Ascites; what's new?

Cell-free ascites from ovarian cancer patients induces Warburg metabolism and cell proliferation through TGFβ-ERK signalling

https://shorturl.at/dorF6

Ascites is part and parcel of ovarian cancer. It is known that ascites or free fluid in the abdomen is a negative indicator for survival warranting a suffix “C” to any staging.

Previously it has been thought that the cellular component of ascites was the problem, with metastasis due to implantation of cells. This article demonstratesthat the fluid alone is detrimental.

In the presence of ascites, ovarian cancer cells show increased aggression seemingly due to metabolic change and increased cytokine activity. Interestingly this is true only for acidic ascites, alkaline ascites appears to be protective.

Once again, some basic science suggests an alternative pathway to ovarian cancer treatment.

PTSD commoner than you think

Post-traumatic stress and depressive symptoms in women with Ovarian Cancer 3-6 Months after diagnosis

http://tinyurl.com/y78ekkxk

Whether cancer causes PTSD remains controversial. This small study, with 45 participants looked at the mental health of women three to six months after diagnosis of ovarian cancer.

The women were assessed using DSM criteria by structured clinical interview. The women had early to advanced stages of ovarian cancer.

29% of the women were diagnosed with PTSD. Those women also had a high rate of depression with significant functional impairment.

The authors suggest clinical suspicion of associated mental illness for ovarian cancer patients will enable early diagnosis and appropriate treatment.

Unexpected adverse effect

Real-World Data Confirm the Incidence of ADC-Related Ocular Toxicities in Ovarian Cancer

http://tinyurl.com/29ct55ck

One of the white hopes for treatment of ovarian cancer is the antibody/drug conjugate Elahere. This drug has FDA approval for use in cases of platinum resistant recurrent ovarian cancer. Clinical trials showed significant improvement in survival which led to the approval.

However, adverse effects were noted with 61% of women receiving two or more cycles of treatment having visual problems. This review confirms the high incidence of eye symptoms due to corneal disease with blurred vision, pain, and photophobia.

Corneal symptoms are not an uncommon side effect of chemo, usually involving inflammation or inclusions, with corneal opacity. The authors state that because of the lack of alternative treatment for these women, managing the adverse effect with local measures such as steroid drops, is more appropriate than cessation. Informed consent prior to commencing treatment should include a warning about possible eye complications.

Hospice care discriminates

Trends in Location of Death for Individuals with Ovarian Cancer in the United States

http://tinyurl.com/2p92v9d4

Access to hospice care is discriminatory. Using the CDC’s WONDER database, this article reviewed the place of death for almost 240.000 women who died from ovarian cancer, during the period 2003-2019.

There was a 22% increase in the number of deaths from ovarian cancer during that time. The likelihood of women dying at home decreased by 6%, with 23% doing so in 2019. An increase in those dying in a hospital to 64% was almost all due to non-white women. The number dying in hospice increased from 9% to 13%, mostly white women.

If you are black in the US, you are almost 70% more likely to die in hospital. Indigenous or Asian women have a 50% greater death rate in hospital compared to white women. 

The authors suggest better access and information about high quality healthcare is required.