Diagnosis-shift between low-grade serous ovarian cancer and serous borderline ovarian tumor: A population-based study https://tinyurl.com/wha6lm2 In 1971 the World Health Organisation introduced the new pathological classification of borderline ovarian tumours. The gradual acceptance of this term has led to fewer early low-grade serous ovarian cancer diagnoses.  Borderline tumours have low mortality, whether progression to cancer occurs is uncertain.             This study is a retrospective analysis of registry data in the period 1988-2000. The number of low-grade cancers diagnosed decreased by a quarter, with worse survival. Most patients were older women. The previous misdiagnosis of borderline tumours as low-grade cancer gave an impression of better survival, the outcomes being skewed by the number of benign tumours included in the reference group.        ...

Tumour immune cell infiltration and survival after platinum-based chemotherapy in high-grade serous ovarian cancer subtypes: A gene expression-based computational study https://tinyurl.com/wqqzfm3 Ovarian Cancer has a variable prognosis, with some patients surviving longer than would be expected from the stage and type at presentation. The extent and type of immune cell infiltration of the tumour, after treatment,  is known to affect the prognosis.  This study, a Meta-analysis, looks at all available large series to try to understand the nature and diversity of the immune reaction following platinum chemotherapy. Better survival is associated with an immune reaction and the presence of large white cells from the blood (macrophages).  Worse survival occurs when there is no immune reaction or in the presence of different white cells called neutrophils. The different immune reactions were also associated with genetic variations making the can...

Association of Powder Use in the Genital Area With Risk of Ovarian Cancer https://tinyurl.com/ye96737v The possible association of the use of talcum powder on the perineum and the development of ovarian cancer has been debunked by this recent analysis. Multiple contingent lawsuits in the US against the defendant Johnson and Johnson, the major producers of baby powder, are now put in jeopardy. There is however some alleged contamination of the talc powder, with asbestos, which will no doubt prolong any settlements. 250,000 women were recruited from the Nurses’ Health Study (another great achievement by this group) and the Women’s Health Initiative. 38% of the group reported use of talc. The follow up was for 11 years. This extensive and incontrovertible analysis shows no association and probably no increased risk.

BRACAVENIR: an observational study of expectations and coping in young women with high hereditary risk of breast and ovarian cancer https://tinyurl.com/txykwuu          Genetic screening with BRCA positive results puts pressure on young women, with difficult decisions about whether to undergo risk reduction surgery causing fertility and body image concerns.          This study from France looked at the value of an educational and psychological support program. Psychometric testing showed increased optimism, self-esteem and quality of life on completion of the program.          Most described the communication of genetic test results as brutal and traumatic,. Relationship issues after surgery were important, body image less so. There was no sense of injustice about BRCA positive status.

The Falling, Wandering and Crashing Business of Cancer Treatment Side Effects https://tinyurl.com/tjn58ke Neuropathy is a common and often unexpected side effect of platinum chemotherapy for ovarian cancer. Some studies suggest up to 100% of patients will develop nerve damage, sensory, autonomic and motor*. The damage is usually reversible but long lasting, frequently for several years. The effects are little discussed, probably because they are so distressing.  This article by Sherry Hanson in “Cure” is brilliant. She talks of the “twitch” causing breakages, weakness, can’t open the wine bottle and falls, giving up roller blading at the age of 75! The story should be compulsory reading for those about to enter the world of platinum chemo. She writes well, tells it as it is, with black humour - “But I’m still here”. *      https://tinyurl.com/vtr86yg

Blue Monday? Not for Ovarian cancer https://tinyurl.com/on3l7m8          Do you know about Blue Monday? It was news for me; it’s an invention by advertisers (of course), aimed at selling more stuff (of course), mostly cruising in the Caribbean. The third Monday in January, Blue Monday is the day when the end of good feelings after Christmas and the reality of failure to honour New Year’s resolutions kick in.          This year Blue Monday is on January 13, 2020, but there will be no reason for those of us involved with ovarian cancer to be gloomy. 2019 has been a momentous year with signs of light: - ·        The mortality from ovarian cancer is decreasing at around 2.5% per annum ·        Australia has the best outcomes for ovarian cancer with 55% survival for patients<60 after 5 years · ...

Biased by design? Clinical trials and patient benefit in oncology https://tinyurl.com/w2jq5zg          A recent study examined the risk of bias and standard of reporting of clinical trials which resulted in the approval of new drugs for cancer treatment, in Europe, during the period 2014-2016 *.          Almost half of these trials were assessed as biased. Only about a quarter measured overall survival as an end point. There was often disparity between the results reported when compared to the stated purpose of the trials.          For many new cancer drug approvals a single pivotal drug trial was deemed sufficient, whereas for other medical conditions multiple supporting trials are required before approval is granted. Pivotal trials tend to be non-randomised, not double blind and usually incomplete.       ...