Ethics and Resource Scarcity: ASCO Recommendations for the Oncology Community During the COVID19 Pandemic https://tinyurl.com/ybadxsuy          The current pandemic has caused major difficulties for Hospitals, with large numbers of very sick patients whose low blood oxygen levels need intensive therapy and frequently mechanical ventilation. There is insufficient resource available and difficult decisions have to be made about who will receive intensive therapy and who will not.          The American Society of Clinical Oncology is concerned that patients with cancer may be missing out on such therapy because of the preconception, “well they’re going to die anyway”.           A list of recommendations states that a protocol should be established prior to acute presentation and if this policy takes pre-existing disease into ...

Molecular Analysis of Clinically Defined Subsets of High Grade Serous Ovarian Cancer https://tinyurl.com/yb5xcha6          It has been shown that High Grade Serous Ovarian Cancer has a better outcome when the complete tumour is removed at the time of the initial diagnosis.          This survey looks at the genotype of tumours, which can be completely removed and compares it to the genotype of tumours that require chemotherapy before surgery.          The study finds that patients with cancers that can be completely removed have a different tumour genotype to those patients who required chemotherapy prior to surgery. This suggests that the fact that complete clearance is a good indicator may be in part due to the tumour genotype

Women's purchasing behaviour may help identify ovarian cancer https://www.imperial.ac.uk/news/194993/womens-purchasing-behaviour-help-identify-ovarian/          The presenting symptoms of ovarian cancer are often vague, women typically present late to their primary care physician. This study is to look at the purchasing behaviour of women prior to presentation to determine whether a pattern of purchase might be an early warning of cancer.          Data from loyalty cards will be collected looking for purchases of non-pharmacy painkillers or indigestion treatment. The purchases of women prior to diagnosis of ovarian cancer will be compared with a similar size control group of women without a cancer diagnosis.          The advantage of this study is that the data is already available; purchasing information is collected to assist in market res...

Epidemiology of Covid-19 in a Long-Term Care Facility in King County, Washington https://tinyurl.com/vguxo9g             The COVID-19 pandemic in Australia is being managed by a strategy of virology testing, with public heath follow-up, contact tracing, quarantine, and isolation. Thus far this strategy has been moderately successful with stabilisation of numbers of new cases and relatively few deaths,             The strategy also depends on a lockdown of people movement, which initially had been non-compulsory. The relatively good numbers are causing some complacency. This is very dangerous, if the lethal potential of the virus is in doubt; the outbreak in Washington State is salutatory.             In Seattle, WS, an outbreak of COVID-19 infection occurred at a long-term care facility, which h...

Oncologists Are 'Sacrificing Common Sense' in Pursuit of Innovation https://tinyurl.com/vxpmj7m             This article by Bish Gyawali an oncologist and academic from Canada looks at oncologist’s reaction to clinical trials, which do not fit with their expectations. The recent GOG-0213 trial previously reported on this blog is cited as an example*.              The trial challenged the general belief that further surgery for ovarian patients after recurrence was beneficial. In fact the evidence shows no benefit, with overall survival being decreased on average by 14 months if surgery was repeated. Despite this finding many oncologists continue to recommend second surgery because it seems logical so to do.              Gyawali says there is a need for critical appraisal of current prac...

COVID-19 Infection in Patients With Cancer in China https://tinyurl.com/v54cbjs             It has been thought that patients who already have cancer and who are exposed to the COVID19 virus would be more likely to be infected and have worse outcomes.             This early study from China supports both these suggestions. It seems that it is approximately four times more likely for a patient with cancer to be infected than for the normal healthy population.              In addition patients with cancer who have been infected with the COVID19 virus are five times more likely to have a poor outcome requiring ventilation or resulting in death. For those patients who have had recent surgery or chemotherapy the risk of a poor outcome was even greater.       ...

Gynecologic Oncology Spotlight: Enhanced Recovery Pathways Improve Patient Outcomes https://tinyurl.com/ww4rt5t             The postoperative care for ovarian cancer patients is difficult. There is the problem of too many patients being discharged too soon, causing subsequent readmission, complications, and patient dissatisfaction.             A proactive approach to this postoperative care has been established known as Enhanced Recovery After Surgery (ERAS). The protocols included in ERAS include aggressive anticoagulation therapy, minimal use of drains and in-dwelling tubes enabling early ambulation, and targeted pain management without opioids, using local anaesthetic epidural block.  Wound infection is avoided by local cleansing of the skin prior to surgery and using negative pressure dressings.              Ea...