The Mechanism and Dynamic Regulation of Epithelial to Mesenchymal Transition in Ovarian Cancer http://tinyurl.com/5rajk8zw Understanding of ovarian cancer has increased, with the recognition of  epithelial mesenchymal transition ,   ( EMT),  which develops in about 50%. EMT results in loss of  adhesion with disruption of the normal tissue st r ucture. Meta stasis  is inevitable with EMT, the cancer is more  aggressive,  and survival is worse.  This  review of the available literature describes the process which leads to EMT  together with information about the  significance   and   possible treatment . EMT occurs because of epigenetic change to the chromosome of the cancer cell, it does not involve genetic mutation. Epigenetic change may involve  cross linking and folding of cancer cell DNA and is potentially reversible. EMT is a response to the environment, it may be due to low  oxygen or glucose levels, mechani...

Hysterectomy not grounds for divorce http://tinyurl.com/4hmhwfwe When  considering  the impact of ovarian cancer on relationships and family it is wise to reme m ber the  ethn ic conte xt. This recent case in the Madras High Court will have  caused concern but it is illustrative of some pressures that women face after surgery that are not often discussed . The Appeal Court in Madras supported the findings of a lower court which  stated  that removal o f a uterus as part of  initial  treatment for ovarian cancer  did not constitute   mental cruelty to the husband and dismissed the appeal.  The husband’s case was that the denial of the ability to have children was cruel to him and that the cancer had been present before the marriage and concea led. Divorce was  sought  by the husband under the Hindu Marriage Act which unlike in most western countries does not have a “no fault ” separation clause, meaning that cause needs to ...

FDA Grants Fast Track Status to  Rinatabart   Sesutecan  for FRα-Expressing Ovarian Cancer http://tinyurl.com/2t5t8pv4 In  November  2022  the FDA  granted accelerated approval of a new drug;  Elahere  which improves survival for patients who have platinum r e s istant ovarian c ancer . This was the first approval of an antibody/drug co njugate  (ADC) . Now, a second fast track development by the FDA of a similar drug ;  Rina-S  shows the importance of this treatment for th ose women.  Both antibodies  act by attaching to a cell membrane protein, fola te receptor  𝛼,   (FR𝛼 ),   enabling  intracellular access for the cytotoxic  drugs,  which destabilise cancer cell DNA ,  causing cell death .  FR𝛼 is found in about 60% of ovarian cancer, Elahere has been shown to be effective in the MIRASOL trial when t here is high expression of FR𝛼 (75% of all cancer cells). FDA appro...

Enhancing Immunotherapy in Ovarian Cancer: The Emerging Role of Metformin and Statins http://tinyurl.com/y8ut3nn5 Some commonly used drugs; metformin for type II   diabet es and  statins  which alter cholesterol metabolism have been shown to increase survival from ovarian cancer. U nderstanding of why thi s is so  ha s  emerged   which may support the inclusion  of low cost readily  available treatment alternatives for ovarian cancer. Free fluid in the peritoneal cavity known as ascites is  frequently  part of advanced ovarian cancer,  ascites alters the insulin and cholesterol pathways through metabolic reprogra mming. This change in metabolism results in immune su ppression and promotes tumour growth. It is now thought that adding metformin and statins to standard therapy will  increase response to chemotherapy, prevent T cell exhaustion, and enhance immunotherapy

The functional trajectories of older women having surgery for  gynae-oncology  cancer: A single site prospective observational study http://tinyurl.com/49sebad9 Whether to put elderly women through the challenge of clearance surgery for ovarian cancer  is a difficult choice. There has previously been a reluctance to treat older women with the same  extensive surgical resection  which is the standard of care for younger fitter women. This  p rospective review looked at about 100  previously self-reliant  women  with cancer ,   who were 65   years old or older  and  measured their postoperative fun ctional recovery ,  with correlation to their  independence before diagnosis. Results from the survey showed that 70% of the women were able to function normally with full independence at 12 mo nths  post-surgery . Some of the women  had impairment of function at six months with  subsequent  recovery....

Unveiling the Immunogenicity of Ovarian  Tumo u rs  as the Crucial Catalyst for Therapeutic Success https://tinyurl.com/bd4ke3sx Ovarian cancer is resistant to immune therapy.  Because of this less than 15% will respond to treatments such as checkpoint  inhibition or T Cell infusion which are effective as treatment for many other cancers . Immune resistance occurs in ovarian cancer  by various processes which include ,  downwards regulation of otherwise protective genes ,  and change of  surface proteins on cancer  cells that act as   targets for immune response.  This leads to platinum resistance and  early recurrence. Understanding of this altered immune status  results in  new  classifications of cancer types , with separation of ovarian cancer into  homologous recombination deficiency,  (about 40%) , and epithelial mesenchymal transition,  (the rest). The latter group are th e most immune resis...

Prevalence of viral DNA in high-grade serous epithelial ovarian cancer and correlation with clinical outcomes https://tinyurl.com/e6e9vaer It becomes clear with new understanding that many cancers including ovarian cancer show evidence of viral infection. This retro spective study looks at tissue samples from 98 patients with ovarian cancer . Using  a  polymerase chain reaction ,  the presence or absence of viral DNA in these samples were  measured  and compared to the survival outcomes. 46 of the patients showed evidence of viral infection  with one or more virus signatures detected. The viruses found included  known carcinogens such as the human papilloma virus and Epstein - Barr  virus. Cancers  containing  viral DNA were more likely to be platinum resistant and had worse survival . This was especially true for younger women, (<70). It is not clear whether the  virus infection is  a   cause of the cancer or an effect...