Does cancer preclude ventilation?

Ethics and Resource Scarcity: ASCO

Recommendations for the Oncology Community During the COVID19 Pandemic

https://tinyurl.com/ybadxsuy

         The current pandemic has caused major difficulties for Hospitals, with large numbers of very sick patients whose low blood oxygen levels need intensive therapy and frequently mechanical ventilation. There is insufficient resource available and difficult decisions have to be made about who will receive intensive therapy and who will not.

         The American Society of Clinical Oncology is concerned that patients with cancer may be missing out on such therapy because of the preconception, “well they’re going to die anyway”. 

         A list of recommendations states that a protocol should be established prior to acute presentation and if this policy takes pre-existing disease into account it should not be biased but evidence-based. Treating oncologists should not allocate resources, but should influence the setting of protocols.    There should be transparency for cancer patients about the likely actions in the event of severe respiratory distress.

Which ovarian cancers do well?

Molecular Analysis of Clinically Defined Subsets of High Grade Serous Ovarian Cancer

https://tinyurl.com/yb5xcha6

         It has been shown that High Grade Serous Ovarian Cancer has a better outcome when the complete tumour is removed at the time of the initial diagnosis.

         This survey looks at the genotype of tumours, which can be completely removed and compares it to the genotype of tumours that require chemotherapy before surgery.

         The study finds that patients with cancers that can be completely removed have a different tumour genotype to those patients who required chemotherapy prior to surgery. This suggests that the fact that complete clearance is a good indicator may be in part due to the tumour genotype

How your credit card use might diagnose your ovarian cancer

Women's purchasing behaviour may help identify ovarian cancer

https://www.imperial.ac.uk/news/194993/womens-purchasing-behaviour-help-identify-ovarian/

         The presenting symptoms of ovarian cancer are often vague, women typically present late to their primary care physician. This study is to look at the purchasing behaviour of women prior to presentation to determine whether a pattern of purchase might be an early warning of cancer.

         Data from loyalty cards will be collected looking for purchases of non-pharmacy painkillers or indigestion treatment. The purchases of women prior to diagnosis of ovarian cancer will be compared with a similar size control group of women without a cancer diagnosis.

         The advantage of this study is that the data is already available; purchasing information is collected to assist in market research by the loyalty card issuers. 500 women with cards and without cancer are being recruited to assist in the study. The hypothesis is that the information will enable earlier diagnosis and hence improve survival outcomes for this often-lethal disease.

Beware the false Dawn

Epidemiology of Covid-19 in a Long-Term Care Facility in King County, Washington

https://tinyurl.com/vguxo9g

            The COVID-19 pandemic in Australia is being managed by a strategy of virology testing, with public heath follow-up, contact tracing, quarantine, and isolation. Thus far this strategy has been moderately successful with stabilisation of numbers of new cases and relatively few deaths,

            The strategy also depends on a lockdown of people movement, which initially had been non-compulsory. The relatively good numbers are causing some complacency. This is very dangerous, if the lethal potential of the virus is in doubt; the outbreak in Washington State is salutatory.

            In Seattle, WS, an outbreak of COVID-19 infection occurred at a long-term care facility, which housed 130 aged residents and 170 staff. As of March 18, 167 confirmed cases of COVID-19 infection had been identified. The preliminary case fatality rate was 33% for residents (many remain in intensive care).

            The message is clear: COVID-19 kills the old and sick, the only current control mechanism is avoidance of infection by social separation.