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Showing posts from February, 2021

Sitting is not good

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Sedentary behaviour in relation to ovarian cancer risk: a systematic review and meta-analysis https://tinyurl.com/2eb2g28v            Inactivity is a health hazard. As a potential risk factor for ovarian cancer, which can be modified, there is little understanding of the increased risk due to a sedentary lifestyle.          Databases at PubMed and Web of Science were accessed and seven studies had suitable data for meta-analysis, with information for just over 2000 women with ovarian cancer.          Retrospective analysis of the data shows an increase in the relative risk of ovarian cancer to 1.29 due to prolonged sitting. This relates to an increase of approximately 3 cases/100,000 women in Australia, each year.          Sedentary behaviour is defined as spending more than half of waking hours sitting o...

Futile screening

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Motivators of Inappropriate Ovarian Cancer Screening: A Survey of Women and Their Clinicians https://tinyurl.com/ipft7e6a            Multiple clinical trials have shown no value in screening for ovarian cancer (OC). This study looked at the prevalence of OC screening for Australian women. The Cancer Australia position statement of 2019 does not support OC screening, even for those deemed at high risk. Despite this, women continue to be sent for OC screening, with more than half of physicians doing so.          For the study 832 women were recruited from multiple-case breast cancer families, only 4% were BRCA1/2 positive. There was misplaced enthusiasm for OC screening, with about 75% of the women thinking that screening was likely to detect OC.          The results showed that the higher a woman’s enthusiasm the more likely it was that OC screening ...

Centres of excellence

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  Clinical auditing as an instrument to improve care for patients with ovarian cancer: The Dutch Gynecological Oncology Audit (DGOA) https://tinyurl.com/kzzntc7r            Unless quality is measured there can be no improvement. Without information the management of ovarian cancer may be a best guess.          The Dutch Institute of Clinical Auditing has a responsibility to determine quality indicators and provide feedback of verified information. In 2010 ovarian cancer care in Holland was rationalised, with surgical staging and primary treatment performed only at centres of excellence as defined by a minimum number of cytoreductive surgery procedures; being more than 20 annually.          As a result Hospitals performing ovarian cancer surgery decreased from 90 to 23. There has been a significant delay in the onset of treatment and chemo but t...

More about PARPi

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  Alternate therapeutic pathways for PARP inhibitors and potential mechanisms of resistance tinyurl.com/ozbdt3cv          PARP inhibitors (PARPi) have the potential to revolutionise the treatment of ovarian cancers. These drugs are the first clinical application of a concept called synthetic lethality; this is a combination of 2 or more gene expression alterations leading to cell death.          PARPi act on two separate pathways; firstly they inhibit DNA repair via the PARP1 enzyme and second they protect the cell from homologous recombination deficiency (HRD), which causes DNA instability.          Many clinical trials have demonstrated the efficacy of 4 different PARPi drugs either alone or in combination. Initially the trials showed survival advantages for patients with germ-line or somatic mutations, recent evidence shows the advantages are mor...