Homologous Recombination Deficiency Assays in Epithelial Ovarian Cancer: Current Status and Future Direction https://tinyurl.com/2pbwkmxm          Sometimes progress in the care of patients with ovarian cancer seems painfully slow. Then new understanding begins to show a way forward. One such innovation was the appreciation that much cancer starts due to a failure of repair in the DNA that makes up the cell nucleus. Cellular DNA is under constant attack from within and without. If DNA is not repaired cells will usually die but sometimes the cell line continues as a cancer.           Faulty DNA repair, known as Homologous Recombination Deficiency (HRD) is seen with  BRCA1/2 mutation  and sometimes with other acquired mutations, being present in about 50% of all ovarian cancer. As a consequence another enzyme; Polyadenosine Ribonucleotide Polymerase (PARP) becomes more important in DNA repair. Repair by PARP i...

Pre-implantation genetic testing for BRCA gene mutation carriers: a cost effectiveness analysis https://tinyurl.com/evhm49d2            For some communities ovarian cancer is a real and constant threat, none more so than for the Ashkenazi in Israel. Ovarian cancer is related to an inherited condition in about 25% of cases. The Ashkenazi have a high incidence of BRCA1/2 mutation, which increases the likelihood of developing ovarian cancer compared to the general population.          One strategy for avoiding ovarian cancer and the common fatal consequence is by prevention through pre-implantation genetic screening and selection of embryos, as part of In Vitro Fertilisation (IVF). This study seeks to determine the cost-effectiveness of doing this for parents who carry the BRCA1/2 gene.          Cost-effectiveness is routinely determined as a measure k...

Association Between Overall Survival and the Tendency for Cancer Programs to Administer Neoadjuvant Chemotherapy for Patients With Advanced Ovarian Cancer https://tinyurl.com/6cmpxrby          Any treatment protocol needs constant reappraisal. Neoadjuvant chemotherapy (Neo) is the use of chemo for ovarian cancer patients  before surgery , at the time of initial presentation. First used for patients who were either too frail or had too big a tumour for surgery, Neo has become more frequent.          Previous studies in 2010 showed no disadvantage in survival. Neo is often preferred because the subsequent surgery is more straightforward with fewer complications. Also logistically it make scheduling surgery simpler. Although generally there has been an increase in the use of Neo, some treatment centres have not done so.          This retrospective stud...

Impact of Surgeon Type and Rurality on Treatment and Survival of Ovarian Cancer Patients https://tinyurl.com/7y2arz8j            Choose your surgeon carefully. Any woman unlucky enough to have ovarian cancer requires surgical removal. This is best done in a centre of excellence, preferably by a surgical oncologist. Unfortunately this is not always possible.          675 women with advanced ovarian cancer from Iowa were included in this study. Of these women, those living in non-urban locations were less likely to have their surgery by a surgical oncologist and also less likely to have complete surgical clearance and to follow the usual chemotherapy regime.          Not surprisingly women who did receive care in a centre of excellence had better outcomes. Survival for these women was increased, being 40% more likely to survive 3 years, compared to wo...

Ovarian Cancer Incidence and Death in Average-Risk Women Undergoing Bilateral Salpingo-Oophorectomy at Benign Hysterectomy https://tinyurl.com/y3t5jkj8                     “Prevention is better than a cure”. This certainly seems to be the case for ovarian cancer, which despite progress in therapy remains a highly lethal condition. One suggestion for prevention of ovarian cancer is that any woman who has a hysterectomy should have removal of the fallopian tubes and ovaries at the same time.          It is thought that most ovarian cancer starts in the tubes.  One in five women will have a hysterectomy during their lifetime. Previously there has been little hard evidence about the benefit from tube and ovary removal.           This retrospective review of almost 200,000 women who had a hysterectomy, in Ontario, ...