Delay not always harmful

Earlier is not always better: Optimal time to initiate adjuvant chemotherapy after surgery for ovarian cancer

https://tinyurl.com/4y2kpmrr

Standard treatment of ovarian cancer includes chemo after surgery, either with or without neoadjuvant chemo beforehand. There has always been an imperative to begin chemo as soon as possible, hoping to reduce the risk of recurrence.

For some women with ovarian cancer, it is not possible to start chemo early. Either because of debility infection or circumstance. This study looks at outcomes for women who start chemo late and compares them to other women whose chemo is not delayed.

The retrospective study looked at the outcomes of 1700 women who had surgery for ovarian cancer at 5 German Hospitals during the period 2020-2021. They were divided into 3 groups; those who had chemo early (less than 3 weeks post-surgery), intermediate (3-5 weeks post-surgery), and late (greater than 5 weeks). The outcomes measured were progress free survival (PFS),
and overall survival (OS).

Results from this study showed both early and late groups had worse OS than those women who started their chemo in the intermediate time frame of 3-5 weeks post-surgery. Previous studies have shown more post-op complications for the early group and women who start chemo late often have more complex disease. Of interest is that PFS was similar for all 3 groups. The authors suggest that women whose chemo is delayed can be reassured that the delay will not cause immediate harm.

Limited understanding

Shared decision making for ovarian cancer survivors with different levels of health literacy: a qualitative interview study on knowledge and comprehension

https://tinyurl.com/n8ubvxhz

Management of ovarian cancer is best when the patient and the carer can share decision making. For this to occur both parties need to be fully informed and able to understand the process.

This shared decision making involves choice of therapy and detection of recurrence. A small retrospective study shows that many women have a limited understanding of medical terms and jargon, making decisions difficult.

A group of 17 women with ovarian cancer were asked about their understanding of the care they had received. They also answered a questionnaire aiming to determine their basic medical knowledge and confidence about sharing decisions.

Results from the study showed limited understanding about the course of their illness with false confidence in physical examination as a means of detecting recurrence. In general, there is a low level of medical literacy which makes shared decisions difficult.

Cataract and Ovarian Cancer

Ovarian Cancer and the Risk of Cataract Episodes: A Nationwide Cohort Study 

https://tinyurl.com/449xa994

Both cataracts and ovarian cancer are found in the elderly. It has been known that cataracts may develop in patients with cancer who have therapy, most often due to radiation but also as a side-effect of chemo.

One of the important causes of cataract is high oxidative stress, which is an imbalance of free oxygen and antioxidants. This is also linked to many cancers including ovarian cancer.A retrospective survey looks at the incidence of cataract in patients with ovarian cancer compared to the general population.

Using data from the Taiwan National Health Insurance database, 5000 women with ovarian cancer were matched with 20,000 women who were cancer free. About 10% of the cancer group had cataract, of whom less than half required surgery. Comparison with the control group showed a slight increase in cataract diagnosis of about 7%, for those women with cancer.

This study is limited by the small ethnic variation with most of the women being Han Taiwanese. However, the authors suggest that routine eye examination should be part of standard care for women with ovarian cancer.