The Centers for Medicare and Medicaid Services has opened a new chapter in the practice of PET with the announcement for a national Medicare payment policy that expands coverage of PET scans in the initial treatment strategy of most solid cancers and for myelo
Prostate-specific antigen testing, the most widely used screening tool in prostate cancer, has long had both critics and supporters. Two studies published in the New England Journal of Medicine continue to generate debate over the value of PSA screening. The papers have two major points in common: They are large-scale studies, and they leave more questions than answers.
Numerous preclinical and clinical studies have demonstrated a role for angiogenesis in the growth and progression of breast cancer. Elevated vascular endothelial growth factor (VEGF) levels have been demonstrated in association with poor outcomes, and thus, this finding is an attractive target for therapeutic intervention.
Ms. D is a 45-year-old woman with ovarian cancer and hepatic metastatic disease. She has received multimodal treatment over the past 5 years. Ms. D lives in her own home, is divorced, and is a single parent of two adolescent children. Her mother is her primary caregiver and also has a deteriorating health condition.
Barbara Goff, MD, has been selected by the Ovarian Cancer Research Fund to lead the Ovarian Cancer Symptoms Study. The appointment was made at the 2009 Gynecologic Oncologists Annual Meeting on Women’s Cancer in San Antonio.
Bill, 53 years old and a 3-year survivor of non-Hodgkin’s lymphoma, reflects on his ongoing journey as a cancer survivor: “I was very sick and treatment was very rough, complete with a severe allergic reaction that was difficult to diagnose for a long time. But I made it through to the other shore…remission. Since then, I’ve been trying to rebuild a new life…Living with an 18-year-old [son], I can see how in some ways I’m in a parallel universe…Both of us are looking out at the world before us, at all the many possible options...trying to figure out what we want tomorrow to look like.
A high intake of meat and fat may increase the risk of epithelial ovarian cancer, according to a study out of Australia. However, women who feasted on fruit and vegetables exhibited a reduced risk.
SAN FRANCISCO-In a debate session at the 2008 Oncology Congress, neither speaker advocated maintenance therapy as the standard of care in patients with advanced ovarian cancer who achieve a complete clinical remission. But the “pro” speaker, Thomas J. Herzog, MD, of Columbia University Medical Center in New York, argued that the evidence in favor of maintenance therapy is strong enough that it should be discussed with these patients as an option, while the “con” speaker, Robert L. Coleman, MD, of Houston’s M.D. Anderson Cancer Center, called the evidence “premature.”
Lung cancer is the leading cause of cancer-related mortality. Improved understanding in the molecular biology and genetics of lung cancer has resulted in the identification of individual genes, gene expression profiles, and molecular pathways that may be useful for clinical management decisions.
Piver gives his perspective on the management of epithelial ovarian cancer in the elderly. This subject has been dealt with previously by numerous authors, with a general consensus that advancing age is an independent negative prognostic factor when multivariate statistics are applied to the multiple parameters affecting outcome
Dr. Piver presents a personal look at the issues he believes to be important in managing ovarian carcinoma in the elderly patient. He begins with an attempt to define elderly.
Omer Kucuk, MD, has joined Emory University’s Winship Cancer Institute in Atlanta as professor of hematology and medical oncology. Dr. Kucuk conducted the earliest clinical trials on soy and lycopene supplements in prostate cancer treatment. He was previously at the Karmanos Cancer Center at Wayne State University in Detroit.
Ortho Biotech recently announced the submission of a new drug application (NDA) to the US Food and Drug Administration (FDA) for trabectedin (Yondelis) when administered in combination with liposomal doxorubicin (Doxil) for the treatment of women with relapsed ovarian cancer.
SAN FRANCISCO-The “preponderance of the evidence” supports intraperitoneal chemotherapy as the preferred treatment for small-volume residual ovarian cancer after surgical debulking, Robert S. Mannel, MD, said at a debate session of the 2008 Oncology Congress. J. Tate Thigpen, MD, who took the con side of the debate, argued that IP chemotherapy remains experimental because of flaws in the design of the three major trials of IP therapy and its “formidable toxicity.”
Given that in the 21st century many believe 70 years of age is the new 60 and 80 years of age is the new 70, any article on ovarian cancer in the elderly depends on one’s definition of elderly. To put this in a 21st century perspective, in a thoughtful article on aging in The New Yorker (“The Way We Age Now,” April 30, 2007), Atul Gawande points out, “for most of our hundred-thousand-year existence-all but the past couple of hundred years-the average life span of human beings has been 30 years or less (research suggests that subjects of the Roman Empire had an average life expectancy of 28 years).
In the United States, approximately 180,000 women are diagnosed with breast cancer annually.
During this election year, approximately 1.4 million U.S. residents will be diagnosed with cancer. For U.S. presidential hopefuls Sen. Barack Obama and Sen. John McCain, cancer has hit close to home. Sen. McCain, 72, has been treated several times for squamous cell carcinoma and malignant melanoma. Sen. Obama lost his grandfather to prostate cancer and his mother to ovarian cancer.
The human epidermal growth factor receptor 2 (HER2) is a transmembrane receptor with tyrosine kinase activity overexpressed in about 20% to 25% of invasive carcinomas of the breast.
The question of a well-defined role for the use of neoadjuvant chemotherapy in the treatment of ovarian cancer is recognized to be one of the most hotly debated issues in the management of female pelvic malignancies.[1-3] One group of oncologists would argue that it should be the rare patient (eg, with severe comorbidity) who is not a candidate for an initial attempt at maximal cytoreduction.[1]
Ovarian cancer is a unique malignancy. While the disease can spread hematogenously or via the lymphatic system, the bulk of the tumor is found on peritoneal surfaces. This peritoneal disease results from shedding of ovarian tumor cells into the peritoneal cavity, circulation of these cells throughout the abdomen and pelvis, and eventual implantation onto peritoneal surfaces.
Conventional therapy for advanced-stage ovarian cancer-ie, aggressive cytoreductive surgery followed by aggressive chemotherapy-was established more than 3 decades ago [Editor’s note: See Dr. Schwartz’s article, “Cytoreductive Surgery in the Management of Ovarian Cancer,” in last month’s issue of ONCOLOGY]. Since that time, no prospective randomized trials have been reported to confirm the efficacy of this treatment strategy.
The magnitude of the role surgical exploration and extirpation play in the contemporary management of patients with advanced ovarian cancer is hard to overstate. Beyond diagnostic confirmation, the aggressive posture taken to remove bulk disease provides-among other benefits-symptomatic relief, theoretically enhanced immunologic integrity, chemosensitivity, and improved survival characteristics.
As outlined in the comprehensive review by Dr. Schwartz, cytoreductive surgery followed by platinum-based chemotherapy is considered the standard of care in the initial management of patients with advanced ovarian cancer. Considering prognostic factors for patients with advanced disease, residual disease after primary surgery is still considered to be the most important modifiable prognostic factor influencing survival. This has again been recently confirmed by a large retrospective study including six different Gynecologic Oncology Group (GOG) studies.[1]
The standard management for advanced-stage ovarian cancer was established in the mid-1970s. At a 1974 National Cancer Institute Consensus Conference on Ovarian Cancer, Griffiths presented data supporting the role for aggressive cytoreductive surgery as the first step in the management of this disease, followed by cytotoxic chemotherapy.
Women’s reports of persistent, recent-onset symptoms linked to ovarian cancer-abdominal or pelvic pain, difficulty eating or feeling full quickly, and abdominal bloating-combined with CA125 testing may improve the early detection of ovarian cancer by 20%, according to Fred Hutchinson Cancer Research Center investigators (Cancer, published online June 23, 2008).
