’s resolutions kick in.

         This year Blue Monday is on January 13, 2020, but there will be no reason for those of us involved with ovarian cancer to be gloomy. 2019 has been a momentous year with signs of light: -

·      The mortality from ovarian cancer is decreasing at around 2.5% per annum

·      Australia has the best outcomes for ovarian cancer with 55% survival for patients<60 after 5 years

·      Radical change in drug treatment with PARP inhibitors helps to stop recurrence

·      Understanding the genetics of ovarian cancer means more patients receive targeted therapy

·      Commercial opportunity is driving research

·      Federal Government funding is at an all-time high

         So, enjoy Christmas, a time for hope and optimism, do not allow the January blues to happen. “Yes we can!”

P.S. Maybe we should hijack “Teal Blue Monday?”

Paul Kelly; how to make gravy

Ovarian cancer RCTs biased

Biased by design? Clinical trials and patient benefit in oncology

https://tinyurl.com/w2jq5zg

         A recent study examined the risk of bias and standard of reporting of clinical trials which resulted in the approval of new drugs for cancer treatment, in Europe, during the period 2014-2016 *.

         Almost half of these trials were assessed as biased. Only about a quarter measured overall survival as an end point. There was often disparity between the results reported when compared to the stated purpose of the trials.

         For many new cancer drug approvals a single pivotal drug trial was deemed sufficient, whereas for other medical conditions multiple supporting trials are required before approval is granted. Pivotal trials tend to be non-randomised, not double blind and usually incomplete. 

         In many cases, subsequent confirmatory trials, after approval, have shown no improvement in overall survival and frequently the initial findings are not replicated. This study suggests there is a major weakness in the approval process with often little patient benefit.

*  https://tinyurl.com/yxqy2qkq

Toxic dense-dose therapy for ovarian cancer not justified

Weekly dose-dense chemotherapy in first-line epithelial ovarian, fallopian tube, or primary peritoneal carcinoma treatment (ICON8): primary progression free survival analysis results from a GCIG phase 3 randomised controlled trial

https://tinyurl.com/uc9w7vt

The current chemotherapy treatment regime for ovarian cancer is single dose every three weeks. In 2013 a Japanese clinical trial* showed increased survival with a dose-dense regime where a double dose of the same chemotherapy is administered weekly.

There is a significant increase in side effects and toxicity with this dose-dense regime. A repeat randomised clinical trial has been completed comparing dose-dense therapy with conventional less toxic treatment regimes.

The findings of this large study with 1566 participants shows no improvement of progression free survival with the dose-dense therapy. Most side effects from treatment were greater with the dose-dense regime. The incidence of nerve injury and decreased white blood cell count was similar for all groups.

*      https://tinyurl.com/qpko65c