HRD backup

Long-molecule scars of backup DNA repair in BRCA1- and BRCA2-deficient cancers

https://tinyurl.com/kvb8em5n

One of the mysteries of ovarian cancer is why is it that chromosomes with a mutation causing defective DNA repair, such as found with BRCA mutations promote cancer cell growth? Usually defective cells are removed as part of the normal stasis or equilibrium of tissue renewal.

With the ready availability of whole genome sequencing it has become clear that homologous recombination deficiency (HRD) of BRCA is complex with multiple other sites of structural change with replication and adhesion or annealing of the DNA strands. The effect of these other abnormalities is to compensate for the defective DNA repair with other pathways to correct the faulty DNA thereby enabling survival of cancer cells that would normally be destroyed.

Discovery of these multiple compensatory mutations may lead to better targeted therapy and possibly the correction of the basic defective mechanism with prevention of subsequent cancer.

Maybe not

Salpingectomy and the Risk of Ovarian Cancer in Ontario

https://tinyurl.com/9s7smv4x

    Science works best when established procedures and protocols are challenged and hopefully verified.

    It has become obvious that much ovarian cancer, especially the commonest; high grade epithelial cancer, arises from the fallopian tube and spreads to the ovary. This suggested risk reduction surgery (RRS) for high-risk patients with elective removal of the fallopian tubes (salpingectomy).

    Whether this will prove to be beneficial in the long term is yet to be confirmed. However, this study looks at a large number of women from the Ontario health database and compares the number who subsequently develop ovarian cancer for women who had a previous salpingectomy with those who did not.

    The findings were that the risk of developing ovarian cancer over the 7.5-year period was the same for both groups. No difference is shown, this raises the question as to whether RRS is appropriate.

More about prognosis

Prognostic Value of Lymph Node Parameters in Elderly Patients with Stage III Serous Ovarian Cancer Based on Competing Risk Model

https://tinyurl.com/4rryr2fp

As part of ovarian cancer local involvement with metastasis to lymph nodes changes the staging of the disease and increases the likelihood of non-survival.

This retrospective survey using the US SEEK database looked at reports from almost 150,000 ovarian cancer patients' initial surgery and determined the number of lymph nodes removed at the time of surgery and the number which were positive for metastasis.

Those women who had more than 8 positive nodes had a worse survival. Interestingly those women who had more than 22 nodes examined had better survival than those who had fewer. Presumably this reflects better patient care when metastasis is excluded early or, maybe lymph nodes are more easily removed when negative for metastasis.

easily removed when negative for metastasis?

Exercise and neuropathy

Effect of Exercise on Chemotherapy-Induced Peripheral Neuropathy Among Patients Treated for Ovarian Cancer

https://tinyurl.com/yh4wtmve

Peripheral neuropathy is common amongst ovarian cancer patients, with some studies saying that every patient gets it to a lesser or greater degree. It is a frequent cause of early cessation of chemotherapy. Any means of reducing this would be of benefit. 

This prospective study looked at 69 patients with ovarian cancer who as part of their treatment commenced moderate exercise and compared them to 65 other women with ovarian cancer who did not.

Those who did the exercise reported better objective and subjective scores for the degree of neuropathy they experienced 6 months after commencement. Adding exercise as part of standard treatment may significantly improve quality of life.