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Ovarian Cancer

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ALEXANDRIA, Virginia-Genetic alterations very early in the disease process lie at the root of every cancer. Functional genomics, the study of which genes are actually functioning at a given time or stage, affords a “new approach” to fighting cancer, reported Kristina Cole, MD, PhD, a cancer research training fellow at the National Cancer Institute, Bethesda, Maryland.

HOUSTON-A multimodal strategy for screening asymptomatic postmenopausal women for ovarian cancer shows promise of being able to find the disease early and improve survival. Researchers for the Ovarian Cancer Screening Project (OCSP) at St. Bartholomew’s Hospital, London, are testing a strategy combining the tumor marker CA 125 with transvaginal ultrasound and a mathematical instrument called the Risk for Ovarian Cancer Algorithm (ROCA).

HOUSTON-Stress is an immediate reaction to cancer that generally becomes more intensified during the course of the disease. Barbara L. Andersen, PhD, Department of Psychology, Ohio State University, Columbus, and her colleagues are conducting a study to examine the effects of stress on the immune system in cancer patients.

HOUSTON-The severity of sexual and fertility problems experienced by women after treatment for ovarian cancer is as diverse as the patient population, Leslie Schover, PhD, said at the First Annual International Conference for Ovarian Cancer, co-sponsored by M.D. Anderson Cancer Center and Memorial Sloan-Kettering Cancer Center.

NEW YORK-Last year, more than 20,000 people took part in the 5-kilometer Revlon Run/Walk for Women in New York City, raising more than $700,000 to fight women’s cancers. This year’s event will take place on Saturday, May 1, following a route that runs from Times Square to Central Park. The event is produced by Rehage Entertainment, Inc. and the New York Road Runners Club in cooperation with the City of New York.

ANAHEIM, California-Bringing together scientists and activists involved in understanding and controlling environmental pollutants associated with cancer can create powerful new research synergies, Sandra Steingraber, PhD, said at a symposium on mixed environmental hazards and cancer at the Annual Meeting of the American Association for the Advancement of Science (AAAS).

There are several million breast cancer survivors worldwide. In the United States, 180,000 women were diagnosed with breast cancer in 1997, and approximately 97,000 of these women have an extremely low chance of a suffering a recurrence of their cancer. With an average age at diagnosis of 60 years and a 25-year expected duration of survival, the current number of breast cancer survivors in the United States may approach 2.5 million women. Since breast cancer is now being detected at an earlier stage than previously and since adjuvant chemotherapy may cause ovarian failure, an increasing number of women are becoming postmenopausal at a younger age after breast cancer treatment. This conference was convened in September 1997 to consider how menopausal breast cancer survivors should be treated at the present time and what future studies are needed to develop improved therapeutic strategies. A total of 47 breast cancer experts and 13 patient advocates participated. The proceedings of the conference are being published in six installments in successive issues of oncology. This third part focuses on the prevention of osteoporosis and the cardiovascular effects of estrogens and antiestrogens. [ONCOLOGY 13(3):397-432, 1999]

NEW YORK-Developing and implementing cancer outreach programs for African-Americans takes planning and sensitivity, said Robin L. Hurdle, CSW, a social worker in charge of the African-American Outreach Program at Cancer Care, Inc., the New York-based program that provides emotional support, information, and practical help to people with cancer and their loved ones free of charge.

MONTREAL-Paraneoplastic syndromes are increasingly being recognized as the earliest warning signs of some cancers, according to presentations at the Presidential Symposium of the 123rd Annual Meeting of the American Neurological Association (ANA).

CHICAGO-Much of cancer treatment rightly relies on evidence from randomized clinical trials. However, definitive clinical trials have not been done on some problem diagnoses, such as ductal carcinoma in situ (DCIS).

PHOENIX-A matched case-control study from Yale University suggests that early-stage breast cancer patients with deleterious BRCA1 or 2 mutations are at greater risk of late recurrences after breast-conserving surgery and radiation therapy than those without a mutation. Further, many of these late recurrences appear to be new primary breast cancers.

PHILADELPHIA-SmithKline Beecham’s topoisomerase I inhibitor Hycamtin (topotecan HCl for injection) has received FDA approval for the treatment of small-cell lung cancer (SCLC) after failure of first-line chemotherapy. The agent was previously approved for use in ovarian cancer after failure of initial or subsequent chemotherapy.

WASHINGTON--Genetic research has produced a growing body of information about the mutations related to breast cancer, but, so far, "no clear algorithm" to help clinicians decide how to use the new findings in the interests of patients, reported Francis S. Collins, MD, PhD, director of the National Human Genome Research Institute.

Cancer chemoprevention is the use of specific natural or synthetic substances with the objective of reversing, suppressing, or preventing carcinogenic progression to invasive cancer. Currently, numerous chemopreventive agents are in various stages of development and testing. Part 1 of this two-part series provides an overview of issues unique to chemoprevention trials, including the use of surrogate biomarkers as end points. This is followed by a discussion of the retinoids, such as all-trans-retinoic acid (ATRA [Vesanoid]), 9-cis-retinoic acid (9cRA), and isotretinoin (Accutane), and the carotenoids (eg, beta-carotene and lycopene) and other "classic" antioxidants (eg, vitamins E and C and selenium). Research on these agents will be delineated by disease site when applicable. Part 2, which will appear in next month’s issue, will focus on hormonally mediated chemopreventive agents, such as tamoxifen (Nolvadex), finasteride (Proscar), oral contraceptives, and dehydroepiandrosterone (DHEA). Part 2 also will cover nonantioxidant natural agents, such as calcium, the polyphenols, the isothiocyanates, and genistein; nonsteroidal anti-inflammatory drugs (NSAIDS), such as celecoxib, sulindac sulfone, and aspirin; difluro-methylornithine (DFMO [Eflornithine]); oltipraz; and N-acetylcysteine. [ONCOLOGY(11):1643-1658, 1998]

ATLANTA--Cancer programs and hospitals wishing to expand their services to include genetic counseling and testing should be aware that the staff and resource needs are intense, Constance Roche, MSN, RN, CS, said at a conference sponsored by the National Consortium of Breast Centers. Ms. Roche and Kevin Hughes, MD, who were instrumental in establishing the Lahey Clinic Risk Assessment Program, Peabody, Massachusetts, offered advice on establishing and operating such a program.

NEW YORK--Caring for a mother with advanced breast cancer can be a lot to deal with for a daughter. She has the tricky task of reversing roles with her mother. She may have a family of her own to care for--and there is the fear that she is at risk for cancer herself.

SAN FRANCISCO--Whether to administer genetic testing to a patient is a complex issue, Patrice Watson, PhD, of Creighton University School of Medicine, Omaha, said at the American Cancer Society Second National Conference on Cancer Genetics.

LOS ANGELES--While the flurry of media attention on antiangiogenesis drugs has focused on angiostatin and endostatin, other such agents are further along in development. One of them, BAY 12-9566, has stopped tumor growth in patients for up to 11 months in an ongoing trial, Louise Grochow, MD, said at an ASCO session on novel approaches in drug development.