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Showing posts from September, 2021

Emergencies best avoided

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Patients with low socio-economic status are more likely to present for non-elective Ovarian Cancer surgery https://tinyurl.com/j2dv32a7          Survival for women with ovarian cancer is dependent on the quality of care provided. One of the most significant markers of better care is the completeness of surgical clearance at the initial surgery. Obviously there will be a better chance of this when the surgery follows careful pre-operative planning.          Sometimes this is not possible and many women present with complications of ovarian cancer requiring immediate emergency surgery. This retrospective survey looked at about 100,000 women in the US who had surgery for ovarian cancer during the period 2010-2015.  Of these women, 19% were emergencies.          Those women who needed emergency care had higher mortality (2.7% vs. 0.6%), longer hospital ...

Toxic means effective

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Adverse Events as a Potential Clinical Marker of Antitumor Efficacy in Ovarian Cancer Patients Treated With Poly ADP-Ribose Polymerase Inhibitor https://tinyurl.com/vcwbxxn4            For cancer patients undergoing chemotherapy adverse reactions are part and parcel of the treatment. Previous studies have shown that patients who have adverse effects early on (within one week) have better response to the treatment. This study looks at PARPi treatment for ovarian cancer and notes a similar outcome.          PARPi drugs are a targeted chemotherapy for ovarian cancer patients. Most if not all patients taking PARPi drugs have adverse effects. 10-15% of the patients cannot complete the course due to significant toxicity, with marrow suppression, nausea, and fatigue being common.          Results from this small prospective study (78 women) confirmed that ...

Hidden benefits

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Clinical and pathological outcomes of risk-reducing salpingo-oophorectomy for Japanese women with hereditary breast and ovarian cancer https://tinyurl.com/jyusbsvx            Increasingly women with a greater genetic risk of developing ovarian cancer are encouraged to have risk reduction surgery. For these women it is important to understand the risk-benefit ratio. Another benefit apart from prevention is early detection of cancer.          In the study 117 women with either BRCA1 (72) or BRCA2 (45) mutations had MRI scan followed by elective surgery one month later. The surgical specimens were examined for cancerous change. Most ovarian cancer arises from the fallopian tube with a precursor condition known as Serous Tubular Intraepithelial Carcinoma (STIC).          At surgery three STIC lesions were found and three stage I invasive carcinomas. All...

False hopes

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Immune checkpoint inhibitors in ovarian cancer: where do we stand? https://tinyurl.com/hrcvufkb            When a new treatment for cancer is found, women with lethal ovarian cancer often have their hopes raised. Checkpoint inhibition is one of these new forms of treatment. First used in the management of melanoma, Pembrolizumab (Keytruda) has radically changed the outcomes for many melanoma and lung cancer patients by “curing the incurable”.          Unfortunately despite multiple trials of Keytruda and similar formulations, both alone and in combination, no benefit in terms of improved survival for ovarian cancer has been shown. This review looks at how checkpoint inhibition works and what the prospects are.          All cells die. Some cancer cells slow the rate of cell death by blocking the T cell immune response, through a checkpoint. It seems ...