Science.gov

Sample records for gynecologic cancer research

  1. Major clinical research advances in gynecologic cancer in 2015

    PubMed Central

    2016-01-01

    In 2015, fourteen topics were selected as major research advances in gynecologic oncology. For ovarian cancer, high-level evidence for annual screening with multimodal strategy which could reduce ovarian cancer deaths was reported. The best preventive strategies with current status of evidence level were also summarized. Final report of chemotherapy or upfront surgery (CHORUS) trial of neoadjuvant chemotherapy in advanced stage ovarian cancer and individualized therapy based on gene characteristics followed. There was no sign of abating in great interest in immunotherapy as well as targeted therapies in various gynecologic cancers. The fifth Ovarian Cancer Consensus Conference which was held in November 7–9 in Tokyo was briefly introduced. For cervical cancer, update of human papillomavirus vaccines regarding two-dose regimen, 9-valent vaccine, and therapeutic vaccine was reviewed. For corpus cancer, the safety concern of power morcellation in presumed fibroids was explored again with regard to age and prevalence of corpus malignancy. Hormone therapy and endometrial cancer risk, trabectedin as an option for leiomyosarcoma, endometrial cancer and Lynch syndrome, and the radiation therapy guidelines were also discussed. In addition, adjuvant therapy in vulvar cancer and the updated of targeted therapy in gynecologic cancer were addressed. For breast cancer, palbociclib in hormone-receptor-positive advanced disease, oncotype DX Recurrence Score in low-risk patients, regional nodal irradiation to internal mammary, supraclavicular, and axillary lymph nodes, and cavity shave margins were summarized as the last topics covered in this review. PMID:27775259

  2. Major clinical research advances in gynecologic cancer in 2015.

    PubMed

    Suh, Dong Hoon; Kim, Miseon; Kim, Hak Jae; Lee, Kyung Hun; Kim, Jae Weon

    2016-11-01

    In 2015, fourteen topics were selected as major research advances in gynecologic oncology. For ovarian cancer, high-level evidence for annual screening with multimodal strategy which could reduce ovarian cancer deaths was reported. The best preventive strategies with current status of evidence level were also summarized. Final report of chemotherapy or upfront surgery (CHORUS) trial of neoadjuvant chemotherapy in advanced stage ovarian cancer and individualized therapy based on gene characteristics followed. There was no sign of abating in great interest in immunotherapy as well as targeted therapies in various gynecologic cancers. The fifth Ovarian Cancer Consensus Conference which was held in November 7-9 in Tokyo was briefly introduced. For cervical cancer, update of human papillomavirus vaccines regarding two-dose regimen, 9-valent vaccine, and therapeutic vaccine was reviewed. For corpus cancer, the safety concern of power morcellation in presumed fibroids was explored again with regard to age and prevalence of corpus malignancy. Hormone therapy and endometrial cancer risk, trabectedin as an option for leiomyosarcoma, endometrial cancer and Lynch syndrome, and the radiation therapy guidelines were also discussed. In addition, adjuvant therapy in vulvar cancer and the updated of targeted therapy in gynecologic cancer were addressed. For breast cancer, palbociclib in hormone-receptor-positive advanced disease, oncotype DX Recurrence Score in low-risk patients, regional nodal irradiation to internal mammary, supraclavicular, and axillary lymph nodes, and cavity shave margins were summarized as the last topics covered in this review.

  3. Major clinical research advances in gynecologic cancer in 2014.

    PubMed

    Suh, Dong Hoon; Lee, Kyung Hun; Kim, Kidong; Kang, Sokbom; Kim, Jae Weon

    2015-04-01

    In 2014, 9 topics were selected as major advances in clinical research for gynecologic oncology: 2 each in cervical and corpus cancer, 4 in ovarian cancer, and 1 in breast cancer. For cervical cancer, several therapeutic agents showed viable antitumor clinical response in recurrent and metastatic disease: bevacizumab, cediranib, and immunotherapies including human papillomavirus (HPV)-tumor infiltrating lymphocytes and Z-100. The HPV test received FDA approval as the primary screening tool of cervical cancer in women aged 25 and older, based on the results of the ATHENA trial, which suggested that the HPV test was a more sensitive and efficient strategy for cervical cancer screening than methods based solely on cytology. For corpus cancers, results of a phase III Gynecologic Oncology Group (GOG) 249 study of early-stage endometrial cancer with high-intermediate risk factors are followed by the controversial topic of uterine power morcellation in minimally invasive gynecologic surgery. Promising results of phase II studies regarding the effectiveness of olaparib in various ovarian cancer settings are summarized. After a brief review of results from a phase III study on pazopanib maintenance therapy in advanced ovarian cancer, 2 outstanding 2014 ASCO presentations cover the topic of using molecular subtypes in predicting response to bevacizumab. A review of the use of opportunistic bilateral salpingectomy as an ovarian cancer preventive strategy in the general population is presented. Two remarkable studies that discussed the effectiveness of adjuvant ovarian suppression in premenopausal early breast cancer have been selected as the last topics covered in this review.

  4. About the Breast and Gynecologic Cancer Research Group | Division of Cancer Prevention

    Cancer.gov

    The Breast and Gynecologic Cancer Research Group conducts and fosters the development of research on the prevention and early detection of breast cancer, cervix and human papillomavirus (HPV)-related cancers, endometrial cancers, ovarian cancers, and precursor conditions related to these cancers. |

  5. Major clinical research advances in gynecologic cancer in 2012.

    PubMed

    Suh, Dong Hoon; Kim, Jae-Weon; Kim, Kidong; Kim, Hak Jae; Lee, Kyung-Hun

    2013-01-01

    Ten topics were chosen among major clinical research achievements in gynecologic oncology in 2012. For ovarian cancer, comprehensive review of the history of bevacizumab studies was followed by poly adenosine diphosphate [ADP]-ribose polymerase (PARP) inhibitors and other molecular targeted agents such as epidermal growth factor receptor tyrosine kinase inhibitor and AMG 386. For the development of genomic study in gynecologic cancers, BRCA and DICER1 mutations were covered in epithelial and nonepithelial ovarian cancer, respectively. For endometrial cancer, targeted agents including mammalian target of rapamycin (mTOR) inhibitors and bevacizumab were discussed. Radiation therapy "sandwiched" between combination chemotherapy schedules for the treatment of uterine papillary serous carcinoma was also reviewed. Preoperative prediction of lymph node metastasis, definition of low-risk group, and recurrence and survival outcomes of laparoscopic approaches were addressed. For cervical cancer, we reviewed long-term benefit of human papillomavirus test and efficacy of paclitaxel/carboplatin versus paclitaxel/cisplatin in stage IVB, persistent or recurrent disease. In addition, the effect of three dimensional image-based high-dose rate brachytherapy was also reviewed. For vulvar cancer, the diagnostic value of sentinel lymph node biopsy was discussed. For breast cancer, positive results of three outstanding phase III randomized clinical trials, CLEOPATRA, EMILIA, and BOLERO-2 were introduced. Lastly, updates of major practice guidelines were summarized.

  6. Major clinical research advances in gynecologic cancer in 2012

    PubMed Central

    Suh, Dong Hoon; Kim, Kidong; Kim, Hak Jae; Lee, Kyung-Hun

    2013-01-01

    Ten topics were chosen among major clinical research achievements in gynecologic oncology in 2012. For ovarian cancer, comprehensive review of the history of bevacizumab studies was followed by poly adenosine diphosphate [ADP]-ribose polymerase (PARP) inhibitors and other molecular targeted agents such as epidermal growth factor receptor tyrosine kinase inhibitor and AMG 386. For the development of genomic study in gynecologic cancers, BRCA and DICER1 mutations were covered in epithelial and nonepithelial ovarian cancer, respectively. For endometrial cancer, targeted agents including mammalian target of rapamycin (mTOR) inhibitors and bevacizumab were discussed. Radiation therapy "sandwiched" between combination chemotherapy schedules for the treatment of uterine papillary serous carcinoma was also reviewed. Preoperative prediction of lymph node metastasis, definition of low-risk group, and recurrence and survival outcomes of laparoscopic approaches were addressed. For cervical cancer, we reviewed long-term benefit of human papillomavirus test and efficacy of paclitaxel/carboplatin versus paclitaxel/cisplatin in stage IVB, persistent or recurrent disease. In addition, the effect of three dimensional image-based high-dose rate brachytherapy was also reviewed. For vulvar cancer, the diagnostic value of sentinel lymph node biopsy was discussed. For breast cancer, positive results of three outstanding phase III randomized clinical trials, CLEOPATRA, EMILIA, and BOLERO-2 were introduced. Lastly, updates of major practice guidelines were summarized. PMID:23346316

  7. Job Opening for Medical Officer in DCP’s Breast and Gynecologic Cancer Research Group | Division of Cancer Prevention

    Cancer.gov

    The Breast and Gynecologic Cancer Research Group (BGCRG), Division of Cancer Prevention (DCP), National Cancer Institute (NCI), has an opening for an experienced Medical Officer. BGCRG focuses on fostering the development and conduct of research on the prevention and early detection of breast cancer, cervix and human papillomavirus (HPV)-related cancers, endometrial cancers, ovarian cancers, and precursor conditions related to these cancers. Learn more about BGCRG. |

  8. Danish Gynecological Cancer Database

    PubMed Central

    Sørensen, Sarah Mejer; Bjørn, Signe Frahm; Jochumsen, Kirsten Marie; Jensen, Pernille Tine; Thranov, Ingrid Regitze; Hare-Bruun, Helle; Seibæk, Lene; Høgdall, Claus

    2016-01-01

    Aim of database The Danish Gynecological Cancer Database (DGCD) is a nationwide clinical cancer database and its aim is to monitor the treatment quality of Danish gynecological cancer patients, and to generate data for scientific purposes. DGCD also records detailed data on the diagnostic measures for gynecological cancer. Study population DGCD was initiated January 1, 2005, and includes all patients treated at Danish hospitals for cancer of the ovaries, peritoneum, fallopian tubes, cervix, vulva, vagina, and uterus, including rare histological types. Main variables DGCD data are organized within separate data forms as follows: clinical data, surgery, pathology, pre- and postoperative care, complications, follow-up visits, and final quality check. DGCD is linked with additional data from the Danish “Pathology Registry”, the “National Patient Registry”, and the “Cause of Death Registry” using the unique Danish personal identification number (CPR number). Descriptive data Data from DGCD and registers are available online in the Statistical Analysis Software portal. The DGCD forms cover almost all possible clinical variables used to describe gynecological cancer courses. The only limitation is the registration of oncological treatment data, which is incomplete for a large number of patients. Conclusion The very complete collection of available data from more registries form one of the unique strengths of DGCD compared to many other clinical databases, and provides unique possibilities for validation and completeness of data. The success of the DGCD is illustrated through annual reports, high coverage, and several peer-reviewed DGCD-based publications. PMID:27822089

  9. Major clinical research advances in gynecologic cancer in 2016: 10-year special edition.

    PubMed

    Suh, Dong Hoon; Kim, Miseon; Kim, Kidong; Kim, Hak Jae; Lee, Kyung Hun; Kim, Jae Weon

    2017-05-01

    In 2016, 13 topics were selected as major research advances in gynecologic oncology. For ovarian cancer, study results supporting previous ones regarding surgical preventive strategies were reported. There were several targeted agents that showed comparable responses in phase III trials, including niraparib, cediranib, and nintedanib. On the contrary to our expectations, dose-dense weekly chemotherapy regimen failed to prove superior survival outcomes compared with conventional triweekly regimen. Single-agent non-platinum treatment to prolong platinum-free-interval in patients with recurrent, partially platinum-sensitive ovarian cancer did not improve and even worsened overall survival (OS). For cervical cancer, we reviewed robust evidences of larger-scaled population-based study and cost-effectiveness of nonavalent vaccine for expanding human papillomavirus (HPV) vaccine coverage. Standard of care treatment of locally advanced cervical cancer (LACC) was briefly reviewed. For uterine corpus cancer, new findings about appropriate surgical wait time from diagnosis to surgery were reported. Advantages of minimally invasive surgery over conventional laparotomy were reconfirmed. There were 5 new gene regions that increase the risk of developing endometrial cancer. Regarding radiation therapy, Post-Operative Radiation Therapy in Endometrial Cancer (PORTEC)-3 quality of life (QOL) data were released and higher local control rate of image-guided adaptive brachytherapy was reported in LACC. In addition, 4 general oncology topics followed: chemotherapy at the end-of-life, immunotherapy with reengineering T-cells, actualization of precision medicine, and artificial intelligence (AI) to make personalized cancer therapy real. For breast cancer, adaptively randomized trials, extending aromatase inhibitor therapy, and ribociclib and palbociclib were introduced. Copyright © 2017. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.

  10. Breast and Gynecologic Cancer | Division of Cancer Prevention

    Cancer.gov

    [[{"fid":"184","view_mode":"default","fields":{"format":"default","field_file_image_alt_text[und][0][value]":"Breast and Gynecologic Cancer Research Group Homepage Logo","field_file_image_title_text[und][0][value]":"Breast and Gynecologic Cancer Research Group Homepage Logo","field_folder[und]":"15"},"type":"media","attributes":{"alt":"Breast and Gynecologic Cancer Research Group Homepage Logo","title":"Breast and Gynecologic Cancer Research Group Homepage Logo","height":"266","width":"400"," | Prevention and early detection of breast, cervix, endometrial and ovarian cancers and their precursors.

  11. Gynecological cancer in Indonesia.

    PubMed

    Aziz, M Farid

    2009-03-01

    To overview the status of gynecologic cancer in Indonesia. Information regarding Indonesia obtained from World Bank Report and Statistical Yearbook of Indonesia 2007, epidemiological data obtained from Histopathological Data of Cancer in Indonesia 2002, Department of Health-Registry Body of Indonesian Specialist of Pathology Association-Indonesian Cancer Society; Various Hospitals in big Cities in Indonesia. Indonesia is an Archipelago with a total area of 1,922,570.00 km(2), the population is 222,192,000 (2006), the fourth world rank. Female is 49.86% with life expectancy 69 years. Gross National Product per Capita is 690.00 USD. Histopathological report in 2002 revealed that cervical cancer, ovarian cancer and uterine cancer were the most frequent cancer among female, which were the first (2,532 cases), the third (829 cases) and the eighth (316 cases) rank respectively. The peak age for cervical, uterine and ovarian cancer was 45-54 years. HPV 16, 18 were found in 82% of invasive cervical. Data from various academic hospitals in 2007 showed that cervical cancer is the most common malignancy followed by ovary, uterus, vulva and vagina. Five-year survival rate of stage I, II, III, IV cervical cancer were 50%, 40%, 20%, and 0% respectively. Overall five-year survival rate of carcinoma of the ovary was 54.8%. If sub-classified by stage, five-year survival rate are 94.3%, 75.0%, 31%, and 11.7% for stage I, II, III, and IV respectively. Five-year disease-free survival rate of endometrial cancer was 71.9%. Indonesia is the biggest Archipelago with a dense population but the income per capita still low (poor country). The most common gynecologic cancer is cervical cancer, followed by ovarian and uterine cancer. These cancers are included in top ten cancers in Indonesia. HPV 16, 18 were the most cause of cervical cancer. The five-year survival rates are comparable with world report.

  12. Major clinical research advances in gynecologic cancer in 2016: 10-year special edition

    PubMed Central

    2017-01-01

    In 2016, 13 topics were selected as major research advances in gynecologic oncology. For ovarian cancer, study results supporting previous ones regarding surgical preventive strategies were reported. There were several targeted agents that showed comparable responses in phase III trials, including niraparib, cediranib, and nintedanib. On the contrary to our expectations, dose-dense weekly chemotherapy regimen failed to prove superior survival outcomes compared with conventional triweekly regimen. Single-agent non-platinum treatment to prolong platinum-free-interval in patients with recurrent, partially platinum-sensitive ovarian cancer did not improve and even worsened overall survival (OS). For cervical cancer, we reviewed robust evidences of larger-scaled population-based study and cost-effectiveness of nonavalent vaccine for expanding human papillomavirus (HPV) vaccine coverage. Standard of care treatment of locally advanced cervical cancer (LACC) was briefly reviewed. For uterine corpus cancer, new findings about appropriate surgical wait time from diagnosis to surgery were reported. Advantages of minimally invasive surgery over conventional laparotomy were reconfirmed. There were 5 new gene regions that increase the risk of developing endometrial cancer. Regarding radiation therapy, Post-Operative Radiation Therapy in Endometrial Cancer (PORTEC)-3 quality of life (QOL) data were released and higher local control rate of image-guided adaptive brachytherapy was reported in LACC. In addition, 4 general oncology topics followed: chemotherapy at the end-of-life, immunotherapy with reengineering T-cells, actualization of precision medicine, and artificial intelligence (AI) to make personalized cancer therapy real. For breast cancer, adaptively randomized trials, extending aromatase inhibitor therapy, and ribociclib and palbociclib were introduced. PMID:28382802

  13. Durvalumab, Tremelimumab + Radiotherapy in Gynecologic Cancer

    ClinicalTrials.gov

    2017-09-08

    Recurrent Gynecological Cancer; Metastatic Cervical Cancer; Metastatic Ovarian Cancer; Metastatic Vaginal Cancer; Metastatic Vulvar Cancer; Metastatic Endometrial Cancer; Recurrent Cervical Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Vaginal Cancer; Recurrent Vulvar Cancer; Recurrent Endometrial Cancer

  14. Social Representations of Gynecologic Cancer Screening Assessment a Qualitative research on Ecuadorian women.

    PubMed

    Godoy, Yolanda; Godoy, Clara; Reyes, Juan

    2016-06-01

    The purpose of this work was to explore: knowledge, attitudes, and beliefs regarding gynecologic cancer screening on Ecuadorian women users of primary care facilities, to identify the social representations that users of health services make about these programs and their influence on the decision to undergo a screening. An exploratory and qualitative research design was held using focus groups and in-depth interviews for data collection. A narrative content analysis of the results was conducted. Women's knowledge on gynecological cancer screening was confusing. Most frequent misconceptions related to the pap smear were: the belief that it could be useful for detecting pregnancy, ovarian cysts or infections. Most of the participants stated that the pap smear procedure is a traumatic and painful experience. Regarding to mammography women said it was used for sick woman and this procedure by itself may cause cancer. El propósito de esta investigación fue explorar los conocimientos, actitudes y creencias respecto a los programas de detección del cáncer ginecológico entre usuarias de centros de atención primaria de salud para identificar las representaciones sociales que las usuarias de los servicios de salud elaboran acerca de estos programas y de los diferentes procedimientos que comprenden. El diseño de la investigación fue exploratorio y cualitativo, mediante grupos focales y entrevistas a profundidad, con el respectivo análisis narrativo e interpretativo del contenido. Se encontró conocimiento confuso acerca de los programas de tamizaje de cáncer ginecológico y dificultades asociadas a la realización de los procedimientos. Los significados más frecuentes acerca de los programas fueron: el uso de la citología cérvico-vaginal para detectar embarazo, quistes ováricos o infecciones. La mayoría de los participantes asociaba este procedimiento con una experiencia dolorosa y traumática. Respecto al autoexamen de mamas, lo calificaron como un masaje

  15. CCCT - NCTN Steering Committees - Gynecologic Cancers

    Cancer.gov

    The Gynecologic Cancers Steering Committee evaluates and prioritizes concepts for phase 2 and 3 clinical trials in adult gynecologic cancers. The GCSC is also intent on fostering collaboration with international groups and institutions conducting trials.

  16. Gynecologic Cancer Center for Racial Disparities

    DTIC Science & Technology

    2008-08-01

    Psychological Outcomes for Gynecologic Cancer Survivors. Arch Sex Behav. 2008 Apr 17. [Epub ahead of print]. 3. Simonelli LE, Fowler J, Maxwell GL, Andersen...Maxwell GL, Andersen BL: Does sexual morbidity predict psychological outcomes in gynecologic cancer survivors? Poster presented at Society of Behavioral...AD_________________ Award Number: W81XWH-05-2-0065 TITLE: Gynecologic Cancer Center for Racial

  17. [Aging and gynecologic cancer].

    PubMed

    Arrighi, Arturo A

    2005-01-01

    The interrelation between cancer and ageing in women is emphasized, on its increased incidence, in their molecular background, into the particular biological characteristics of the different tumors and the effects of ageing in the affected women.

  18. A Public Health Priority: Disparities in Gynecologic Cancer Research for African-Born Women in the United States

    PubMed Central

    Pinder, Leeya F.; Nelson, Brett D.; Eckardt, Melody; Goodman, Annekathryn

    2016-01-01

    African-born immigrants comprise one of the fastest growing populations in the U.S., nearly doubling its population size in recent years. However, it is also one of the most underrepresented groups in health-care research, especially research focused on gynecologic and breast malignancies. While the opportunity exists for access to an advanced health-care system, as immigrants migrate to the U.S., they encounter the same health-care inequalities that are faced by the native-born population based on ethnicity and social class, potentiated by limitations of health literacy and lack of familiarity with U.S. health systems. Given the continued influx of African-born immigrants in the U.S., we sought to understand the representation of this population in cervical and breast cancer research, recognizing the population’s high risk for these diseases at baseline while residing in their native countries. We determined that there is limited research in these diseases that disproportionately affect them; yet, there are identifiable and potentially modifiable factors that contribute to this paucity of evidence. This clinical commentary seeks to underscore the clear lack of research available involving African-born immigrants with respect to gynecologic and breast malignancies in the existing literature, demonstrate the need for more robust research in this population, and provide fundamental insights into barriers and solutions critical to the continued health of this growing population. PMID:27499654

  19. Gynecologic Cancer Disparities: a Report from the Health Disparities Taskforce of the Society of Gynecologic Oncology

    PubMed Central

    Collins, Yvonne; Holcomb, Kevin; Chapman-Davis, Eloise; Khabele, Dineo; Farley, John H.

    2014-01-01

    Objectives To review the extent of health disparities in gynecologic cancer care and outcomes and to propose recommendations to help counteract the disparities. Methods We searched the electronic databases PubMed and the Cochrane Library. We included studies demonstrating quantifiable differences by race and ethnicity in the incidence, treatment, and survival of gynecologic cancers in the United States (US). Most studies relied on retrospective data. We focused on differences between Black and White women, because of the limited number of studies on non-Black women. Results White women have a higher incidence of ovarian cancer compared to Black women. However, the all-cause ovarian cancer mortality in Black women is 1.3 times higher than that of White women. Endometrial and cervical cancer mortality in Black women is twice that of White women. The etiology of these disparities is multifaceted. However, much of the evidence suggests that equal care leads to equal outcomes for Black women diagnosed with gynecologic cancers. Underlying molecular factors may play an additional role in aggressive tumor biology and endometrial cancer disparities. Conclusion Gynecologic cancer disparities exist between Black and White women. The literature is limited by the lack of large prospective trials and adequate numbers of non-Black racial and ethnic groups. We conclude with recommendations for continued research and a multifaceted approach to eliminate gynecologic cancer disparities. PMID:24406291

  20. Clinical statistics of gynecologic cancers in Japan.

    PubMed

    Yamagami, Wataru; Nagase, Satoru; Takahashi, Fumiaki; Ino, Kazuhiko; Hachisuga, Toru; Aoki, Daisuke; Katabuchi, Hidetaka

    2017-03-01

    Cervical, endometrial, and ovarian cancers, have both high morbidity and mortality among the gynecologic malignant tumors in Japan. The present study was conducted using both the population-based cancer registry and the gynecologic cancer registry to elucidate the characteristics of gynecologic malignant tumors in Japan. Based on nationwide estimates from the population-based cancer registry in Japan, the morbidities and mortality of cervical, endometrial, and ovarian cancers were obtained and used for analysis. Clinicopathologic factors for cervical cancer, endometrial cancer, ovarian cancer, including age, clinical stage, postsurgical stage, histological type, therapeutic strategy, and prognosis were retrieved from the gynecologic cancer registry published by the Japan Society of Obstetrics and Gynecology and used for analysis. The morbidities of cervical, endometrial, and ovarian cancers were 10,908, 13,606, and 9,384 women in 2012, respectively. The prevalence of endometrial cancer has significantly and consistently been increasing and represents the most common gynecologic malignant tumor in Japan. The mortalities of cervical, endometrial, and ovarian cancers were 2.1, 1.3, and 3.2 per 100,000 in 2012, respectively. In 2014, 52.2% of cervical cancer patients were classified as stage I, 22.5% as stage II, 10.2% as stage III, and 11.2% as stage IV. In addition, 71.9% of endometrial cancer patients were classified as stage I, 6.0% as stage II, 13.3% as stage III, and 7.5% as stage IV. Finally, 43.2% of ovarian cancer patients were classified as stage I, 9.1% as stage II, 27.6% as stage III, and 7.2% as stage IV. Twelve-point six percent of ovarian cancer patients received neoadjuvant chemotherapy. Copyright © 2017. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.

  1. Clinical statistics of gynecologic cancers in Japan

    PubMed Central

    Nagase, Satoru

    2017-01-01

    Cervical, endometrial, and ovarian cancers, have both high morbidity and mortality among the gynecologic malignant tumors in Japan. The present study was conducted using both the population-based cancer registry and the gynecologic cancer registry to elucidate the characteristics of gynecologic malignant tumors in Japan. Based on nationwide estimates from the population-based cancer registry in Japan, the morbidities and mortality of cervical, endometrial, and ovarian cancers were obtained and used for analysis. Clinicopathologic factors for cervical cancer, endometrial cancer, ovarian cancer, including age, clinical stage, postsurgical stage, histological type, therapeutic strategy, and prognosis were retrieved from the gynecologic cancer registry published by the Japan Society of Obstetrics and Gynecology and used for analysis. The morbidities of cervical, endometrial, and ovarian cancers were 10,908, 13,606, and 9,384 women in 2012, respectively. The prevalence of endometrial cancer has significantly and consistently been increasing and represents the most common gynecologic malignant tumor in Japan. The mortalities of cervical, endometrial, and ovarian cancers were 2.1, 1.3, and 3.2 per 100,000 in 2012, respectively. In 2014, 52.2% of cervical cancer patients were classified as stage I, 22.5% as stage II, 10.2% as stage III, and 11.2% as stage IV. In addition, 71.9% of endometrial cancer patients were classified as stage I, 6.0% as stage II, 13.3% as stage III, and 7.5% as stage IV. Finally, 43.2% of ovarian cancer patients were classified as stage I, 9.1% as stage II, 27.6% as stage III, and 7.2% as stage IV. Twelve-point six percent of ovarian cancer patients received neoadjuvant chemotherapy. PMID:28198168

  2. Obstetric Outcomes in Non-Gynecologic Cancer Patients in Remission

    PubMed Central

    Timur, Hakan; Tokmak, Aytekin; Iskender, Cantekin; Yildiz, Elif Sumer; Inal, Hasan Ali; Uygur, Dilek; Danisman, Nuri

    2016-01-01

    Objective: The aim of the present study was to evaluate the obstetric and perinatal outcomes in treated women who were diagnosed with non-gynecologic cancer and to compare these findings with pregnant women with no history of cancer. Materials and Methods: This retrospective study was conducted on 21 pregnant women with non-gynecologic cancer who were in remission (study group) and 63 pregnant women with no history of cancer (control group). The women were admitted to the high-risk pregnancy clinic of Zekai Tahir Burak Women’s Health Training and Research Hospital with a diagnosis of pregnancy and cancer between January 2010 and January 2015. Obstetric outcomes and demographic characteristics of the patients were recorded. Age, gravida, parity, abortus, body mass index (BMI), gestational week, smoking, mode of delivery, gestational weight, and perinatal outcomes were examined for each woman. Results: The most common cancer types were thyroid (28.5%) and breast cancers (23.8%), which constituted just over half of the non-gynecologic cancer cases during pregnancy. The time elapsed after the diagnosis was 3.8±2.2 (1–9) years. No statistically significant differences were found between the two groups with regard to age, obstetric history, BMI, gestational week, smoking, and obstetric and perinatal outcomes (p>0.05). Conclusion: Negative perinatal outcomes in non-gynecologic cancer patients in remission were found to be within acceptable levels. PMID:27551177

  3. [Research and medicine in obstetrics and gynecology].

    PubMed

    Shalev, Eliezer

    2009-07-01

    The current issue of "Harefuah" is dedicated to original and descriptive research as well as to reviews of obstetric and gynecological topics. Original research includes the study on the progesterone receptor's profile in endometrial carcinoma cell lines, as well as the correlation of maternal serum and amniotic fluid Leptin Levels with neonatal birth weight. There are three descriptive articles and one review that are related to pain in gynecology and post partum, and two articles describing one complication and the second presenting a simulation of gynecological surgery. ULtrasound is represented in one descriptive case and two reviews describe sonographic signs for chromosomal abnormalities and fetal viral infection.

  4. Inside Knowledge about Gynecologic Cancer

    MedlinePlus

    ... Rates by U.S. State Cancer Rates by Race/Ethnicity and Sex Cancer Trends by Race/Ethnicity and Sex Incidence Trends Among Men Mortality Trends ... Collection Tool for Cancer Registry Planning Anxiety and Depression Medicine Use Among Cancer Survivors Breast Cancer Rates ...

  5. Gynecological cancers: A summary of published Indian data

    PubMed Central

    Maheshwari, Amita; Kumar, Neha; Mahantshetty, Umesh

    2016-01-01

    Gynecological cancers are among the most common cancers in women and hence an important public health issue. Due to the lack of cancer awareness, variable pathology, and dearth of proper screening facilities in developing countries such as India, most women report at advanced stages, adversely affecting the prognosis and clinical outcomes. Ovarian cancer has emerged as one of the most common malignancies affecting women in India and has shown an increase in the incidence rates over the years. Although cervical cancer is on a declining trend, it remains the second most common cancer in women after breast cancer. Many researchers in India have published important data in the field of gynecologic oncology, covering all domains such as basic sciences, preventive oncology, pathology, radiological imaging, and clinical outcomes. This work has given us an insight into the in-depth understanding of these cancers as well as the demographics and survival rates in the Indian population. This aim of this review is to discuss the important studies done in India for all gynecological cancers. PMID:27606294

  6. Obesity and gynecologic cancer etiology and survival.

    PubMed

    Webb, Penelope M

    2013-01-01

    The prevalence of overweight and obesity in the United States and elsewhere has increased dramatically in recent decades. It has long been known that obese women have an increased risk of developing endometrial cancer, but recent studies suggest this association is strongest for the most common low-grade endometrioid endometrial cancers and weaker for the other histologic subtypes. There are insufficient data to assess whether obesity affects endometrial cancer-specific survival or whether the relation with all-cause mortality is similar to that seen in the general population. Recent data suggest obesity also increases risk of ovarian cancer, although it may not influence risk of the high-grade serous cancers that account for the majority of ovarian cancer deaths, and that it is also associated with poorer outcomes. There is currently insufficient evidence to draw any clear conclusions regarding the relation between obesity and risk of/survival from other gynecologic cancers although there are suggestions that obesity may increase risk of cervical cancer, particularly adenocarcinoma, and perhaps vulvar cancer. Possible mechanisms whereby obesity might influence gynecologic cancer risk and survival include: its strong association with endogenous estrogen levels among postmenopausal women, its effects on glucose metabolism, its effects on the wide range of adipocytokines and inflammatory mediators that are produced by adipose tissue and altered in concentration among obese individuals, and its potential effects on patient management, particularly with regard to chemotherapy dosing.

  7. Prophylactic Gynecologic Specimens from Hereditary Cancer Carriers.

    PubMed

    Shaw, Patricia A; Clarke, Blaise A

    2016-06-01

    Hereditary breast ovarian cancer and Lynch/hereditary nonpolyposis colorectal cancer syndrome account for most hereditary gynecologic cancers. In the absence of effective cancer screening and other preventative strategies, risk-reducing surgery in women who are known to be at genetic risk of BRCA-associated or of Lynch syndrome carcinomas is effective in significantly decreasing the lifetime risk of developing malignancy. Reflex genomic testing of high-grade ovarian cancers and reflex immunohistochemistry in endometrial cancers will lead to greater recognition of germline-associated cancers. Approaches to processing surgical specimens, the recognition and classification of cancer precursor lesions, and differentiation from their mimics are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Synchronous gynecologic cancer and the use of imaging for diagnosis.

    PubMed

    Boaventura, Camila Silva; Galvão, José Lucas Scarpinetti; Soares, Giovanna Milanes Bego; Bitencourt, Almir Galvão Vieira; Chojniak, Rubens; Bringel, Shenia Lauanna Rezende; Brot, Louise De

    2016-04-01

    Endometrial and cervical cancers are the most prevalent gynecologic neoplasms. While endometrial cancer occurs in older women, cervical cancer is more prevalente in young subjects. The most common clinical manifestation in these two gynecological cancers is vaginal bleeding. In the first case, diagnosis is made based on histological and imaging evaluation of the endometrium, while cervical cancers are diagnosed clinically, according to the International Federation of Gynecology and Obstetrics (FIGO). The authors present a case of synchronous gynecological cancer of the endometrium and cervix diagnosed during staging on MRI and confirmed by histological analysis of the surgical specimen.

  9. New drugs in gynecologic cancer.

    PubMed

    Daud, A; Munster, P; Munster, P; Spriggs, D R

    2001-04-01

    The implementation of new drug treatments has improved the prognosis for advanced cancers of the cervix, uterus, and ovary. Platinum analogs are the most effective drugs in the treatment of ovarian cancer. Other drugs, such as oxaliplatin, have been proposed as a rational treatment of platinum refractory ovarian cancer. Epothilones are also being studied in clinical trials, as are histone deacetylase inhibitors. Several promising agents may soon receive Food and Drug Administration approval.

  10. Estrogen therapy in gynecological cancer survivors.

    PubMed

    Guidozzi, F

    2013-12-01

    Treatment of gynecological cancer has significant impact on a woman's quality of life because it commonly includes removal of the uterus and ovaries, both being the core of a woman's femininity, whilst irradiation and chemotherapy, be they as primary therapy or when indicated as postoperative adjuvant therapy, will lead to ablation of ovarian function if the ovaries had not been removed. This will lead to an acute onset of menopausal symptoms, which may be more debilitating than those occurring as a result of natural aging, and of which hot flushes, night sweats, insomnia, mood swings, vaginal dryness, decreased libido, malaise and a general feeling of apathy are the most common. About 25% of gynecological cancers will occur in pre- and perimenopausal women, a large percentage of whom will become menopausal as a result of their treatment. There are also the gynecological cancer survivors who are not rendered menopausal as a result of the treatment strategy but who will become menopausal because of natural aging. Concern among the medical attendants of these women is whether use of estrogen therapy or estrogen and progestogens for their menopausal symptoms will reactivate tumor deposits and therefore increase the rate of recurrence and, as a result, decrease overall survival among these women. Yet the data that are available do not support this concern. There are eight retrospective studies and only one randomized study that have analyzed outcome in endometrial cancer survivors who used hormone therapy after their surgery, whilst, among ovarian cancer survivors, there are four retrospective studies and one randomized study. The studies do suffer from small numbers and, although the studies pertaining to endometrial cancer analyze mostly women with early-stage disease, a number of the studies in both the endometrial and ovarian cancer survivors do have a sizeable follow-up. These studies seem to support that estrogen therapy after the treatment for gynecological

  11. [Laparoscopy and gynecologic cancer in 2005].

    PubMed

    Canis, M; Farina, M; Jardon, K; Rabischong, B; Rivoire, C; Nohuz, E; Botchorishvili, R; Pouly, J-L; Mage, G

    2006-04-01

    All the surgical procedures, which may be required to treat a gynecologic cancer, can be performed endoscopically. However prospective randomized studies required to confirm the oncologic efficacy of the technique are still lacking in gynecology, whereas such studies are available in digestive surgery. Animal studies suggested that the risk of tumor dissemination in non traumatized peritoneum is higher after a pneumoperitoneum than after a laparotomy. Experimental studies also emphasized two points: the surgeon and the surgical technique are essential, all the parameters of the pneumoperitoneum may influence the postoperative dissemination. Changing these parameters we may, in the future, be able to create a peritoneal environment adapted to oncologic patients in order to prevent or to decrease the risks of peritoneal dissemination and/or of postoperative tumor growth. Until the results of prospective randomized studies become available, the preoperative selection of the patients and the surgical technique should be very strict. In patients with endometrial cancer, the laparoscopic approach should be reserved to clinical stage I disease, if the vaginal extraction is anticipated to be easy accounting for the volume of the uterus and the local conditions. In cervical cancer, the laparoscopic approach should be reserved to patients with favorable prognostic factors: stage IB of less than 2 cm in diameter. Laparoscopy is the gold standard for the surgical diagnosis of adnexal masses. But the puncture should be avoided whenever possible. The surgical treatment of invasive ovarian cancer should be performed by laparotomy whatever the stage. In contrast restaging of an early ovarian cancer initially managed as a benign mass, is a good indication of the laparoscopic approach. The laparoscopic management of low malignant potential tumors should include a complete staging of the peritoneum. Knowledge of the principles of endoscopy and of oncologic surgery is required

  12. The Relevance of Gynecologic Oncologists to Provide High-Quality of Care to Women with Gynecological Cancer

    PubMed Central

    Minig, Lucas; Padilla-Iserte, Pablo; Zorrero, Cristina

    2016-01-01

    Gynecologic oncologists have an essential role to treat women with gynecological cancer. It has been demonstrated that specialized physicians who work in multidisciplinary teams to treat women with gynecological cancers are able to obtain the best clinical and oncological outcomes. However, the access to gynecologic oncologists for women with suspected gynecological cancer is scarce. Therefore, this review analyzes the importance of specialized care of women with ovarian, cervical, and endometrial cancer. In addition, the role of gynecologic oncologists who offer fertility-sparing treatment as well as their role in assisting general gynecologists and obstetricians is also reviewed. PMID:26835417

  13. Sexuality and intimacy after gynecological cancer.

    PubMed

    Ratner, Elena S; Foran, Kelly A; Schwartz, Peter E; Minkin, Mary Jane

    2010-05-01

    Matters of sexuality and intimacy greatly impact quality of life of patients with gynecologic cancers. Vast amount of evidence exists showing that cancer dramatically impacts woman's sexuality, sexual functioning, intimate relationships and sense of self. Sexual functioning can be affected by illness, pain, anxiety, anger, stressful circumstances and medications. There is a growing acknowledgement that these needs are not being appropriately addressed by providers. With improvements in early detection, surgery and adjuvant therapy for gynecologic cancer, long term survival and cure are becoming possible. Quality of life is thus becoming a major issue for patients. Patients suffer from hot flashes, difficulty sleeping, loss of libido and intimacy, all resulting in significant morbidity and loss of quality of life. Using hormone replacement therapy in gynecologic cancer survivors is a topic a great debate. While limited studies are available to date, retrospective cohort reviews show no reported differences in overall or disease-free survival in patients using hormone replacements vs. controls in patients with ovarian cancer, endometrial cancer, cervical, vaginal or vulva cancer. Since safety of using HRT remains controversial and prospective studies are lacking, providers need to be able to provide alternatives to HRT. Centrally acting agents such as antiseizure agent gabapentin and selective serotonine re-uptake inhibitors, such as venlafaxine and fluoxitine have been demonstrated to show effectiveness in treating vasomotor symptoms and are easily tolerated. To address cardiovascular and osteoporosis risks of post-menopausal status, exercise, healthy diet, bisphosphonates, raloxifen and statins have been found to be effective. Psychotherapy plays an essential part in management of these issues. Review of the literature reveals recent trends among health psychologists to utilize psychoeducational interventions that include combined elements of cognitive and

  14. Gynecological cancers: an alternative approach to healing

    PubMed Central

    Saso, Srdjan; Jones, Benjamin P; Bracewell-Milnes, Timothy; Huseyin, Gulsen; Boyle, Deborah C; Priore, Giuseppe Del; Smith, James Richard

    2017-01-01

    Grief and hope are two conflicting emotions that a patient recently diagnosed with cancer has to master. The real challenge for gynecologic oncologists is how to reach out. Conventional wisdom states that offering patients focus and belief when combating cancer in their lives allows them to embrace hope with greater confidence, which minimizes their grief. Three pictorial models are presented: ‘4-cusp approach’ model used at the initial consultation; ‘tapestry of bereavement or landscape of grief’ model at the postsurgery consultation; and ‘Venn-diagram’ model at any time during patient management. We have applied these models in our practice and believe that they can act as a fulcrum for the patient, the family and healthcare team around which therapy should be centered. PMID:28884005

  15. Extreme Sport/Adventure Activity Correlates in Gynecologic Cancer Survivors.

    PubMed

    Crawford, Jennifer J; Vallance, Jeff K; Holt, Nicholas L; Courneya, Kerry S

    2016-03-01

    We examined the demographic, medical and behavioral correlates of participation and interest in extreme sport/adventure activities (ESAA) in gynecologic cancer survivors. A random sample of 621 gynecologic cancer survivors in Alberta, Canada, completed a mailed self-report questionnaire assessing medical, demographic, and behavioral variables and participation and interest in ESAA. Multivariate analyses revealed that gynecologic cancer survivors were more likely to participate in ESAA if they met aerobic exercise guidelines (OR=1.75 [95%CI:1.02-2.99]), had better general health (OR=1.71 [95%CI: 1.01-2.90]), had cervical or ovarian cancer (OR=1.95 [95%CI:0.97-3.93]), were employed (OR=1.71 [95%CI:0.95-3.08]), and were of healthy weight (OR=1.58 [95%CI:0.93-2.68]). Moreover, gynecologic cancer survivors were more likely to be interested in trying an ESAA if they had cervical or ovarian cancer (OR=1.76 [95%CI:0.94-3.27]) and were meeting the strength exercise guidelines (OR=1.68 [95%CI:0.95-2.98]). Medical, demographic, and behavioral variables correlate with participation and interest in ESAA in gynecologic cancer survivors. The pattern of correlates suggests that gynecologic cancer survivors are more likely to participate in ESSA if they have the physical capability and financial resources. Interventions to promote ESAA in gynecologic cancer survivors need to address these 2 key barriers.

  16. Surveillance and Care of the Gynecologic Cancer Survivor

    PubMed Central

    MacLaughlin, Kathy L.; Long, Margaret E.; Pruthi, Sandhya; Casey, Petra M.

    2015-01-01

    Abstract Background: Care of the gynecologic cancer survivor extends beyond cancer treatment to encompass promotion of sexual, cardiovascular, bone, and brain health; management of fertility, contraception, and vasomotor symptoms; and genetic counseling. Methods: This is a narrative review of the data and guidelines regarding care and surveillance of the gynecologic cancer survivor. We searched databases including PubMed, Cochrane, and Scopus using the search terms gynecologic cancer, cancer surveillance, and cancer survivor and reached a consensus for articles chosen for inclusion in the review based on availability in the English language and publication since 2001, as well as key older articles, consensus statements, and practice guidelines from professional societies. However, we did not undertake an extensive systematic search of the literature to identify all potentially relevant studies, nor did we utilize statistical methods to summarize data. We offer clinical recommendations for the management of gynecologic cancer survivors based on review of evidence and our collective clinical experience. Results: Key messages include the limitations of laboratory studies, including CA-125, and imaging in the setting of gynecologic cancer surveillance, hormonal and non-hormonal management of treatment-related vasomotor symptoms and genitourinary syndrome of menopause, as well as recommendations for general health screening, fertility preservation, and contraception. Conclusions: A holistic approach to care extending beyond cancer treatment alone benefits gynecologic cancer survivors. In addition to surveillance for cancer recurrence and late treatment side effects, survivors benefit from guidance on hormonal, contraceptive, and fertility management and promotion of cardiovascular, bone, brain, and sexual health. PMID:26208166

  17. Obesity management in gynecologic cancer survivors: provider practices and attitudes.

    PubMed

    Jernigan, Amelia M; Tergas, Ana I; Satin, Andrew J; Fader, Amanda N

    2013-05-01

    Obesity is associated with the development and risk of death from several women's cancers. The study objective was to describe and compare oncologic providers' attitudes and practices as they relate to obesity counseling and management in cancer survivors. Society of Gynecologic Oncology members (n = 924) were surveyed with the use of a web-based, electronic questionnaire. χ(2) and Fisher exact tests were used to analyze responses. Of the 240 respondents (30%), 92.9% were practicing gynecologic oncologists or fellows, and 5.1% were allied health professionals. Median age was 42 years; 50.8% of the respondents were female. Of the respondents, 42.7% reported that they themselves were overweight/obese and that ≥50% of their survivor patients were overweight/obese. Additionaly, 82% of the respondents believed that discussing weight would not harm the doctor-patient relationship. Most of the respondents (95%) agreed that addressing lifestyle modifications with survivors is important. Respondents believed that gynecologic oncologists (85.1%) and primary care providers (84.5%) were responsible for addressing obesity. More providers who were ≤42 years old reported undergoing obesity management training (P < .001) and were more likely to believe that survivors would benefit from obesity education than providers who were >42 years old (P = .017). After initial counseling, 81.5% of the respondents referred survivors to other providers for obesity interventions. Oncology provider respondents believe that addressing obesity with cancer survivors is important. Providers believed themselves to be responsible for initial counseling but believed that obesity interventions should be directed by other specialists. Further research is needed to identify barriers to care for obese cancer survivors and to improve physician engagement with obesity counseling in the "teachable moment" that is provided by a new cancer diagnosis. Copyright © 2013 Mosby, Inc. All rights reserved.

  18. Leptomeningeal metastasis from gynecologic cancers diagnosed by brain MRI.

    PubMed

    Toyoshima, Masafumi; Tsuji, Keita; Shigeta, Shogo; Tokunaga, Hideki; Ito, Kiyoshi; Watanabe, Yoh; Yoshinaga, Kosuke; Otsuki, Takeo; Niikura, Hitoshi; Yaegashi, Nobuo

    Leptomeningeal metastasis (LM) is rarely observed in gynecologic cancers. As gadolinium-enhanced magnetic resonance imaging (Gd-MRI) is highly effective for diagnosing LM, the aim of this study is to describe the clinical behaviors and outcomes of LM patients who were diagnosed by Gd-MRI. After securing institutional review board approvals, we retrospectively reviewed patient records. Eight patients were found to have LM from gynecological malignancies. Primary tumors included three ovarian cancers, one tubal cancer, one peritoneal cancer, two endometrial cancers, and one cervical cancer. Gd-MRI of the brain and the spine is indicated as the high-priority inspection for the diagnosis of this devastating complication.

  19. Gynecological malignancy risk in colorectal cancer survivors: A population-based cohort study.

    PubMed

    Chang, Wei-Chun; Muo, Chih-Hsin; Liang, Ji-An; Sung, Fung-Chang; Kao, Chia-Hung

    2015-10-01

    This study was carried out to assess the risk of gynecological malignancy in colorectal cancer survivors using a population-based retrospective cohort study. Using the National Health Insurance Research Database (NHIRD) of Taiwan, we identified 37,176 patients with colorectal cancer diagnosed in 1998-2009, aged 20 years and above, without other cancer history. We also randomly selected 148,700 women without any cancer in the comparison cohort, frequency matched by age and diagnosis date. Incidences and hazards of breast, cervix, endometrial and ovarian cancers were evaluated by 201l. The overall incidence of the 4 types of gynecological cancer was 39.0% higher in colorectal cancer patients than in comparisons (2.99 vs. 2.14 per 1000 person-years) with an adjusted hazard ratio (HR) of 1.46 (95% confidence interval (CI) = 1.31-1.62). Breast cancer accounted for most subsequent cancer. The multivariable Cox method measured HR was the highest for endometrial cancer (3.40, 95% CI = 2.59-4.47) for the colorectal cohort relative to comparisons, followed by ovarian cancer and breast cancer, except cervix cancer. The risk of gynecological malignancies was apparently elevated for colorectal cancer survivors <50 years of age. Follow-up measures are suggested for women with colorectal cancer for early detection and prevention of the subsequent gynecological malignancy. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. New radiation techniques in gynecological cancer.

    PubMed

    Ahamad, A; Jhingran, A

    2004-01-01

    Radiation therapy has been a major therapeutic modality for eradicating malignant tumors over the past century. In fact, it was not long after the discovery of radium that the first woman with cervical cancer underwent intracavitary brachytherapy. Progress in the way that this cytotoxic agent is manipulated and delivered has seen an explosive growth over the past two decades with technological developments in physics, computing capabilities, and imaging. Although radiation oncologists are educated in and familiar with the wealth of new revolutionary techniques, it is not easy for other key members of the team to keep up with the rapid progress and its significance. However, to fully exploit these enormous gains and to communicate effectively, medical and gynecological oncologists are expected to be aware of state-of-the-art radiation oncology. Here, we elucidate and illustrate contemporary techniques in radiation oncology, with particular attention paid to the external beam radiotherapy used for adjuvant and primary definitive management of malignancies of the female pelvis.

  1. The global impact of the Gynecologic Cancer InterGroup in enhancing clinical trials in ovarian cancer.

    PubMed

    Bacon, Monica; Kitchener, Henry; Stuart, Gavin C E; Vermorken, Jan B

    2011-05-01

    The Gynecologic Cancer InterGroup (GCIG) has developed from a small network of ovarian cancer researchers to a large international forum addressing multiple issues related to research in gynecologic cancers. Member groups of the GCIG have collaboratively conducted pivotal clinical trials in cancers of the ovary, endometrium, and cervix. The participation of operational and statistical personnel from the GCIG member groups has facilitated a collegial approach to international differences and restrictions.One of the powerful initiatives of the GCIG is the facilitation of the Ovarian Cancer Consensus Conference every few years. The 4th Ovarian Cancer Consensus Conference was held in Vancouver, Canada, in June 2010, and the resulting publications (herein) provide an invaluable resource to researchers in the field of gynecologic oncology.

  2. Learning Needs of Gynecologic Cancer Survivors.

    PubMed

    Akkuzu, Gulcihan; Kurt, Gonul; Guvenc, Gulten; Kok, Gulsah; Simsek, Sevgi; Dogrusoy, Safiye; Ayhan, Ali

    2016-10-15

    To define the learning needs of patients with gynecological oncology. The study was performed as a descriptive study. A total of 92 patients were participated. Data were collected using Patient Learning Needs Scale (PLNS). The Pearson correlation test, independent sample t test, and analysis of one-way of variance (ANOVA) followed by Tukey's-B post hoc tests were used for statistical analyses by the SPSS 15.0 software package. The mean age of women's was 50.37 ± 12.20 years. The women's diagnoses were cervical (45.7 %), ovarian (27.2 %), and endometrial (19.6 %) cancers. The most frequently stated learning needs topics were coping with pain (47.8 %), daily living activities (46.2 %), and psychological support (44.6 %). The mean PLNS score of women was 212.56 ± 35.83. The mean subscales scores of PLNS were 34.06 ± 7.29 for medicines, 38.34 ± 6.74 for daily living activities, and 24.68 ± 5.41 for community subscales. Women who graduated from elementary school needed more education than the women with higher education (p < 0.001). Learning needs level of the women are high and related to increase quality of life, medicine usage, complications of treatment, skin problems, pain management, and supportive care. As a healthcare professional, we should plan and develop educational programs in order to adequately inform patients about their learning needs.

  3. Overexpression of Cancer-Associated Genes via Epigenetic Derepression Mechanisms in Gynecologic Cancer.

    PubMed

    Jeong, Hae Min; Kwon, Mi Jeong; Shin, Young Kee

    2014-01-01

    Like other cancers, most gynecologic cancers are caused by aberrant expression of cancer-related genes. Epigenetics is one of the most important gene expression mechanisms, which contribute to cancer development and progression by regulating cancer-related genes. Since the discovery of differential gene expression patterns in cancer cells when compared with normal cells, extensive efforts have been made to explore the origins of abnormal gene expression in cancer. Epigenetics, the study of inheritable changes in gene expression that do not alter DNA sequence is a key area of this research. DNA methylation and histone modification are well-known epigenetic mechanisms, while microRNAs and alternative splicing have recently been identified as important regulators of epigenetic mechanisms. These mechanisms not only affect specific target gene expression but also regulate the functioning of other epigenetic mechanisms. Moreover, these diverse epigenetic regulations occur simultaneously. Epigenetic regulation of gene expression is extraordinarily complicated and all epigenetic mechanisms to be studied at once to determine the exact gene regulation mechanisms. Traditionally, the contribution of epigenetics to cancer is thought to be mediated through the inactivation of tumor suppressor genes expression. But recently, it is arising that some oncogenes or cancer-promoting genes (CPGs) are overexpressed in diverse type of cancers through epigenetic derepression mechanism, such as DNA and histone demethylation. Epigenetic derepression arises from diverse epigenetic changes, and all of these mechanisms actively interact with each other to increase oncogenes or CPGs expression in cancer cell. Oncogenes or CPGs overexpressed through epigenetic derepression can initiate cancer development, and accumulation of these abnormal epigenetic changes makes cancer more aggressive and treatment resistance. This review discusses epigenetic mechanisms involved in the overexpression of

  4. Compliance with research standards within gynecologic oncology fellowship: A Gynecologic Oncology Fellowship Research Network (GOFRN) study.

    PubMed

    Moulton, Laura J; Michener, Chad M; Levinson, Kimberly; Cobb, Lauren; Tseng, Jill; Jernigan, Amelia

    2017-09-01

    Participation in clinical and basic science research is emphasized in gynecologic oncology training. We sought to identify trends in adherence to expected research practices and reasons for non-adherence among gynecologic oncology fellows. An anonymous 31-question online survey assessing academic behaviors, including IRB compliance, authorship assignment, data sharing, and potential barriers to non-adherence was distributed to all SGO gynecologic oncology fellow members in July 2016. Descriptive statistics and univariate analyses were performed. Of 190 members, 35.3% (n=67) responded. 73% (n=49) of respondents reported personal non-compliance and 79.1% (n=53) reported having witnessed others being non-complaint with at least one expected research practice. Areas of compliance failure included changing a research question without appropriate IRB amendment (20%; n=14), conducting research under a nonspecific IRB (13.9%; n=9), and performing research without IRB approval (6.1%; n=4). Longer institutional time for IRB approval was significantly associated with IRB non-adherence (p<0.05). First year fellows were more likely to use a nonspecific IRB (p=0.04) or expand a question without amending the IRB (p=0.04). When asked about storage of protected health information (PHI) for research, 53% reported non-secure storage with 17.1% (n=6) having done so for >1000 patients. Thirty respondents (45.5%) assigned authorship to someone who failed to meet ICMJE criteria and twelve (18.5%) accepted authorship without meeting ICMJE criteria. Most commonly cited reasons for non-adherence were: cumbersome IRB processes (80.3%), pressure from senior authors (78.8%), fear of someone else publishing first, (74.2%) and lack of support navigating appropriate research practices (71.2%). Fellow non-compliance with expected research practices is high, particularly with regards to secure storage of PHI and appropriate authorship assignment. Time-consuming and cumbersome IRB procedures

  5. The epidemiologic status of gynecologic cancer in Thailand.

    PubMed

    Wilailak, Sarikapan; Lertchaipattanakul, Nuttapong

    2016-11-01

    Between the years of 2010-2012, it was estimated there were a total of 112,392 new cases of cancers in Thailand, thus, the total age-standardized rate (ASR) per 100,000 is 137.6. In regards to the most prevalent types of cancer in female, breast cancer has the highest ASR, followed by cervical cancer (ASR=14.4); liver and bile duct cancer; colon and rectum cancer; trachea, bronchus and lung cancer; ovarian cancer (ASR=6.0); thyroid cancer; non-Hodgkin lymphoma and uterine cancer (ASR=4.3). The trend of cervical cancer in Thailand is decreasing, one key factor in making this possible was the employment of dual tract strategy (Pap smear and visual inspection with acetic acid [VIA]) by the government in 2005. In the future, the government is also considering integrating human papillomavirus (HPV) vaccination into the national immunization program, which may assist in the prevention of cervical cancer. By studying the statistical data of gynecologic cancer, it will be possible to formulate measures for the prevention, control and treatment of gynecologic cancer. Eventually, it will potentially improve the quality of life (QoL) of patients as well as decrease the mortality rate caused by gynecologic cancer.

  6. The epidemiologic status of gynecologic cancer in Thailand

    PubMed Central

    2016-01-01

    Between the years of 2010–2012, it was estimated there were a total of 112,392 new cases of cancers in Thailand, thus, the total age-standardized rate (ASR) per 100,000 is 137.6. In regards to the most prevalent types of cancer in female, breast cancer has the highest ASR, followed by cervical cancer (ASR=14.4); liver and bile duct cancer; colon and rectum cancer; trachea, bronchus and lung cancer; ovarian cancer (ASR=6.0); thyroid cancer; non-Hodgkin lymphoma and uterine cancer (ASR=4.3). The trend of cervical cancer in Thailand is decreasing, one key factor in making this possible was the employment of dual tract strategy (Pap smear and visual inspection with acetic acid [VIA]) by the government in 2005. In the future, the government is also considering integrating human papillomavirus (HPV) vaccination into the national immunization program, which may assist in the prevention of cervical cancer. By studying the statistical data of gynecologic cancer, it will be possible to formulate measures for the prevention, control and treatment of gynecologic cancer. Eventually, it will potentially improve the quality of life (QoL) of patients as well as decrease the mortality rate caused by gynecologic cancer. PMID:27775261

  7. Update on immune checkpoint inhibitors in gynecological cancers

    PubMed Central

    2017-01-01

    In recent years, progress in our understanding of immune-modulatory signaling pathways in immune cells and the tumor microenvironment (TME) has led to rejuvenated interest in cancer immunotherapy. In particular, immunotherapy targeting the immune checkpoint receptors such as cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), programmed cell-death 1 (PD-1), and programmed cell-death ligand 1 (PD-L1) have demonstrated clinical activity in a wide variety of tumors, including gynecological cancers. This review will focus on the emerging clinical data on the therapeutic role of immune checkpoint inhibitors, and potential strategies to enhance the efficacy of this class of compounds, in the context of gynecological cancers. It is anticipated that future biomarker-directed clinical trials will provide further insights into the mechanisms underlying response and resistance to immunotherapy, and help guide our approach to designing therapeutic combinations that have the potential to enhance the benefit of immunotherapy in patients with gynecologic cancers. PMID:28028993

  8. Gamma Knife Surgery for Metastatic Brain Tumors from Gynecologic Cancer.

    PubMed

    Matsunaga, Shigeo; Shuto, Takashi; Sato, Mitsuru

    2016-05-01

    The incidences of metastatic brain tumors from gynecologic cancer have increased. The results of Gamma Knife surgery (GKS) for the treatment of patients with brain metastases from gynecologic cancer (ovarian, endometrial, and uterine cervical cancers) were retrospectively analyzed to identify the efficacy and prognostic factors for local tumor control and survival. The medical records were retrospectively reviewed of 70 patients with 306 tumors who underwent GKS for brain metastases from gynecologic cancer between January 1995 and December 2013 in our institution. The primary cancers were ovarian in 33 patients with 147 tumors and uterine in 37 patients with 159 tumors. Median tumor volume was 0.3 cm(3). Median marginal prescription dose was 20 Gy. The local tumor control rates were 96.4% at 6 months and 89.9% at 1 year. There was no statistically significant difference between ovarian and uterine cancers. Higher prescription dose and smaller tumor volume were significantly correlated with local tumor control. Median overall survival time was 8 months. Primary ovarian cancer, controlled extracranial metastases, and solitary brain metastasis were significantly correlated with satisfactory overall survival. Median activities of daily living (ADL) preservation survival time was 8 months. Primary ovarian cancer, controlled extracranial metastases, and higher Karnofsky Performance Status score were significantly correlated with better ADL preservation. GKS is effective for control of tumor progression in patients with brain metastases from gynecologic cancer, and may provide neurologic benefits and preservation of the quality of life. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Physical Sequelae and Depressive Symptoms in Gynecologic Cancer Survivors: Meaning in Life as a Mediator

    PubMed Central

    Simonelli, Laura E.; Fowler, Jeffrey; Maxwell, G. Larry

    2009-01-01

    Background Continuing symptoms and poor health following cancer treatments may alter meaning in life for cancer survivors. Gynecologic cancer survivors are particularly troubled with physical sequelae. In addition, for the most common sites of disease, such as breast and gynecologic cancers, the prevalence of depression is also high. Purpose This study tests meaning in life as a mechanism for the relationship between physical symptoms and depressive symptoms. Methods Gynecologic cancer survivors (N=260) participated. Measures of physical sequelae (nurse rated symptoms/signs, patient-reported gynecologic symptoms), meaning in life (harmony, life purpose, spirituality, and conversely, confusion and loss), and depressive symptoms were obtained at the time of a routine clinical follow-up visit 2–10 years following the completion of treatment. Latent variables were defined, and structural equation modeling tested a mediator model. Results Analyses support partial mediation. That is, survivors with more physical sequelae also reported lower levels of meaning in life, which was associated with higher levels of depressive symptoms. Conclusions Gynecologic cancer patients have been neglected in psychosocial research, and findings highlight the importance of existential issues in their lives. While many adjust well, those with persistent physical functioning deficits may experience depressive symptoms. By appreciating the role of meaning in their experience, we may help survivors foster their own growth and perspectives important for their future. PMID:18386113

  10. Use of Complementary and Alternative Medicine in Patients with Gynecologic Cancer: a Systematic Review.

    PubMed

    Akpunar, Dercan; Bebis, Hatice; Yavan, Tulay

    2015-01-01

    Research carried out with gynecologic cancer patients using CAM was reviewed to provide a source for discussing which CAM method is used for which purpose, patients' perceptions on the effects/side effects occurred during/after using CAM and their sources of information regarding CAM. This literature review was carried out for the period between January 2000 and March 2015 using Scopus, Dynamed, Med-Line, Science Direct, Ulakbim, Research Starters, Ebscohost, Cinahl Complete, Academic Onefile, Directory of Open Access Journals, BMJ Online Journals (2007-2009), Ovid, Oxford Journal, Proquest Hospital Collection, Springer-Kluwer Link, Taylor and Francis, Up To Date, Web Of Science (Citation Index), Wiley Cochrane-Evidence Base, Wiley Online Library, and Pub-Med search databases with "complementary and alternative medicine, gynecologic cancer" as keywords. After searching through these results, a total of 12 full length papers in English were included. CAM use in gynecologic cancer patients was discussed in 8 studies and CAM use in breast and gynecologic cancer patients in 4. It was determined that the frequency of CAM use varies between 40.3% and 94.7%. As the CAM method, herbal medicines, vitamins/minerals were used most frequently in 8 of the studies. When the reasons why gynecologic cancer patients use CAM are examined, it is determined that they generally use to strengthen the immune system, reduce the side effects of cancer treatment and for physical and psychological relaxation. In this review, most of the gynecologic cancer patients perceived use of CAM as beneficial. In order that the patients obtain adequate reliable information about CAM and avoid practices which may harm the efficiency of medical treatment, it is recommended that "Healthcare Professionals" develop a common language.

  11. Other Gynecologic Cancers: endometrial, ovarian, vulvar and vaginal cancers

    PubMed Central

    Duarte-Franco, Eliane; Franco, Eduardo L

    2004-01-01

    Health issue In Canada, cancers of the endometrium, ovaries, vulva, vagina, placenta and adnexa account for 11% of all malignant neoplasms in women and 81% of all genital cancers. Although the incidence and mortality from vulvar and vaginal cancers are very low, endometrium and ovarian cancer are important public health problems. Key findings In Canada, there has been no appreciable improvement in survival for women with advanced endometrial (EC) or ovarian cancer (OC) over the past 30 years. The prognosis of EC is good for most patients because diagnosis is made at early stages. However, survival of OC is poor; more than 70% of cases are diagnosed at late stages. Up to 10% of OCs is linked to familial aggregation. Cancers of the vulva and of the vagina are very rare. The survival experience for women with the latter is worse than for those with the former. Both share many risk factors with cervical cancer and the recent developments in the study of HPV infection should be applicable to these diseases as well. Of particular interest will be the advent of vaccines for the primary prevention of HPV infection. Data gaps and recommendations At present, the best available means to diagnose gynecologic malignancies is a detailed clinical examination, considering the totality of information on potential and proven risk factors, such as age, reproductive health, sexual practices, use unopposed estrogens or of oral contraceptives or tubal ligation, obesity, diet, smoking, and the familial clustering of some of these cancers. PMID:15345077

  12. The loneliness level of patients with gynecological cancer.

    PubMed

    Sevil, U; Ertem, G; Kavlak, O; Coban, A

    2006-01-01

    The purpose of this descriptive study was to determine the loneliness levels and the variables that have an effect on the loneliness of women with a gynecological cancer diagnosis. The main questions that the study addressed were as follows: (1) What is the loneliness level of patients with gynecological cancer? and (2) What kind of relationships are there between general demographic characteristics of patients with gynecological cancer and their loneliness? This descriptive study was conducted at Ege University, Faculty of Medicine, Application and Investigation Hospital, Maternity and Women Diseases Gynecology Clinic, from July to December 2002. Maternity and Women Diseases Clinic Oncology Service treated 161 patients during this time period. While all patients hospitalized between the specified dates constituted the universe of the investigation; the actual sample was 94 patients. As data collection tools, a questionnaire form, which aimed at identifying sociodemographic characteristics of patients and the features related to their diseases relevant to the literature and the UCLA-loneliness scale were used. The general loneliness mean score of women with gynecological cancer was 35.85 +/- 9.302. Women's mean scores of loneliness were affected by whether psychologic support was needed, genital organ diseases were treated, or a family member had a gynecological operation, and by the income situation. The disease of cancer, which creates the most fear and anxiety in the community, has adverse psychologic effects on both the patient and the family. In societies where men dominate, as is the case in our society, women's place in the society has been reduced to their reproductive capacity, and thus, the health of their genital organs is very important.

  13. Usefulness of duloxetine for Paclitaxel-induced peripheral neuropathy treatment in gynecological cancer patients.

    PubMed

    Otake, Akiko; Yoshino, Kiyoshi; Ueda, Yutaka; Sawada, Kenjiro; Mabuchi, Seiji; Kimura, Toshihiro; Kobayashi, Eiji; Isobe, Aki; Egawa-Takata, Tomomi; Matsuzaki, Shinya; Fujita, Masami; Kimura, Tadashi

    2015-01-01

    The present study aimed at evaluating the usefulness and adverse effects of duloxetine treatment for paclitaxel-induced peripheral neuropathy in gynecological cancer patients. Medical records of gynecological cancer patients treated with duloxetine were retrospectively studied to evaluate the drug's efficacy for paclitaxel-induced peripheral neuropathy. RESULTS from 25 patients showed that an improved response was observed in 14 (56%). By univariate and multivariate analysis, the patient's age, tumor origin, regimen of chemotherapy, accumulated doses of paclitaxel or carboplatin, previous medication, maintenance dosage and timing of treatment with duloxetine were found not to be associated with the effectiveness of duloxetine treatment. Adverse effects with duloxetine were mild and well-tolerated. As an option, duloxetine can be effectively used for paclitaxel-induced peripheral neuropathy in patients with gynecological cancers, irrespective of patients' age, origin of the tumor, regimen of chemotherapy, or previous medication. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  14. Development and evaluation of the Korean version of the Gynecologic Cancer Lymphedema Questionnaire in gynecologic cancer survivors.

    PubMed

    Lim, Myong Cheol; Lee, Jeong Seon; Joo, Jungnam; Park, Kibyung; Yoo, Heon Jong; Seo, Sang-Soo; Kang, Sokbom; Chung, Seung Hyun; Park, Sang-Yoon

    2014-04-01

    The purpose of this study was two-fold: first, to develop a Korean version of the Gynecologic Cancer Lymphedema Questionnaire (GCLQ-K) and evaluate its reliability and reproducibility and second, to examine the diagnostic efficacy of GCLQ-K in predicting lymphedema in gynecologic cancer survivors. We designed a case-control study, and the GCLQ-K was completed by 33 gynecologic cancer survivors with lymphedema and 34 gynecologic cancer survivors without lymphedema. A follow-up GCLQ-K was completed 3weeks after the baseline questionnaire. The GCLQ-K showed high reliability with a Cronbach's α of 0.83 and high reproducibility with an intraclass correlation of 0.96. Of the 7 symptom clusters, 6 identified patients with lymphedema with statistical significance; identification of lymphedema using the physical functioning and infection-related symptom clusters did not reach significance. The area under the receiver operating characteristic curve (AUC) to distinguish patients with and without lymphedema was 0.868 (95% confidence interval [CI], 0.779-0.956). Following the exclusion of the physical functioning and infection-related symptom clusters, which showed poor prediction value for lymphedema, the AUC of the GCLQ-K total score further improved to 0.922 (95% CI, 0.864-0.981). The GCLQ-K was successfully developed with minimal modifications to adapt the original GCLQ to the Korean culture and showed high internal consistency and reproducibility. Moreover, gynecologic cancer survivors with and without lymphedema could be satisfactorily distinguished using the GCLQ-K. Thus, GCLQ-K was proven to be a reliable tool, capable of identifying lymphedema in Korean gynecological cancer survivors. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Gynecologic Cancer Center for Racial Disparities

    DTIC Science & Technology

    2006-08-01

    required approvals from the Committee on Experimental Medicine as well as the Uterine Committee of the Gynecologic Oncology Group. Currently, our...WRAMC in conjunction with the Armed Forces Institute of Pathology (Months 1-48). The focus during Months 1-12 will be on validating abnormal ...was administered twice at three and six weeks. Sera was collected by bleed from ear at every week after each immunization for determination of

  16. New clinical research strategies for rare gynecologic malignancies.

    PubMed

    Ray-Coquard, Isabelle; Pujade-Lauraine, Eric; Ledermann, Jonathan A

    2015-02-01

    More than 50% of all gynecologic cancers can be classified as rare tumors (defined as an incidence of <6 per 100 000) and as such represent a major challenge for clinicians. The rapidly increasing number of targeted therapies provides a unique opportunity to improve treatment options of rare gynecologic cancers; however, their low frequency makes it difficult to test these new agents. Harmonization of medical practices and novel trial designs are needed to identify and develop new treatments for rare gynecologic tumors. This requires international partnerships, harmonization of treatment recommendations, and international collaborations to overcome existing regulatory barriers in international trials. Whereas randomized trials may be possible in some rare tumor types, there are others for which conducting even single arm studies may be challenging. For these very rare tumors, robust collection of data through national registries could lead to improvements in treatment.

  17. Outcome and clinical management of 275 patients with advanced ovarian cancer International Federation of Obstetrics and Gynecology II to IV inside the European Ovarian Cancer Translational Research Consortium-OVCAD.

    PubMed

    Chekerov, Radoslav; Braicu, Ioana; Castillo-Tong, Dan Cacsire; Richter, Rolf; Cadron, Isabelle; Mahner, Sven; Woelber, Linn; Marth, Christian; Van Gorp, Toon; Speiser, Paul; Zeillinger, Robert; Vergote, Ignace; Sehouli, Jalid

    2013-02-01

    The Sixth Framework Program European Union project OVCAD, "Ovarian Cancer-Diagnosis of a Silent Killer," aimed to investigate new predictors for early detection of minimal residual disease in epithelial ovarian cancer (EOC). Here we present the main pathologic, surgical, and chemotherapy characteristics of the OVCAD patient cohort. Between February 2005 and December 2008, 5 European gynecologic cancer centers (WP2 group) enrolled prospective 275 consecutive patients with EOC into this translational study. Inclusion criteria were as follows: advanced International Federation of Obstetrics and Gynecology II to IV stage, cytoreductive surgery, platinum-based chemotherapy, and collected tumor samples. WP2 coordinated the implementation, screening, and recruiting of the patients and tumor samples into a Web-based data bank according established standard operating procedures. Median age at the time of diagnosis was 58 years. Most patients presented advanced high-grade EOC: International Federation of Obstetrics and Gynecology III/IV (94.5%), grade 2/3 (96%), serous histology (86.2%), ascites (76%), peritoneal carcinomatosis (67.6%), and lymph node involvement (52%). The most common surgical procedures were omentectomy (92.4%), bilateral salpingo-oophorectomy (90.9%), hysterectomy (77.3%), pelvic (69.5%) and paraaortic (66.9%) lymphadenectomy, and large (37.7%) or small bowel resection (13.4%). Patients were treated commonly with platinum-based therapy (98.2%). The macroscopic cytoreduction rate was 68.4%. After a median follow-up of 37 months, 70 patients (25.5%) developed a platinum-resistant recurrence. Biological materials such as tumor and paraffin tissue, ascites, and blood samples were collected consecutively. The implementation of the OVCAD cohort demonstrated the feasibility and advantages of an open, prospective, and multicenter recruitment inside a translational research study. Essential was the predefinition of all inclusion criteria, standard operating

  18. The Lymphedema and Gynecologic Cancer (LEG) Study: Incidence, Risk Factors, and | Division of Cancer Prevention

    Cancer.gov

    DESCRIPTION (provided by applicant): The proposed study, Lymphedema and Gynecologic cancer (LEG): Incidence, Risk Factors and Impact, will innovatively utilize the cooperative group setting of the GOG (Gynecologic Oncology Group) to prospectively study 1300 women newly diagnosed with cervical, endometrial, or vulvar cancer to determine the incidence and impact of lower extremity lymphedema following surgical treatment of these diseases. |

  19. Contemporary Quality of Life Issues Affecting Gynecologic Cancer Survivors

    PubMed Central

    Carter, Jeanne; Penson, Richard; Barakat, Richard; Wenzel, Lari

    2015-01-01

    Gynecologic cancers account for approximately 11% of the newly diagnosed cancers in women in the United States and 18% in the world.1 The most common gynecologic malignancies occur in the uterus and endometrium (53%), ovary (25%), and cervix (14%).2 Cervical cancer is most prevalent in premenopausal women, during their childbearing years, whereas uterine and ovarian cancers tend to present in the perimenopausal or menopausal period. Vaginal and vulvar cancers and malignancies arising from gestation, or gestational trophoblastic neoplasms, occur to a lesser extent. Regardless of cancer origin or age of onset, the disease and its treatment can produce short- and long-term sequelae (ie, sexual dysfunction, infertility, or lymphedema) that adversely affect quality of life (QOL). This article outlines the primary contemporary issues or concerns that may affect QOL and offers strategies to offset or mitigate QOL disruption. These contemporary issues are identified within the domains of sexual functioning, reproductive issues, lymphedema, and the contribution of health-related QOL (HRQOL) in influential gynecologic cancer clinical trials. PMID:22244668

  20. Breast and Gynecologic Cancer Clinical Trials | Division of Cancer Prevention

    Cancer.gov

    The Division of Cancer Prevention (DCP) conducts and supports research to determine a person's risk of cancer and to find ways to reduce the risk. This knowledge is critical to making progress against cancer because risk varies over the lifespan as genetic and epigenetic changes can transform healthy tissue into invasive cancer.

  1. Active Breast and Gynecologic Cancer Grants | Division of Cancer Prevention

    Cancer.gov

    The Division of Cancer Prevention (DCP) conducts and supports research to determine a person's risk of cancer and to find ways to reduce the risk. This knowledge is critical to making progress against cancer because risk varies over the lifespan as genetic and epigenetic changes can transform healthy tissue into invasive cancer.

  2. Breast and Gynecologic Cancer Staff | Division of Cancer Prevention

    Cancer.gov

    The Division of Cancer Prevention (DCP) conducts and supports research to determine a person's risk of cancer and to find ways to reduce the risk. This knowledge is critical to making progress against cancer because risk varies over the lifespan as genetic and epigenetic changes can transform healthy tissue into invasive cancer.

  3. Effect of home care service on the quality of life in patients with gynecological cancer.

    PubMed

    Aktas, Demet; Terzioglu, Fusun

    2015-01-01

    The purpose of the research was to determine the effect of home care service on the quality of life in patients with gynecological cancer. This randomized case control study was carried out in a womans hospital between September 2011 and February 2012. Women undergoing gynecological cancer treatment were separated into intervention and control groups, of 35 patients each. The intervention group was provided with nursing care service through hospital and home visits (1st, 12th weeks) within the framework of a specifically developed nursing care plan. The control group was monitored without any intervention through the hospital routine protocols (1st, 12th weeks). Data were collected using An Interview Form, Home Visit Monitoring Form and Quality of Life Scale/Cancer Survivors. Effects of home care service on the quality of life in gynecological cancer patients were investigated using chi-square tests, McNemar's test, independent t-test and ANOVA. This study found that the intervention group receiving home care service had a moderately high quality of life (average mean: 6.01±0.64), while the control group had comparatively lower quality (average mean: 4.35±0.79) within the 12 week post- discharge period (p<0.05). This study found home care services to be efficient in improving the quality of life in patients with gynecological cancer.

  4. [Pregnancy after gynecologic or breast cancer].

    PubMed

    Carbonne, Bruno; Ansquer, Yan

    2010-03-01

    Breast cancer often occurs in women of childbearing age, many of whom go on to have children. Several studies suggest that pregnancy does not worsen the outcome of breast cancer, and that a history of breast cancer does not affect the outcome of pregnancy. The timing of pregnancy after breast cancer should take into account the risk of recurrence and metastasis. Conservative surgical treatment for cervical cancer may increase the risk of late fetal loss or preterm birth. Candidates for conservative treatment of ovarian and endometrial cancer must be carefully selected, as recurrence during or after pregnancy is not uncommon.

  5. Experiences of gynecological cancer patients receiving care from specialist nurses: a qualitative systematic review.

    PubMed

    Cook, Olivia; McIntyre, Meredith; Recoche, Katrina; Lee, Susan

    2017-08-01

    The care needs of women with gynecological cancer are complex and change over the course of their cancer journey. Specialist nurses are well positioned to play a role in meeting the needs of women with gynecological cancer although their role and scope of practice have not been well defined. As patients are a key stakeholder, understanding their experience of care is an important step in better defining the role and scope of practice of specialist nurses in gynecological oncology in Australia and New Zealand. This review sought to consider gynecological cancer patients' experiences of specialist nursing care. Exploring the patient's experience of care by a specialist nurse is one step in the process of better defining the role and scope of practice of specialist gynecological-oncology nurses in Australia and New Zealand. This review included studies with a focus on women with gynecological cancer who had been cared for by a specialist nurse. Studies of women with gynecological cancer at any point on the continuum of care from pre-diagnosis to survivorship or end of life, including those with a recurrence of the disease, were included, with no limit to the duration of care received for inclusion in the review. Studies that explored how women with gynecological cancer experience the care and interventions of specialist nurses were included. Qualitative studies including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research were considered for review. This review also considered the qualitative components of mixed method studies. Research conducted in any country was considered for inclusion in this review providing that the study was reported in English. Studies conducted in any setting including, but not limited to, acute hospitals, outpatient/ambulatory clinics, chemotherapy or radiotherapy units, support groups, palliative care units or the patient's home were included. A three-step search strategy

  6. [Comparison of robotic surgery documentary in gynecological cancer].

    PubMed

    Vargas-Hernández, Víctor Manuel

    2012-01-01

    Robotic surgery is a surgical technique recently introduced, with major expansion and acceptance among the medical community is currently performed in over 1,000 hospitals around the world and in the management of gynecological cancer are being developed comprehensive programs for implementation. The objectives of this paper are to review the scientific literature on robotic surgery and its application in gynecological cancer to verify its safety, feasibility and efficacy when compared with laparoscopic surgery or surgery classical major surgical complications, infections are more common in traditional radical surgery compared with laparoscopic or robotic surgery and with these new techniques surgical and staying hospital are lesser than the former however, the disadvantages are the limited number of robot systems, their high cost and applies only in specialized centers that have with equipment and skilled surgeons. In conclusion robotic surgery represents a major scientific breakthrough and surgical management of gynecological cancer with better results to other types of conventional surgery and is likely in the coming years is become its worldwide.

  7. Quality of life research in endometrial cancer: what is needed to advance progress in this disease site? Methodological considerations from the Gynecologic Cancer InterGroup Symptom Benefit Working Group brainstorming session, Leiden 2012.

    PubMed

    McAlpine, Jessica N; Greimel, Elfriede; Brotto, Lori A; Nout, Remy A; Shash, Emad; Avall-Lundqvist, Elisabeth; Friedlander, Michael L; Joly, Florence

    2014-11-01

    Quality of life (QoL) in endometrial cancer (EC) is understudied. Incorporation of QoL questionnaires and patient-reported outcomes in clinical trials has been inconsistent, and the tools and interpretation of these measures are unfamiliar to most practitioners. In 2012, the Gynecologic Cancer InterGroup Symptom Benefit Working Group convened for a brainstorming collaborative session to address deficiencies and work toward improving the quality and quantity of QoL research in women with EC. Through literature review and international expert contributions, we compiled a comprehensive appraisal of current generic and disease site-specific QoL assessment tools, strengths and weaknesses of these measures, assessment of sexual health, statistical considerations, and an exploration of the unique array of histopathologic and clinical factors that may influence QoL outcomes in women with EC. This collaborative composition is the first publication specific to EC that addresses methodology in QoL research and the components necessary to achieve high quality QoL data in clinical trials. Future recommendations regarding (1) the incorporation of patient-reported outcomes in all clinical trials in EC, (2) definition of an a priori hypothesis, (3) utilization of validated tools and consideration of new tools corresponding to new therapies or specific symptoms, (4) publication within the same time frame as clinical outcome data, and (5) attempt to correct for disease site-specific potential confounders are presented. Improved understanding of methodology in QoL research and an increased undertaking of EC-specific QoL research in clinical trials are imperative if we are to improve outcomes in women with EC.

  8. Genetics of Breast and Gynecologic Cancers (PDQ®)—Health Professional Version

    Cancer.gov

    Expert-reviewed information summary about the genetics of breast and gynecologic cancers, including information about specific genes and family cancer syndromes. The summary also contains information about interventions that may influence the risk of developing breast and gynecologic cancers in individuals who may be genetically susceptible to these diseases. Psychosocial issues associated with genetic testing are also discussed.

  9. A Review of mTOR Pathway Inhibitors in Gynecologic Cancer

    PubMed Central

    Paulino, Eduardo; Garces, Álvaro Henrique Ingles

    2017-01-01

    The treatment of advanced gynecologic cancers remains palliative in most of cases. Although systemic treatment has entered into the era of targeted drugs the antitumor efficacies of current therapies are still limited. In this context there is a great need for more active treatment and rationally designed targeted therapies. The PI3K/AKT/mTOR is a signaling pathway in mammal cells that coordinates important cell activities. It has a critical function in the survival, growth, and proliferation of malignant cells and was object of important research in the last two decades. The mTOR pathway emerges as an attractive therapeutic target in cancer because it serves as a convergence point for many growth stimuli and, through its downstream substrates, controls cellular processes that contribute to the initiation and maintenance of cancer. Aberrant PI3K-dependent signaling occurs frequently in a wide range of tumor types, including endometrial, cervical, and ovarian cancers. The present study reviewed the available evidence regarding the potential impact of some mTOR pathway inhibitors in the treatment of gynecological cancer. Few advances in medical management have occurred in recent years in the treatment of advanced or recurrent gynecological malignancies, and a poor prognosis remains. Rationally designed molecularly targeted therapy is an emerging and important option in this setting; then more investigation in PI3K/AKT/mTOR pathway-targeted therapies is warranted. PMID:28286604

  10. Surgical site infection in women undergoing surgery for gynecologic cancer.

    PubMed

    Mahdi, Haider; Gojayev, Anar; Buechel, Megan; Knight, Jason; SanMarco, Janice; Lockhart, David; Michener, Chad; Moslemi-Kebria, Mehdi

    2014-05-01

    The objectives of this study were to describe the rate and predictors of surgical site infection (SSI) after gynecologic cancer surgery and identify any association between SSI and postoperative outcome. Patients with endometrial, cervical, or ovarian cancers from 2005 to 2011 were identified from the American College of Surgeons National Surgical Quality Improvement Program. The extent of surgical intervention was categorized into modified surgical complexity scoring (MSCS) system. Univariate and multivariate logistic regression analyses were used. Odds ratios were adjusted for patient demographics, comorbidities, preoperative laboratory values, and operative factors. Of 6854 patients, 369 (5.4%) were diagnosed with SSI. Surgical site infection after laparotomy was 3.5 times higher compared with minimally invasive surgery (7% vs 2%; P < 0.001). Among laparotomy group, independent predictors of SSI included endometrial cancer diagnosis, obesity, ascites, preoperative anemia, American Society of Anesthesiologists class greater than or equal to 3, MSCS greater than or equal to 3, and perioperative blood transfusion. Among laparoscopic cases, independent predictors of SSI included only preoperative leukocytosis and overweight. For patients with deep or organ space SSI, significant predictors included hypoalbuminemia, preoperative weight loss, respiratory comorbidities, MSCS greater than 4, and perioperative blood transfusion for laparotomy and only preoperative leukocytosis for minimally invasive surgery. Surgical site infection was associated with longer mean hospital stay and higher rate of reoperation, sepsis, and wound dehiscence. Surgical site infection was not associated with increased risk of acute renal failure or 30-day mortality. These findings were consistent in subset of patients with deep or organ space SSI. Seven percent of patients undergoing laparotomy for gynecologic malignancy developed SSI. Surgical site infection is associated with longer hospital

  11. Avoidance of small intestine injury in gynecologic cancer

    SciTech Connect

    Green, N.

    1983-09-01

    The evolution of systematized operative staging and radical surgical procedures in the management of gynecologic cancer has increased the complexities of integrating radiation therapy. High dose irradiation to large treatment volumes has been associated with an increased incidence of small intestine injury. This complication is morbid and often fatal. Although predisposing factors have been extensively studied, there has been a paucity of reports evaluating preventative measures. Between 1975 and 1980, 140 patients with gynecologic cancer were treated at the Valley Presbyterian Hospital in the Division of Radiation Therapy. Twenty-six patients with cervix cancer received definitive irradiation and seven received adjunct irradiation. Seventy-two with corpus cancer received adjunct irradiation, seven received definitive irradiation and three palliative irradiation. Eleven patients with ovarian cancer received adjunct irradiation and 15 palliative irradiation. Eight-five patients were at potential risk for small intestine injury and had treatment planning small intestine x rays. Fixation was observed in 7/39 (18%) without prior pelvic surgery and 30/46 (65%) with prior pelvic surgery. Information from the small intestine x rays were used in 41 patients to make 60 treatment modifications. Twenty-five of 140 (17%) had a reduction of total dose, 26/140 (18%) had exclusion of the small intestine by shrinking fields, or patient positioning and 13/140 (9%) had displacement of the small intestine by distension of the bladder. No patient developed small intestine injury. The disease free survival for cervix cancer 27/33 (82%), corpus cancer 68/79 (86%) and ovarian cancer 5/11 (45%).

  12. Genetic screening for gynecological cancer: where are we heading?

    PubMed

    Manchanda, Ranjit; Jacobs, Ian

    2016-01-01

    The landscape of cancer genetics in gynecological oncology is rapidly changing. The traditional family history-based approach has limitations and misses >50% mutation carriers. This is now being replaced by population-based approaches. The need for changing the clinical paradigm from family history-based to population-based BRCA1/BRCA2 testing in Ashkenazi Jews is supported by data that demonstrate population-based BRCA1/BRCA2 testing does not cause psychological harm and is cost effective. This article covers various genetic testing strategies for gynecological cancers, including population-based approaches, panel and direct-to-consumer testing as well as the need for innovative approaches to genetic counseling. Advances in genetic testing technology and computational analytics have facilitated an integrated systems medicine approach, providing increasing potential for population-based genetic testing, risk stratification, and cancer prevention. Genomic information along-with biological/computational tools will be used to deliver predictive, preventive, personalized and participatory (P4) and precision medicine in the future.

  13. Direct and Buffering Effects of Social Support among Gynecologic Cancer Survivors

    PubMed Central

    Carpenter, Kristen M.; Fowler, Jeffrey M.; Maxwell, G. Larry; Andersen, Barbara L.

    2013-01-01

    Background There are few studies of QoL among long-term gynecologic cancer survivors; available data suggest significant sequelae of disease and treatment. Research clarifying circumstances that improve difficult survivorship trajectories is lacking. Purpose The present study examines whether social support moderates the relationship between physical functioning and psychological outcomes by testing the stress-buffering hypothesis. Methods Participants (N=260) were gynecologic cancer survivors (cervical, n=47; endometrial, n=133; ovarian, n=69; vulvar, n=11). Compromised physical health was conceptualized as multidimensional. Social support (SNI, PSS-Fa, PSS-Fr, ISEL) was tested as a buffer of adverse psychological outcomes (IES-R, CES-D). Results Results for traumatic stress provided evidence for buffering; whereas social support was of general benefit for depressive symptoms. Effects varied by source/type of support. Conclusions These results suggest that circumstances for gynecologic cancer survivors burdened with physical symptoms may be worse for those with fewer support resources, providing needed insight into a common target of psychosocial interventions for cancer survivors. PMID:20151235

  14. Clinical practice recommendations for quality of life assessment in patients with gynecological cancer.

    PubMed

    Leppert, Wojciech; Gottwald, Leszek; Forycka, Maria

    2015-12-01

    Quality of life (QoL) is a multidimensional concept regarding self-assessment of patients' situation. Quality of life has not been clearly defined up to date, although it is clear that it is a subjective self-assessment that to a significant extent is determined by individual needs, beliefs, values, attitudes, which are changing with time. Health-related QoL comprises basic dimensions such as patients' performance status, physical, emotional, and social functioning, symptoms of the disease and adverse effects of treatment, spiritual (God and existential) and other dimensions. In women, the ovary, cervical, corpus uterus, vagina and vulva cancers deteriorate QoL by disease progression and consequences of treatment, also in cancer survivors. Common symptoms include the genito-urinary system, the lower gastrointestinal tract and peripheral neuropathies induced by chemotherapy. In young women, QoL is impaired by infertility, sexual problems and menopause symptoms. An overview of QoL questionnaires used in oncology with special regard to patients with gynecological tumors was conducted. A screening tool for psychological state assessment of oncology patients (distress thermometer), the Edmonton Symptom Assessment System (ESAS) and modular approach of QoL assessment recommended by the EORTC (European Organization for the Research and Treatment of Cancer) were presented. Practical guidelines were proposed to assess appropriately QoL in patients with gynecological cancers who stay at in-patient gynecology units and those treated at home and in an ambulatory care setting.

  15. Clinical practice recommendations for quality of life assessment in patients with gynecological cancer

    PubMed Central

    Gottwald, Leszek; Forycka, Maria

    2015-01-01

    Quality of life (QoL) is a multidimensional concept regarding self-assessment of patients’ situation. Quality of life has not been clearly defined up to date, although it is clear that it is a subjective self-assessment that to a significant extent is determined by individual needs, beliefs, values, attitudes, which are changing with time. Health-related QoL comprises basic dimensions such as patients’ performance status, physical, emotional, and social functioning, symptoms of the disease and adverse effects of treatment, spiritual (God and existential) and other dimensions. In women, the ovary, cervical, corpus uterus, vagina and vulva cancers deteriorate QoL by disease progression and consequences of treatment, also in cancer survivors. Common symptoms include the genito-urinary system, the lower gastrointestinal tract and peripheral neuropathies induced by chemotherapy. In young women, QoL is impaired by infertility, sexual problems and menopause symptoms. An overview of QoL questionnaires used in oncology with special regard to patients with gynecological tumors was conducted. A screening tool for psychological state assessment of oncology patients (distress thermometer), the Edmonton Symptom Assessment System (ESAS) and modular approach of QoL assessment recommended by the EORTC (European Organization for the Research and Treatment of Cancer) were presented. Practical guidelines were proposed to assess appropriately QoL in patients with gynecological cancers who stay at in-patient gynecology units and those treated at home and in an ambulatory care setting. PMID:26848300

  16. Handling Sexuality Concerns in Women with Gynecological Cancer: Egyptian Nurse's Knowledge and Attitudes

    ERIC Educational Resources Information Center

    Mansour, Suzan E.; Mohamed, Hanan E.

    2015-01-01

    Sexuality is an important part of normal human functioning. Gynecological cancer diagnosis and treatment has devastating effect on Sexual issues. Study aim was to investigate Oncology Nurses knowledge and attitudes in Relation to Provision of Sexual Health Care to Women Diagnosed with Gynecological Cancer. The study setting was conducted at…

  17. Multi-disciplinary summit on genetics services for women with gynecologic cancers: A Society of Gynecologic Oncology White Paper.

    PubMed

    Randall, Leslie M; Pothuri, Bhavana; Swisher, Elizabeth M; Diaz, John P; Buchanan, Adam; Witkop, Catherine T; Bethan Powell, C; Smith, Ellen Blair; Robson, Mark E; Boyd, Jeff; Coleman, Robert L; Lu, Karen

    2017-08-01

    To assess current practice, advise minimum standards, and identify educational gaps relevant to genetic screening, counseling, and testing of women affected by gynecologic cancers. The Society of Gynecologic Oncology (SGO) organized a multidisciplinary summit that included representatives from the American College of Obstetricians and Gynecologists (ACOG), the American Society Clinical Oncology (ASCO), the National Society of Genetic Counselors (NSGC), and patient advocacy groups, BrightPink and Facing our Risk of Cancer Empowered (FORCE). Three subject areas were discussed: care delivery models for genetic testing, barriers to genetic testing, and educational opportunities for providers of genetic testing. The group endorsed current SGO, National Comprehensive Cancer Network (NCCN), and NSGC genetic testing guidelines for women affected with ovarian, tubal, peritoneal cancers, or DNA mismatch repair deficient endometrial cancer. Three main areas of unmet need were identified: timely and universal genetic testing for women with ovarian, fallopian tube, and peritoneal cancers; education regarding minimum standards for genetic counseling and testing; and barriers to implementation of testing of both affected individuals as well as cascade testing of family members. Consensus building among all stakeholders resulted in an action plan to address gaps in education of gynecologic oncology providers and delivery of cancer genetics care. Copyright © 2017. Published by Elsevier Inc.

  18. The role of antifibrinolytic agents in gynecologic cancer surgery.

    PubMed

    Celebi, Nalan; Celebioglu, Bilge; Selcuk, Mehtap; Canbay, Ozgur; Karagoz, Ayse H; Aypar, Ulku

    2006-05-01

    To compare the effects of crystalloid and colloid solutions, tranexamic acid and epsilon-aminocaproic acid on the need for allogenic blood transfusion and on coagulation and fibrinolysis parameters. We conducted the study in the Anesthesiology and Reanimation Department of Hacettepe University Medical Faculty, Ankara, Turkey between March 2004 and April 2005. The study included 105 patients, classified by the American Society of Anesthesiology as physical status groups I-II, undergoing gynecologic cancer treatment. We divided them into 5 groups: group I (crystalloid) received crystalloid solutions, group II (colloid) received colloid solutions, group III (tranexamic acid) received 10 mg x kg(-1) tranexamic acid, and group 5 (epsilon-aminocaproic acid) received 100 mg x kg(-1) epsilon-aminocaproic acid. All patients bleeding amount was measured and recorded perioperatively, and at the 12th and 24th hours postoperatively. We then evaluated the patients' hemoglobin, hematocrit, activated thromboplastin time, international normalized ration, fibrinogen, and thrombocyte count and symptoms of pulmonary embolism. In comparing the amount of bleeding, the bleeding in the tranexamic acid group was 30.8% less than the crystalloid group (p<0.05), 33.3% less than the colloid group (p<0.05), and 23.9% less than the epsilon-aminocaproic acid group (p<0.05). When the negative effects of blood transfusions were considered, tranexamic acid administration can be recommended for decreasing the need for blood transfusion in gynecologic cancer surgery.

  19. Phytochemicals: A Multitargeted Approach to Gynecologic Cancer Therapy

    PubMed Central

    Oh, Se-Woong; Song, Yong Sang; Tsang, Benjamin K.

    2014-01-01

    Gynecologic cancers constitute the fourth most common cancer type in women. Treatment outcomes are dictated by a multitude of factors, including stage at diagnosis, tissue type, and overall health of the patient. Current therapeutic options include surgery, radiotherapy, and chemotherapy, although significant unmet medical needs remain in regard to side effects and long-term survival. The efficacy of chemotherapy is influenced by cellular events such as the overexpression of oncogenes and downregulation of tumor suppressors, which together determine apoptotic responses. Phytochemicals are a broad class of natural compounds derived from plants, a number of which exhibit useful bioactive effects toward these pathways. High-throughput screening methods, rational modification, and developments in regulatory policies will accelerate the development of novel therapeutics based on these compounds, which will likely improve overall survival and quality of life for patients. PMID:25093186

  20. Surgery for invasive gynecologic cancer in the elderly female population.

    PubMed

    Lawton, F G; Hacker, N F

    1990-08-01

    Radical, curative surgery may not be considered in elderly patients with gynecologic cancer, yet the morbidity for this population from radiotherapy and cytotoxics may be high. This study compared the feasibility and outcome of such surgery in 226 consecutive patients, 72 women over 70 years old and 154 younger patients, in our institution over a 26-month period. Older patients presented with more advanced-stage cancers and, as a group, had significantly poorer presurgical performance status and more intercurrent medical problems. Nevertheless, the planned radical surgical procedure could be carried out in 90% of elderly patients, with a postoperative mortality of 1.5%. Minor postoperative complication rates were similar for the two groups and, except for vulvectomy patients, the mean inpatient stay was the same for both groups. Chronological age alone is a poor determinant of surgical risk, and elderly patients withstand radical surgery almost as well as their younger counterparts.

  1. Assessment of Sexual Activity and Dysfunction in Medically Underserved Women with Gynecologic Cancers

    PubMed Central

    Bradford, Andrea; Fellman, Bryan; Urbauer, Diana; Gallegos, Jessica; Meaders, Kristen; Tung, Celestine; Ramondetta, Lois

    2015-01-01

    Background Sexual dysfunction is a common long-term side effect of treatments for gynecologic cancer. Studies of sexual problems in gynecologic cancer survivors overrepresent White non-Hispanic, highly educated, and married women. Less is known about the sexual health needs of women in medically underserved populations. We therefore conducted a study to characterize sexual activity and sexual function in this population. Methods We recruited patients attending two gynecologic oncology clinics in a large public healthcare system that primarily serves uninsured and low-income patients. Participants were invited to complete a one-time survey to assess sexual function, sexual communication, sexual distress, relationship adjustment, depression, anxiety, prior help-seeking and help-seeking preferences, and reasons for sexual inactivity. Data were analyzed using descriptive statistics and multivariate models to predict sexual activity status and sexual dysfunction. Results Among 243 participants, the majority (n=160, 65.8%) were not sexually active in the past 4 weeks, most often due to lack of a partner or lack of desire for sex. Just over one-fourth of sexually active participants were identified as likely cases of sexual dysfunction. Greater endorsement of depressive symptoms predicted both sexual inactivity and sexual dysfunction in multivariate analyses. Prior help-seeking for sexual problems was uncommon; however, a significant minority of participants expressed interest in receiving care for sexual problems. Conclusions Gynecologic cancer survivors in our medically underserved population have high rates of sexual inactivity and sexual dysfunction. Future research should identify feasible strategies to address barriers to sexual health care in low-resource settings. PMID:26325527

  2. The Lived Experience of Gynecologic Cancer Survivors in Taiwan.

    PubMed

    Tsai, Li-Yun; Wang, Kung-Liahng; Liang, Shu-Yuan; Tsai, Jung-Mei; Tsay, Shiow-Luan

    2017-10-12

    Although it is now possible to achieve permanent remission in a large percentage of gynecologic cancer (GC) cases, many GC patients in remission experience side effects or complications that influence their physical function and family relationships. Compared with other types of cancer patients, survivors of GC face greater challenges in terms of physical and psychological adaptations, and many of these do not receive sufficient assistance. An in-depth understanding of the lived experiences and demands of GC survivors is key to constructing comprehensive related healthcare services. The aim of this study was to understand the lived experience of GC survivors in Taiwan to help their return to a healthy life. This was a phenomenological study. Twenty-three survivors of GC participated in semistructured interviews that were held in a private environment. The transcripts were based on synchronous recordings from the interviews. Giorgi's phenomenology analysis was adopted for data analysis. Three themes with six subthemes were extracted from the data, including (a) the inner struggle of living with cancer and recurrence: repeatedly exploring the causes of cancer and treatment and facing a fear of cancer recurrence, (b) the interpretation and adjustment to cancer treatment: filled with fluctuating physical and mental distress and working to adopt a different perspective, and (c) the long passage of finding a desirable lifestyle: adjusting to long-term coexistence with side effects and realizing the strength of society, body, and mind. The journey of rehabilitation for GC survivors is very long. The participants in this study faced different respective challenges during the diagnosis, treatment, and adjustment phases. Conventional disease-oriented medical care cannot satisfy the requirements of cancer patients because of patient-decentralized services. Our results indicate that GC survivors face diverse problems, both physically and mentally. Healthcare professionals

  3. Evidence-based practice in the management of lower limb lymphedema after gynecological cancer.

    PubMed

    Iwersen, Lisandra Fossari; Sperandio, Fabiana Flores; Toriy, Ariana Machado; Palú, Marina; Medeiros da Luz, Clarissa

    2017-01-01

    Lower limb lymphedema (LLL) is characterized as a physical-functional chronic complication that impacts the quality of life of women who have gone through treatment for gynecological cancer. The present study aims to check the conservative treatments available for lymphedema after gynecological cancer in the context of evidence-based practice. The selection criteria included papers from May 1993 discussing treatment protocols used in LLL after treatment for gynecological cancer. The search was performed until October 2014 in MEDLINE, SciVerse, and PEDro using "rehabilitation," "treatment outcome," "therapeutics," "clinical protocol," "gynecologic surgery," "lower extremity," "lower limb," and "lymphedema" as keywords, focused on women with a previous diagnosis of gynecological cancer who received radiation and/or chemotherapy and/or surgery and/or lymphadenectomy as part of their treatment. From 110 studies found, 3 articles that used the complex decongestive therapy (CDT) as a treatment protocol were selected. There were no randomized clinical trials associated with the conservative treatment of LLL post-treatment of gynecological cancer. The three selected articles are retrospective, and had the same outcome - decreased volume of the affected limb lymphedema. Although LLL is more or as frequent and detrimental as upper limb lymphedema post-cancer treatment, there are only a few studies about this subject. Publications are even scarcer when considering studies with interventional approach. Randomized controlled trials are necessary to support rehabilitation resources on lymphedema post-gynecological cancer treatment.

  4. Women with Gynecologic Malignancies Have a Greater Incidence of Suicide than Women with Other Cancer Types

    ERIC Educational Resources Information Center

    Ward, Kristy K.; Roncancio, Angelica M.; Plaxe, Steven C.

    2013-01-01

    To evaluate risk of suicide of women with invasive gynecologic malignancies, the National Cancer Institute's Surveillance, Epidemiology, and End Results Program (1973-2007) was queried. Suicide per 100,000 women with gynecologic malignancies was compared with that of women with other malignancies; suicide was 30% more likely in those with…

  5. Women with Gynecologic Malignancies Have a Greater Incidence of Suicide than Women with Other Cancer Types

    ERIC Educational Resources Information Center

    Ward, Kristy K.; Roncancio, Angelica M.; Plaxe, Steven C.

    2013-01-01

    To evaluate risk of suicide of women with invasive gynecologic malignancies, the National Cancer Institute's Surveillance, Epidemiology, and End Results Program (1973-2007) was queried. Suicide per 100,000 women with gynecologic malignancies was compared with that of women with other malignancies; suicide was 30% more likely in those with…

  6. 6 Common Cancers - Gynecologic Cancers Cervical, Endometrial, and Ovarian

    MedlinePlus

    ... country this year from cancers of the female reproductive system. To avoid these cancers, it's important to understand ... deaths than any other cancer of the female reproductive system and is the leading cause of death from ...

  7. Development of the M. D. Anderson Cancer Center Gynecologic Applicators for the Treatment of Cervical Cancer: Historical Analysis

    SciTech Connect

    Yordy, John S.; Almond, Peter R.; Delclos, Luis

    2012-03-15

    Purpose: To provide historical background on the development and initial studies of the gynecological (gyn) applicators developed by Dr. Gilbert H. Fletcher, a radiation oncologist and chairperson from 1948 to 1981 of the department at the M.D. Anderson Hospital (MDAH) for Cancer Research in Houston, TX, and to acknowledge the previously unrecognized contribution that Dr. Leonard G. Grimmett, a radiation physicist and chairperson from 1949 to 1951 of the physics department at MDAH, made to the development of the gynecological applicators. Methods and Materials: We reviewed archival materials from the Historical Resource Center and from the Department of Radiation Physics at University of Texas M. D. Anderson Cancer Center, as well as contemporary published papers, to trace the history of the applicators. Conclusions: Dr. Fletcher's work was influenced by the work on gynecologic applicators in the 1940s in Europe, especially work done at the Royal Cancer Hospital in London. Those efforts influenced not only Dr. Fletcher's approach to the design of the applicators but also the methods used to perform in vivo measurements and determine the dose distribution. Much of the initial development of the dosimetry techniques and measurements at MDAH were carried out by Dr. Grimmett.

  8. Nutrition interventions in patients with gynecological cancers requiring surgery.

    PubMed

    Obermair, Andreas; Simunovic, Marko; Isenring, Liz; Janda, Monika

    2017-04-01

    Including developing countries, between 20 and 88% of gynecological oncology patients may present with at least mild malnutrition at diagnosis. Significant morbidity and mortality is attributed to malnutrition. Here we reviewed randomized clinical trials of nutritional interventions used to achieve early return to oral diet, enhance recovery from surgery and reduce adverse events in gynecological cancer patients undergoing surgery. Ebscohost (CINAHL+Medline+PsycINFO), Cochrane, Embase, PubMed and Scopus databases were searched for articles published from 2000 onwards. Potentially eligible articles were screened by two reviewers. Length of hospital stay (LOS), postoperative complications, recovery of intestinal function, quality of life (QOL), hematological and immunological parameters were outcome measures of the nutritional interventions. Seven randomized clinical trials were included in the review. Early clear liquid diet, semiliquid diet, regular diet or immune-enhanced enteral diets were all found to be safe as nutritional interventions. In five of the seven trials significantly better outcomes were observed in the intervention group compared to usual care for one of more of the outcomes intestinal recovery time, LOS, postoperative complications and immunological parameters. However, the nutritional interventions varied greatly between the trials, making it difficult to directly compare their findings. Trial quality was low to moderate. Recommended malnutrition screening and assessment tools and guidelines for treatment are reviewed. From the limited findings it would appear that nutritional interventions of early oral feeding and enteral feeding are safe. Receiving nutritional interventions seems to reduce LOS, intestinal recovery time and postoperative complications for some patients. Increasing use of neoadjuvant treatment may reduce the prevalence of patients presenting malnourished for surgery in the future. Crown Copyright © 2017. Published by Elsevier

  9. Ways of coping with stress and perceived social support in gynecologic cancer patients.

    PubMed

    Yilmaz, Sema Dereli; Bal, Meltem Demirgöz; Beji, Nezihe Kzlkaya; Arvas, Macit

    2015-01-01

    Stress is commonly encountered among cancer patients and may be a challenge affecting immune system resistance. Social support may contribute positively to the health of cancer patients, playing a role in coping with stress. The aim of this study was to determine whether ways of coping are related to social support given to women with gynecologic cancer. The study was performed as a cross-sectional design in a university hospital in Istanbul, Turkey, with 221 women with gynecologic cancer; the data were collected via 3 questionnaires, the first with sociodemographic and clinical features, the second with multidimensional scale of perceived social support, and the third with the scale of ways of coping with stress. Women with gynecologic cancer who were employed and declared their incomes as balanced and reported more years of education were more likely to perceive higher social support and to use the ineffective coping ways with stress at a lower rate (P < .05) than other participants. Based on correlational analysis, effective coping ways with stress increase as perceived social support from family, friends, significant other, and total increases (P < .05). Social support from family members is the mainstay of coping with stress by women with gynecologic cancer. Nurses are indispensable in increasing social support required by women with gynecologic cancer. Well-trained clinical nurses via in-service programs should be experienced and aware of women diagnosed with gynecologic cancer in need of social support during hospital visits and provide necessary guidance.

  10. Radiotherapy for gynecologic cancer in nonagenarian patients: a framework for new paradigms.

    PubMed

    Méry, Benoîte; Ndong, Sylvie Mengue; Guy, Jean-Baptiste; Assouline, Avi; Falk, Alexander T; Valeille, Anaïs; Trone, Jane-Chloé; Rivoirard, Romain; Auberdiac, Pierre; Vallard, Alexis; Espenel, Sophie; Moriceau, Guillaume; Collard, Olivier; Bosacki, Claire; Jacquin, Jean-Philippe; de Laroche, Guy; Fournel, Pierre; Chargari, Cyrus; Magné, Nicolas

    2016-05-09

    No consensus exists regarding the role of radiotherapy in the management of gynecologic cancer in nonagenarian patients. We retrospectively reviewed the outcomes of 19 consecutive nonagenarian patients with gynecologic cancer (6 endometrial cancers, 6 cervical cancers, 4 vulvar cancers, and 3 vaginal cancers) who were treated with radiotherapy. Radiotherapy was performed mainly in a palliative setting (n = 12; 63.2%), with a median dose of 45 Gy (range, 6-76 Gy). Infrequent major acute or late toxicities were reported. Among 19 patients, 9 (47.4%) experienced tumor progression, 5 (26.3%) experienced complete response, 2 (10.5%) experienced stable disease and/or partial response. At last follow-up, 12 patients (63.2%) had died; most deaths (n = 9) occurred because of the cancer. These results suggest that radiotherapy is feasible in the treatment of nonagenarian patients with gynecologic cancer.

  11. [Awareness of cervical cancer prevention among patients of gynecological outpatient clinic].

    PubMed

    Ulman-Włodarz, Izabela; Nowosielski, Krzysztof; Romanik, Małgorzata; Pozowski, Janusz; Jurek, Marzena

    2011-01-01

    Improvement of cervical cancer statistics in Poland is believed to be one of the main goals of all medical services. Cervical cancer is an easily preventable neoplasm thus effective strategies for its prophylaxis should be proposed and introduced to the whole population of Polish citizens. The aim of the study was to measure the extent of knowledge of females about cervical cancer and its prevention. 250 female patients of gynecological clinic at the Medical Centre in Krakow, Poland, aged 18-60, were included into the retrospective study The research was based on an original questionnaire designed by the authors containing questions concerning general socio-epidemiological status, as well as cervical cancer epidemiology and HPV infection prevention methods. The majority of respondents (68%) rated their knowledge on cervical cancer prevention strategies as medium. The main sources of information on that prophylaxis were: women's magazines (59% of respondents), media (47%) and Internet (38%). Additionally only one in three women acquired that information from gynecologist The main reason for performing the Pap smear test was the request of the respondent (43% of cases). Only 3% of them attended the test as a result of a personal invitation sent by National Health Service. The main reasons for not attending Pap smear test were: fear of pain (39%), lack of any symptoms (18%), carelessness (15%) and embarrassment (12%). 1. Knowledge on HPV infections and cervical cancer prevention among women attending gynecological outpatient clinic is insufficient. 2. Education, especially in the field of cervical cancer main risk factors as well as the course of pap smear collection, seems to be necessary in order to reduce the cervical cancer morbidity and the fear of performing pap smear tests.

  12. Woman to woman: a peer to peer support program for women with gynecologic cancer.

    PubMed

    Moulton, Arden; Balbierz, Amy; Eisenman, Stephanie; Neustein, Elizabeth; Walther, Virginia; Epstein, Irwin

    2013-01-01

    Gynecologic cancer has significant emotional and psychosocial implications for patients and their families. This article describes the origin and implementation of a peer to peer support program providing emotional support and information to women in treatment for gynecologic cancer and their families, in collaboration with medical and social work staff in a large, urban medical center. A formative evaluation of the program is included which suggests program participants view the program as a helpful source of support throughout treatment.

  13. Pelvic floor disorders and sexual function in gynecologic cancer survivors: a cohort study

    PubMed Central

    Rutledge, Teresa L.; Heckman, Seth R.; Qualls, Clifford; Muller, Carolyn Y.; Rogers, Rebecca G.

    2017-01-01

    OBJECTIVE The purpose of this study was to assess the prevalence of pelvic floor disorders and sexual function in survivors of gynecologic cancer. STUDY DESIGN We surveyed survivors of gynecologic cancer (survivors) and women seeking gynecologic care (control patients) who were >30 years old. All survivors were disease- and treatment-free for ≥ 1 year. Validated questionnaires were used to evaluate pelvic floor disorders. RESULTS One hundred eight control patient and 260 survivor questionnaires were completed. A high prevalence of pelvic floor disorders was observed in both groups; 56% of control subjects and 70% of survivors reported moderate-to-severe urinary incontinence (P > .05). Survivors were more likely to experience fecal incontinence (42% vs 32%; P = .02). Survivors reported less sexual desire (P = .04) and less ability to climax (P = .04), despite no difference in dyspareunia. CONCLUSION Fecal incontinence and sexual dysfunction are significant problems in survivors of gynecologic cancer. PMID:20869691

  14. How patients with gynecological cancer experience the information process.

    PubMed

    Carlsson, M E; Strang, P M

    1998-12-01

    This qualitative study was designed to explore the kind of experiences women with a diagnosis of gynecological cancer have with regard to information given during their illness and how it could be improved. Data were collected through a semistructured interview which focused on the 24 women's experiences of the information given. The interviews were tape-recorded and transcribed verbatim for each participant, and analysed using a content analysis. Two main themes were revealed: to actively address questions, and the right to receive honest information. The results also include a short description on how information was offered, the patients' opinion of it and how the patients had sought information for themselves. When patients address questions they want honest answers. Some effort should also be made to identify patients who do not want information. If it is in accordance with the patient's and next-of-kin's wishes, efforts should be made to provide information at times when both can participate. Information given jointly to the patient and her family lessens the burden for the patient. In Sweden today, as a result of recent political decisions, caregivers must also consider the need to discuss economic issues.

  15. Morbidity and mortality in gynecological cancers among first- and second-generation immigrants in Sweden.

    PubMed

    Mousavi, Seyed Mohsen; Sundquist, Kristina; Hemminki, Kari

    2012-07-15

    We studied the effect of new environment on the risk in and mortality of gynecological cancers in first- and second-generation immigrants in Sweden. We used the nationwide Swedish Family-Cancer Database to calculate standardized incidence/mortality ratios (SIRs/SMRs) of cervical, endometrial and ovarian cancers among immigrants in comparison to the native Swedes. Risk of cervical cancer increased among first-generation immigrants with Danish (SIR = 1.64), Norwegian (1.33), former Yugoslavian (1.21) and East European (1.35) origins, whereas this risk decreased among Finns (0.88) and Asians (SIRs varies from 0.11 in Iranians to 0.54 in East Asians). Risk of endometrial (SIRs varies from 0.28 in Africans to 0.86 in Finns) and ovarian (SIRs varies from 0.23 in Chileans to 0.82 in Finns) cancers decreased in first-generation immigrants. The overall gynecological cancer risk for the second-generation immigrants, independent of the birth region, was almost similar to that obtained for the first generations. The birth region-specific SMRs of gynecological cancers in first- and second-generation immigrants co-varied with the SIRs. Risk of gynecological cancers among the first-generation immigrants is similar to that in their original countries, except for cervical cancer among Africans and endometrial cancer among North Americans and East Europeans. Our findings show that risk and mortality of gynecological cancers observed in the first-generation immigrants remain in the second generation. We conclude that the risk and protective factors of gynecological cancers are preserved upon immigration and through generations, suggesting a role for behavioral factors or familial aggregation in the etiology of these diseases.

  16. Diabetes mellitus and gynecologic cancer: molecular mechanisms, epidemiological, clinical and prognostic perspectives.

    PubMed

    Vrachnis, Nikolaos; Iavazzo, Christos; Iliodromiti, Zoe; Sifakis, Stavros; Alexandrou, Andreas; Siristatidis, Charalambos; Grigoriadis, Charalambos; Botsis, Dimitrios; Creatsas, George

    2016-02-01

    Diabetes mellitus, the prevalence of which has increased dramatically worldwide, may put patients at a higher risk of cancer. The aim of our study is the clarification of the possible mechanisms linking diabetes mellitus and gynecological cancer and their epidemiological relationship. This is a narrative review of the current literature, following a search on MEDLINE and the Cochrane Library, from their inception until January 2012. Articles investigating gynecologic cancer (endometrial, ovarian, and breast) incidence in diabetic patients were extracted. The strong evidence for a positive association between diabetes mellitus and the risk for cancer indicates that energy intake in excess to energy expenditure, or the sequelae thereof, is involved in gynecological carcinogenesis. This risk may be further heightened by glucose which can directly promote the production of tumor cells by functioning as a source of energy. Insulin resistance accompanied by secondary hyperinsulinemia is hypothezised to have a mitogenic effect. Steroid hormones are in addition potent regulators of the balance between cellular differentiation, proliferation, and apoptosis. Inflammatory pathways may also be implicated, as a correlation seems to exist between diabetes mellitus and breast or endometrial carcinoma pathogenesis, although an analogous correlation with ovarian carcinoma is still under investigation. Antidiabetic agents have been correlated with elevated cancer risk, while metformin seems to lower the risk. Diabetes mellitus is associated with an elevation in gynecologic cancer risk. Moreover, there are many studies exploring the prognosis of patients with diabetes and gynecological cancer, the outcome and the overall survival in well-regulated patients.

  17. Women's poorer satisfaction with their sex lives following gynecologic cancer treatment.

    PubMed

    Lara, Lucia Alves Silva; de Andrade, Jurandyr Moreira; Consolo, Flavio Donaire; Romão, Adriana Peterson Mariano Salata

    2012-06-01

    Gynecologic cancer treatment can lead to anatomical changes in the genitalia that may impair sexual response. As a result, the authors aimed to assess women's self-perceptions of their sex lives following gynecologic cancer treatment and the impact of such treatment on sexual function. Thirty sexually active women were examined. At the first meeting with a physician sex therapist, women were asked about their satisfaction with their sexual activities prior to and after gynecologic cancer treatment, either with a partner or alone, and how many times per month they had sexual intercourse prior to the cancer diagnosis and after treatment. Women reported significantly worse sex lives and a significantly lower frequency of sexual relations following cancer treatment. All participants reported pain on vaginal penetration and feeling uncomfortable in discussing their sexual difficulties with the oncologist. The findings show that women experienced impaired sexual function, as well as poorer quality of sexual function, following gynecologic cancer treatment. Nurses should provide basic guidelines about sexual function to all patients who undergo treatment for gynecologic cancer.

  18. A national initiative for women and healthcare providers: CDC's Inside Knowledge: Get the Facts About Gynecologic Cancer campaign.

    PubMed

    Rim, Sun Hee; Polonec, Lindsey; Stewart, Sherri L; Gelb, Cynthia A

    2011-11-01

    The Inside Knowledge: Get the Facts About Gynecologic Cancer campaign raises awareness of the five main types of gynecologic cancer: cervical, ovarian, uterine, vaginal, and vulvar. It encourages women to pay attention to their bodies and know what is normal for them so they can recognize the warning signs of gynecologic cancers and seek medical care. This report provides an overview of the development of this national campaign.

  19. Process of coping with intracavity radiation treatment for gynecologic cancer

    SciTech Connect

    Nail, L.M.D.

    1985-01-01

    The purpose of this study was to describe the process of coping with the experience of receiving intracavity radiation treatment (ICR) for gynecologic cancer. Data were collected on the outcomes of coping, emotion (Profile of Mood States) and level of function (Sickness Impact Profile), and symptom severity and upset the evening before, during, the day after, and 1 to 2 weeks after treatment. The subjects (N = 28) had a mean age of 52 years, 39% were employed full-time, 56% had occupations as manual workers, 57% had completed 12 or more years of education, and 68% were married or widowed. The treatment required the subjects to be hospitalized on complete bedrest with radiation precautions for an average of 48 hours. Intrauterine devices were used to treat 18 subjects and vaginal applications were used to treat 10 subjects. Negative mood and level of disruption in function were generally low. Repeated measures ANOVA showed no change in negative mood over time while the change in function was attributable to the increase in disruption during treatment. Utilization of affective coping strategies and problem-oriented coping strategies was positively correlated with negative mood and disruption in function over the points of measurement. The results indicate that subjects tolerated ICR well and rapidly resumed usual function following discharge from the hospital, despite the persistence of some symptoms 1 to 2 weeks after treatment. The positive association between the utilization of coping strategies and negative outcomes of coping suggests a need to examine the measurement of coping strategies and consider the possibility that these actions represent a response to a stressful situation rather than a method of dealing with the situation.

  20. A clinical analysis of brain metastasis in gynecologic cancer: a retrospective multi-institute analysis.

    PubMed

    Kim, Young Zoon; Kwon, Jae Hyun; Lim, Soyi

    2015-01-01

    This study analyzes the clinical characteristics of the brain metastasis (BM) of gynecologic cancer based on the type of cancer. In addition, the study examines the factors influencing the survival. Total 61 BM patients of gynecologic cancer were analyzed retrospectively from January 2000 to December 2012 in terms of clinical and radiological characteristics by using medical and radiological records from three university hospitals. There were 19 (31.1%) uterine cancers, 32 (52.5%) ovarian cancers, and 10 (16.4%) cervical cancers. The mean interval to BM was 25.4 months (21.6 months in ovarian cancer, 27.8 months in uterine cancer, and 33.1 months in cervical cancer). The mean survival from BM was 16.7 months (14.1 months in ovarian cancer, 23.3 months in uterine cancer, and 8.8 months in cervical cancer). According to a multivariate analysis of factors influencing survival, type of primary cancer, Karnofsky performance score, status of primary cancer, recursive partitioning analysis class, and treatment modality, particularly combined therapies, were significantly related to the overall survival. These results suggest that, in addition to traditional prognostic factors in BM, multiple treatment methods such as neurosurgery and combined chemoradiotherapy may play an important role in prolonging the survival for BM patients of gynecologic cancer.

  1. New Targeted Agents in Gynecologic Cancers: Synthetic Lethality, Homologous Recombination Deficiency, and PARP Inhibitors.

    PubMed

    Liu, Fong W; Tewari, Krishnansu S

    2016-03-01

    Inhibitors of poly (ADP-ribose) polymerase (PARP) have emerged as a new class of anti-cancer drugs, specifically for malignancies bearing aberrations of the homologous recombination pathway, like those with mutations in the BRCA 1 and BRCA 2 genes. Olaparib, a potent PARP1 and PARP2 inhibitor, has been shown to significantly increase progression-free survival (PFS) in women with recurrent ovarian cancer related to a germline BRCA mutation and is currently approved fourth-line treatment in these patients. PARP inhibitors (PARPi) target the genetic phenomenon known as synthetic lethality to exploit faulty DNA repair mechanisms. While ovarian cancer is enriched with a population of tumors with known homologous recombination defects, investigations are underway to help identify pathways in other gynecologic cancers that may demonstrate susceptibility to PARPi through synthetically lethal mechanisms. The ARIEL2 trial prospectively determined a predictive assay to identify patients with HRD. The future of cancer therapeutics will likely incorporate these HRD assays to determine the best treatment plan for patients. While the role of PARPi is less clear in non-ovarian gynecologic cancers, the discovery of a predictive assay for HRD may open the door for clinical trials in these other gynecologic cancers enriched with patients with HRD. Identification of patients with tumors deficient in homologous repair or have HRD-like behavior moves cancer treatment towards individualized therapies in order to maximize treatment effect and quality of life for women living with gynecologic cancers.

  2. [Clinical evaluation of ureteral stenting for managing extrinsic ureteral obstruction due to gynecological and gastrointestinal cancer].

    PubMed

    Takehara, Kosuke; Onita, Toru; Mochizuki, Yasushi; Miyata, Yasuyoshi; Igawa, Tsukasa; Sakai, Hideki

    2014-01-01

    We retrospectively reviewed patients who were treated with an indwelling ureteral stent to manage extrinsic ureteral obstruction due to advanced gynecological and gastrointestinal cancers. A total of 34 patients, including 17 with gynecological cancer and 17 with gastrointestinal cancer, underwent a successful initial ureteral stent placement from January 2007 to December 2011. Functional ureteral stent failures, which required percutaneous nephrostomy within 3 months after initial ureteral stenting, occurred in 14 of the 34 patients (41%) during follow-up. The risk factors of functional ureteral stent failure were bilateral ureteral obstruction, elevated serum creatinine level, poor performance status, subsequent therapy for primary cancer after ureteral stent placement, presence of peritonitis carcinomatosa, and gastrointestinal cancer. Patients with gastrointestinal cancer had a higher rate of stent failure than did those with gynecological cancer (p = 0.01). Median survival from the diagnosis of hydronephrosis for patients with gastrointestinal and gynecological cancers was 9 and 23 months, respectively (p = 0. 02). Retrograde ureteral stenting is a useful treatment for malignant ureteral obstruction. However, patients with gastrointestinal cancer had a high stent failure rate and a short survival time from the diagnosis of hydronephrosis. Indications for retrograde ureteral stenting for malignant ureteral obstruction should be carefully considered while taking into account stent failure risk, patient prognosis and quality of life.

  3. Clinical research education study teams: a research curriculum for obstetric and gynecology residents.

    PubMed

    Brubaker, Linda; Kenton, Kimberly

    2011-06-01

    Research education is a requirement for obstetrics and gynecology residents. Most obstetrics and gynecology residencies struggle with barriers to efficient, effective research education and productivity for their residents. These barriers include constraints on faculty time, lack of intrinsic desire within individual residents, and lack of relevant outcome measures. We developed an efficient, novel research education curriculum that overcomes many of these barriers and provides obstetrics and gynecology residents with a structured format that maximizes the likelihood of a successful, positive research experience. Since the start of the Clinical Research Education Study Team program, the graduating resident cohorts reliably complete and present prospective research projects, including three registered randomized trials. Residency-wide support for other team research has grown dramatically. The residents' work was acknowledged with several research awards, which further reinforces the positive perception of the program. The certainty of completion of their research requirement relieved our residents of the anxiety commonly reported by residents nearing graduation. The Clinical Research Education Study Team program's team design makes efficient use of faculty time. In addition, Clinical Research Education Study Team mentors also have incorporated junior faculty members who wish to improve their own research education skills. We offer our experience with this program in hopes that it may be of value to other programs that wish to improve their resident research education curriculum. It remains important for residents to acquire research skills before continuing into practice or fellowship. The Clinical Research Education Study Team program facilitates this education in an efficient, organized manner.

  4. Maintaining Sexual Health throughout Gynecologic Cancer Survivorship: A Comprehensive Review and Clinical Guide

    PubMed Central

    Huffman, Laura B.; Hartenbach, Ellen M.; Carter, Jeanne; Rash, Joanne K.; Kushner, David M.

    2016-01-01

    Objective The diagnosis and treatment of gynecologic cancer can cause short- and long-term negative effects on sexual health and quality of life (QoL). The aim of this article is to present a comprehensive overview of the sexual health concerns of gynecologic cancer survivors and discuss evidence-based treatment options for commonly encountered sexual health issues. Methods A comprehensive literature search of English language studies on sexual health in gynecologic cancer survivors and the treatment of sexual dysfunction was conducted in MEDLINE databases. Relevant data are presented in this review. Additionally, personal and institutional practices are incorporated where relevant. Results Sexual dysfunction is prevalent among gynecologic cancer survivors as a result of surgery, radiation, and chemotherapy--negatively impacting QoL. Many patients expect their healthcare providers to address sexual health concerns, but most have never discussed sex-related issues with their physician. Lubricants, moisturizers, and dilators are effective, simple, non-hormonal interventions that can alleviate the morbidity of vaginal atrophy, stenosis, and pain. Pelvic floor physical therapy can be an additional tool to address dyspareunia. Cognitive behavioral therapy has been shown to be beneficial to patients reporting problems with sexual interest, arousal, and orgasm. Conclusion Oncology providers can make a significant impact on the QoL of gynecologic cancer survivors by addressing sexual health concerns. Simple strategies can be implemented into clinical practice to discuss and treat many sexual issues. Referral to specialized sexual health providers may be needed to address more complex problems. PMID:26556768

  5. Coping and Communication-Enhancing Intervention versus Supportive Counseling for Women Diagnosed with Gynecological Cancers

    ERIC Educational Resources Information Center

    Manne, Sharon L.; Rubin, Stephen; Edelson, Mitchell; Rosenblum, Norman; Bergman, Cynthia; Hernandez, Enrique; Carlson, John; Rocereto, Thomas; Winkel, Gary

    2007-01-01

    This study compared the efficacy of 2 psychological interventions, a coping and communication-enhancing intervention (CCI) and supportive counseling (SC), in reducing depressive symptoms and cancer-specific distress of women diagnosed with gynecological cancer. Demographic, medical, and psychological moderators of intervention effects were…

  6. Genetics of Breast and Gynecologic Cancers (PDQ®)—Health Professional Version

    Cancer.gov

    Expert-reviewed information summary about the genetics of breast and gynecologic cancers, including information about specific genes and family cancer syndromes. The summary also contains information about interventions that may influence the risk of developing breast and Psychosocial issues associated with genetic testing are also discussed.

  7. Leveraging immunotherapy for the treatment of gynecologic cancers in the era of precision medicine.

    PubMed

    Zamarin, Dmitriy; Jazaeri, Amir A

    2016-04-01

    During the past decade significant progress in the understanding of stimulatory and inhibitory signaling pathways in immune cells has reinvigorated the field of immuno-oncology. In this review we outline the current immunotherapy based approaches for the treatment of gynecological cancers, and focus on the emerging clinical data on immune checkpoint inhibitors, adoptive cell therapies, and vaccines. It is anticipated that in the coming years biomarker-guided clinical trials, will provide for a better understanding of the mechanisms of response and resistance to immunotherapy, and guide combination treatment strategies that will extend the benefit from immunotherapy to patients with gynecologic cancers.

  8. Leveraging Immunotherapy for the treatment of Gynecologic Cancers in the Era of Precision Medicine

    PubMed Central

    Zamarin, Dmitriy; Jazaeri, Amir A.

    2016-01-01

    During the past decade significant progress in the understanding of stimulatory and inhibitory signaling pathways in immune cells has reinvigorated the field of immuno-oncology. In this review we outline the current immunotherapy based approaches for the treatment of gynecological cancers, and focus on the emerging clinical data on immune checkpoint inhibitors, adoptive cell therapies, and vaccines. It is anticipated that in the coming years biomarker-guided clinical trials, will provide for a better understanding of the mechanisms of response and resistance to immunotherapy, and guide combination treatment strategies that will extend the benefit from immunotherapy to patients with gynecologic cancers. PMID:27016233

  9. Gynecologic Cancer Translational Research Center of Excellence

    DTIC Science & Technology

    2012-01-01

    controlling for hysterectomy (9-11). However, African American women are about two times more likely to die from their disease than are Caucasians(11, 12...carcinoma. Am J Surg Pathol.35(5):625-32. PMCID: 3077471. 9. Sherman ME, Carreon JD, Lacey JV, Jr., Devesa SS. Impact of hysterectomy on endometrial

  10. Disparities in Use of Gynecologic Oncologists for Women with Ovarian Cancer in the United States

    PubMed Central

    Austin, Shamly; Martin, Michelle Y; Kim, Yongin; Funkhouser, Ellen M; Partridge, Edward E; Pisu, Maria

    2013-01-01

    Objective To examine disparities in utilization of gynecologic oncologists (GOs) across race and other sociodemographic factors for women with ovarian cancer. Data Sources Obtained SEER-Medicare linked dataset for 4,233 non-Hispanic White, non-Hispanic African American, Hispanic of any race, and Non-Hispanic Asian women aged ≥66 years old diagnosed with ovarian cancer during 2000–2002 from 17 SEER registries. Physician specialty was identified by linking data to the AMA master file using Unique Physician Identification Numbers. Study Design Retrospective claims data analysis for 1999–2006. Logistic regression models were used to analyze the association between GO utilization and race/ethnicity in the initial, continuing, and final phases of care. Principal Findings GO use decreased from the initial to final phase of care (51.4–28.8 percent). No racial/ethnic differences were found overall and by phase of cancer care. Women >70 years old and those with unstaged disease were less likely to receive GO care compared to their counterparts. GO use was lower in some SEER registries compared to the Atlanta registry. Conclusions GO use for the initial ovarian cancer treatment or for longer term care was low but not different across racial/ethnic groups. Future research should identify factors that affect GO utilization and understand why use of these specialists remains low. PMID:23206237

  11. Can we maximize both value and quality in gynecologic cancer care? A work in progress.

    PubMed

    Havrilesky, Laura J; Fountain, Cynthia

    2014-01-01

    Value is defined as desirable health outcomes achieved per monetary unit spent. Comparative effectiveness research and cost-effectiveness research are methods that have been developed to quantify effectiveness and value to inform management decisions. In this article we review the comparative and cost-effectiveness literature in the field of ovarian cancer treatment. Studies have shown that improved ovarian cancer survival is associated with complete primary surgical cytoreduction, with treatment at high volume facilities by subspecialist providers (gynecologic oncologists) and with National Comprehensive Cancer Network (NCCN) guideline-adherent care in both surgical staging and chemotherapy regimens. Intraperitoneal/intravenous chemotherapy (compared with intravenous alone) has been associated with improved survival and cost-effectiveness. Bevacizumab for primary and maintenance therapy has been found to not be cost-effective (even in selective subsets) despite a small progression-free survival (PFS) advantage. For platinum-sensitive recurrent ovarian cancer, secondary cytoreduction and platinum-based combinations are associated with improved overall survival (OS); several platinum-based combinations have also been found cost-effective. For platinum-resistant recurrence, single agent therapy and supportive care are cost-effective compared with combination therapies. Although little prospective clinical research has been done around end-of-life care, one study reported that for platinum-resistant ovarian cancer, palliative intervention would potentially reduce costs and increase quality adjusted life years compared with usual care (based on improvement in quality of life [QOL]). Overall, cost comparisons of individual chemotherapy regimens are highly dependent on market prices of novel therapeutic agents.

  12. Reliability and Validity of Amharic Version of EORTC QLQ-C 30 Questionnaire among Gynecological Cancer Patients in Ethiopia

    PubMed Central

    Ayana, Birhanu Abera; Negash, Shiferaw; Yusuf, Lukman; Tigeneh, Wendemagegnhu

    2016-01-01

    Background Cancer is a growing public health problem worldwide. The focus of cancer treatment, in addition to curation, is improving the quality of life (QOL). This study aimed to assess the reliability and validity of Amharic version of European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) among gynecological cancer patients in Ethiopia. Methods A facility-based cross-sectional study was conducted using the Amharic version of EORTC QLQ-C30 on 153 gynecological cancer patients in Tikur Anbassa Specialized Hospital (TASH), Addis Ababa, Ethiopia. Descriptive statistics, correlation analysis and multivariable linear regression were employed in statistical analysis. Results The Amharic version of EORTC QLQ-C30 had a Cronbach’s α value of 0.81. The internal consistency for each domain of EORTC QLQ-C30 was also acceptable (Cronbach’s α >0.7) except for cognitive function domain (Cronbach’s α = 0.29). Stepwise multivariable linear regression analysis showed that emotional functioning (p<0.001), fatigue (p<0.001) and social functioning (p = 0.004) were the determinative scales of EORTC QLQ-C30 on global health status (GHS). The clinical validity test (Known group validity) showed that there were significant differences in score for twelve out of 15 domains, between surgery and radiation scheduled patients. All items of emotional function, role function, fatigue, and GHS meet the discriminate validity criterion. Conclusion The Amharic version of EORTC QLQ-C30 found to be reliable and had an acceptable validity to assess the QOL for gynecological cancer patients. We recommend further work on the validity and responsiveness of the EORTC QLQ-C30 with stronger design. PMID:27304066

  13. Reliability and Validity of Amharic Version of EORTC QLQ-C 30 Questionnaire among Gynecological Cancer Patients in Ethiopia.

    PubMed

    Ayana, Birhanu Abera; Negash, Shiferaw; Yusuf, Lukman; Tigeneh, Wendemagegnhu; Haile, Demewoz

    2016-01-01

    Cancer is a growing public health problem worldwide. The focus of cancer treatment, in addition to curation, is improving the quality of life (QOL). This study aimed to assess the reliability and validity of Amharic version of European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) among gynecological cancer patients in Ethiopia. A facility-based cross-sectional study was conducted using the Amharic version of EORTC QLQ-C30 on 153 gynecological cancer patients in Tikur Anbassa Specialized Hospital (TASH), Addis Ababa, Ethiopia. Descriptive statistics, correlation analysis and multivariable linear regression were employed in statistical analysis. The Amharic version of EORTC QLQ-C30 had a Cronbach's α value of 0.81. The internal consistency for each domain of EORTC QLQ-C30 was also acceptable (Cronbach's α >0.7) except for cognitive function domain (Cronbach's α = 0.29). Stepwise multivariable linear regression analysis showed that emotional functioning (p<0.001), fatigue (p<0.001) and social functioning (p = 0.004) were the determinative scales of EORTC QLQ-C30 on global health status (GHS). The clinical validity test (Known group validity) showed that there were significant differences in score for twelve out of 15 domains, between surgery and radiation scheduled patients. All items of emotional function, role function, fatigue, and GHS meet the discriminate validity criterion. The Amharic version of EORTC QLQ-C30 found to be reliable and had an acceptable validity to assess the QOL for gynecological cancer patients. We recommend further work on the validity and responsiveness of the EORTC QLQ-C30 with stronger design.

  14. Gynecologic cancer screening and communication with health care providers in women with Lynch syndrome

    PubMed Central

    Burton-Chase, AM; Hovick, SR; Sun, CC; Boyd-Rogers, S; Lynch, PM; Lu, KH; Peterson, SK

    2014-01-01

    We evaluated knowledge of gynecologic cancer screening recommendations, screening behaviors, and communication with providers among women with Lynch syndrome (LS). Women aged ≥25 years who were at risk for LS-associated cancers completed a semi-structured interview and a questionnaire. Of 74 participants (mean age 40 years), 61% knew the appropriate age to begin screening, 75–80% correctly identified the recommended screening frequency, and 84% reported no previous screening endometrial biopsy. Women initiated discussions with their providers about their LS cancer risks, but many used nonspecific terms or relied on family history. Most were not offered high-risk screening options. While many women were aware of risk-appropriate LS screening guidelines, adherence was suboptimal. Improving communication between women and their providers regarding LS-related gynecologic cancer risk and screening options may help improve adherence. PMID:23906188

  15. Can surgical management of bone metastases improve quality of life among women with gynecologic cancer?

    PubMed

    Ji, Tao; Eskander, Ramez; Wang, Yifei; Sun, Kunkun; Hoang, Bang H; Guo, Wei

    2014-08-05

    The evaluation, counseling, and management of gynecologic patients with bone metastasis remain a challenge for clinicians. In order to critically evaluate the role of surgery, we retrospectively analyzed the records of 18 patients surgically treated for metastatic gynecologic tumors of bone, focusing on quality of life, local tumor control, and survival. Eighteen patients underwent surgical procedures for the treatment of bone metastases secondary to gynecologic cancer between September 2003 and April 2012. The primary cancer sites included the uterus (n = 10), the cervix (n = 5), and an ovary (n = 3). Patients were followed for an average period of 13.8 months (range, 2 to 34 months). A visual analog pain scale (VAS) and Eastern Cooperative Oncology Group (ECOG) performance status were evaluated both pre- and postoperatively. The median survival time following diagnosis of bone metastasis was 10.0 months. The mean VAS score was 5.8 preoperatively compared with 2.1, 3 months after surgery. The mean pre and postoperative ECOG performance status grades were 3.1 and 2.3, respectively. The prognosis of gynecological cancer patients with bone metastasis is poor. Some patients had improvement in their quality of life after surgical intervention for bone metastases; however, novel integrated treatment modalities should be investigated.

  16. Gynecologic Cancer InterGroup (GCIG) consensus review for cervical adenocarcinoma.

    PubMed

    Fujiwara, Hiroyuki; Yokota, Harushige; Monk, Bradley; Treilleux, Isabelle; Devouassoux-Shisheboran, Mojgan; Davis, Alison; Kim, Jae-Weon; Mahner, Sven; Stany, Michael; Pignata, Sandro; Ray-Coquard, Isabelle; Fujiwara, Keiichi

    2014-11-01

    Cervical adenocarcinoma is known to be less common than squamous cell carcinoma of the cervix comprising approximately 25% of all cervical carcinomas. Differences in associated human papillomavirus types, patterns of spread, and prognosis call for treatments that are not always like those for squamous cancers. In this review, we report a consensus developed by the Gynecologic Cancer InterGroup surrounding cervical adenocarcinoma for epidemiology, pathology, treatment, and unanswered questions. Prospective clinical trials are needed to help develop treatment guidelines.

  17. A pilot study using the Gynecologic Cancer Lymphedema Questionnaire (GCLQ) as a clinical care tool to identify lower extremity lymphedema in gynecologic cancer survivors.

    PubMed

    Carter, Jeanne; Raviv, Leigh; Appollo, Kathleen; Baser, Raymond E; Iasonos, Alexia; Barakat, Richard R

    2010-05-01

    This study aimed to determine the feasibility and efficacy of using the Gynecologic Cancer Lymphedema Questionnaire (GCLQ) as a symptom scale for lymphedema of the lower extremity (LLE). Twenty-eight gynecologic cancer survivors with documented LLE and 30 without a history or presence of lymphedema completed the GCLQ and provided feedback about their satisfaction with and feasibility of using the GCLQ at their oncology follow-ups. The study survey took approximately 5-10 min to complete, and it was easily understood by the majority of the sample. Participants had a mean age of 59.6 years (range, 28-80 years). Twenty-eight women (48%) had LLE, and 30 (52%) had no history or presence of LLE (confirmed by limb volume [LV] measurements at assessment). Type of cancer history included endometrial, 38 (66%); cervical, 13 (22%); and vulvar, 7 (12%). GCLQ scores differed significantly by lymphedema diagnosis; LLE patients had higher scores (P<0.01). The large area under the curve (AUC) of 0.95 (95% CI: 0.90-1.000) suggests that the GCLQ can distinguish between patients with and without LLE. Although all 28 (100%) of the LLE patients were aware of their LLE diagnosis, only 23 (82%) underwent treatment. The GCLQ was easily understood by most (55/58, 95%), and overall, patients showed a high willingness (56/58, 96%) to complete the questionnaire at future appointments. Twenty-five (88%) of the LLE patients found the GCLQ to be helpful in identifying symptoms of lymphedema. The GCLQ effectively distinguished between gynecologic cancer survivors with and those without LLE, with good sensitivity and specificity. The patients, particularly those with LLE, showed high confidence in the GCLQ's ability to detect LLE symptoms. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  18. A Pilot Study Using the Gynecologic Cancer Lymphedema Questionnaire (GCLQ) as a Clinical Care Tool to Identify Lower Extremity Lymphedema in Gynecologic Cancer Survivors

    PubMed Central

    Carter, Jeanne; Raviv, Leigh; Appollo, Kathleen; Baser, Raymond E.; Iasonos, Alexia; Barakat, Richard R.

    2016-01-01

    Objective To determine the feasibility and efficacy of using the Gynecologic Cancer Lymphedema Questionnaire (GCLQ) as a symptom scale for lymphedema of the lower extremity (LLE). Methods Twenty-eight gynecologic cancer survivors with documented LLE and 30 without a history or presence of lymphedema completed the GCLQ and provided feedback about their satisfaction with and feasibility of using the GCLQ at their oncology follow-ups. The study survey took approximately 5–10 minutes to complete, and it was easily understood by the majority of the sample. Results Participants had a mean age of 59.6 years (range, 28–80 years). Twenty-eight women (48%) had LLE and 30 (52%) had no history or presence of LLE (confirmed by limb volume [LV] measurements at assessment). Type of cancer history included: endometrial, 38 (66%); cervical, 13 (22%); and vulvar, 7 (12%). GCLQ scores differed significantly by lymphedema diagnosis; LLE patients had higher scores (P<0.01). The large area under the curve (AUC) of 0.95 (95% CI: 0.90–1.000) suggests that the GCLQ can distinguish between patients with and without LLE. Although all 28 (100%) of the LLE patients were aware of their LLE diagnosis, only 23 (82%) underwent treatment. The GCLQ was easily understood by most (55/58, 95%); and overall, patients showed a high willingness (56/58, 96%) to complete the questionnaire at future appointments. Twenty-five (88%) of the LLE patients found the GCLQ to be helpful in identifying symptoms of lymphedema. Conclusions The GCLQ effectively distinguished between gynecologic cancer survivors with and those without LLE, with good sensitivity and specificity. The patients, particularly those with LLE, showed high confidence in the GCLQ’s ability to detect LLE symptoms. PMID:20163847

  19. Challenges in the Gynecologic Care of Premenopausal Women With Breast Cancer

    PubMed Central

    Bakkum-Gamez, Jamie N.; Laughlin, Shannon K.; Jensen, Jani R.; Akogyeram, Clement O.; Pruthi, Sandhya

    2011-01-01

    Premenopausal women with a new diagnosis of breast cancer are faced with many challenges. Providing health care for issues such as gynecologic comorbidities, reproductive health concerns, and vasomotor symptom control can be complicated because of the risks of hormone treatments and the adverse effects of adjuvant therapies. It is paramount that health care professionals understand and be knowledgeable about hormonal and nonhormonal treatments and their pharmacological parameters so they can offer appropriate care to women who have breast cancer, with the goal of improving quality of life. Articles for this review were identified by searching the PubMed database with no date limitations. The following search terms were used: abnormal uterine bleeding, physiologic sex steroids, endometrial ablation, hysteroscopic sterilization, fertility preservation in endometrial cancer, tranexamic acid and breast cancer, menorrhagia treatment and breast cancer, abnormal uterine bleeding and premenopausal breast cancer, levonorgestrel IUD and breast cancer, tamoxifen and gynecologic abnormalities, tamoxifen metabolism, hormones and breast cancer risk, contraception and breast cancer, pregnancy and breast cancer, and breast cancer and infertility treatment. PMID:21307388

  20. Improving care for women after gynecological cancer: the development of a sexuality clinic.

    PubMed

    Barbera, Lisa; Fitch, Margaret; Adams, Lauran; Doyle, Catherine; Dasgupta, Tracey; Blake, Jennifer

    2011-12-01

    The impact of a gynecological cancer diagnosis and the subsequent treatment on women is profound, both physically and psychologically, in particular with respect to sexual function and sexuality. We describe our experience creating a specialized clinic to address concerns about sexual health and rehabilitation. We used a case study approach to describe the clinic's inception and first 2 years of operation. Fifty-six survivors of gynecological cancer were seen at the clinic in the first 2 years. These patients had a significant symptom burden, many related to menopause, as well as those aftereffects of radiation therapy, chemotherapy, and surgical operation as well as psychological and emotional responses to cancer. The most common interventions were education and counseling. Patients reported high levels of satisfaction with their experience at the clinic. We hope our experience may be of assistance to others considering a similar endeavor.

  1. Single-site robotic surgery in gynecologic cancer: a pilot study

    PubMed Central

    Yoo, Ha-Na; Lee, Yoo-Young; Choi, Chel Hun; Lee, Jeong-Won; Bae, Duk-Soo; Kim, Byoung-Gie

    2015-01-01

    Objective To discuss the feasibility of single-site robotic surgery for benign gynecologic tumors and early stage gynecologic cancers. Methods In this single institution, prospective analysis, we analyzed six patients who had undergone single-site robotic surgery between December 2013 and August 2014. Surgery was performed using the da Vinci Si Surgical System. Patient characteristics and surgical outcomes were analyzed. Results Single-site robotic surgery was performed successfully in all six cases. The median patient age was 48 years, and the median body mass index was 25.5 kg/m2 (range, 22 to 33 kg/m2). The median total operative time was 211 minutes, and the median duration of intracorporeal vaginal cuff suturing was 32 minutes (range, 22 to 47 minutes). The median duration of pelvic lymph node dissection was 31 minutes on one side and 27 minutes on the other side. Patients' postoperative courses were uneventful. The median postoperative hospital stay was 4 days. No postoperative complications occurred. Conclusion When used to treat benign gynecologic tumors and early stage gynecologic cancers, the single-site da Vinci robotic surgery is feasible, safe, and produces favorable surgical outcomes. PMID:25609162

  2. Effect of methylphenidate on fatigue in women with recurrent gynecologic cancer.

    PubMed

    Johnson, Rhonda L; Block, Ingrid; Gold, Michael A; Markwell, Stephen; Zupancic, Melanie

    2010-09-01

    Fatigue is the most common and often the most bothersome complaint of individuals who are treated for cancer. One intervention now commonly suggested to treat fatigue is the use of psychostimulant medication. Early studies indicate some success in individuals with a mixed cancer diagnoses. This study evaluates the effect of methylphenidate on fatigue in women with recurrent gynecologic cancer. Thirty-two women treated for recurrent gynecologic cancer were prescribed methylphenidate at morning and noon over a 8-week period. Participants completed the Fatigue Symptom Inventory (FSI) along with assessments of quality of life and mood at baseline, week 2, 4 and 8 to determine changes in levels of fatigue experienced. Patients reported significant declines in fatigue (p=0.0001), and improvement in both mood (p=0.0020) and quality of life (p=0.0351) when comparing baseline scores to study end. This study provides support for the use of a psychostimulant to treat fatigue in women who have recurrent gynecologic cancer. It is particularly relevant for these patients with incurable disease who are facing the end of life. (c) 2010 John Wiley & Sons, Ltd.

  3. Perception of naturopathy for female patients with metastatic gynecological cancer: A qualitative study.

    PubMed

    Legenne, Myriam; Chirac, Anne; Ruer, Murielle; Reix, Fanny; Filbet, Marilène

    2015-12-01

    Women with gynecological cancer have been reported as very high users of complementary medicine. The goal of our study was to explore the perceptions of patients with an advanced gynecological cancer who use naturopathy as complementary medicine. We were looking more specifically at patients' opinions on the effect of naturopathy on their quality of life and its relation to conventional oncological treatments. This pilot qualitative study used semistructured interviews, and data were analyzed using grounded theory and qualitative methods. The main criterion for inclusion in the study was the use of naturopathy as a treatment complementary to conventional cancer treatment for gynecological metastatic cancer on the oncology day care unit. Six patients were included until data saturation. They express the physical and psychological impact of treatments and disease. Usually, chemotherapy is perceived as something that may be curative or may at least lead to remission. Unlike conventional treatments, naturopathy is not perceived as drugs, and it is seen as a way to relieve symptoms, improve well-being, and as a way of enabling them to take an active decision-making role in their care journey. Patients want to have more information about naturopathy. This study suggests that patients are aware of the benefits of a specific cancer treatment as chemotherapy, but they resort to naturopathy for symptom control, and also to take a more active role during treatment.

  4. Role of Gamma Knife® Radiosurgery for the Treatment of Brain Metastases from Gynecological Cancers.

    PubMed

    Keller, Andrew; Ismail, Rahim; Potrebko, Peter S; Pepe, Julie; Wu, Meiling; Saigal, Kunal; Biagioli, Matthew; Shridhar, Ravi; Holloway, Robert; Field, Melvin; Rao, Nikhil G

    2016-12-31

    Gamma Knife(®) (GK) (Elekta Instruments, Stockholm, Sweden) radiosurgery is well established for treatment of brain metastases. There are limited data on patients treated with GK from gynecological cancers. The authors sought to determine the effectiveness of the GK in patients with brain metastases from gynecological cancers. An IRB-approved database was queried for patients with gynecologic cancers treated with GK between June 1996 and May 2016. Imaging studies were reviewed post-SRS (stereotactic radiosurgery) to evaluate local control (LC) and distant brain control (DC). Overall survival (OS), local control, and distant brain control were calculated using the Kaplan-Meier (KM) method and log-rank test.  Results: Thirty-three patients underwent SRS for 73 separate cranial lesions. The median age was -58.5 years, and 17 (52%) also had extracranial metastases. Ten (30%) patients had previously received whole brain radiotherapy (WBRT), and 11 (33%) underwent concurrent WBRT. The median tumor volume was 0.96 cm(3). Median radiographic follow-up was 11 months. At the time of treatment, 39% of patients were categorized as recursive partitioning analysis (RPA) Class I, 55% as RPA Class II, and 6% as RPA Class III. The local failure rate was 8%. Five patients (15%) developed new brain lesions outside the radiation field with a median progression-free survival (PFS) of seven (range: 3-9) months. Median OS was 15 months from GK treatment. One-year OS was 72.9% from GK treatment. Primary cancer histology was a significant predictor of OS, favoring ovarian and endometrial cancer (p = 0.03). Gamma Knife stereotactic radiosurgery for gynecologic brain metastases leads to excellent control rates of treated lesions. Primary histology may have a significant impact on OS following GK, with improved survival seen with ovarian and cervical cancer following Gamma Knife radiosurgery (p = 0.03).

  5. Role of Gamma Knife® Radiosurgery for the Treatment of Brain Metastases from Gynecological Cancers

    PubMed Central

    Ismail, Rahim; Potrebko, Peter S; Pepe, Julie; Wu, Meiling; Saigal, Kunal; Biagioli, Matthew; Shridhar, Ravi; Holloway, Robert; Field, Melvin; Rao, Nikhil G

    2016-01-01

    Objective: Gamma Knife® (GK) (Elekta Instruments, Stockholm, Sweden) radiosurgery is well established for treatment of brain metastases. There are limited data on patients treated with GK from gynecological cancers. The authors sought to determine the effectiveness of the GK in patients with brain metastases from gynecological cancers. Methods: An IRB-approved database was queried for patients with gynecologic cancers treated with GK between June 1996 and May 2016. Imaging studies were reviewed post-SRS (stereotactic radiosurgery) to evaluate local control (LC) and distant brain control (DC). Overall survival (OS), local control, and distant brain control were calculated using the Kaplan-Meier (KM) method and log-rank test.  Results: Thirty-three patients underwent SRS for 73 separate cranial lesions. The median age was ­58.5 years, and 17 (52%) also had extracranial metastases. Ten (30%) patients had previously received whole brain radiotherapy (WBRT), and 11 (33%) underwent concurrent WBRT. The median tumor volume was 0.96 cm3. Median radiographic follow-up was 11 months. At the time of treatment, 39% of patients were categorized as recursive partitioning analysis (RPA) Class I, 55% as RPA Class II, and 6% as RPA Class III. The local failure rate was 8%. Five patients (15%) developed new brain lesions outside the radiation field with a median progression-free survival (PFS) of seven (range: 3-9) months. Median OS was 15 months from GK treatment. One-year OS was 72.9% from GK treatment. Primary cancer histology was a significant predictor of OS, favoring ovarian and endometrial cancer (p = 0.03). Conclusions: Gamma Knife stereotactic radiosurgery for gynecologic brain metastases leads to excellent control rates of treated lesions. Primary histology may have a significant impact on OS following GK, with improved survival seen with ovarian and cervical cancer following Gamma Knife radiosurgery (p = 0.03). PMID:28168125

  6. Impact of Nutrition on Non-Coding RNA Epigenetics in Breast and Gynecological Cancer.

    PubMed

    Krakowsky, Rosanna H E; Tollefsbol, Trygve O

    2015-01-01

    Cancer is the second leading cause of death in females. According to the American Cancer Society, there are 327,660 new cases in breast and gynecological cancers estimated in 2014, placing emphasis on the need for cancer prevention and new cancer treatment strategies. One important approach to cancer prevention involves phytochemicals, biologically active compounds derived from plants. A variety of studies on the impact of dietary compounds found in cruciferous vegetables, green tea, and spices like curry and black pepper have revealed epigenetic changes in female cancers. Thus, an important emerging topic comprises epigenetic changes due to the modulation of non-coding RNA levels. Since it has been shown that non-coding RNAs such as microRNAs and long non-coding RNAs are aberrantly expressed in cancer, and furthermore are linked to distinct cancer phenotypes, understanding the effects of dietary compounds and supplements on the epigenetic modulator non-coding RNA is of great interest. This article reviews the current findings on nutrition-induced changes in breast and gynecological cancers at the non-coding RNA level.

  7. Impact of Nutrition on Non-Coding RNA Epigenetics in Breast and Gynecological Cancer

    PubMed Central

    Krakowsky, Rosanna H. E.; Tollefsbol, Trygve O.

    2015-01-01

    Cancer is the second leading cause of death in females. According to the American Cancer Society, there are 327,660 new cases in breast and gynecological cancers estimated in 2014, placing emphasis on the need for cancer prevention and new cancer treatment strategies. One important approach to cancer prevention involves phytochemicals, biologically active compounds derived from plants. A variety of studies on the impact of dietary compounds found in cruciferous vegetables, green tea, and spices like curry and black pepper have revealed epigenetic changes in female cancers. Thus, an important emerging topic comprises epigenetic changes due to the modulation of non-coding RNA levels. Since it has been shown that non-coding RNAs such as microRNAs and long non-coding RNAs are aberrantly expressed in cancer, and furthermore are linked to distinct cancer phenotypes, understanding the effects of dietary compounds and supplements on the epigenetic modulator non-coding RNA is of great interest. This article reviews the current findings on nutrition-induced changes in breast and gynecological cancers at the non-coding RNA level. PMID:26075205

  8. Society of Gynecologic Surgeons

    MedlinePlus

    ... Myers, MD SGS Mission The mission of the Society of Gynecologic Surgeons is to promote excellence in ... research, and professional and public education. Research The Society prides itself in mentoring young gynecologic surgeons and ...

  9. JAK1 truncating mutations in gynecologic cancer define new role of cancer-associated protein tyrosine kinase aberrations.

    PubMed

    Ren, Yuan; Zhang, Yonghong; Liu, Richard Z; Fenstermacher, David A; Wright, Kenneth L; Teer, Jamie K; Wu, Jie

    2013-10-24

    Cancer-associated protein tyrosine kinase (PTK) mutations usually are gain-of-function (GOF) mutations that drive tumor growth and metastasis. We have found 50 JAK1 truncating mutations in 36 of 635 gynecologic tumors in the Total Cancer Care® (TCC®) tumor bank. Among cancer cell lines containing JAK1 truncating mutations in the Cancer Cell Line Encyclopedia databank, 68% are gynecologic cancer cells. Within JAK1 the K142, P430, and K860 frame-shift mutations were identified as hot spot mutation sites. Sanger sequencing of cancer cell lines, primary tumors, and matched normal tissues confirmed the JAK1 mutations and showed that these mutations are somatic. JAK1 mediates interferon (IFN)-γ-regulated tumor immune surveillance. Functional assays show that JAK1 deficient cancer cells are defective in IFN-γ-induced LMP2 and TAP1 expression, loss of which inhibits presentation of tumor antigens. These findings identify recurrent JAK1 truncating mutations that could contribute to tumor immune evasion in gynecologic cancers, especially in endometrial cancer.

  10. Gynecologic conditions and HIV.

    PubMed

    1997-07-01

    Studies are reinforcing the need for HIV-infected women to continue getting regular gynecologic examinations so that gynecologic complications can be detected early and monitored regularly. HIV-infected women who also have the human papillomavirus are more likely to progress to cervical cancer than their HIV-negative counterparts. Also, HIV-infected women are more likely to have abnormal pap smears and the presence of squamous intraepithelial lesions (SIL) compared to women who are HIV-negative. Because pap smears are not always accurate, women who have a history of cervical intraepithelial neoplasia (CIN) or SIL should probably include a colposcopy with their pap smear. Studies are showing a positive effect of anti-HIV therapy in lowering viral levels in vaginal secretions and in blood and semen in men. HIV RNA levels, however, have increased in vaginal secretions in response to standard treatment for CIN. HIV levels have also been shown to increase in the presence of sexually transmitted diseases, but when HIV viral levels are suppressed, there appears to be a lower susceptibility to gynecologic infections. Since research shows the benefits of early detection and treatment of gynecologic infections or conditions, all women should be aggressive and proactive in maintaining their health through regular gynecologic care.

  11. [Possible association of gynecological cancer and rheumatoid arthritis].

    PubMed

    Mercado, Ulises

    2012-06-01

    The association between rheumatoid arthritis and cancer is controversial. Previous studies have shown a correlation between rheumatoid arthritis and the development of lymphoma. Describe a case of rheumatoid arthritis and associated breast cancer plus the identification of the clinical features of a set of cases in which arthritis and cancer go along. This is a retrospective clinical series study. A database of Hospital General ISSSTECALI of Mexicali, Mexico, containing information on patients suffering from both rheumatoid arthritis and cancer until 2012 was checked. The medical files confirmed the diagnoses. The data available included age, date of arthritis diagnosis, date of cancer diagnosis, related conditions, results of serological tests, type of cancer, treatments used and follow-up information. Fifteen cases of women suffering from both rheumatoid arthritis and cancer were identified on the database of the Hospital General ISSSTECALI in Mexicali. The case described here is the number four on that list. The average age was 54 years and the average time between arthritis and cancer diagnoses was four years. Ten patients were administered methotrexate. Nine patients (60%) suffered from breast cancer and six more from cervical cancer. Three patients suffered from cervical dysplasia. These cases emphasize the need of strict follow-up on patients suffering from inflammatory rheumatoid condition. If cancer follows chronic inflammation, immunosuppression, or it is pure coincidence, is still a matter of debate.

  12. Gynecological cancer patients’ differentiated use of help from a nurse navigator: a qualitative study

    PubMed Central

    2012-01-01

    Background Fragmentation in healthcare can present challenges for patients with suspected cancer. It can add to existing anxiety, fear, despair and confusion during disease trajectory. In some circumstances patients are offered help from an extra contact person, a Nurse Navigator (NN). Scientific studies showing who will benefit from the extra help offered are missing. This study aims to explore who could benefit from the help on offer from a nurse appointed as NN in the early part of a cancer trajectory, and what would be meaningful experiences in this context. Methods A longitudinal study with a basis in phenomenology and hermeneutics was performed among Danish women with gynecological cancer. Semi-structured interviews provided data for the analysis, and comprehensive understanding was arrived at by first adopting an open-minded approach to the transcripts and by working at three analytical levels. Results Prior experience of trust, guarded trust or distrust of physicians in advance of encountering the NN was of importance in determining whether or not to accept help from the NN. For those lacking trust in physicians and without a close relationship to a healthcare professional, the NN offered a new trusting relationship and they felt reassured by her help. Conclusions Not everyone could use the help offered by the NN. This knowledge is vital both to healthcare practitioners and to administrators, who want to do their best for cancer patients but who are obliged to consider financial consequences. Moreover patients’ guarded trust or distrust in physicians established prior to meeting the NN showed possible importance for choosing extra help from the NN. These findings suggest increased focus on patients’ trust in healthcare professionals. How to find the most reliable method to identify those who can use the help is still a question for further debate and research. PMID:22721253

  13. Resilience, Positive Coping, and Quality of Life Among Women Newly Diagnosed With Gynecological Cancers.

    PubMed

    Manne, Sharon L; Myers-Virtue, Shannon; Kashy, Deborah; Ozga, Melissa; Kissane, David; Heckman, Carolyn; Rubin, Stephen C; Rosenblum, Norman

    2015-01-01

    Resilience has been linked to psychological adaptation to many challenging life events. The goal was to examine 3 coping strategies--expressing positive emotions, positive reframing of the cancer experience, and cultivating a sense of peace and meaning in life--as potential mechanisms by which resilience translates to quality of life among women recently diagnosed with gynecological cancer. This cross-sectional study utilized baseline data from women diagnosed with gynecological cancer participating in an ongoing randomized clinical trial (n = 281; mean age, 55 years; 80% were white). Participants completed measures of resilience, positive emotional expression, positive reappraisal, cultivating a sense of peace and meaning, and quality of life. Univariate and multiple mediation analyses were conducted. Greater resilience was related to higher quality of life (P < .001). Multiple mediation analyses indicated that the coping strategies, as a set, accounted for 62.6% of the relationship between resilience and quality of life. When considered as a set, cultivating a sense of peace and meaning had the strongest indirect effect (b = 0.281, SE = 0.073, P < .05). The findings suggested that resilient women may report higher quality of life during gynecological cancer diagnosis because they are more likely to express positive emotions, reframe the experience positively, and cultivate a sense of peace and meaning in their lives. Interventions promoting a sense of purpose in one's life and facilitating expression of positive emotions may prove beneficial, particularly for women reporting higher levels of resilience.

  14. Resilience, positive coping, and quality of life among women newly diagnosed with gynecological cancers

    PubMed Central

    Manne, Sharon; Myers-Virtue, Shannon; Kashy, Deborah; Ozga, Melissa; Kissane, David; Heckman, Carolyn; Rubin, Stephen C.; Rosenblum, Norman

    2014-01-01

    Background Resilience has been linked to psychological adaptation to many challenging life events. Objective The goal was to examine three coping strategies - expressing positive emotions, positive reframing of the cancer experience, and cultivating a sense of peace and meaning in life - as potential mechanisms by which resilience translates to quality of life among women recently diagnosed with gynecological cancer. Method This cross-sectional study utilized baseline data from women diagnosed with gynecological cancer participating in an ongoing randomized clinical trial (N = 281; Mage = 55, 80% Caucasian). Participants completed measures of resilience, positive emotional expression, positive reappraisal, and cultivating a sense of peace and meaning, and quality of life. Univariate and multiple mediation analyses were conducted. Results Greater resilience was related to higher quality of life (p < .001). Multiple mediation analyses indicated that the coping strategies, as a set, accounted for 62.6% of the relationship between resilience and quality of life. When considered as a set, cultivating a sense of peace and meaning had the strongest indirect effect (b = .281, se = .073, p < .05). Conclusion The findings suggested that resilient women may report higher quality of life during gynecological cancer diagnosis because they are more likely to express positive emotions, reframe the experience positively, and cultivate a sense of peace and meaning in their lives. Implications for Practice Interventions promoting a sense of purpose in one’s life and facilitating expression of positive emotions may prove beneficial, particularly for women reporting higher levels of resilience. PMID:25521911

  15. Personalized Circulating Tumor DNA Biomarkers Dynamically Predict Treatment Response and Survival In Gynecologic Cancers

    PubMed Central

    Anand, Sanya; Sebra, Robert; Catalina Camacho, Sandra; Garnar-Wortzel, Leopold; Nair, Navya; Moshier, Erin; Wooten, Melissa; Uzilov, Andrew; Chen, Rong; Prasad-Hayes, Monica; Zakashansky, Konstantin; Beddoe, Ann Marie; Schadt, Eric; Dottino, Peter; Martignetti, John A.

    2015-01-01

    Background High-grade serous ovarian and endometrial cancers are the most lethal female reproductive tract malignancies worldwide. In part, failure to treat these two aggressive cancers successfully centers on the fact that while the majority of patients are diagnosed based on current surveillance strategies as having a complete clinical response to their primary therapy, nearly half will develop disease recurrence within 18 months and the majority will die from disease recurrence within 5 years. Moreover, no currently used biomarkers or imaging studies can predict outcome following initial treatment. Circulating tumor DNA (ctDNA) represents a theoretically powerful biomarker for detecting otherwise occult disease. We therefore explored the use of personalized ctDNA markers as both a surveillance and prognostic biomarker in gynecologic cancers and compared this to current FDA-approved surveillance tools. Methods and Findings Tumor and serum samples were collected at time of surgery and then throughout treatment course for 44 patients with gynecologic cancers, representing 22 ovarian cancer cases, 17 uterine cancer cases, one peritoneal, three fallopian tube, and one patient with synchronous fallopian tube and uterine cancer. Patient/tumor-specific mutations were identified using whole-exome and targeted gene sequencing and ctDNA levels quantified using droplet digital PCR. CtDNA was detected in 93.8% of patients for whom probes were designed and levels were highly correlated with CA-125 serum and computed tomography (CT) scanning results. In six patients, ctDNA detected the presence of cancer even when CT scanning was negative and, on average, had a predictive lead time of seven months over CT imaging. Most notably, undetectable levels of ctDNA at six months following initial treatment was associated with markedly improved progression free and overall survival. Conclusions Detection of residual disease in gynecologic, and indeed all cancers, represents a diagnostic

  16. Peering into the Deep: Characterizing the Internet Search Patterns of Patients with Gynecologic Cancers.

    PubMed

    McLeod, Jane; Yu, Irene; Ingledew, Paris-Ann

    2017-03-01

    Cancer patients are increasingly using the Internet to learn about their disease, connect with others undergoing similar treatments and obtain support outside of the clinical encounter. The goal of this project was to explore how patients with gynecological cancers (ovarian, cervical, and endometrial) used the Internet as an information resource and how this influenced their treatment decisions and interactions with their health care specialists. From 2013 to 2014, ovarian, endometrial, and cervical cancer patients attending a comprehensive cancer centre were invited to complete a 24-item paper questionnaire detailing their experiences in searching the Internet. Twenty-eight patients completed survey. The largest portion of participants had an ovarian cancer diagnosis (61 %), followed by endometrial (29 %) and cervical cancer (11 %). Results indicate that the majority (85 %) of patients used the Internet as a resource to learn about their gynecological cancers. Most respondents (89 %) used Google as their search engine, and some used multiple search engines. The most frequently searched topics included treatment information (85 %), management of symptoms/treatment toxicity (59 %), and alternative treatments (37 %). Many patients (74 %) felt that the Internet was a useful tool for understanding their diagnosis; however, 33 % reported that the Internet was somewhat hard to understand. Most (78 %) patients reported that Internet information increased their understanding of their diagnosis, and 56 % felt it did not affect their decision-making. This study highlights how gynecological patients are accessing cancer information online and how physicians may support this within the clinical setting.

  17. Sexual Self Schema as a Moderator of Sexual and Psychological Outcomes for Gynecologic Cancer Survivors

    PubMed Central

    Andersen, Barbara L.; Fowler, Jeffrey M.; Maxwell, G. Larry

    2008-01-01

    Abstract Gynecologic cancer patients are at high risk for emotional distress and sexual dysfunction. The present study tested sexual self schema as an individual difference variable that might be useful in identifying those at risk for unfavorable outcomes. First, we tested schema as a predictor of sexual outcomes,including bodychangestress. Second,we examined schema as a contributor to broader quality of life outcomes, specifically as a moderator of the relationship between sexual satisfaction and psychological statue (depressive symptoms and quality of life). A cross-sectional design was used. Gynecologic cancer survivors (N = 175) 2−10 years post treatment were assessed during routine follow up. In regression analyses controlling for sociodemographic variables, patients' physical symptoms/signs as evaluated by nurses, health status, and extent of partner sexual difficulties, sexual self schema accounted for significant variance in the prediction of current sexual behavior, responsiveness, and satisfaction. Moreover, schema moderated the relationship between sexual satisfaction and psychological outcomes, suggesting that a positive sexual self schema might “buffer” patients from depressive symptoms when their sexual satisfaction is low. Furthermore, the combination of a negative sexual self schema and low sexual satisfaction might heighten survivors' risk for psychological distress, including depressive symptomatology. These data support the consideration of sexual self schema as a predictor of sexual morbidity among gynecologic cancer survivors. PMID:18418707

  18. Evaluation of the complexity of postoperative care following breast and gynecologic cancer surgery.

    PubMed

    Meloni Rosa, Teresa Celina; Dias de Souza, João Paulo; Sarian, Luis Otávio; Soares, Fabiano Miguel; Morais, Sirlei Siani; Mauricette Derchain, Sophie Françoise

    2006-01-01

    The purpose of this study was to evaluate the complexity of postoperative care required by women who had undergone breast or gynecologic cancer surgery, using the Therapeutic Intervention Scoring System-28. An observational, longitudinal study was carried out on 83 women admitted postoperatively to the Intensive Care Unit of the Center for Women's Integrated Healthcare. The results of this study show that women diagnosed with gynecologic cancer had a significantly higher mean Therapeutic Intervention Scoring System-28 score compared with women who had been diagnosed with breast cancer (P = .01). Women who underwent gynecologic surgery had a significantly higher mean Therapeutic Intervention Scoring System-28 score than women who had breast surgery (P = .03). Most of the activities performed by staff during the postoperative intensive care unit period involved only basic care procedures. Only advanced age and hypertension were related to death during the postoperative period. In conclusion, from the nursing standpoint, the complexity of care required in the intensive care unit during the postoperative period was moderate. Women aged 80 years or older were at the highest risk of death during this period.

  19. Altered Sexuality and Body Image after Gynecological Cancer Treatment: How Can Psychologists Help?

    PubMed Central

    Sacerdoti, Rebecca Caldwell; Lagana’, Luciana; Koopman, Cheryl

    2010-01-01

    Once medical treatment for gynecological cancer is completed, what happens to patients’ sexuality and body image? Due to the delicate nature of the cancer site, treating this cancer typically affects sexual functioning and body image adversely, making it critical to identify the concerns of these patients and do so in a manner less restrictive than paper-and-pencil assessment. To gain a deeper understanding of the phenomenological experiences in question, we interviewed nine gynecological cancer patients and seven cancer-free women. After implementing a relaxation protocol, we asked each woman to describe her feelings and thoughts on her sexuality and body image in one-on-one interviews. A variety of themes emerged on patients' attitudes and perspectives concerning sexuality and body image following diagnosis and treatment of the cancer. The themes that were considerably different from those of the cancer-free women included decreased sexual functioning and body image, abrupt shifts in self-identity due to loss of physical integrity, and distancing in intimate relationships. Several implications of these findings for clinical practice are discussed, as well as the need to train medical professionals to properly assess these patients’ alterations in sexuality. PMID:21572538

  20. Chemotherapy toxicity in gynecologic cancer patients with a body surface area (BSA)>2 m2.

    PubMed

    Schwartz, Joanna; Toste, Beth; Dizon, Don S

    2009-07-01

    Although many clinicians practice empiric dose reduction to prevent toxicity, it is unknown whether obese patients given chemotherapy dosed according to actual body weight (ABW) experience excess toxicity. At our institution, cancer patients receive chemotherapy dosed by ABW unless on a protocol capping doses at a maximum body surface area (BSA). We compared toxicities and dose modifications between women with a BSA>2 m(2) on uncapped versus capped paclitaxel as part of adjuvant paclitaxel/carboplatin for gynecologic malignancy. In this retrospective study, women with a BSA>2 m(2) treated with paclitaxel (P) and carboplatin (C) for endometrial and ovarian cancer between January 1999 and July 2007 were identified using the chemotherapy database. Records were reviewed for patient age, BSA, diagnosis, stage, standardized and actual doses for each cycle, adverse drug reactions, and dosing modifications. Statistical comparisons were made using Fisher's exact test. We identified 59 women with BSA>2 m(2) on adjuvant P/C for endometrial and ovarian cancers. 50 received paclitaxel dosed by ABW and 9 received paclitaxel capped at a BSA of 2 m(2). There were no statistically significant differences in rates of toxicity or dose modification. Obese women with a BSA>2 m(2) on paclitaxel dosed by ABW do not experience excess toxicity in comparison to women on paclitaxel capped at a maximum BSA or women in published trials of adjuvant P/C. Empiric dose reduction is unnecessary and may result in suboptimal treatment of obese patients. However, as this was a retrospective review, more research is needed to make definitive recommendations on this topic.

  1. Fertility Drugs and the Risk of Breast and Gynecologic Cancers

    PubMed Central

    Brinton, Louise A.; Sahasrabuddhe, Vikrant V.; Scoccia, Bert

    2014-01-01

    The evaluation of cancer risk among patients treated for infertility is complex, given the need to consider indications for use, treatment details, and the effects of other factors (including parity status) that independently affect cancer risk. Many studies have had methodologic limitations. Recent studies that have overcome some of these limitations have not confirmed a link between drug use and invasive ovarian cancers, although there is still a lingering question as to whether borderline tumors might be increased. It is unclear whether this merely reflects increased surveillance. Investigations regarding breast cancer risk have produced inconsistent results. In contrast, an increasing number of studies suggest that fertility drugs may have a special predisposition for the development of uterine cancers, of interest given that these tumors are recognized as particularly hormonally responsive. Additional studies are needed to clarify the effects on cancer risk of fertility drugs, especially those used in conjunction with in vitro fertilization. Because many women who have received such treatments are still relatively young, further monitoring should be pursued in large well-designed studies that enable assessment of effects within a variety of subgroups defined by both patient and disease characteristics. PMID:22549713

  2. Gynecologic cancer mortality in Trinidad and Tobago and comparisons of mortality-to-incidence rate ratios across global regions.

    PubMed

    Llanos, Adana A M; Warner, Wayne A; Luciani, Silvana; Lee, Tammy Y; Bajracharya, Smriti; Slovacek, Simeon; Roach, Veronica; Lamont-Greene, Marjorie

    2017-09-15

    To examine the factors associated with gynecologic cancer mortality risks, to estimate the mortality-to-incidence rate ratios (MIR) in Trinidad and Tobago (TT), and to compare the MIRs to those of select countries. Data on 3,915 incident gynecologic cancers reported to the National Cancer Registry of TT from 1 January 1995 to 31 December 2009 were analyzed using proportional hazards models to determine factors associated with mortality. MIRs for cervical, endometrial, and ovarian cancers were calculated using cancer registry data (TT), GLOBOCAN 2012 incidence data, and WHO Mortality Database 2012 data (WHO regions and select countries). Among the 3,915 incident gynecologic cancers diagnosed in TT during the study period, 1,795 (45.8%) were cervical, 1,259 (32.2%) were endometrial, and 861 (22.0%) were ovarian cancers. Older age, African ancestry, geographic residence, tumor stage, and treatment non-receipt were associated with increased gynecologic cancer mortality in TT. Compared to GLOBOCAN 2012 data, TT MIR estimates for cervical (0.49 vs. 0.53), endometrial (0.61 vs. 0.65), and ovarian cancers (0.32 vs. 0.48) were elevated. While the Caribbean region had intermediate gynecologic cancer MIRs, MIRs in TT were among the highest of the countries examined in the Caribbean region. Given its status as a high-income economy, the relatively high gynecologic cancer MIRs observed in TT are striking. These findings highlight the urgent need for improved cancer surveillance, screening, and treatment for these (and other) cancers in this Caribbean nation.

  3. Peripheral neuropathy in patients with gynecologic cancer receiving chemotherapy: patient reports and provider assessments.

    PubMed

    Kiser, Deleslie W; Greer, Tara B; Wilmoth, Margaret C; Dmochowski, Jacek; Naumann, R Wendel

    2010-11-01

    To analyze the incidence of chemotherapy-induced neuropathy in a set of patients with gynecologic cancer who were treated with known neurotoxic agents, to identify correlative factors related to patients' experience of neuropathy, and to analyze providers' assessment and treatment of neuropathy. Observational descriptive study of patient-reported neuropathy using a retrospective chart analysis. A hospital-based outpatient infusion center in the southeastern United States. A convenience sample of 171 patients with gynecologic cancer for a total of 302 chemotherapy treatments. A mixed model and compound symmetry covariance matrix was used to adjust for correlations between neuropathy treatment scores and patients who completed more than one chemotherapy cycle. Backward elimination method was used to determine the final model. Functional Assessment of Cancer Treatment/Gynecologic Oncology Group-Neuropathy Treatment scores, patients' demographic information, past medical history, and chemotherapy history. Patients who were physically shorter and heavier than the average population had the highest rating of neuropathy. Patients who were treated with nontaxane and platinum therapies had less neuropathy than patients who were treated with first-line taxanes and platinums. Neuropathy was noted by providers early in the course of treatment, and providers' grading was consistent with the patients' scoring. First-line treatments for gynecologic malignancies resulted in the highest neuropathy scores; however, patients who had received previous treatment with taxane and platinum therapies had lower neuropathy scores than patients currently receiving taxanes and platinums, suggesting that neuropathy improved after completion of first-line therapy and that second-line therapies were not necessarily correlative with worsening scores. Nurses must educate patients about symptoms of neuropathy and the need to report symptoms. Nurses must recognize patients at highest risk for

  4. Surgical management of lung, liver and brain metastases from gynecological cancers: a literature review.

    PubMed

    Hacker, Neville F; Rao, Archana

    2016-01-01

    The management of patients with recurrent gynecological malignancy is complex, and often contentious. While historically, patients with metastases in the lungs, liver or brain have been treated with palliative intent, surgery is proving to have an increasing role in the management of such patients. In this review article, the surgical management of lung, liver and brain metastases from gynecological cancers is examined. A search of the English language literature over the last 25 years was conducted using the Medline and PubMed databases. The results for management of metastases from the endometrium, ovary and cervix to the lung, brain and liver show that surprisingly good long-term survival results can be achieved for resection of metastases from all three organs. Patient selection is critical, and surgery is often used in conjunction with other treatment modalities. From this review, it is apparent that surgery should play an increasing role in the management of patients with parenchymal metastases from gynecological cancers. The surgery should ideally be performed in high volume, tertiary centers where there is a committed multi-disciplinary team with the necessary infrastructure to achieve the best possible outcomes in terms of both survival and morbidity.

  5. Surgical manual of the Korean Gynecologic Oncology Group: ovarian, tubal, and peritoneal cancers

    PubMed Central

    2017-01-01

    The Surgery Treatment Modality Committee of the Korean Gynecologic Oncology Group has determined to develop a surgical manual to facilitate clinical trials and to improve communication between investigators by standardizing and precisely describing operating procedures. The literature on anatomic terminology, identification of surgical components, and surgical techniques were reviewed and discussed in depth to develop a surgical manual for gynecologic oncology. The surgical procedures provided here represent the minimum requirements for participating in a clinical trial. These procedures should be described in the operation record form, and the pathologic findings obtained from the procedures should be recorded in the pathologic report form. Here, we describe surgical procedure for ovarian, fallopian tubal, and peritoneal cancers. PMID:27670260

  6. Depot medroxyprogesterone acetate contraception and the risk of breast and gynecologic cancer.

    PubMed

    Kaunitz, A M

    1996-05-01

    As the use of depot medroxyprogesterone acetate (DMPA) contraception increases in the United States and worldwide, assessing any impact on the risk of breast and gynecologic cancers becomes increasingly important. Overall, use of DMPA does not affect breast cancer risk. An elevated risk of this disease, however, has been noted in recent or current users. Hence, the association between DMPA use and breast cancer risk appears similar to that observed with oral contraceptives. Use of DMPA is associated with an 80% risk reduction of endometrial adenocarcinoma, a level of protection even greater than that noted with oral contraceptives. The risk of epithelial ovarian cancer and cervical neoplasia does not appear to be affected by DMPA use. Except for a substantial reduction in the risk of endometrial adenocarcinoma, use of DMPA does not appear to influence reproductive tract cancer risks.

  7. Emotion episodes during psychotherapy sessions among women newly diagnosed with gynecological cancers.

    PubMed

    Myers Virtue, Shannon; Manne, Sharon L; Darabos, Kathleen; Heckman, Carolyn J; Ozga, Melissa; Kissane, David; Rubin, Stephen; Rosenblum, Norman

    2015-09-01

    The aim of this study was to describe emotion episodes during early and late psychotherapy sessions among women newly diagnosed with gynecological cancer and to examine whether the total number of emotion episodes during early and later sessions was associated with baseline psychological distress, dispositional emotion expressivity, and patient-rated therapeutic progress. The study utilized data from an ongoing study examining the efficacy of two psychotherapy interventions, a coping and communication intervention and a supportive counseling intervention, for women diagnosed with gynecological cancer. Emotion episode coding was completed for the first and sixth psychotherapy sessions for each patient randomized to receive psychotherapy (N = 173). Patients completed baseline survey measures of psychological distress and dispositional emotional expressivity and post-session ratings of therapeutic progress. The average number of emotion episodes was 7.4 in the first session and 5.2 episodes in the sixth session. In both sessions, the majority of emotion episodes contained only negative emotions and focused on a cancer-related topic. A higher number of emotion episodes in the first session was associated with higher psychological distress reported in the baseline survey (p = 0.02). A higher number of emotion episodes in the sixth session was associated with a higher number of emotion episodes in the first session (p < 0.001) and higher patient-rated progress as rated in the sixth session (p = 0.016). The findings highlight the importance of expressed emotions, particularly negative emotions about cancer-related topics, in therapeutic progress during psychotherapy among women diagnosed with gynecological cancer. Copyright © 2014 John Wiley & Sons, Ltd.

  8. Emotion Episodes during Psychotherapy Sessions among Women Newly Diagnosed with Gynecological Cancers

    PubMed Central

    Virtue, Shannon Myers; Manne, Sharon L.; O’Neill, Kathleen; Heckman, Carolyn J.; Ozga, Melissa; Kissane, David; Rubin, Stephen; Rosenblum, Norman

    2015-01-01

    Objective To describe emotion episodes during early and late psychotherapy sessions among women newly diagnosed with gynecological cancer and to examine whether the total number of emotional episodes during early and later sessions were associated with baseline psychological distress, dispositional emotion expressivity, and patient-rated therapeutic progress. Methods The study utilized data from an ongoing study examining the efficacy of two psychotherapy interventions, a coping and communication intervention (CCI) and a supportive counseling intervention (SC), for women diagnosed with gynecological cancer. Emotion episode coding was completed for the first and sixth psychotherapy session for each patient randomized to receive psychotherapy (N = 173). Patients completed baseline survey measures of psychological distress and dispositional emotional expressivity and post-session ratings of therapeutic progress. Results The average number of emotion episodes was 7.4 in the first session and 5.2 episodes in the sixth session. In both sessions, the majority of emotion episodes contained only negative emotions and focused on a cancer-related topic. A higher1number of emotion episodes in the first session was associated with higher psychological distress reported in the baseline survey (p = .02). A higher number of emotions episodes in the sixth session was associated with a higher number of emotion episodes in the first session (p < .001) and higher patient-rated progress as rated in the sixth session (p = .016). Conclusion The findings highlight the importance of expressed emotions, particularly negative emotions about cancer-related topics, in therapeutic progress during psychotherapy among women diagnosed with gynecological cancer. PMID:25521772

  9. Practice Patterns of Radiotherapy in Cervical Cancer Among Member Groups of the Gynecologic Cancer Intergroup (GCIG)

    SciTech Connect

    Gaffney, David K. . E-mail: david.gaffney@hci.utah.edu; Du Bois, Andreas; Narayan, Kailash; Reed, Nick; Toita, Takafumi; Pignata, Sandro; Blake, Peter; Portelance, Lorraine; Sadoyze, Azmat; Poetter, Richard; Colombo, Alessandro; Randall, Marcus; Mirza, Mansoor R.; Trimble, Edward L.

    2007-06-01

    Purpose: The aim of this study was to describe radiotherapeutic practice of the treatment of cervical cancer in member groups of the Gynecologic Cancer Intergroup (GCIG). Methods and Materials: A survey was developed and distributed to the members of the GCIG focusing on details of radiotherapy practice. Different scenarios were queried including advanced cervical cancer, postoperative patients, and para-aortic-positive lymph node cases. Items focused on indications for radiation therapy, radiation fields, dose, use of chemotherapy, brachytherapy and others. The cooperative groups from North America were compared with the other groups to evaluate potential differences in radiotherapy doses. Results: A total of 39 surveys were returned from 13 different cooperative groups. For the treatment of advanced cervical cancer, external beam pelvic doses and total doses to point A were 47 + 3.5 Gy (mean + SD) and 79.1 + 7.9 Gy, respectively. Point A doses were not different between the North American cooperative groups compared with the others (p = 0.103). All groups used concomitant chemotherapy, with 30 of 36 respondents using weekly cisplatin. Of 33 respondents, 31 intervened for a low hemoglobin level. For a para-aortic field, the upper border was most commonly (15 of 24) at the T12-L1 interspace. Maintenance chemotherapy (after radiotherapy) was not performed by 68% of respondents. For vaginal brachytherapy after hysterectomy, 23 groups performed HDR brachytherapy and four groups used LDR brachytherapy. In the use of brachytherapy, there was no uniformity in dose prescription. Conclusions: Radiotherapy practices among member groups of the GCIG are similar in terms of both doses and use of chemotherapy.

  10. The effects of hysterectomy on body image, self-esteem, and marital adjustment in Turkish women with gynecologic cancer.

    PubMed

    Pinar, Gul; Okdem, Seyda; Dogan, Nevin; Buyukgonenc, Lale; Ayhan, Ali

    2012-06-01

    The purpose of this research was to investigate the differences in the effect of hysterectomy on body image, self-esteem, and marital adjustment in Turkish women with gynecologic cancer based on specific independent variables, including age, education, employment, having or not having children, and income. This cross-sectional study compared a group of women who underwent a hysterectomy (n = 100) with a healthy control group (n = 100). The study findings indicate that women who had a hysterectomy were found in worse conditions in terms of body image, self-esteem, and dyadic adjustment compared to healthy women. In terms of dyadic adjustment and body image among women who had undergone a hysterectomy, those with lower levels of income and education were found in poorer conditions. The study's findings show that hysterectomies have negative effects on body image, self-esteem, and dyadic adjustment in women affected by gynecologic cancer. Nursing assessment of self-esteem and marital adjustment indicators and implementation of strategies to increase self-confidence and self-esteem are needed for high-risk women.

  11. Is bariatric surgery an option for women with gynecologic cancer? Examining weight loss counseling practices and training among gynecologic oncology providers☆

    PubMed Central

    Neff, Robert; McCann, Georgia A.; Carpenter, Kristen M.; Cohn, David E.; Noria, Sabrena; Mikami, Dean; Needleman, Bradley J.; O’Malley, David M.

    2015-01-01

    Objective The objective of this study was to evaluate gynecologic oncology provider (GOP) practices regarding weight loss (WL) counseling, and to assess their willingness to initiate weight loss interventions, specifically bariatric surgery (WLS). Methods Members of the Society of Gynecologic Oncology were invited to complete an online survey of 49 items assessing knowledge, attitudes, and behaviors related to WL counseling. Results A total of 454 participants initiated the survey, yielding a response rate of 30%. The majority of respondents (85%) were practicing GOP or fellows. A majority of responders reported that >50% of their patient population is clinically obese (BMI ≥ 30). Only 10% reported having any formal training in WL counseling, most often in medical school or residency. Providers who feel adequate about WL counseling were more likely to offer multiple WL options to their patients (p < .05). Over 90% of responders believe that WLS is an effective WL option and is more effective than self-directed diet and medical management of obesity. Providers who were more comfortable with WL counseling were significantly more likely to recommend WLS (p < .01). Approximately 75% of respondents expressed interest in clinical trials evaluating WLS in obese cancer survivors. Conclusions The present study suggests that GOP appreciate the importance of WL counseling, but often fail to provide it. Our results demonstrate the paucity of formal obesity training in oncology. Providers seem willing to recommend WLS as an option to their patients but also in clinical trials examining gynecologic cancer outcomes in women treated with BS. PMID:24933102

  12. Reduced vaginal elasticity, reduced lubrication, and deep and superficial dyspareunia in irradiated gynecological cancer survivors.

    PubMed

    Stinesen Kollberg, Karin; Waldenström, Ann-Charlotte; Bergmark, Karin; Dunberger, Gail; Rossander, Anna; Wilderäng, Ulrica; Åvall-Lundqvist, Elisabeth; Steineck, Gunnar

    2015-05-01

    The purpose of this study was to examine whether or not vaginal elasticity or lack of lubrication is associated with deep or superficial dyspareunia. We investigated gynecological cancer survivors treated with radiation therapy. In a population-based study with 616 women answering a questionnaire (participation rate 78%) and who were treated with radiotherapy for gynecological cancer, we analyzed information from 243 women (39%) who reported that they had had intercourse during the previous six months. Analyses included log-binomial regression (relative risks) and multiple imputations by chained equations in combination with Bayesian Model Averaging, yielding a posterior probability value. Age range of this cancer recurrent-free group of women was 29-80. Dyspareunia affected 164 of 243 of the women (67%). One hundred thirty-four women (55%) reported superficial pain, 97 women (40%) reported deep pain, and 87 women (36%) reported both types of dyspareunia. The relative risk (RR) of deep dyspareunia was 1.87 (CI 1.41-2.49) with impaired vaginal elasticity compared to normal vaginal elasticity. Age and lower abdominal swelling were separate risk factors for deep dyspareunia. However, effects remain after adjusting for these factors. The relative risk of deep dyspareunia was almost twice as high with impaired vaginal elasticity compared to normal vaginal elasticity. If we wish to treat or even prevent deep dyspareunia in women with gynecological cancer, we may use our knowledge of the pathophysiology of deep dyspareunia and increasingly provide dilators together with instructions on how to use them for stretching exercises in order to retain vaginal elasticity. Results highlight the need for studies with more precise questions distinguishing superficial from deep dyspareunia so that in the future we may be able to primarily try to avoid reduced vaginal elasticity and secondarily reduce the symptoms.

  13. Phase I Clinical Trials in 85 Patients with Gynecologic Cancer: The M. D. Anderson Cancer Center Experience

    PubMed Central

    Moroney, John; Wheler, Jennifer; Hong, David; Naing, Aung; Falchook, Gerald; Bodurka, Diane; Coleman, Robert; Lu, Karen; Xiao, Lianchun; Kurzrock, Razelle

    2010-01-01

    Objective Disseminated gynecologic cancers are usually fatal due to chemoresistance. Recently, rationally-developed, targeted agents are entering the early clinical trials setting. We assessed patients with metastatic gynecologic cancers in a dedicated Phase I clinical trials clinic in order to determine their outcome. Methods We reviewed records for 89 consecutive patients with gynecologic cancers referred to the Phase I Clinical Trials Program, 85 (96%) of whom were treated on ≥1 trial. Results Cancer diagnoses were: ovarian (N = 43), uterine (N = 19), cervix (N = 17), and other. Median age was 58 years; median number of prior cytotoxic regimens, five. Two patients (2.4%) achieved a CR, four (4.7%), a PR, and eight (9.4%), SD ≥ six months (total CR/PR/SD ≥ six months = 16.5%) for the first phase I trial. Twenty-five patients enrolled on a second trial and three on a third (N = 113 trials total). Combining response data for all trials, of the 85 patients, two achieved CR (2.4%), nine achieved PR (10.6%), and 12 (14%) had SD for ≥ six months. One-year survival was 30% (95% C.I., 21% to 44%). There was no difference in time-to-treatment failure (TTF) on Phase I versus the patient's last standard treatment. Conclusion Twenty-three of 85 patients (27%) with advanced, heavily-pretreated, gynecologic cancers achieved CR/PR/SD ≥ six months on a phase I trial, and overall TTF on phase I was comparable to that of last conventional therapy, suggesting that participation in a phase I trial is a reasonable option for these patients. PMID:20347123

  14. Phase I clinical trials in 85 patients with gynecologic cancer: the M. D. Anderson Cancer Center experience.

    PubMed

    Moroney, John; Wheler, Jennifer; Hong, David; Naing, Aung; Falchook, Gerald; Bodurka, Diane; Coleman, Robert; Lu, Karen; Xiao, Lianchun; Kurzrock, Razelle

    2010-06-01

    Disseminated gynecologic cancers are usually fatal due to chemoresistance. Recently, rationally developed, targeted agents are entering the early clinical trials setting. We assessed patients with metastatic gynecologic cancers in a dedicated phase I clinical trials clinic in order to determine their outcome. We reviewed records for 89 consecutive patients with gynecologic cancers referred to the Phase I Clinical Trials Program, 85 (96%) of whom were treated on > or = 1 trial. Cancer diagnoses were ovarian (N=43), uterine (N=19), cervix (N=17), and other. Median age was 58 years; median number of prior cytotoxic regimens, five. Two patients (2.4%) achieved a CR; four (4.7%), a PR; and eight (9.4%), SD > or = 6 months (total CR/PR/SD > or = 6 months=16.5%) for the first phase I trial. Twenty-five patients enrolled on a second trial and three, on a third (N=113 trials total). Combining response data for all trials, of the 85 patients, two achieved CR (2.4%), nine achieved PR (10.6%), and 12 (14%) had SD for > or = 6 months. One-year survival was 30% (95% CI, 21% to 44%). There was no difference in time-to-treatment failure (TTF) on phase I versus the patient's last standard treatment. Twenty-three of 85 patients (27%) with advanced, heavily pretreated, gynecologic cancers achieved CR/PR/SD > or = 6 months on a phase I trial, and overall TTF on phase I was comparable to that of last conventional therapy, suggesting that participation in a phase I trial is a reasonable option for these patients. Copyright 2010 Elsevier Inc. All rights reserved.

  15. Drug Repositioning for Gynecologic Tumors: A New Therapeutic Strategy for Cancer

    PubMed Central

    Banno, Kouji; Yanokura, Megumi; Irie, Haruko; Masuda, Kenta; Kobayashi, Yusuke; Tominaga, Eiichiro; Aoki, Daisuke

    2015-01-01

    The goals of drug repositioning are to find a new pharmacological effect of a drug for which human safety and pharmacokinetics are established and to expand the therapeutic range of the drug to another disease. Such drug discovery can be performed at low cost and in the short term based on the results of previous clinical trials. New drugs for gynecologic tumors may be found by drug repositioning. For example, PPAR ligands may be effective against ovarian cancer, since PPAR activation eliminates COX-2 expression, arrests the cell cycle, and induces apoptosis. Metformin, an antidiabetic drug, is effective for endometrial cancer through inhibition of the PI3K-Akt-mTOR pathway by activating LKB1-AMPK and reduction of insulin and insulin-like growth factor-1 due to AMPK activation. COX-2 inhibitors for cervical cancer may also be examples of drug repositioning. PGE2 is induced in the arachidonate cascade by COX-2. PGE2 maintains high expression of COX-2 and induces angiogenic factors including VEGF and bFGF, causing carcinogenesis. COX-2 inhibitors suppress these actions and inhibit carcinogenesis. Combination therapy using drugs found by drug repositioning and current anticancer drugs may increase efficacy and reduce adverse drug reactions. Thus, drug repositioning may become a key approach for gynecologic cancer in drug discovery. PMID:25734181

  16. Determination of sexual problems of Turkish patients receiving gynecologic cancer treatment: a cross-sectional study.

    PubMed

    Demirtas, Basak; Pinar, Gul

    2014-01-01

    The present study aimed to determine the prevalence and types of sexual problems of Turkish patients receiving gynecologic cancer treatment. A cross-sectional convenience sample of 168 women completed the Index of Female Sexual Function (IFSF) and a Patient Identification Form in a hospital in Ankara, Turkey. Mean IFSF scores of the patients were low (15.7±5.72, out of a possible 45), indicating high rates of sexual problems. Women frequently reported problems with dyspareunia (97.1%), vaginal dryness (97.6%), decreased sexual desire (91.1%), and difficulties of sexual arousal (92.9%) related with the cancer treatment process. They reported increased sexual problems following the period of treatment as compared to before treatment (p<0.05). Sexual dysfunction was associated with low educational and income levels, advanced age, TAH-BSO-LND surgery (total abdominal hysterectomy-bilateral salphingoopherectomy- lymph node dissection), experiencing side effects of chemotherapy, receiving chemotherapy in addition to surgery and radiotherapy (CT+RT+Surgery), and having a large number of chemotherapy cycles (p<0.05). Patients hoped for and expected counseling from healthcare professionals about their sexual functioning in relation to cancer treatments. Nurses and physicians can help to improve the overall quality of life for gynecologic cancer patients through sexual counseling.

  17. The experience of lower limb lymphedema for women after treatment for gynecologic cancer.

    PubMed

    Ryan, Mary; Stainton, M Colleen; Jaconelli, Carmel; Watts, Sally; MacKenzie, Patricia; Mansberg, Tamar

    2003-01-01

    To describe women's experiences with lower limb lymphedema to inform both preventive and management clinical practices. A retrospective survey. The gynecology/oncology unit of a tertiary referral women's hospital in Australia. 82 women who developed lower limb lymphedema after surgical and radiation treatment for gynecologic cancers. Structured interviews. Psychosocial and emotional impact, physical effects, knowledge, support, treatment modalities. Women identified changes in appearance and sensation in the legs and the triggers that both preceded and exacerbated symptoms. Women described seeking help and receiving inappropriate advice with as many as three assessments prior to referral to lymphedema specialists. Many women implemented self-management strategies. Lower limb lymphedema had an impact on appearance, mobility, finances, and self-image. Increasing longevity after gynecologic oncology treatment requires all practitioners to be aware of known or potential triggers of lower limb lymphedema and the appropriate referral and management strategies available. Women at risk need to know early signs and symptoms and where to seek early care. The role of nursing in acute and community care of women at risk for developing lower limb lymphedema includes (a) engaging women in protecting their legs from infection or trauma pre- and postoperatively, (b) providing nursing care and education during the pre- and postoperative phases, and (c) ensuring that women being discharged are aware of early signs and symptoms of lower limb lymphedema and how to access qualified, specialized therapists so that early and effective management can be initiated.

  18. Elevated preoperative plasma D-dimer levels and the incidence of venous thromboembolism in Japanese females with gynecological cancer.

    PubMed

    Kodama, Junichi; Seki, Noriko; Fukushima, Chikako; Kusumoto, Tomoyuki; Nakamura, Keiichiro; Hongo, Atsushi; Hiramatsu, Yuji

    2013-01-01

    The purpose of the present study was to determine the incidence of increased levels of D-dimer and associated factors in preoperative patients with gynecological cancer. Furthermore, we determined the incidence and risk factors associated with preoperative venous thromboembolism (VTE). Overall, 456 patients with invasive gynecological cancer scheduled to undergo surgery were recruited. Preoperative plasma D-dimer levels were measured and patients whose plasma D-dimer concentration exceeded the pre-set cut-off value underwent computed tomography scanning. The incidence of elevated D-dimer and VTE was identified as significantly higher in patients with ovarian cancer. Multivariate analysis revealed that advanced age, low hemoglobin levels and elevated C-reactive protein (CRP) levels were independent factors for preoperative elevations in plasma D-dimer levels. Advanced age was an independent risk factor for preoperative VTE. Massive ascites and the presence of co-morbidities were independent risk factors for preoperative VTE in ovarian cancer. Advanced age and stage were independent risk factors for preoperative VTE in endometrial cancer. Advanced age was an independent risk factor for preoperative VTE in cervical cancer. Plasma D-dimer levels and the incidence of preoperative VTE were higher in patients with ovarian cancer compared with those with other gynecological cancers. Advanced age, low hemoglobin levels and elevated CRP levels were significant factors associated with elevated plasma D-dimer levels and age was an independent risk factor for preoperative VTE in gynecological cancer.

  19. Metformin use and gynecological cancers: A novel treatment option emerging from drug repositioning.

    PubMed

    Gadducci, Angiolo; Biglia, Nicoletta; Tana, Roberta; Cosio, Stefania; Gallo, Martina

    2016-09-01

    Metformin exerts antitumor effects mainly through AMP-activated protein kinase [AMPK] activation and phosphatidylinositol 3-kinase [PI3K]-Akt-mammalian target of rapamycin [mTOR] inhibition. This drug leads to activation of the cellular energy-sensing liver kinase B1 [LKB1]/AMPK pathway. LKB1 is implicated as a tumor suppressor gene in molecular pathogenesis of different malignancies. AMPK is a serine/threonine protein kinase that acts as an ultra-sensitive cellular energy sensor maintaining the energy balance within the cell. AMPK activation inhibits mRNA translation and proliferation in cancer cells via down-regulation of PI3K/Akt/mTOR pathway. Moreover, metformin decreases the production of insulin, insulin-like growth factor, inflammatory cytokines and vascular endothelial growth factor, and therefore it exerts anti-mitotic, anti-inflammatory and anti-angiogenetic effects. Recent in vitro and experimental data suggest that metformin electively targets cancer stem cells, and acts together with chemotherapy to block tumor growth in different cancers. Several epidemiological studies and meta-analysis have shown that metformin use is associated with decreased cancer risk and/or reduced cancer mortality for different malignancies. The present review analyzes the recent biological and clinical data suggesting a possible growth-static effect of metformin also in gynecological cancers. The large majority of available clinical data on the anti-cancer potential of metformin are based on observational studies. Therefore long-term phase II-III clinical trials are strongly warranted to further investigate metformin activity in gynecological cancers.

  20. Pain and Mean Absorbed Dose to the Pubic Bone After Radiotherapy Among Gynecological Cancer Survivors

    SciTech Connect

    Waldenstroem, Ann-Charlotte; Olsson, Caroline; Wilderaeng, Ulrica; Dunberger, Gail; Lind, Helena; Al-Abany, Massoud; Palm, Asa; Avall-Lundqvist, Elisabeth; Johansson, Karl-Axel; Steineck, Gunnar

    2011-07-15

    Purpose: To analyze the relationship between mean absorbed dose to the pubic bone after pelvic radiotherapy for gynecological cancer and occurrence of pubic bone pain among long-term survivors. Methods and Materials: In an unselected, population-based study, we identified 823 long-term gynecological cancer survivors treated with pelvic radiotherapy during 1991-2003. For comparison, we used a non-radiation-treated control population of 478 matched women from the Swedish Population Register. Pain, intensity of pain, and functional impairment due to pain in the pubic bone were assessed with a study-specific postal questionnaire. Results: We analyzed data from 650 survivors (participation rate 79%) with median follow-up of 6.3 years (range, 2.3-15.0 years) along with 344 control women (participation rate, 72 %). Ten percent of the survivors were treated with radiotherapy; ninety percent with surgery plus radiotherapy. Brachytherapy was added in 81%. Complete treatment records were recovered for 538/650 survivors, with dose distribution data including dose-volume histograms over the pubic bone. Pubic bone pain was reported by 73 survivors (11%); 59/517 (11%) had been exposed to mean absorbed external beam doses <52.5 Gy to the pubic bone and 5/12 (42%) to mean absorbed external beam doses {>=}52.5 Gy. Thirty-three survivors reported pain affecting sleep, a 13-fold increased prevalence compared with control women. Forty-nine survivors reported functional impairment measured as pain walking indoors, a 10-fold increased prevalence. Conclusions: Mean absorbed external beam dose above 52.5 Gy to the pubic bone increases the occurrence of pain in the pubic bone and may affect daily life of long-term survivors treated with radiotherapy for gynecological cancer.

  1. Scientific research in obstetrics and gynecology: changes in the trends over three decades

    PubMed Central

    Kassem, Gamal A

    2015-01-01

    Aim The aim of this work was to assess scientific research of master’s and doctoral theses and essays in the Department of Obstetrics and Gynecology, Zagazig University, Egypt. Materials and methods All master’s and doctoral theses and essays since the foundation of Department of Obstetrics and Gynecology, Zagazig University, Egypt, in 1975 till end of 2012 were reviewed. Results A total of 703 theses and essays were reviewed. The important topics in the specialty of obstetrics and gynecology were covered and updated. Infertility, in vitro fertilization–embryo transfer (IVF-ET) and related techniques, and polycystic ovarian disease were the most common gynecologic topics (27.2%), followed by gynecologic oncology (18.5%). Preeclampsia was the most common obstetrics topic (18.8%), followed by issues of high-risk pregnancy, fetal growth restriction, and fetal well-being (11.6%). The number of researches that allow the candidates to learn skills was 183 and it was increased from 4.4% of all research in the period 1979–1988 to 33.2% in period 1989–2000 then slightly decreased to 31.2% in period 2001–2012. Ultrasonography was on the top and was present in 99 out of 183 (54.1%) followed by laparoscopy (30, 16.4%), hysteroscopy (25, 13.7%), IVF-ET and related techniques (16, 8.7%) and colposcopy (13, 7.1%) researches. Multi-disciplinary research was decreased by 61.7% in the period 2001–2012. Researches in academic fields were abandoned and in some clinically important areas like preeclampsia were decreased. Conclusion Scientific research of master’s and doctoral theses and essays was comprehensive, updated, and had some autonomy independent of plans. Research which enable the candidate to learn skills were increased on the expense of academic, clinical and multidisciplinary research. It could be recommended that plans for scientific research should be flexible and should leave a space for local departmental views. Proper training of residents during their

  2. Scientific research in obstetrics and gynecology: changes in the trends over three decades.

    PubMed

    Kassem, Gamal A

    2015-01-01

    The aim of this work was to assess scientific research of master's and doctoral theses and essays in the Department of Obstetrics and Gynecology, Zagazig University, Egypt. All master's and doctoral theses and essays since the foundation of Department of Obstetrics and Gynecology, Zagazig University, Egypt, in 1975 till end of 2012 were reviewed. A total of 703 theses and essays were reviewed. The important topics in the specialty of obstetrics and gynecology were covered and updated. Infertility, in vitro fertilization-embryo transfer (IVF-ET) and related techniques, and polycystic ovarian disease were the most common gynecologic topics (27.2%), followed by gynecologic oncology (18.5%). Preeclampsia was the most common obstetrics topic (18.8%), followed by issues of high-risk pregnancy, fetal growth restriction, and fetal well-being (11.6%). The number of researches that allow the candidates to learn skills was 183 and it was increased from 4.4% of all research in the period 1979-1988 to 33.2% in period 1989-2000 then slightly decreased to 31.2% in period 2001-2012. Ultrasonography was on the top and was present in 99 out of 183 (54.1%) followed by laparoscopy (30, 16.4%), hysteroscopy (25, 13.7%), IVF-ET and related techniques (16, 8.7%) and colposcopy (13, 7.1%) researches. Multi-disciplinary research was decreased by 61.7% in the period 2001-2012. Researches in academic fields were abandoned and in some clinically important areas like preeclampsia were decreased. Scientific research of master's and doctoral theses and essays was comprehensive, updated, and had some autonomy independent of plans. Research which enable the candidate to learn skills were increased on the expense of academic, clinical and multidisciplinary research. It could be recommended that plans for scientific research should be flexible and should leave a space for local departmental views. Proper training of residents during their rotation in these subspecialties may help to revive the lost

  3. Emotional and sexual concerns in women undergoing pelvic surgery and associated treatment for gynecologic cancer

    PubMed Central

    Stabile, Cara; Gunn, Abigail; Sonoda, Yukio

    2015-01-01

    The surgical management of gynecologic cancer can cause short- and long-term effects on sexuality, emotional well being, reproductive function, and overall quality of life (QoL). Fortunately, innovative approaches developed over the past several decades have improved oncologic outcomes and reduced treatment sequelae; however, these side effects of treatment are still prevalent. In this article, we provide an overview of the various standard-of-care pelvic surgeries and multimodality cancer treatments (chemotherapy and radiation therapy) by anatomic site and highlight the potential emotional and sexual consequences that can influence cancer survivorship and QoL. Potential screening tools that can be used in clinical practice to identify some of these concerns and treatment side effects and possible solutions are also provided. These screening tools include brief assessments that can be used in the clinical care setting to assist in the identification of problematic issues throughout the continuum of care. This optimizes quality of care, and ultimately, QoL in these women. Prospective clinical trials with gynecologic oncology populations should include patient-reported outcomes to identify subgroups at risk for difficulties during and following treatment for early intervention. PMID:26816823

  4. Gynecologic Cancer Information on YouTube: Will Women Watch Advertisements to Learn More?

    PubMed Central

    Cooper, Crystale Purvis; Chu, Jennifer

    2015-01-01

    The quality and accuracy of health content posted on YouTube varies widely. To increase dissemination of evidence-based gynecologic cancer information to US YouTube users, the Centers for Disease Control and Prevention (CDC) sponsored two types of advertisements: (1) pre-roll videos that users had to watch for at least 5 s before seeing a video they selected and (2) keyword-targeted listings that appeared in search results when users entered terms related to gynecologic cancer. From July 2012 to November 2013, pre-roll videos were shown 9.2 million times, viewed (watched longer than the mandatory 5 s) 1.6 million times (17.6%), and cost $0.09 per view. Keyword-targeted listings were displayed 15.3 million times, viewed (activated by users) 59,766 times (0.4%), and cost $0.31 per view. CDC videos in advertisements played completely in 17.0% of pre-roll video views and 44.4% of keyword-targeted listing views. Advertisements on YouTube can disseminate evidence-based cancer information broadly with minimal cost. PMID:25877466

  5. Gynecologic Cancer Information on YouTube: Will Women Watch Advertisements to Learn More?

    PubMed

    Cooper, Crystale Purvis; Gelb, Cynthia A; Chu, Jennifer

    2016-09-01

    The quality and accuracy of health content posted on YouTube varies widely. To increase dissemination of evidence-based gynecologic cancer information to US YouTube users, the Centers for Disease Control and Prevention (CDC) sponsored two types of advertisements: (1) pre-roll videos that users had to watch for at least 5 s before seeing a video they selected and (2) keyword-targeted listings that appeared in search results when users entered terms related to gynecologic cancer. From July 2012 to November 2013, pre-roll videos were shown 9.2 million times, viewed (watched longer than the mandatory 5 s) 1.6 million times (17.6 %), and cost $0.09 per view. Keyword-targeted listings were displayed 15.3 million times, viewed (activated by users) 59,766 times (0.4 %), and cost $0.31 per view. CDC videos in advertisements played completely in 17.0 % of pre-roll video views and 44.4 % of keyword-targeted listing views. Advertisements on YouTube can disseminate evidence-based cancer information broadly with minimal cost.

  6. Cryotherapy for massive vulvar lymphatic leakage complicated with lymphangiomas following gynecological cancer treatment.

    PubMed

    Yanazume, Shintaro; Douzono, Haruhiko; Kubo, Hidemichi; Nagata, Tomomi; Douchi, Tsutomu; Kobayashi, Hiroaki

    2014-11-01

    Vulvar lymphatic leakage is a severe complication associated with gynecological cancer treatments. However, standard treatment strategies have not yet been determined. We encountered a rare case of a 76-year-old multiparous woman suffering from massive lymphatic fluid leakage from the entire vulva, and papules developed and were identified as lymphangiomas. A large amount of straw-colored discharge continued from all vulvar papules, which extended over the mons pubis. Nine years ago, the patient had undergone a radical hysterectomy with concurrent chemoradiation for uterine cervical cancer treatment. Her serum albumin level was 1.9 mg/dl, which was attributed to the loss of a large amount of lymph fluid due to leakage from the vulva. Her quality of life gradually decreased because of general fatigue and the need for frequent diaper exchanges every 2 h. The patient received a less-invasive treatment with cryotherapy using liquid nitrogen. She also received a multimodality treatment consisting of the intravenous administration of albumin, massage of the lower limbs and intensive rehabilitation. Cryotherapy was administered once a week for 3 months. Her discharge almost stopped and vulvar lymphangiomas decreased without any major complications. To the best of our knowledge, this is the first case report of massive lymphatic leakage complicated with vulvar lymphangiomas. Additionally, this case may represent the first successful treatment of vulva lymph leakage by cryotherapy without recurrence. Cryotherapy may have the potential to improve the quality of life as a less-invasive treatment for gynecological cancer survivors without serious complications.

  7. Social-Cognitive Processes Associated with Fear of Recurrence Among Women Newly Diagnosed with Gynecological Cancers

    PubMed Central

    Myers, Shannon B.; Manne, Sharon L; Kissane, David W.; Ozga, Melissa; Kashy, Deborah A.; Rubin, Stephen; Heckman, Carolyn; Rosenblum, Norman; Morgan, Mark; Graff, John J.

    2012-01-01

    Objective This cross sectional study aimed to characterize fears of recurrence among women newly diagnosed with gynecologic cancer. The study also evaluated models predicting the impact of recurrence fears on psychological distress through social and cognitive variables. Methods Women (N = 150) who participated in a randomized clinical trial comparing a coping and communication intervention to a supportive counseling intervention to usual care completed baseline surveys that were utilized for the study. The survey included the Concerns about Recurrence Scale (CARS), Beck Depression Inventory (BDI), Impact of Event Scale (IES), and measures of social (holding back from sharing concerns and negative responses from family and friends) and cognitive (positive reappraisal, efficacy appraisal, and self-esteem appraisal) variables. Medical data was obtained via medical chart review. Results Moderate-to-high levels of recurrence fears were reported by 47% of the women. Younger age (p < .01) and functional impairment (p < .01) correlated with greater recurrence fears. A social-cognitive model of fear of recurrence and psychological distress was supported. Mediation analyses indicated that as a set, the social and cognitive variables mediated the association between fear of recurrence and both depression and cancer-specific distress. Holding back and self-esteem showed the strongest mediating effects. Conclusion Fears of recurrence are prevalent among women newly diagnosed with gynecologic cancer. Social and cognitive factors play a role in women’s adaptation to fears and impact overall psychological adjustment. These factors may be appropriate targets for intervention. PMID:23088925

  8. What's the appeal? Testing public service advertisements to raise awareness about gynecologic cancer.

    PubMed

    Cooper, Crystale Purvis; Gelb, Cynthia A; Chu, Jennifer

    2014-06-01

    In 2013, the Centers for Disease Control and Prevention's (CDC) Inside Knowledge: Get the Facts About Gynecologic Cancer campaign tested creative concepts for English- and Spanish-language video advertisements (for use on television and the Internet) with women aged 35-64 years. Sixteen English and nine Spanish focus groups were conducted in four U.S. cities. CDC used animatics (a series of photographs edited together with a sound track) to simulate produced advertisements, without having to incur the high cost of filming and production. Advertisement concepts consistently resonating with participants featured cancer survivors, were straightforward, included information about cancer symptoms, displayed Inside Knowledge educational materials, and featured diverse women. In the general population focus groups, a primacy testing order effect was observed in which the concept tested first tended to be the most favorably received. Varying the order in which concepts were tested and considering testing order when interpreting results was critical.

  9. Epidemiology and surgical management of breast cancer in gynecological department of Douala General Hospital.

    PubMed

    Nguefack, Charlotte Tchente; Biwole, Martin Essomba; Massom, Annie; Kamgaing, Jacques Tsingaing; Njamen, Theophile Nana; Ekane, Gregory Halle; Obinchemti, Thomas Egbe; Priso, Eugene Belley

    2012-01-01

    Breast cancer is one of the most common gynecological cancers in our environment. Douala General Hospital (DGH) is one of the two main centers in Cameroon, where the cancerous patient can receive multidisciplinary management including radiotherapy. The aim of our study was to describe the epidemiological, clinical profile and surgical management of patients with breast cancer in gynecological department of DGH. A total of 42 patients were recruited in our department within a period of 3 years (from November 2006 to October 2009). The mean age was 46 years (range: 29-73 years). Characteristics of our study group were as followed: female sex (100%); breast feeding (95.245%); familial history of breast cancer (7.14%); 14.29% of patients were nulliparous and 19.05% primiparous. The main mode of discovering the disease was auto examination (92.86%). The clinical tumor size ranges from 2cm to 20cm with a mean of 6.83cm. Patients were then mostly diagnosed at stage III (54.76%) of the WHO classification. Only 2.38% were diagnosed at stage I. The main method of diagnosis was breast fine needle aspiration. Neo adjuvant treatment was administered in 78.57% of patients and the main surgical treatment was mastectomy (92.86%). Many patients are still followed up (59.52%), but we already had a mortality rate of 14.29% at the end of December 2010. We had no feedback for 26.19% of the study group. Breast cancer is generally diagnosed in advanced stage in our milieu; there is therefore a need for generalized sensitization of the population.

  10. OncoLink: a cancer information resource for gynecologic oncologists and the public on the Internet.

    PubMed

    Benjamin, I; Goldwein, J W; Rubin, S C; McKenna, W G

    1996-01-01

    The Internet is a computer network accessible to over 30 million computers users worldwide. By default, it has become the "information superhighway" that is growing at an explosive rate of between 1 and 2 million new users per month. Internet contains thousands of information of interest to cancer patients and healthcare professionals. Identifying the outstanding "golden" resources from the chaos is difficult. To address this problem and to provide information specific to gynecologic oncology, we developed a cancer information server called "OncoLink" at our institution that is available at no cost 24 hr per day, 7 days per week to all Internet users. OncoLink has two major goals: (1) To provide quality, original content for cancer patients and healthcare professionals and (2) to provide well-organized, consistent access to existing Internet cancer resources. This service may be used by anyone with a Microsoft Windows, Apple Macintosh, or UNIX computer. The service is rich in multimedia content containing text, pictures, illustrations, sound, and video. The information includes (1) original content written by authors at our institution, (2) original content submitted by authors from other institutions and, (3) publicly available information from other resources. Patient-oriented articles, physician-oriented review articles, and NIH, NCI, and FDA documents are available. All content is reviewed by an Editorial Board prior to posting. We have kept a detailed log file of each time the system has been accessed by an Internet user. OncoLink went online in March 1994. During the first 18 months (542 days) of operation, the service received 4,051,901 request for information from 105,589 unique Internet addresses worldwide. There is tremendous public and professional demand for online cancer information via the Internet. We feel that the Internet is an outstanding vehicle for providing quality cancer information for gynecologic oncologist other healthcare professionals

  11. Society of Gynecologic Oncology recommendations for the prevention of ovarian cancer.

    PubMed

    Walker, Joan L; Powell, C Bethan; Chen, Lee-May; Carter, Jeanne; Bae Jump, Victoria L; Parker, Lynn P; Borowsky, Mark E; Gibb, Randall K

    2015-07-01

    Mortality from ovarian cancer may be dramatically reduced with the implementation of attainable prevention strategies. The new understanding of the cells of origin and the molecular etiology of ovarian cancer warrants a strong recommendation to the public and health care providers. This document discusses potential prevention strategies, which include 1) oral contraceptive use, 2) tubal sterilization, 3) risk-reducing salpingo-oophorectomy in women at high hereditary risk of breast and ovarian cancer, 4) genetic counseling and testing for women with ovarian cancer and other high-risk families, and 5) salpingectomy after childbearing is complete (at the time of elective pelvic surgeries, at the time of hysterectomy, and as an alternative to tubal ligation). The Society of Gynecologic Oncology has determined that recent scientific breakthroughs warrant a new summary of the progress toward the prevention of ovarian cancer. This review is intended to emphasize the importance of the fallopian tubes as a potential source of high-grade serous cancer in women with and without known genetic mutations in addition to the use of oral contraceptive pills to reduce the risk of ovarian cancer. © 2015 American Cancer Society.

  12. The quality and readability of online consumer information about gynecologic cancer.

    PubMed

    Sobota, Aleksandra; Ozakinci, Gozde

    2015-03-01

    The Internet has become an important source of health-related information for consumers, among whom younger women constitute a notable group. The aims of this study were (1) to evaluate the quality and readability of online information about gynecologic cancer using validated instruments and (2) to relate the quality of information to its readability. Using the Alexa Rank, we obtained a list of 35 Web pages providing information about 7 gynecologic malignancies. These were assessed using the Health on the Net (HON) seal of approval, the Journal of the American Medical Association (JAMA) benchmarks, and the DISCERN instrument. Flesch readability score was calculated for sections related to symptoms and signs and treatment. Less than 30% of the Web pages displayed the HON seal or achieved all JAMA benchmarks. The majority of the treatment sections were of moderate to high quality according to the DISCERN. There was no significant relationship between the presence of the HON seal and readability. Web pages achieving all JAMA benchmarks were significantly more difficult to read and understand than Web pages that missed any of the JAMA benchmarks. Treatment-related content of moderate to high quality as assessed by the DISCERN had a significantly better readability score than the low-quality content. The online information about gynecologic cancer provided by the most frequently visited Web pages is of variable quality and in general difficult to read and understand. The relationship between the quality and readability remains unclear. Health care providers should direct their patients to reliable material online because patients consider the Internet as an important source of information.

  13. Photodynamic Therapy in Gynecologic Malignancies: A Review of the Roswell Park Cancer Institute Experience

    PubMed Central

    Mayor, Paul C.; Lele, Shashikant

    2016-01-01

    Photodynamic therapy (PDT) is a treatment modality used in the management of solid tumor malignancies that employs the use of a photosensitizing agent, a light source and oxygen in order to illicit a direct cytotoxic effect. Its use in gynecologic malignancies is somewhat novel and has been used for palliative and curative intent. At the Roswell Park Cancer Institute, the use of PDT in the management of gynecologic cancers began in the mid 1980s and since that time 35 patients have received PDT as a treatment for recurrent or metastatic cutaneous and vulvar, vaginal, anal, and cervical recurrences. In our experience, 85% patients with metastatic cutaneous lesions had a complete response. Twenty-seven percent of patients with metastatic vaginal, cervical or anal recurrences had a complete response to therapy with a median response time of 28 months. Side effects from the treatment included moderate to severe burning sensation, pain and edema at the treatment site requiring narcotic pain medication for symptom management in patients who underwent treatment to cutaneous lesions as well as lower genital tract recurrences. PDT should be considered an option in patients who are too frail to undergo the standard of care or decline the standard of care in lieu of a less invasive treatment modality. PMID:27669307

  14. Computed tomography-based quantitative assessment of lower extremity lymphedema following treatment for gynecologic cancer

    PubMed Central

    Chung, Seung Hyun; Kim, Young Jae; Kim, Kwang Gi; Hwang, Ji Hye

    2017-01-01

    Objective To develop an algorithmic quantitative skin and subcutaneous tissue volume measurement protocol for lower extremity lymphedema (LEL) patients using computed tomography (CT), to verify the usefulness of the measurement techniques in LEL patients, and to observe the structural characteristics of subcutaneous tissue according to the progression of LEL in gynecologic cancer. Methods A program for algorithmic quantitative analysis of lower extremity CT scans has been developed to measure the skin and subcutaneous volume, muscle compartment volume, and the extent of the peculiar trabecular area with a honeycombed pattern. The CT venographies of 50 lower extremities from 25 subjects were reviewed in two groups (acute and chronic lymphedema). Results A significant increase in the total volume, subcutaneous volume, and extent of peculiar trabecular area with a honeycombed pattern except quantitative muscle volume was identified in the more-affected limb. The correlation of CT-based total volume and subcutaneous volume measurements with volumetry measurement was strong (correlation coefficient: 0.747 and 0.749, respectively). The larger extent of peculiar trabecular area with a honeycombed pattern in the subcutaneous tissue was identified in the more-affected limb of chronic lymphedema group. Conclusion CT-based quantitative assessments could provide objective volume measurements and information about the structural characteristics of subcutaneous tissue in women with LEL following treatment for gynecologic cancer. PMID:28028991

  15. Facts, misconceptions, and myths about cancer. What do patients with gynecological cancer and the female public at large know?

    PubMed

    Carlsson, M E; Strang, P M

    1997-04-01

    Misconceptions about cancer may increase the level of fear in the general public and render coping more difficult in cancer patients. The aim of this survey was to study the level of knowledge and misconceptions. A questionnaire comprising 27 questions related to cancer etiology, treatment, and prognosis was mailed to 100 patients with gynecological cancers and to 120 healthy women. The response rates were 86 and 78%, respectively. The proportion of correct answers was similar in both groups. Everyone considered cancer to be noncontagious. A majority knew that gynecological cancers have a good prognosis if diagnosed in early stages and that morphine is very effective in the treatment of severe cancer pain, but believed that it causes addiction. Questions with a significant proportion of erroneous answers were related to hormones and cancer. Patients were more aware of the risk associated between unopposed estrogen therapy and endometrial carcinoma (P < 0.05). However, the patients incorrectly believed that combined hormonal therapy (estrogen + gestagens) also increased the risk of endometrial and ovarians carcinoma and they did so much more often than the control group (P < 0.05). The general public more often believed that cancer often arises as a consequence of previous physical injury (P < 0.05). Formal education correlated positively with correct responses (P < 0.01). In conclusion, the results emphasize the importance of proper information about cancer and cancer treatment, especially with regard to hormonal treatment and the use of morphine. Individuals with the least formal education constitute an especially important target group for information.

  16. A focus group study exploring gynecological cancer survivors' experiences and perceptions of participating in a RCT testing the efficacy of a home-based physical activity intervention.

    PubMed

    Donnelly, C M; Lowe-Strong, A; Rankin, J P; Campbell, A; Blaney, J M; Gracey, J H

    2013-06-01

    This study aims to explore gynecological cancer survivors' perceptions and experiences following participation in a randomised controlled trial (RCT) testing the efficacy of a home-based physical activity behavioral change intervention (Donnelly et al., Gynecol Oncol 122:618-624, 2011). All participants completing a two-armed parallel RCT were invited to participate in the study (31/33) (Donnelly et al., Gynecol Oncol 122:618-624, 2011). Sixteen participants took part (16/31; physical activity (PA) group n = 9, contact control (CC) group n = 7). Four qualitative group interviews were conducted (focus group size 3-5). A structured interview guide was followed by an independent moderator. Groups were audio recorded, transcribed verbatim, and analyzed using the framework approach (Ritchie and Spencer 2001), a five-stage qualitative method of analysis. One of the most unanimously perceived benefits of taking part in the programme regarded participants' psychological well-being. Additional benefits included improved physical fitness and functioning. Important programme features included the weekly telephone calls from a physiotherapist, the patient-professional relationship, and goal setting. Participants' own motivation and programme timing were also identified as important factors. Suggestions for improvements include: opportunities for social interaction with other gynecological cancer survivors and greater exercise choice. Findings suggest that women diagnosed with gynecological cancer perceive participation in physical activity as important and participation provides benefits in terms of psychological well-being and improved physical functioning. Support for continuation of many of the current features of the home-based programme was provided. Findings provide insight and rationale for the selection of components for future home-based physical activity interventions. Findings also support further research into the development of multidimensional

  17. Is bariatric surgery an option for women with gynecologic cancer? Examining weight loss counseling practices and training among gynecologic oncology providers.

    PubMed

    Neff, Robert; McCann, Georgia A; Carpenter, Kristen M; Cohn, David E; Noria, Sabrena; Mikami, Dean; Needleman, Bradley J; O'Malley, David M

    2014-09-01

    The objective of this study was to evaluate gynecologic oncology provider (GOP) practices regarding weight loss (WL) counseling, and to assess their willingness to initiate weight loss interventions, specifically bariatric surgery (WLS). Members of the Society of Gynecologic Oncology were invited to complete an online survey of 49 items assessing knowledge, attitudes, and behaviors related to WL counseling. A total of 454 participants initiated the survey, yielding a response rate of 30%. The majority of respondents (85%) were practicing GOP or fellows. A majority of responders reported that >50% of their patient population is clinically obese (BMI ≥ 30). Only 10% reported having any formal training in WL counseling, most often in medical school or residency. Providers who feel adequate about WL counseling were more likely to offer multiple WL options to their patients (p<.05). Over 90% of responders believe that WLS is an effective WL option and is more effective than self-directed diet and medical management of obesity. Providers who were more comfortable with WL counseling were significantly more likely to recommend WLS (p<.01). Approximately 75% of respondents expressed interest in clinical trials evaluating WLS in obese cancer survivors. The present study suggests that GOP appreciate the importance of WL counseling, but often fail to provide it. Our results demonstrate the paucity of formal obesity training in oncology. Providers seem willing to recommend WLS as an option to their patients but also in clinical trials examining gynecologic cancer outcomes in women treated with BS. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Loss of ARID1A expression leads to sensitivity to ROS-inducing agent elesclomol in gynecologic cancer cells

    PubMed Central

    Kwan, Suet-Yan; Cheng, Xuanjin; Tsang, Yvonne T.M.; Choi, Jong-Sun; Kwan, Suet-Ying; Izaguirre, Daisy I.; Kwan, Hoi-Shan; Gershenson, David M.; Wong, Kwong-Kwok

    2016-01-01

    Inactivating mutations in ARID1A are found in a broad spectrum of cancer types, with the highest frequency in gynecologic cancers. However, therapeutic strategies targeting ARID1A-mutant cancer cells remain limited. In this study, we aimed to identify drugs sensitivities in ARID1A-mutant cancer cell lines. By analyzing the Genomics of Drug Sensitivity in Cancer database, we found that ARID1A-mutant cancer cell lines were more sensitive to treatment with the reactive oxygen species (ROS)-inducing agent elesclomol. In a panel of 14 gynecologic cancer cell lines, treatment with elesclomol inhibited growth and induced apoptosis more potently in ARID1A-mutant cells. Knockdown of ARID1A in RMG1 and OVCA432 ovarian cancer cells resulted in increased sensitivity to elesclomol, whereas restoration of ARID1A expression in TOV21G ovarian cancer cells resulted in increased resistance to elesclomol. Furthermore, we found that knockdown of ARID1A expression resulted in increased intracellular ROS levels. In ovarian clear cell carcinoma patient samples, low expression of ARID1A correlated with high expression of 8-hydroxyguanosine, a marker for oxidative stress. In summary, we demonstrate for the first time that loss of ARID1A leads to accumulation of ROS and suggest that elesclomol may be used to target ARID1A-mutant gynecologic cancer cells. PMID:27486766

  19. Types of Cancer Research

    Cancer.gov

    An infographic from the National Cancer Institute (NCI) describing the four broad categories of cancer research: basic research, clinical research, population-based research, and translational research.

  20. Comparison of teaching about breast cancer via mobile or traditional learning methods in gynecology residents.

    PubMed

    Alipour, Sadaf; Moini, Ashraf; Jafari-Adli, Shahrzad; Gharaie, Nooshin; Mansouri, Khorshid

    2012-01-01

    Mobile learning enables users to interact with educational resources while in variable locations. Medical students in residency positions need to assimilate considerable knowledge besides their practical training and we therefore aimed to evaluate the impact of using short message service via cell phone as a learning tool in residents of Obstetrics and Gynecology in our hospital. We sent short messages including data about breast cancer to the cell phones of 25 residents of gynecology and obstetrics and asked them to study a well-designed booklet containing another set of information about the disease in the same period. The rate of learning derived from the two methods was compared by pre- and post-tests and self-satisfaction assessed by a relevant questionnaire at the end of the program. The mobile learning method had a significantly better effect on learning and created more interest in the subject. Learning via receiving SMS can be an effective and appealing method of knowledge acquisition in higher levels of education.

  1. Current academic clinical trials in ovarian cancer: Gynecologic Cancer Intergroup and US National Cancer Institute Clinical Trials Planning Meeting, May 2009.

    PubMed

    Trimble, Edward L; Birrer, Michael J; Hoskins, William J; Marth, Christian; Petryshyn, Ray; Quinn, Michael; Thomas, Gillian M; Kitchener, Henry C; Aghajanian, Carol; Alberts, David S; Armstrong, Deborah; Brown, Jubilee; Coleman, Robert L; Colombo, Nicoletta; Eisenhauer, Elizabeth; Friedlander, Michael; Fujiwara, Keiichi; Hunsberger, Sally; Kaye, Stan; Ledermann, Jonathan A; Lee, Susanna; Look, Katherine; Mannel, Robert; McNeish, Iain A; Minasian, Lori; Oza, Amit; Paul, Jim; Poveda, Andres; Pujade-Lauraine, Eric; Schoenfeldt, Mason; Swart, Ann Marie; von Gruenigen, Vivian; Wenzel, Lari

    2010-10-01

    To review the current status of large phase academic clinical trials for women with ovarian cancer, address cross-cutting issues, and identify promising areas for future collaboration. In May 2009, the Gynecologic Cancer Intergroup, which represents 19 Cooperative Groups conducting trials for women with gynecologic cancer, and the US National Cancer Institute convened a Clinical Trials Planning Meeting. The topics covered included the impact of new developments in cancer biology upon molecular targets and novel agents, pharmacogenomics, advances in imaging, the potential benefit of diet and exercise to reduce the risk of recurrence, academic partnership with industry, statistical considerations for phases 2 and 3 trials, trial end points, and symptom benefit and health-related quality-of-life issues. The clinical trials discussed spanned the spectrum of ovarian cancer from initial diagnosis, staging, and cytoreductive surgery to consolidation chemotherapy, and treatment of recurrent disease. Ongoing and effective collaboration with industry, government, and patients aims to ensure that the most important scientific questions can be answered rapidly. We encourage women with ovarian cancer and their oncologists to consider participation in the academic clinical trials conducted by the member groups of the Gynecologic Cancer Intergroup.

  2. Quality of life, lifestyle behavior and employment experience: a comparison between young and midlife survivors of gynecology early stage cancers.

    PubMed

    Bifulco, G; De Rosa, N; Tornesello, M L; Piccoli, R; Bertrando, A; Lavitola, G; Morra, I; Di Spiezio Sardo, A; Buonaguro, F M; Nappi, C

    2012-03-01

    To evaluate differences and changes in quality of life (QoL), lifestyle behavior and employment experience of young in comparison to midlife adults in response to early stage gynecologic cancer diagnoses. 263 patients, divided into two age groups (Group A: ≤ 45 and Group B: >45 years), were interviewed on their QoL, lifestyle behavior (dietary habits, tobacco and alcohol use, physical activity) and employment experience (employment status and working time) at diagnosis and within 4 years from the treatment. The QoL was evaluated by European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 (QLQ-C30) and its specific modules for each cancer type (in particular endometrium, cervix, ovarian and breast). Global health status was significantly different between the two groups. In the younger age group a more relevant cancer interference on family life and social activities and a greater impact on perception of health status have been observed. Young women were more affected by fatigue, constipation, gastrointestinal symptoms, lymphedema, poor body image and impaired sexuality. Cancer diagnosis had a major negative impact on employment of younger patients. Conversely, younger patients had overall better health behavior. They reported a higher daily intake of fruits and vegetables, along with lower alcohol consumption, furthermore they were a little more physically active than midlife adults. To enhance quality of life and to promote healthy lifestyle behavior of female cancer patients, particularly in younger age, it is essential to assure multidisciplinary approaches with specific medical intervention and psychosocial supports. Indeed, midlife adults seem to have a more rapid adaptive tendency to return towards levels of well-being, following cancer diagnosis and treatment, than younger patients. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. Patient Generated Subjective Global Assessment as a prognosis tool in women with gynecologic cancer.

    PubMed

    Rodrigues, Camila Santos; Lacerda, Marina Seraphim; Chaves, Gabriela Villaça

    2015-01-01

    The aim of this study was to assess the nutritional status (NS) of women hospitalized for gynecologic tumors and relate it to such outcomes as hospital length of stay and 1-y mortality. We assessed 146 women diagnosed with gynecologic tumors who were admitted to a referral oncologic hospital in November 2012. Data collected included medical history, duration and reason for admission, and cases of death within 1 y. NS was assessed using Patient-Generated Subjective Global Assessment (PG-SGA). The receiver operating characteristic curve was used to define the best cutoff point for discriminating individuals who did or did not die. We used proportional hazards regression to assess associations between malnutrition and 1-y mortality. According to the PG-SGA, 62.4% of the women were classified as being at nutritional risk or having moderate or severe malnutrition. Sorting patients by stage of cancer, there was no statistical difference in NS classification according to the different cancer sites. The median hospital stay, in days, was statistically lower in patients classified as well nourished. Individuals with a score above the cutoff point of 10 were 30.7 times more likely (95% confidence interval, 11.8-79.4) to die. There was a 52.1% rate of mortality within 1 y. Patients classed as having some degree of malnutrition had a significantly lower median survival rate. A diagnosis of cervical cancer and severe malnourishment increases the likelihood of death. Our findings suggest that the PG-SGA can be considered not just as an indicator of nutritional risk, but also as a major predictor of prognosis and mortality in this population. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Lymphatic mapping and sentinel node biopsy in gynecological cancers: a critical review of the literature

    PubMed Central

    Ayhan, Ali; Celik, Husnu; Dursun, Polat

    2008-01-01

    Although it does not have a long history of sentinel node evaluation (SLN) in female genital system cancers, there is a growing number of promising study results, despite the presence of some aspects that need to be considered and developed. It has been most commonly used in vulvar and uterine cervivcal cancer in gynecological oncology. According to these studies, almost all of which are prospective, particularly in cases where Technetium-labeled nanocolloid is used, sentinel node detection rate sensitivity and specificity has been reported to be 100%, except for a few cases. In the studies on cervical cancer, sentinel node detection rates have been reported around 80–86%, a little lower than those in vulva cancer, and negative predictive value has been reported about 99%. It is relatively new in endometrial cancer, where its detection rate varies between 50 and 80%. Studies about vulvar melanoma and vaginal cancers are generally case reports. Although it has not been supported with multicenter randomized and controlled studies including larger case series, study results reported by various centers around the world are harmonious and mutually supportive particularly in vulva cancer, and cervix cancer. Even though it does not seem possible to replace the traditional approaches in these two cancers, it is still a serious alternative for the future. We believe that it is important to increase and support the studies that will strengthen the weaknesses of the method, among which there are detection of micrometastases and increasing detection rates, and render it usable in routine clinical practice. PMID:18492253

  5. Oncogenic Role of SET/I2PP2A for Gynecologic Cancers.

    PubMed

    Jiang, Shi-Wen; Xu, Siliang; Chen, Haibin; Liu, Jiayin; Duan, Ping

    2017-01-01

    SET (SE translocation, SET) is an evolutionarily conserved gene broadly expressed in various human tissues, especially in the gonadal and neural system. As a multitasking protein, SET is involved in essential cell processes such as histone modification, chromatin remodeling, DNA repair, gene transcription, and androgen synthesis. Recent studies showed that SET is overexpressed in breast cancers, ovary cancers and a variety of other malignancies. The strong correlation between SET expression levels and survival of ovarian cancer patients, and SET-mediated activation of androgen synthesis, strongly indicated that this factor may play a significant role in gynecologic cancers. Here, we summarized data pertaining to the pathological implications of SET in tumorigenesis and cancer progression. We analyzed how SET, through the PP2A-dependent and PP2A-independent pathways, may regulate different cell functions. Potential interactions among these pathways and future studies on SET's oncogenic activities are also discussed. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  6. Therapist and Patient Perceptions of Alliance and Progress in Psychological Therapy for Women Diagnosed with Gynecological Cancers

    ERIC Educational Resources Information Center

    Manne, Sharon L.; Kashy, Deborah A.; Rubin, Stephen; Hernandez, Enrique; Bergman, Cynthia

    2012-01-01

    Objective: The goal was to understand both therapist and patient perspectives on alliance and session progress for women in treatment for gynecological cancer. We used a longitudinal version of the one-with-many design to partition variation in alliance and progress ratings into therapist, patient/dyad, and time-specific components. We also…

  7. Therapist and Patient Perceptions of Alliance and Progress in Psychological Therapy for Women Diagnosed with Gynecological Cancers

    ERIC Educational Resources Information Center

    Manne, Sharon L.; Kashy, Deborah A.; Rubin, Stephen; Hernandez, Enrique; Bergman, Cynthia

    2012-01-01

    Objective: The goal was to understand both therapist and patient perspectives on alliance and session progress for women in treatment for gynecological cancer. We used a longitudinal version of the one-with-many design to partition variation in alliance and progress ratings into therapist, patient/dyad, and time-specific components. We also…

  8. Practice guidelines for management of uterine corpus cancer in Korea: a Korean Society of Gynecologic Oncology Consensus Statement

    PubMed Central

    Hong, Dae Gy; Shin, So-Jin; Ju, Woong; Cho, Hanbyoul; Lee, Chulmin; Kim, Hyun-Jung; Bae, Duk-Soo

    2017-01-01

    Clinical practice guidelines for gynecologic cancers have been developed by many organizations. Although these guidelines have much in common in terms of the practice of standard of care for uterine corpus cancer, practice guidelines that reflect the characteristics of patients and healthcare and insurance systems are needed for each country. The Korean Society of Gynecologic Oncology (KSGO) published the first edition of practice guidelines for gynecologic cancer treatment in late 2006; the second edition was released in July 2010 as an evidence-based recommendation. The Guidelines Revision Committee was established in 2015 and decided to produce the third edition of the guidelines as an advanced form based on evidence-based medicine, considering up-to-date clinical trials and abundant qualified Korean data. These guidelines cover screening, surgery, adjuvant treatment, and advanced and recurrent disease with respect to endometrial carcinoma and uterine sarcoma. The committee members and many gynecologic oncologists derived key questions from the discussion, and a number of relevant scientific literatures were reviewed in advance. Recommendations for each specific question were developed by the consensus conference, and they are summarized here, together with other details. The objective of these practice guidelines is to establish standard policies on issues in clinical areas related to the management of uterine corpus cancer based on the findings in published papers to date and the consensus of experts as a KSGO Consensus Statement. PMID:27894165

  9. Risks of Breast Cancer Screening

    MedlinePlus

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Screening (PDQ®)–Patient Version What is screening? Go ... cancer screening: Cancer Screening Overview General Information About Breast Cancer Key Points Breast cancer is a disease in ...

  10. Benign breast and gynecologic conditions, reproductive and hormonal factors, and risk of thyroid cancer.

    PubMed

    Braganza, Melissa Z; de González, Amy Berrington; Schonfeld, Sara J; Wentzensen, Nicolas; Brenner, Alina V; Kitahara, Cari M

    2014-04-01

    The higher incidence of thyroid cancer in women compared with men suggests an influence of sex steroid hormones in the etiology of this malignancy. We investigated a comprehensive set of potential indicators of lifetime sex steroid hormone exposure in relation to thyroid cancer risk. Using data from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, which enrolled 70,047 women, 50 to 78 years old, we prospectively examined associations of self-reported history of benign breast and gynecologic conditions, reproductive factors, and exogenous sex hormone use with thyroid cancer risk. Multivariable-adjusted HRs and 95% confidence intervals (CI) were calculated in models using age as the time metric. During follow-up (median, 11 years), 127 women were diagnosed with first primary thyroid cancer. Older age at natural menopause (≥55 vs. <50 years; HR, 2.24; 95% CI, 1.20-4.18), greater estimated lifetime number of ovulatory cycles (≥490 vs. <415 cycles; HR, 2.40; 95% CI, 1.33-4.30), greater number of live births (≥5 vs. 1-2; HR, 1.72; 95% CI, 1.05-2.82), and history of uterine fibroids (HR, 1.72; 95% CI, 1.18-2.50) were associated with an increased risk of thyroid cancer. Earlier age at menarche, greater number of reproductive years, history of a tubal ligation, and history of ovarian cysts were nonsignificantly associated with increased thyroid cancer risk. No associations were observed for oral contraceptive use, menopausal hormone therapy, or history of benign breast disease or endometriosis. In general, we found that factors reflecting a greater length of exposure to endogenous hormones, particularly during the reproductive years, were associated with risk of postmenopausal thyroid cancer.

  11. Ovarian cancer clinical trial endpoints: Society of Gynecologic Oncology white paper

    PubMed Central

    Herzog, Thomas J.; Armstrong, Deborah K.; Brady, Mark F.; Coleman, Robert L.; Einstein, Mark H.; Monk, Bradley J.; Mannel, Robert S.; Thigpen, J. Tate; Umpierre, Sharee A.; Villella, Jeannine A.; Alvarez, Ronald D.

    2015-01-01

    Objective To explore the value of multiple clinical endpoints in the unique setting of ovarian cancer. Methods A clinical trial workgroup was established by the Society of Gynecologic Oncology to develop a consensus statement via multiple conference calls, meetings and white paper drafts. Results Clinical trial endpoints have profound effects on late phase clinical trial design, result interpretation, drug development, and regulatory approval of therapeutics. Selection of the optimal clinical trial endpoint is particularly provocative in ovarian cancer where long overall survival (OS) is observed. The lack of new regulatory approvals and the lack of harmony between regulatory bodies globally for ovarian cancer therapeutics are of concern. The advantages and disadvantages of the numerous endpoints available are herein discussed within the unique context of ovarian cancer where both crossover and post-progression therapies potentially uncouple surrogacy between progression-free survival (PFS) and OS, the two most widely supported and utilized endpoints. The roles of patient reported outcomes (PRO) and health related quality of life (HRQoL) are discussed, but even these widely supported parameters are affected by the unique characteristics of ovarian cancer where a significant percentage of patients may be asymptomatic. Original data regarding the endpoint preferences of ovarian cancer advocates is presented. Conclusions Endpoint selection in ovarian cancer clinical trials should reflect the impact on disease burden and unique characteristics of the treatment cohort while reflecting true patient benefit. Both OS and PFS have led to regulatory approvals and are clinically important. OS remains the most objective and accepted endpoint because it is least vulnerable to bias; however, the feasibility of OS in ovarian cancer is compromised by the requirement for large trial size, prolonged time-line for final analysis, and potential for unintended loss of treatment effect

  12. Benign breast and gynecological conditions, reproductive and hormonal factors, and risk of thyroid cancer

    PubMed Central

    Braganza, Melissa Z.; de González, Amy Berrington; Schonfeld, Sara J.; Wentzensen, Nicolas; Brenner, Alina V.; Kitahara, Cari M.

    2014-01-01

    The higher incidence of thyroid cancer in women compared to men suggests an influence of sex steroid hormones in the etiology of this malignancy. We investigated a comprehensive set of potential indicators of lifetime sex steroid hormone exposure in relation to thyroid cancer risk. Using data from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, which enrolled 70,047 women, 50–78 years old, we prospectively examined associations of self-reported history of benign breast and gynecological conditions, reproductive factors, and exogenous sex hormone use with thyroid cancer risk. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated in models using age as the time metric. During follow-up (median=11 years), 127 women were diagnosed with first primary thyroid cancer. Older age at natural menopause (≥55 vs. <50 years: HR=2.24, 95% CI:1.20–4.18), greater estimated lifetime number of ovulatory cycles (≥490 vs. <415 cycles: HR= 2.40, 95% CI:1.33–4.30), greater number of live births (≥5 vs. 1–2: HR=1.72, 95% CI:1.05–2.82), and history of uterine fibroids (HR=1.72, 95% CI:1.18–2.50) were associated with an increased risk of thyroid cancer. Earlier age at menarche, greater number of reproductive years, history of a tubal ligation, and history of ovarian cysts were non-significantly associated with increased thyroid cancer risk. No associations were observed for oral contraceptive use, menopausal hormone therapy, or history of benign breast disease or endometriosis. In general, we found that factors reflecting a greater length of exposure to endogenous hormones, particularly during the reproductive years, were associated with risk of postmenopausal thyroid cancer. PMID:24449056

  13. Impact of lower limb lymphedema on quality of life in gynecologic cancer survivors after pelvic lymph node dissection.

    PubMed

    Kim, Se Ik; Lim, Myong Cheol; Lee, Jeong Seon; Lee, Yumi; Park, KiByung; Joo, Jungnam; Seo, Sang-Soo; Kang, Sokbom; Chung, Seung Hyun; Park, Sang-Yoon

    2015-09-01

    To evaluate the impact of lower limb lymphedema (LLL) on quality of life (QOL) in cervical, ovarian, and endometrial cancer survivors after pelvic lymph node dissection. A cross-sectional case-control study was performed using the Korean version of the Gynecologic Cancer Lymphedema Questionnaire (GCLQ-K) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). In total, 25 women with LLL and 28 women without LLL completed both questionnaires. The GCLQ-K total symptom score and scores for swelling-general, swelling-limb, and heaviness were significantly higher in the LLL group than in the control group. In the EORTC QLQ-C30, the LLL group reported more financial difficulties compared to the control group (mean score, 16.0 vs. 6.0; P=0.035). Global health status was poorer in the LLL group with borderline statistical significance (mean score, 62.7 vs. 71.4; P=0.069). Spearman's correlations suggested that global health status in the EORTC QLQ-C30 correlated with the GCLQ-K total symptom score (in the LLL group, R=-0.64, P=0.001; in the control group, R=-0.42, P=0.027). QOL decreases due to LLL-related symptoms and financial difficulty in women with LLL. Well-designed prospective studies are required to confirm these findings. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. Video-, Audio-, and Computer-Mediated Education of Patients and Relatives in Gynecologic Cancer Care: A Systematic Review.

    PubMed

    Thygesen, Marianne K; Nicolaisen, Anne; Mogensen, Ole

    2015-01-01

    Cancer patients can often experience emotional distress, and gynecologic cancer patients may be among the most distressed. As hospital stays become shorter, nurses are challenged to educate patients and relatives adequately. The use of computer-based technologies may alleviate the situation. This article aims to review the literature related to the use of audio-, visual-, or computer-based technologies to support healthcare professional training of adult female patients and their close relatives in gynecologic cancer care. We describe to what extent these technologies were found to be effective and evaluate clinical implications. PubMed, EMBASE and PsycINFO via Ovid, CINAHL via EBSCO, and the Cochrane Library were searched, and 4177 unique references were examined. All studies evaluating healthcare professional training of women with gynecologic cancer and/or their relatives via audio-, visual-, or computer-based technologies were included. We found scarce and conflicting evidence of benefits to gynecologic patients of healthcare professional use of video- or computer-based patient education. These interventions might be best suited to the highest educated with coping skills beyond the average. No studies were found to include relatives or found to test audio-based patient education. More rigorously produced and reported studies of healthcare professional training initiatives for gynecologic cancer patients and their relatives are recommended. Measures used to capture the perceived benefits to patients might be reconsidered. Precautions should be taken before recommending technologies that are unevaluated in own context. Attention must be on both what is provided when and to whom.

  15. Consequences of gynecological cancer in patients and their partners from the sexual and psychological perspective

    PubMed Central

    Woźniak, Katarzyna; Iżycka, Natalia

    2016-01-01

    The diagnosis of gynecological cancer and the following consequences of the treatment radically change the lives of cancer patients and their partners. Women experience negative consequences in terms of sexual, psychological and social functioning. Surgical treatment may result in a decrease in sexual pleasure and pain during intercourse. Chemotherapy and radiotherapy can cause a loss of libido and negatively affect the capacity to experience pleasure or orgasm. Treatment-related changes may include the occurrence of body image disorders, decreased quality of life as well as depressive and anxiety disorders among patients. Furthermore, a negative influence on the relationship between the affected women and their partners, as well as an adverse effect on the social activity, can be observed. Cancer is not an individual experience. It also affects partners of the sick women in terms of psychological and sexual functioning. This article depicts possible problems encountered by cancer patients and their partners from the psychological and sexual perspective. The emphasis is put on understanding sexuality not only in the context of sexual performance, but also in a wider perspective. PMID:27582686

  16. The relationship between symptom prevalence, body image, and quality of life in Asian gynecologic cancer patients.

    PubMed

    Teo, Irene; Cheung, Yin Bun; Lim, Timothy Yong Kuei; Namuduri, Rama Padmavathi; Long, Victoria; Tewani, Komal

    2017-05-15

    Gynecologic cancer is associated with long-term effects that can be both physical and emotional. We examined symptom prevalence and body image disturbance in patients with gynecologic cancer and their association with quality of life. Predictors of clinically-relevant body image disturbance were examined. A sample of patients in Singapore (n = 104) was assessed for symptom prevalence, quality of life, and body image dissatisfaction. Clinical factors were extracted from medical records. The most frequently reported symptoms were fatigue, abdominal bloatedness, weight gain, constipation, hot flashes, and pelvic pain. Approximately one quarter patients reported feeling less physically attractive and dissatisfied with their body. Ordinary least squares regression indicated that symptom prevalence alone predicted physical well-being, b = -1.09, P < .001, 95% CI, -1.45 to -0.73, and functional well-being, b = -0.88, P < .001, 95% CI, -1.32 to -0.45. Body image dissatisfaction alone significantly predicted emotional well-being, b = -0.21, P < .01, 95% CI, -0.35 to -0.06. Younger age was a significant risk factor for clinically-relevant score of body image distress, OR = 0.95 per year older, 95% CI, 0.92 to 0.99, P = .02. Symptom prevalence and body image dissatisfaction were associated with different domains of quality of life. Emotional well-being of patients was better explained by body image, rather than extent of symptoms experienced. Patients who are younger appear particularly susceptible to body image disturbance. Copyright © 2017 John Wiley & Sons, Ltd.

  17. Development of the short version of the Gynecologic Cancer Lymphedema Questionnaire: GCLQ-7.

    PubMed

    Kim, Se Ik; Kim, Namjoo; Lee, Seonjoo; Lee, Sujung; Joo, Jungnam; Seo, Sang Soo; Chung, Seung Hyun; Park, Sang Yoon; Lim, Myong Cheol

    2017-03-01

    The Gynecologic Cancer Lymphedema Questionnaire (GCLQ) was designed to identify gynecologic cancer patients with lower limb lymphedema (LLL). The questionnaire consists of 20 items distributed over 7 symptom clusters. The present study aimed to develop an abridged form of the GCLQ for simpler screening and more effective follow-up of LLL. Data that had been collected for the development and validation of the Korean version of the GCLQ (GCLQ-K) were used in this study. Receiver-operating characteristic (ROC) curves were drawn according to the individual items of the GCLQ-K. Based on discrimination ability, the candidate items were selected in each symptom cluster. After combining the items, the best model was identified and named GCLQ-7. The area under the ROC curve (AUC) was compared between the GCLQ-7 and the original GCLQ-K. In total, 11 candidate items were selected from the original GCLQ-K. Among the models made with the candidate items, GCLQ-7, the best model, was constructed with 7 items as follows: 1) limited knee movement, 2) general swelling, 3) redness, 4) firmness/tightness, 5) groin swelling, 6) heaviness, and 7) aching. This model exhibited an AUC of 0.945 (95% confidence interval [CI], 0.900-0.991), which is comparable with that of the original GCLQ-K (AUC, 0.867; 95% CI, 0.779-0.956). The best cutoff value was 2 points, at which the sensitivity and specificity were 97.0% and 76.5%, respectively. The newly developed short version model, GCLQ-7, showed acceptable discrimination ability as compared with the original GCLQ-K.

  18. Validation of catheter segmentation for MR-guided gynecologic cancer brachytherapy.

    PubMed

    Pernelle, Guillaume; Mehrtash, Alireza; Barber, Lauren; Damato, Antonio; Wang, Wei; Seethamraju, Ravi Teja; Schmidt, Ehud; Cormack, Robert A; Wells, Williams; Viswanathan, Akila; Kapur, Tina

    2013-01-01

    Segmentation of interstitial catheters from MRI needs to be addressed in order for MRI-based brachytherapy treatment planning to become part of the clinical practice of gynecologic cancer radiotherapy. This paper presents a validation study of a novel image-processing method for catheter segmentation. The method extends the distal catheter tip, interactively provided by the physician, to its proximal end, using knowledge of catheter geometry and appearance in MRI sequences. The validation study consisted of comparison of the algorithm results to expert manual segmentations, first on images of a phantom, and then on patient MRI images obtained during MRI-guided insertion of brachytherapy catheters for the treatment of gynecologic cancer. In the phantom experiment, the maximum disagreement between automatic and manual segmentation of the same MRI image, as computed using the Hausdorf distance, was 1.5 mm, which is of the same order as the MR image spatial resolution, while the disagreement between automatic segmentation of MR images and "ground truth", manual segmentation of CT images, was 3.5 mm. The segmentation method was applied to an IRB-approved retrospective database of 10 interstitial brachytherapy patients which included a total of 101 catheters. Compared with manual expert segmentations, the automatic method correctly segmented 93 out of 101 catheters, at an average rate of 0.3 seconds per catheter using a 3 GHz Intel Core i7 computer with 16 GB RAM and running Mac OS X 10.7. These results suggest that the proposed catheter segmentation is both technically and clinically feasible.

  19. Validation of Catheter Segmentation for MR-guided Gynecologic Cancer Brachytherapy

    PubMed Central

    Pernelle, Guillaume; Mehrtash, Alireza; Barber, Lauren; Damato, Antonio; Wang, Wei; Seethamraju, Ravi Teja; Schmidt, Ehud; Cormack, Robert; Wells, Williams; Viswanathan, Akila; Kapur, Tina

    2014-01-01

    Segmentation of interstitial catheters from MRI needs to be addressed in order for MRI-based brachytherapy treatment planning to become part of the clinical practice of gynecologic cancer radiotherapy. This paper presents a validation study of a novel image-processing method for catheter segmentation. The method extends the distal catheter tip, interactively provided by the physician, to its proximal end, using knowledge of catheter geometry and appearance in MRI sequences. The validation study consisted of comparison of the algorithm results to expert manual segmentations, first on images of a phantom, and then on patient MRI images obtained during MRI-guided insertion of brachytherapy catheters for the treatment of gynecologic cancer. In the phantom experiment, the maximum disagreement between automatic and manual segmentation of the same MRI image, as computed using the Hausdorf distance, was 1.5 mm, which is of the same order as the MR image spatial resolution, while the disagreement between automatic segmentation of MR images and “ground truth”, manual segmentation of CT images, was 3.5 mm. The segmentation method was applied to an IRB-approved retrospective database of 10 interstitial brachytherapy patients which included a total of 101 catheters. Compared with manual expert segmentations, the automatic method correctly segmented 93 out of 101 catheters, at an average rate of 0.3 seconds per catheter using a 3GHz Intel Core i7 computer with 16 GB RAM and running Mac OS X 10.7. These results suggest that the proposed catheter segmentation is both technically and clinically feasible. PMID:24505784

  20. Development of the short version of the Gynecologic Cancer Lymphedema Questionnaire: GCLQ-7

    PubMed Central

    Kim, Namjoo; Lee, Seonjoo; Lee, Sujung; Seo, Sang-Soo; Chung, Seung Hyun

    2017-01-01

    Objective The Gynecologic Cancer Lymphedema Questionnaire (GCLQ) was designed to identify gynecologic cancer patients with lower limb lymphedema (LLL). The questionnaire consists of 20 items distributed over 7 symptom clusters. The present study aimed to develop an abridged form of the GCLQ for simpler screening and more effective follow-up of LLL. Methods Data that had been collected for the development and validation of the Korean version of the GCLQ (GCLQ-K) were used in this study. Receiver-operating characteristic (ROC) curves were drawn according to the individual items of the GCLQ-K. Based on discrimination ability, the candidate items were selected in each symptom cluster. After combining the items, the best model was identified and named GCLQ-7. The area under the ROC curve (AUC) was compared between the GCLQ-7 and the original GCLQ-K. Results In total, 11 candidate items were selected from the original GCLQ-K. Among the models made with the candidate items, GCLQ-7, the best model, was constructed with 7 items as follows: 1) limited knee movement, 2) general swelling, 3) redness, 4) firmness/tightness, 5) groin swelling, 6) heaviness, and 7) aching. This model exhibited an AUC of 0.945 (95% confidence interval [CI], 0.900–0.991), which is comparable with that of the original GCLQ-K (AUC, 0.867; 95% CI, 0.779–0.956). The best cutoff value was 2 points, at which the sensitivity and specificity were 97.0% and 76.5%, respectively. Conclusion The newly developed short version model, GCLQ-7, showed acceptable discrimination ability as compared with the original GCLQ-K. PMID:27819411

  1. Shyness and openness--common ground for dialogue between health personnel and women about sexual and intimate issues after gynecological cancer.

    PubMed

    Sekse, Ragnhild J T; Råheim, Målfrid; Gjengedal, Eva

    2015-01-01

    In this article we explore shyness and openness related to sexuality and intimacy in long-term female survivors of gynecological cancer, and how these women experienced dialogue with health personnel on these issues. Further analysis on two core themes, based on empirical data presented elsewhere, inspired continued theoretical and philosophical thinking drawing on Løgstrup's expressions of life and unified opposites. The findings show that gynecological cancer survivors and health personnel share common ground as human beings because shyness and openness are basic human phenomena. Health personnel's own movement between these phenomena may represent a resource because it can help women to handle sexual and intimacy challenges following gynecological cancer.

  2. Randomized phase III study of erlotinib versus observation in patients with no evidence of disease progression after first-line platin-based chemotherapy for ovarian carcinoma: a European Organisation for Research and Treatment of Cancer-Gynaecological Cancer Group, and Gynecologic Cancer Intergroup study.

    PubMed

    Vergote, Ignace B; Jimeno, Antonio; Joly, Florence; Katsaros, Dionyssios; Coens, Corneel; Despierre, Evelyn; Marth, Christian; Hall, Marcia; Steer, Christopher B; Colombo, Nicoletta; Lesoin, Anne; Casado, Antonio; Reinthaller, Alexander; Green, John; Buck, Martin; Ray-Coquard, Isabelle; Ferrero, Annamaria; Favier, Laure; Reed, Nick Simon; Curé, Hervé; Pujade-Lauraine, Eric

    2014-02-01

    This trial evaluated the efficacy of maintenance erlotinib, an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, after first-line chemotherapy. Eligible patients had high-risk International Federation of Gynecology and Obstetrics stage I or stage II to IV epithelial ovarian, primary peritoneal, or fallopian tube cancer and were not selected for EGFR expression. All patients underwent first-line platinum-based chemotherapy (CT) and showed no signs of progression at the end of CT. Patients were randomly assigned to maintenance erlotinib 150 mg orally daily for 2 years or to observation. EGFR immunohistochemistry (IHC), fluorescent in situ hybridization (FISH), and mutation analyses were performed in 318 patients. Between October 2005 and February 2008, 835 patients were randomly assigned (median follow-up, 51 months). Twenty-six percent of the patients stopped erlotinib as a result of adverse effects (of these, 67% were due to rash). For erlotinib and observation, respectively, the median progression-free survival was 12.7 and 12.4 months (hazard ratio [HR], 1.05; 95% CI, 0.90 to 1.23), and the median overall survival was 50.8 and 59.1 months (HR, 0.99; 95% CI, 0.81 to 1.20 months), respectively. No subgroup could be identified with improved effect of erlotinib, based on IHC or FISH for EGFR, or mutations in genes related to the EGFR pathway, or on rash during erlotinib therapy. However, patients with a positive FISH EGFR score had a worse overall survival (46.1 months) than those with a negative score (67.0 months; HR, 1.56; 95% CI, 1.01 to 2.40; P = .044). Global health/quality-of-life scores showed a significant difference during the first year (P = .0102) in favor of the observation arm. Maintenance erlotinib after first-line treatment in ovarian cancer did not improve progression-free or overall survival.

  3. Fertility sparing treatments in young patients with gynecological cancers: Iranian experience and literature review.

    PubMed

    Karimi Zarchi, Mojgan; Mousavi, Azamsadat; Gilani, Mitra Modares; Barooti, Esmat; Amini Rad, Omid; Ghaemmaghami, Fatemeh; Teimoori, Soraya; Behtas, Nadereh

    2011-01-01

    With increase in the marriage age some women experience gynecological cancers before giving birth. Thus fertility sparing in these patients is an important point and much work has been done on conservative management. We here report our experience on fertility sparing with cervical, endometrial and ovarian cancers and include a review of the literature. With cervical cancer, radical trachelectomy with para-aortic and pelvic lymphadenectomy can be performed in patients with early stage IA1-IB cancers, because they have low recurrence rates. The complications are fewer than with radical hysterectomy. For endometrial cancer, the accepted treatment is total abdominal hysterectomy+bilateral salpango-oopherectomy (TAH+BSO), but in young patients with early stage 1 lesions, we can suggest use of hormonal therapy in place of radical surgery if we evaluate with MRI and the result is early stage disease without the other site involvement and the grade of tumor is well differentiated. GNRH analog, oral medroxyprogestrone acetate (MPA), 100-800 mg/day, megestrol acetate 40-160 mg/day and combination of tamoxifen and a progestin have been applied, but we must remember, they should underwent repeated curettage for investigating medical outcome after 3 months. With normal pathology we follow medical therapy for 3 months and can evaluate for infertility treatment. The best option for patients who treated by medical therapy is TAH+BSO after normal term pregnancy. With ovarian cancer, there is much experience on fertility sparing surgery and in Iran conservative surgical management in young patients with stage I (grade 1,2) of epithelial ovarian tumor and sex cord-stromal tumor and patients with borderline and germ cell ovarian tumors is being successfully performed.

  4. Pain management strategies used by patients with breast and gynecologic cancer with postoperative pain.

    PubMed

    Kwekkeboom, K L

    2001-10-01

    Many people with cancer will experience pain when they are outside of structured care settings. Patients must provide their own self-care, drawing on instructions from healthcare providers and on independently developed plans for pain management. With growing interest in complementary therapies, the scope of nonpharmacologic interventions used by patients with cancer to manage pain may be very different than 10-15 years ago. The purpose of this study was to describe steps taken by patients with breast and gynecologic cancer to manage pain after discharge from a surgical hospitalization. A secondary analysis was completed using data from 34 women who participated in a randomized trial of guided imagery. Techniques used included positioning, distraction, relaxation, heat, and eating/drinking. Compared to results of previous studies, increased use of relaxation strategies (breathing, imagery, music, meditation) was noted in the current study. The majority of participants used nonpharmacologic strategies in addition to analgesic medications. Pain-related outcomes were similar among persons who used analgesic medications alone and those who used a combination of analgesics and nonpharmacologic strategies. Nurses may benefit from knowing which pain management strategies patients find helpful so that they can encourage their use and teach similar strategies to the patients who find them useful.

  5. Gene therapy strategies using engineered stem cells for treating gynecologic and breast cancer patients (Review).

    PubMed

    Kim, Ye-Seul; Hwang, Kyung-A; Go, Ryeo-Eun; Kim, Cho-Won; Choi, Kyung-Chul

    2015-05-01

    There are three types of stem cells: embryonic stem (ES) cells, adult stem (AS) cells and induced pluripotent stem (iPS) cells. These stem cells have many benefits including the potential ability to differentiate into various organs. In addition, engineered stem cells (GESTECs) designed for delivering therapeutic genes may be capable of treating human diseases including malignant cancers. Stem cells have been found to possess the potential for serving as novel delivery vehicles for therapeutic or suicide genes to primary or metastatic cancer formation sites as a part of gene-directed enzyme/prodrug combination therapy (GEPT). Given the advantageous properties of stem cells, tissue-derived stem cells are emerging as a new tool for anticancer therapy combined with prodrugs. In this review, the effects of GESTECs with different origins, i.e., neural, amniotic membrane and amniotic fluid, introduced to treat patients with diverse types of gynecologic and breast cancers are discussed. Data from the literature indicate the therapeutic potential of these cells as a part of gene therapy strategies to selectively target malignancies in women at clinically terminal stages.

  6. Longitudinal perceptions of the side effects of chemotherapy in patients with gynecological cancer.

    PubMed

    Hsu, Hui-Chun; Tsai, Su-Yu; Wu, Shang-Liang; Jeang, Shiow-Roug; Ho, Mei-Yao; Liou, Wen-Shiung; Chiang, An-Jen; Chang, Tsung-Hsien

    2017-06-21

    This study aimed to assess the incidence and difference of side effects among six courses of chemotherapy (C/T) in gynecological cancer patients. The study period was from Sep. 2010 to Dec. 2011 at the Kaohsiung Veterans General Hospital in Taiwan. The treating protocols, courses, and drugs of C/T in patient were considered according to the different malignant cancers and clinical conditions. The patient data of age, marriage status, education, religion, and experiences of C/T were collected. The patients' or their families' reported side effects of C/T were recorded daily from the beginning of C/T to the 10th day after C/T in each cycle and every course of C/T. Total 89 patients enrolled into the study received total 450 courses of C/T. The mean age was 54.52 ± 11.02. Ovarian cancer was the most common malignant disease (64.0%). The most often combination of drugs used was Taxol and carboplatin (40.9%). Patients complained peripheral numbness of limbs, with the highest incidence of 58.6%. The side effects with incidence about 50% were decreased fatigue (55.0%) and hair loss (49.9%). Other side effects with different levels of incidence were also noticed, such as lack of appetite, changes in taste, and muscle ache. The incidences of peripheral limb numbness and hair loss were increased with following courses of C/T. The high incidence of fatigue did not show variation between different courses of C/T. This study revealed the incidence of side effects and occurrence timing during C/T in patients with gynecological cancer. These data provide substantial information to patients and their families to understand the potential side effects of C/T courses, which might increase their compliance in receiving adjuvant C/T. Relieving the side effects in C/T would be important to improve their quality of daily life and treatment willingness.

  7. [Combination Therapy of Pregabalin with Tramadol for Treatment of Peripheral Neuropathy in Patients with Gynecological Cancer Receiving Taxane Containing Chemotherapy].

    PubMed

    Nishikawa, Tadaaki; Hasegawa, Kosei; Shintani, Daisuke; Yano, Yuri; Sato, Sho; Yabuno, Akira; Kurosaki, Akira; Yoshida, Hiroyuki; Fujiwara, Keiichi

    2017-03-01

    Taxane-based regimens are often used in gynecologic cancer chemotherapy. Chemotherapy-induced peripheral neuropathy( CIPN)is one of the typical side effects caused by taxanes. Grade 2 or higher CIPN is observed in 5% to 30% of ovarian cancer patients who are treated with paclitaxel, which is recognized as one of the unmanageable side effects leading to treatment interruption. We retrospectively investigated the significance of combination therapy of pregabalin with tramadol for CIPN in patients with gynecological cancer. In the current study, 19 patients(19/22; 86%)were administered pregabalin with tramadol orally for at least 1week, and we observed improvement of the CIPN in 15 patients(15/19; 79%).We suggest that the combination therapy of pregabalin with tramadol has a positive impact on the CIPN in patients under a taxane-based chemotherapy.

  8. Profiling of Discrete Gynecological Cancers Reveals Novel Transcriptional Modules and Common Features Shared by Other Cancer Types and Embryonic Stem Cells

    PubMed Central

    Jacob-Hirsch, Jasmine; Amariglio, Ninette; Vlachos, George D.; Loutradis, Dimitrios; Anagnou, Nicholas P.

    2015-01-01

    Studies on individual types of gynecological cancers (GCs), utilizing novel expression technologies, have revealed specific pathogenetic patterns and gene markers for cervical (CC), endometrial (EC) and vulvar cancer (VC). Although the clinical phenotypes of the three types of gynecological cancers are discrete, the fact they originate from a common embryological origin, has led to the hypothesis that they might share common features reflecting regression to early embryogenesis. To address this question, we performed a comprehensive comparative analysis of their profiles. Our data identified both common features (pathways and networks) and novel distinct modules controlling the same deregulated biological processes in all three types. Specifically, four novel transcriptional modules were discovered regulating cell cycle and apoptosis. Integration and comparison of our data with other databases, led to the identification of common features among cancer types, embryonic stem (ES) cells and the newly discovered cell population of squamocolumnar (SC) junction of the cervix, considered to host the early cancer events. Conclusively, these data lead us to propose the presence of common features among gynecological cancers, other types of cancers, ES cells and the pre-malignant SC junction cells, where the novel E2F/NFY and MAX/CEBP modules play an important role for the pathogenesis of gynecological carcinomas. PMID:26559525

  9. Hormone-related factors and gynecological conditions in relation to endometrial cancer risk.

    PubMed

    Zucchetto, Antonella; Serraino, Diego; Polesel, Jerry; Negri, Eva; De Paoli, Angela; Dal Maso, Luigino; Montella, Maurizio; La Vecchia, Carlo; Franceschi, Silvia; Talamini, Renato

    2009-08-01

    The objective of this study is to investigate the effect of menstrual and reproductive variables, breastfeeding, exogenous hormones, and gynecological conditions on endometrial cancer risk. We conducted a case-control study in Italy, including 454 women with endometrial cancer and 908 hospital controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariate logistic regression models. Endometrial cancer risk was inversely associated with age at menarche (OR = 0.7, 95% CI = 0.5-1.0, for > or =14 vs. <12 years), and directly associated with age at menopause (OR = 1.8, 95% CI = 1.1-2.7, for > or =55 vs. <50 years) and years of menstruation (OR = 2.4, 95% CI = 1.7-3.4, for highest vs. lowest tertile). Multiparity strongly reduced the risk among women under 60 years of age (OR = 0.3, 95% CI = 0.2-0.6, for > or =3 deliveries vs. <2). Oral contraceptive use conferred a 40% reduced risk (95% CI = 0.4-1.0), irrespective of time since cessation. Although based on small numbers, women with a history of treated infertility (OR = 2.7, 95% CI = 1.1-6.4) or endometriosis (OR = 4.0, 95% CI = 1.0-15.5) were at increased risks. No significant associations with endometrial cancer risk emerged for age at first/last birth, breastfeeding, menopausal status, hormone replacement therapy, and history of uterine fibromyomas or polycystic ovary. In conclusion, this study confirms the importance of multiparity, years of menstruation, and oral contraceptive use in endometrial cancer etiology, thus contributing to identify women at elevated risk of such neoplasm.

  10. International Brachytherapy Practice Patterns: A Survey of the Gynecologic Cancer Intergroup (GCIG)

    PubMed Central

    Viswanathan, Akila N.; Creutzberg, Carien L.; Craighead, Peter; McCormack, Mary; Toita, Takafumi; Narayan, Kailash; Reed, Nicholas; Long, Harry; Kim, Hak-Jae; Marth, Christian; Lindegaard, Jacob C.; Cerrotta, Annmarie; Small, William; Trimble, Edward

    2012-01-01

    Purpose To determine current practice patterns with regard to gynecologic high-dose-rate (HDR) brachytherapy among international members of the Gynecologic Cancer Intergroup (GCIG) in Japan/Korea (Asia), Australia/New Zealand (ANZ), Europe (E) and North America (NAm). Materials and Methods A 32-item survey was developed requesting information on brachytherapy practice patterns and standard management for Stage IB-IVA cervical cancer. The chair of each GCIG member cooperative group selected radiation oncology members to receive the survey. Results A total of 72 responses were analyzed; 61 respondents (85%) utilized HDR. The three most common HDR brachytherapy fractionation regimens for Stage IB-IIA patients were 6 Gy for 5 fractions (18%), 6 Gy × 4 (15%), 7 Gy × 3 (11%), and for Stage IIB-IVA patients were 6 Gy for 5 fractions (19%), 7 Gy × 4 (8%), and 7 Gy × 3 (8%). Overall, the mean combined external-beam and brachytherapy equivalent dose (EQD2) was 81.1 (standard deviation [SD], 10.16). The mean EQD2 recommended for Stage IB-IIA patients was 78.9 Gy (SD, 10.7) and for Stage IIB-IVA was 83.3 Gy (SD, 11.2) (p=0.02). By region, the mean combined EQD2 was: Asia, 71.2 Gy (SD, 12.65); ANZ, 81.18 (SD, 4.96); E, 83.24 (SD, 10.75); and NAm, 81.66 (SD, 6.05; p=0.02 for Asia vs. other regions). The ratio of brachytherapy to total prescribed dose was significantly higher for Japan (p=0.0002). Conclusion Although fractionation patterns may vary, the overall mean dose administered for cervical cancer is similar in Australia/New Zealand, Europe and North America, with practitioners in Japan administering a significantly lower external-beam dose but higher brachytherapy dose to the cervix. Given common goals, standardization should be possible in future clinical trials. PMID:21183288

  11. International Brachytherapy Practice Patterns: A Survey of the Gynecologic Cancer Intergroup (GCIG)

    SciTech Connect

    Viswanathan, Akila N.; Creutzberg, Carien L.; Craighead, Peter; McCormack, Mary; Toita, Takafumi; Narayan, Kailash; Reed, Nicholas; Long, Harry; Kim, Hak-Jae; Marth, Christian; Lindegaard, Jacob C.; Cerrotta, Annmarie; Small, William; Trimble, Edward

    2012-01-01

    Purpose: To determine current practice patterns with regard to gynecologic high-dose-rate (HDR) brachytherapy among international members of the Gynecologic Cancer Intergroup (GCIG) in Japan/Korea (Asia), Australia/New Zealand (ANZ), Europe (E), and North America (NAm). Methods and Materials: A 32-item survey was developed requesting information on brachytherapy practice patterns and standard management for Stage IB-IVA cervical cancer. The chair of each GCIG member cooperative group selected radiation oncology members to receive the survey. Results: A total of 72 responses were analyzed; 61 respondents (85%) used HDR. The three most common HDR brachytherapy fractionation regimens for Stage IB-IIA patients were 6 Gy for five fractions (18%), 6 Gy for four fractions (15%), and 7 Gy for three fractions (11%); for Stage IIB-IVA patients they were 6 Gy for five fractions (19%), 7 Gy for four fractions (8%), and 7 Gy for three fractions (8%). Overall, the mean combined external-beam and brachytherapy equivalent dose (EQD2) was 81.1 (standard deviation [SD] 10.16). The mean EQD2 recommended for Stage IB-IIA patients was 78.9 Gy (SD 10.7) and for Stage IIB-IVA was 83.3 Gy (SD 11.2) (p = 0.02). By region, the mean combined EQD2 was as follows: Asia, 71.2 Gy (SD 12.65); ANZ, 81.18 (SD 4.96); E, 83.24 (SD 10.75); and NAm, 81.66 (SD, 6.05; p = 0.02 for Asia vs. other regions).The ratio of brachytherapy to total prescribed dose was significantly higher for Japan (p = 0.0002). Conclusion: Although fractionation patterns may vary, the overall mean doses administered for cervical cancer are similar in Australia/New Zealand, Europe, and North America, with practitioners in Japan administering a significantly lower external-beam dose but higher brachytherapy dose to the cervix. Given common goals, standardization should be possible in future clinical trials.

  12. International brachytherapy practice patterns: a survey of the Gynecologic Cancer Intergroup (GCIG).

    PubMed

    Viswanathan, Akila N; Creutzberg, Carien L; Craighead, Peter; McCormack, Mary; Toita, Takafumi; Narayan, Kailash; Reed, Nicholas; Long, Harry; Kim, Hak-Jae; Marth, Christian; Lindegaard, Jacob C; Cerrotta, Annmarie; Small, William; Trimble, Edward

    2012-01-01

    To determine current practice patterns with regard to gynecologic high-dose-rate (HDR) brachytherapy among international members of the Gynecologic Cancer Intergroup (GCIG) in Japan/Korea (Asia), Australia/New Zealand (ANZ), Europe (E), and North America (NAm). A 32-item survey was developed requesting information on brachytherapy practice patterns and standard management for Stage IB-IVA cervical cancer. The chair of each GCIG member cooperative group selected radiation oncology members to receive the survey. A total of 72 responses were analyzed; 61 respondents (85%) used HDR. The three most common HDR brachytherapy fractionation regimens for Stage IB-IIA patients were 6 Gy for five fractions (18%), 6 Gy for four fractions (15%), and 7 Gy for three fractions (11%); for Stage IIB-IVA patients they were 6 Gy for five fractions (19%), 7 Gy for four fractions (8%), and 7 Gy for three fractions (8%). Overall, the mean combined external-beam and brachytherapy equivalent dose (EQD2) was 81.1 (standard deviation [SD] 10.16). The mean EQD2 recommended for Stage IB-IIA patients was 78.9 Gy (SD 10.7) and for Stage IIB-IVA was 83.3 Gy (SD 11.2) (p = 0.02). By region, the mean combined EQD2 was as follows: Asia, 71.2 Gy (SD 12.65); ANZ, 81.18 (SD 4.96); E, 83.24 (SD 10.75); and NAm, 81.66 (SD, 6.05; p = 0.02 for Asia vs. other regions).The ratio of brachytherapy to total prescribed dose was significantly higher for Japan (p = 0.0002). Although fractionation patterns may vary, the overall mean doses administered for cervical cancer are similar in Australia/New Zealand, Europe, and North America, with practitioners in Japan administering a significantly lower external-beam dose but higher brachytherapy dose to the cervix. Given common goals, standardization should be possible in future clinical trials. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Cryopreservation of in vitro matured oocytes after ex vivo oocyte retrieval from gynecologic cancer patients undergoing radical surgery.

    PubMed

    Park, Chan Woo; Lee, Sun Hee; Yang, Kwang Moon; Lee, In Ho; Lim, Kyung Teak; Lee, Ki Heon; Kim, Tae Jin

    2016-06-01

    The aim of this study was to report a case series of in vitro matured (IVM) oocyte freezing in gynecologic cancer patients undergoing radical surgery under time constraints as an option for fertility preservation (FP). Case series report. University-based in vitro fertilization center. Six gynecologic cancer patients who were scheduled to undergo radical surgery the next day were referred for FP. The patients had endometrial (n=2), ovarian (n=3), and double primary endometrial and ovarian (n=1) cancer. Ex vivo retrieval of immature oocytes from macroscopically normal ovarian tissue was followed by mature oocyte freezing after IVM or embryo freezing with intracytoplasmic sperm injection. A total of 53 oocytes were retrieved from five patients, with a mean of 10.6 oocytes per patient. After IVM, a total of 36 mature oocytes were obtained, demonstrating a 67.9% maturation rate. With regard to the ovarian cancer patients, seven IVM oocytes were frozen from patient 3, who had stage IC cancer, whereas one IVM oocyte was frozen from patient 4, who had stage IV cancer despite being of a similar age. With regard to the endometrial cancer patients, 15 IVM oocytes from patient 1 were frozen. Five embryos were frozen after the fertilization of IVM oocytes from patient 6. Immature oocytes can be successfully retrieved ex vivo from macroscopically normal ovarian tissue before radical surgery. IVM oocyte freezing provides a possible FP option in patients with advanced-stage endometrial or ovarian cancer without the risk of cancer cell spillage or time delays.

  14. Gynecologic examination and cervical biopsies after (chemo) radiation for cervical cancer to identify patients eligible for salvage surgery

    SciTech Connect

    Nijhuis, Esther R.; Zee, Ate G.J. van der; Hout, Bertha A. in 't; Boomgaard, Jantine J.; Hullu, Joanne A. de; Pras, Elisabeth; Hollema, Harry; Aalders, Jan G.; Nijman, Hans W.; Willemse, Pax H.B.; Mourits, Marian J.E. . E-mail: m.j.e.mourits@og.umcg.nl

    2006-11-01

    Purpose: The aim of this study was to evaluate efficacy of gynecologic examination under general anesthesia with cervical biopsies after (chemo) radiation for cervical cancer to identify patients with residual disease who may benefit from salvage surgery. Methods and Materials: In a retrospective cohort study data of all cervical cancer patients with the International Federation of Gynecology and Obstetrics (FIGO) Stage IB1 to IVA treated with (chemo) radiation between 1994 and 2001 were analyzed. Patients underwent gynecologic examination under anesthesia 8 to 10 weeks after completion of treatment. Cervical biopsy samples were taken from patients judged to be operable. In case of residual cancer, salvage surgery was performed. Results: Between 1994 and 2001, 169 consecutive cervical cancer patients received primary (chemo) radiation, of whom 4 were lost to follow-up. Median age was 56 years (interquartile range [IQR], 44-71) and median follow-up was 3.5 years (IQR, 1.5-5.9). In each of 111 patients a biopsy sample was taken, of which 90 (81%) showed no residual tumor. Vital tumor cells were found in 21 of 111 patients (19%). Salvage surgery was performed in 13 of 21 (62%) patients; of these patients, 5 (38%) achieved long-term, complete remission after salvage surgery (median follow-up, 5.2 years; range, 3.9-8.8 years). All patients with residual disease who did not undergo operation (8/21) died of progressive disease. Locoregional control was more often obtained in patients who underwent operation (7 of 13) than in patients who were not selected for salvage surgery (0 of 8 patients) (p < 0.05). Conclusions: Gynecologic examination under anesthesia 8 to 10 weeks after (chemo) radiation with cervical biopsies allows identification of those cervical cancer patients who have residual local disease, of whom a small but significant proportion may be salvaged by surgery.

  15. [Effects of Lifestyle Intervention on Fatigue, Nutritional Status and Quality of Life in Patients with Gynecologic Cancer].

    PubMed

    An, Hyunjin; Nho, Ju Hee; Yoo, Sunyoung; Kim, Hyunmin; Nho, Minji; Yoo, Hojeong

    2015-12-01

    The purpose of this study was to examine the effect of lifestyle intervention on the development of fatigue, nutritional status and quality of life of patients with gynecologic cancer. A nonequivalent control group quasi-experimental design was used. Participants were 49 patients with gynecologic cancer. They were assigned to the experiment group (n=24) or the control group (n=25). The lifestyle intervention for this study consisted of physical activity, nutritional education, telephone call counseling, health counseling, monitoring for lifestyle, and affective support based on Cox's Interaction Model of Client Health Behavior and was implemented for six weeks. Significant group differences were found for fatigue (p =.037), nutritional status (p =.034) and social/family well-being (p =.035) in these patients with gynecologic cancer. Results indicate that this lifestyle intervention is effective in lessening fatigue, and improving nutritional status and social/family well-being. Therefore, nurses in hospitals should develop strategies to expand and provide lifestyle interventions for patients with cancer.

  16. Comparison of Age- Standard Incidence Rate Trends of Gynecologic and Breast Cancer in Iran and Other Countries

    PubMed Central

    ARAB, Maliheh; NOGHABAEI, Giti

    2014-01-01

    Abstract Background Female cancer, especially breast and gynecologic cancers are considered multistage disease, highly influenced by risk and protective factors and/or screening preventive modalities. Consequences of all these factors result in the trend of change over time. Methods In this comparative study, based on data of national cancer registry of Iran 2004 published by Iranian Ministry of Health, age — standard incidence rate (ASR) according to the world population was calculated in all reported gynecologic and breast cancers. Source of all subjects are pathologic based. In the next step, the calculated ASR of Iran and those of the other countries in 2004 were compared to GLOBOCAN ASR reports of 2008. Results In Iran ASR of breast cancer 2004 (24.93) changed to 18.4 in 2008. Ovarian cancer ASR of 2004, 3.07 was 3.1 in 2008. Endometrial cancer ASR in 2004 (2.29) was 1.7 in 2008. Cervical cancer ASR of 1.71 in 2004 was 2.2 in 2008. Conclusions In Iran incidence trend of breast and endometrium are decreasing in the same direction of USA and Australia. Increasing trend of ovary and cervix ASR in Iran is in the inverse direction of USA and Australia which are decreasing. Future studies to find out the same trend or any changes, might develop these findings and improve consequent practical decisions based on results of this study and complementary future studies. PMID:26060699

  17. Predictors of Toxicity After Image-guided High-dose-rate Interstitial Brachytherapy for Gynecologic Cancer

    SciTech Connect

    Lee, Larissa J.; Viswanathan, Akila N.

    2012-12-01

    Purpose: To identify predictors of grade 3-4 complications and grade 2-4 rectal toxicity after three-dimensional image-guided high-dose-rate (HDR) interstitial brachytherapy for gynecologic cancer. Methods and Materials: Records were reviewed for 51 women (22 with primary disease and 29 with recurrence) treated with HDR interstitial brachytherapy. A single interstitial insertion was performed with image guidance by computed tomography (n = 43) or magnetic resonance imaging (n = 8). The median delivered dose in equivalent 2-Gy fractions was 72.0 Gy (45 Gy for external-beam radiation therapy and 24 Gy for brachytherapy). Toxicity was reported according to the Common Toxicity Criteria for Adverse Events. Actuarial toxicity estimates were calculated by the Kaplan-Meier method. Results: At diagnosis, the median patient age was 62 years and the median tumor size was 3.8 cm. The median D90 and V100 were 71.4 Gy and 89.5%; the median D2cc for the bladder, rectum, and sigmoid were 64.6 Gy, 61.0 Gy, and 52.7 Gy, respectively. The actuarial rates of all grade 3-4 complications at 2 years were 20% gastrointestinal, 9% vaginal, 6% skin, 3% musculoskeletal, and 2% lymphatic. There were no grade 3-4 genitourinary complications and no grade 5 toxicities. Grade 2-4 rectal toxicity was observed in 10 patients, and grade 3-4 complications in 4; all cases were proctitis with the exception of 1 rectal fistula. D2cc for rectum was higher for patients with grade 2-4 (68 Gy vs 57 Gy for grade 0-1, P=.03) and grade 3-4 (73 Gy vs 58 Gy for grade 0-2, P=.02) rectal toxicity. The estimated dose that resulted in a 10% risk of grade 2-4 rectal toxicity was 61.8 Gy (95% confidence interval, 51.5-72.2 Gy). Discussion: Image-guided HDR interstitial brachytherapy results in acceptable toxicity for women with primary or recurrent gynecologic cancer. D2cc for the rectum is a reliable predictor of late rectal complications. Three-dimensional-based treatment planning should be performed to ensure

  18. Breast Cancer Prevention

    MedlinePlus

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Prevention (PDQ®)–Patient Version What is prevention? Go ... from starting. Risk-reducing surgery . General Information About Breast Cancer Key Points Breast cancer is a disease in ...

  19. A prospective study on the efficacy of octreotide in the management of malignant bowel obstruction in gynecologic cancer.

    PubMed

    Watari, Hidemichi; Hosaka, Masayoshi; Wakui, Yukio; Nomura, Eiji; Hareyama, Hitoshi; Tanuma, Fumie; Hattori, Rifumi; Azuma, Masaki; Kato, Hidenori; Takeda, Naoki; Ariga, Satoshi; Sakuragi, Noriaki

    2012-05-01

    Malignant bowel obstruction (MBO), of which symptoms lead to a poor quality of life, is a common and distressing clinical complication in advanced gynecologic cancer. The aim of this study was to prospectively assess the clinical efficacy of octreotide to control vomiting in patients with advanced gynecologic cancer with inoperable gastrointestinal obstruction. Patients with advanced gynecologic cancer, who presented at least one episode of vomiting per day due to MBO, were enrolled in this prospective study from 2006 to 2009. Octreotide was administered when necessary at doses starting with 300 μg up to 600 μg a day by continuous infusion for 2 weeks. Primary end point was vomiting control, which was evaluated by common terminology criteria for adverse events version 3 (CTCAE v3.0). Adverse events were also evaluated by CTCAE v3.0. Twenty-two cases were enrolled in this study. Octreotide controlled vomiting in 15 cases (68.2%) to grade 0 and 3 cases (13.6%) to grade 1 on CTCAE v3.0. Overall response rate to octreotide treatment was 81.8% in our patients' cohort. Among 14 cases without nasogastric tube, the overall response rate was 93.1% (13/14). Among 8 cases with nasogastric tube, 4 cases were free of tube with decrease of drainage, and overall response rate was 62.5% (5/8). No major adverse events related to octreotide were reported. We conclude that 300-μg/d dose of octreotide was effective and safe for Japanese patients with MBO by advanced gynecologic cancer. Octreotide could contribute to better quality of life by avoiding placement of nasogastric tube.

  20. Classification of Ovarian Cancer Surgery Facilitates Treatment Decisions in a Gynecological Multidisciplinary Team.

    PubMed

    Bjørn, Signe Frahm; Schnack, Tine Henrichsen; Lajer, Henrik; Christensen, Ib Jarle; Lundvall, Lene; Thomsen, Lotte Nedergaard; Høgdall, Claus

    2017-02-01

    Proper planning of intervention and care of ovarian cancer surgery is of outmost importance and involves a wide range of personnel at the departments involved. The aim of this study is to evaluate the introduction of an ovarian surgery classification (COVA) system for facilitating multidisciplinary team (MDT) decisions. Four hundred eighteen women diagnosed with ovarian cancers (n = 351) or borderline tumors (n = 66) were selected for primary debulking surgery from January 2008 to July 2013. At an MDT meeting, women were allocated into 3 groups named "pre-COVA" 1 to 3 classifying the expected extent of the primary surgery and need for postoperative care. On the basis of the operative procedures performed, women were allocated into 1 of the 3 corresponding COVA 1 to 3 groups. The outcome measure was the predictive value of the pre-COVA score compared with the actual COVA performed. The MDT meeting allocated 213 women (51%) to pre-COVA 1, 136 (33%) to pre-COVA 2, and 52 (12%) to pre-COVA 3. At the end of surgery, 168 (40%) were classified as COVA 1, 158 (38%) were classified as COVA 2, and 28 (7%) were classified as COVA 3. Traced individually, 212 (51%) patients were correctly preclassified at the MDT meeting and distributed into 110 (52%) COVA 1, 71 (52%) COVA 2, and 17 (32%) COVA 3. Analyzing the subgroup of patients with cancer, 164 (47%) were correctly preclassified. Regarding the International Federation of Gynecology and Obstetrics (FIGO) stages, the pre-COVA classification predicted the actual COVA group in 79 (49%) FIGO stages I to IIIB and in 85 (45%) FIGO stages IIIC to IV. The COVA classification system is a simple and useful tool in the MDT setting where specialists make treatment decisions based on advanced technology. The use of pre-COVA classification facilitates well-organized patient care-relevant procedures to be undertaken. Pre-COVA accurately predicts the final COVA in 51% classified women.

  1. Interobserver variability of the International Federation of Gynecology and Obstetrics staging in cervical cancer.

    PubMed

    Tummers, Philippe; Gerestein, Kees; Mens, Jan Willem; Verstraelen, Hans; van Doorn, Helena

    2013-06-01

    The objective of this study was to assess the interobserver variability of pelvic examination under anesthesia (EUA) in cervical cancer. Subsequent patients undergoing a staging procedure under anesthesia for primary cervical cancer were enrolled in the study. All clinicians assessed "blinded" tumor size, and the involvement of vagina, parametria, sacrouterine ligaments, pelvic sidewalls, bladder, and/or rectum. Items were scored varying from 1 ("certainly no involvement"), 2 ("not sure about involvement"), to 3 ("involvement"). Each individual decided on the International Federation of Gynecology and Obstetrics (FIGO) stage; also, the urge for imaging and treatment proposal were accounted for. Final FIGO staging was obtained by consensus of the team. Investigators were classified as experienced after more than 50 EUAs. All others were classified less experienced. The free-marginal κ values between experienced and less experienced investigators were calculated for all previously mentioned items. Between February 2009 and December 2010, a total of 86 patients were enrolled. Among experienced investigators, a moderate interobserver agreement was found with regard to FIGO stage (free-marginal κ value of 0.49) and an excellent interobserver agreement on their proposed therapy (free-marginal κ value of 0.84). A lower level of agreement was found when comparing experienced with less experienced investigators: only a slight level of agreement on FIGO stage and a substantial agreement on their therapy proposal (free-marginal κ values of 0.03 and 0.66). We describe only a moderate interobserver agreement on clinical staging of patients with cervical cancer. The interobserver agreement increases in the group of experienced doctors, indicating that EUA can be learned.

  2. MAPK13 is preferentially expressed in gynecological cancer stem cells and has a role in the tumor-initiation.

    PubMed

    Yasuda, Kazuyo; Hirohashi, Yoshihiko; Kuroda, Takafumi; Takaya, Akari; Kubo, Terufumi; Kanaseki, Takayuki; Tsukahara, Tomohide; Hasegawa, Tadashi; Saito, Tsuyoshi; Sato, Noriyuki; Torigoe, Toshihiko

    2016-04-15

    Cancer stem-like cells (CSCs)/cancer-initiating cells (CICs) are defined as small subpopulation of cancer cells that are endowed with higher tumor-initiating ability. CSCs/CICs are resistant to standard cancer therapies including chemotherapy and radiotherapy, and they are thus thought to be responsible for cancer recurrence and metastasis. Therefore, elucidation of molecular mechanisms of CSCs/CICs is essential to cure cancer. In this study, we analyzed the gene expression profiles of gynecological CSCs/CICs isolated as aldehyde dehydrogenase high (ALDH(high)) cells, and found that MAPK13, PTTG1IP, CAPN1 and UBQLN2 were preferentially expressed in CSCs/CICs. MAPK13 is expressed in uterine, ovary, stomach, colon, liver and kidney cancer tissues at higher levels compared with adjacent normal tissues. MAPK13 gene knockdown using siRNA reduced the ALDH(high) population and abrogated the tumor-initiating ability. These results indicate that MAPK13 is expressed in gynecological CSCs/CICs and has roles in the maintenance of CSCs/CICs and tumor-initiating ability, and MAPK13 might be a novel molecular target for treatment-resistant CSCs/CICs. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. MAPK13 is preferentially expressed in gynecological cancer stem cells and has a role in the tumor-initiation

    SciTech Connect

    Yasuda, Kazuyo; Hirohashi, Yoshihiko; Kuroda, Takafumi; Takaya, Akari; Kubo, Terufumi; Kanaseki, Takayuki; Tsukahara, Tomohide; Hasegawa, Tadashi; Saito, Tsuyoshi; Sato, Noriyuki; Torigoe, Toshihiko

    2016-04-15

    Cancer stem-like cells (CSCs)/cancer-initiating cells (CICs) are defined as small subpopulation of cancer cells that are endowed with higher tumor-initiating ability. CSCs/CICs are resistant to standard cancer therapies including chemotherapy and radiotherapy, and they are thus thought to be responsible for cancer recurrence and metastasis. Therefore, elucidation of molecular mechanisms of CSCs/CICs is essential to cure cancer. In this study, we analyzed the gene expression profiles of gynecological CSCs/CICs isolated as aldehyde dehydrogenase high (ALDH{sup high}) cells, and found that MAPK13, PTTG1IP, CAPN1 and UBQLN2 were preferentially expressed in CSCs/CICs. MAPK13 is expressed in uterine, ovary, stomach, colon, liver and kidney cancer tissues at higher levels compared with adjacent normal tissues. MAPK13 gene knockdown using siRNA reduced the ALDH{sup high} population and abrogated the tumor-initiating ability. These results indicate that MAPK13 is expressed in gynecological CSCs/CICs and has roles in the maintenance of CSCs/CICs and tumor-initiating ability, and MAPK13 might be a novel molecular target for treatment-resistant CSCs/CICs.

  4. Estimation of the Optimal Brachytherapy Utilization Rate in the Treatment of Gynecological Cancers and Comparison With Patterns of Care

    SciTech Connect

    Thompson, Stephen R.; Delaney, Geoff P.; Gabriel, Gabriel S.; Jacob, Susannah; Das, Prabir; Barton, Michael B.

    2013-02-01

    Purpose: We aimed to estimate the optimal proportion of all gynecological cancers that should be treated with brachytherapy (BT)-the optimal brachytherapy utilization rate (BTU)-to compare this with actual gynecological BTU and to assess the effects of nonmedical factors on access to BT. Methods and Materials: The previously constructed inter/multinational guideline-based peer-reviewed models of optimal BTU for cancers of the uterine cervix, uterine corpus, and vagina were combined to estimate optimal BTU for all gynecological cancers. The robustness of the model was tested by univariate and multivariate sensitivity analyses. The resulting model was applied to New South Wales (NSW), the United States, and Western Europe. Actual BTU was determined for NSW by a retrospective patterns-of-care study of BT; for Western Europe from published reports; and for the United States from Surveillance, Epidemiology, and End Results data. Differences between optimal and actual BTU were assessed. The effect of nonmedical factors on access to BT in NSW were analyzed. Results: Gynecological BTU was as follows: NSW 28% optimal (95% confidence interval [CI] 26%-33%) compared with 14% actual; United States 30% optimal (95% CI 26%-34%) and 10% actual; and Western Europe 27% optimal (95% CI 25%-32%) and 16% actual. On multivariate analysis, NSW patients were more likely to undergo gynecological BT if residing in Area Health Service equipped with BT (odds ratio 1.76, P=.008) and if residing in socioeconomically disadvantaged postcodes (odds ratio 1.12, P=.05), but remoteness of residence was not significant. Conclusions: Gynecological BT is underutilized in NSW, Western Europe, and the United States given evidence-based guidelines. Access to BT equipment in NSW was significantly associated with higher utilization rates. Causes of underutilization elsewhere were undetermined. Our model of optimal BTU can be used as a quality assurance tool, providing an evidence-based benchmark against

  5. [Enhanced liposomal transfection through the application of sex steroids in gynecological cancer cells].

    PubMed

    Köster, F; Finas, D; Saupp, A; Schulz, C; Diedrich, K; Hauser, C; Felberbaum, R

    2003-01-01

    Liposomal transfection in gene therapeutic application against gynecological malignoma does not reach satisfying efficacy. A desirable goal would be the specific intensification of transfection in these kind of cells. Steroids have successfully been used in other systems to increase liposomal transfection and hopefully there might be a specific impact of sexual steroids in cells from high sex steroid receptor expressing malignoma, like some mamma- and endometrium cancer. The mamma carcinoma cell line T-47D was transfected with the transfection agent DOTAP and cyclodextrin solubilized steroids and cholesterol were co-applied. The efficiency of transfection was followed by luciferase activity resulting from the transfected reporter gene. Like cholesterol, which is already established as transfection co-agent, also the steroids progesterone, estrogen, testosterone and hydrocortisone provoked a clear increase in transfection efficiency shown in a dose dependent manner. These results indicate the usefulness of steroids as additives for liposomal transfection procedures in gene therapeutic application. As sexual steroid receptors migrate into the nucleus of a cell after binding its specific ligand a targeted enhancement of transfection is supposable in malignoma overexpressing steroid receptors. There is evidence that plasmid DNA can be co-transported with nuclear proteins into the nucleus.

  6. Correlation between bone marrow dose volumes and acute hematological toxicity in postoperative gynecological cancer patients

    PubMed Central

    Li, Qian; Jiang, Ming-Hua; Chen, Jing; Liu, Wei; Zhu, Bi-Qing; Lu, E-Mei

    2016-01-01

    Objective: To identify the association between radiation dose volume and acute hematological toxicity (HT) in postoperative gynecological cancer patients receiving whole pelvic radiotherapy (RT) or intensity-modulated RT (IMRT), a principal component regression model was used to calculate HT. Methods: Women (n=100) receiving with or without chemotherapy RT were retrospectively analyzed, 52 of whom received chemotherapy (paclitaxel and nedaplatin). The pelvis and lumbar vertebrae, defined as the prolong-pelvic bone marrow, were divided into the (1) combined ilium, ischium and pubis and the (2) lumbar vertebrae and the sacrum. The V5-V40 of subsides was calculated. The complete blood counts were recorded weekly. The principal component analysis was performed on volumes which generated the principal components (PCs), followed by using a logistic regression model. Results: Forty-seven patients presented with grade 2-3 HT during RT. Chemotherapy increased the incidence of HT compared with RT alone (70.21% vs. 29.79%; p=0.001). Fifty-three patients with persistent HT developed more serious HT at an earlier stage of RT. The chemotherapy cycles and three PCs associated with grade 2-3 HT was identified to form the resulting principal logistic regression model. Conclusion: A new method to calculate the NTCP was achieved by PCs logistic regression. PMID:28083062

  7. Development of an 241Am applicator for intracavitary irradiation of gynecologic cancers.

    PubMed

    Nath, R; Peschel, R E; Park, C H; Fischer, J J

    1988-05-01

    Sealed sources of 241Am that emit primarily 60 keV photons produce relative dose distributions in water comparable to those from 137Cs or 226Ra sources and can produce dose rates of up to 100 cGy/hr at 1 cm in water. Also, 241Am gamma rays can be effectively shielded by thin layers of high atomic number materials (HVL is 1/8th mm of lead) placed on the applicator or inside some body cavities (for example, hypaque in bladder, barium sulphate in rectum). These properties of 241Am sources open a new approach to optimizing intracavitary irradiation of various cancers by allowing a reduction in dose and volume of irradiated critical organs or by increasing tumor doses. The relative ease with which highly effective shielding is achievable with 241Am sources would allow the design and fabrication of partially shielded applicators which can produce asymmetric dose distributions to allow unidirectional irradiation of localized lesions. Design and dosimetry characteristics of a gynecological applicator containing 241Am sources are presented. The applicator consists of a 2, 3, or 4 segment vaginal plaque (loaded with 2 and 5 Ci 241Am sources) and a tandem made up of a single 8 Ci 241Am source. Dose rates at 2 cm from the plaques are 42.0, 47.4, 58.3 and 56.7 cGy/hr for 5-5, 5-4-5, 5-5-5, and 5-4-4-5 Ci plaques, respectively. The 5-4-5 Ci plaque in combination with the 8 Ci tandem produces dose rates of 60.0 and 22.8 cGy/hr to points A and B, respectively. Surface dose rates on the plaque applicators are 143, 124, 142 and 132 cGy/hr for 5-5, 5-4-5, 5-5-5 and 5-4-4-5 Ci applicators, respectively. The shielding effect of a 0.5 mm thick lead foil on one side of the 5-4-5 Ci applicator is found to be a factor of 16.8; for example, the dose rate at 2 cm from the unshielded side is 42.0 cGy/hr compared to a dose rate of 2.5 cGy/hr at 2 cm from the shielded side. Initial clinical experience with this applicator in the treatment of recurrent gynecological lesions is also presented.

  8. Conducting Nursing Intervention Research in a Cooperative Group Setting – A Gynecologic Oncology Group (GOG) Experience

    PubMed Central

    Donovan, Heidi S.; Nolte, Susan; Edwards, Robert P.; Wenzel, Lari

    2014-01-01

    Objectives To provide a history on nursing science within the Gynecology Oncology Group (GOG); to discuss challenges and facilitators of nursing science in the cooperative group (CG) using a current nurse-led protocol (GOG-0259) as an exemplar; and to propose recommendations aimed at advancing nursing science in the CG setting. Data Source GOG reports and protocol databases, online databases of indexed citations, and experiences from the development and implementation of GOG-0259. Conclusions Benefits of CG research include opportunities for inter-disciplinary collaboration and ability to rapidly accrue large national samples. Challenges include limited financial resources to support non-treatment trials, a cumbersome protocol approval process, and lack of experience with nursing/quality of life intervention studies. Formal structures within GOG need to be created to encourage nurse scientists to become active members; promote collaboration between experienced GOG advanced practice nurses and new nurse scientists to identify nursing research priorities; and consider innovative funding structures to support pilot intervention studies. Implications for Nursing Practice Understanding the CG research process is critical for nurse scientists. A multi-disciplinary team of CG leaders can help investigators navigate a complex research environment and can increase awareness of the value of nursing research. PMID:24559780

  9. [The observatory of rare malignant gynecologic tumors].

    PubMed

    Devouassoux-Shisheboran, Mojgan; Vacher-Lavenu, Marie-Cécile

    2014-02-01

    The observatory of gynecological rare tumors (TMRG) has been initially created for ovarian rare neoplasms (TMRO). Because of the similarities between ovarian and other gynecological tumors, this observatory has been then extended to all gynecological rare tumors. The recognition by INCa of three national expert centers (centre Léon-Bérard, hôpitaux de Paris, institut Gustave-Roussy) in rare gynecological cancers and a network of regional expert centers in 2010, expend the experience of the website "Observatoire francophone des tumeurs rares de l'ovaire". The major goals of this gynecology rare tumors experts network, are to promote systematic second opinion for initial diagnostic by experts in gynecopathology, systematic multidisciplinary advice by surgeons and medical oncologist experts, to disseminate clinical guidelines dedicated to rare gynecological tumors, to promote specific fundamental and translational research within clinical trials dedicated to rare tumors. At the end, we would like to improve benefit in term of survival and/or fertility for all these potential young patients.

  10. Primary vaginal reconstruction at the time of pelvic exenteration for gynecologic cancer: morbidity revisited.

    PubMed

    Jurado, Matías; Bazán, Antonio; Alcázar, Juan Luis; Garcia-Tutor, Emilio

    2009-01-01

    The aim of this study is to analyze our experience about the benefits and morbidity of primary vaginal reconstruction in pelvic exenteration. Over a 10-year period, 64 patients underwent a pelvic exenteration for gynecologic cancer, except for ovarian and fallopian cancer. Twenty-nine patients underwent pelvic exenteration with vaginal reconstruction [21 cases with transverse rectus-abdominis myocutaneous (TRAM) flap and eight cases with Singapore fascio-cutaneous flap]. Thirty-five patients did not undergo vaginal reconstruction. Postoperative morbidity was recorded and a comparative analysis of morbidity between groups was made. Pelvic abscess and small bowel fistula occurred more frequently in the no neovagina group (20% versus 6.9% and 20% versus 3.4%, respectively). There were no differences between groups regarding fever, colorectal anastomosis (CRA) dehiscence-leakage, prolonged ileus, deep venous thrombosis, pulmonary embolism or wound complications. Surgery time was significantly longer for the neovagina group. There was only one perioperative death, which occurred in the neovagina group. Vaginal stenosis, necrosis, and shortness occurred less frequently for TRAM flap compared with Singapore flap (19.0% versus 28.6%, 14.5% versus 50% and 0% versus 100%, respectively). CRA dehiscence-leakage appeared more frequently (83.3% versus 28.6%) in the Singapore group. Nevertheless, this complication was statistically associated (p = 0.0009) with low CRA (<5 cm). TRAM flap seems to be the preferable option for reconstructing the vagina after pelvic exenteration. The Singapore fascio-cutaneous flap carries a higher rate of complications, does not work as functional neovagina after pelvic exenteration, and does not seem to be a good choice in cases of low colorectal anastomosis.

  11. Psychosocial reaction patterns to alopecia in female patients with gynecological cancer undergoing chemotherapy.

    PubMed

    Ishida, Kazuko; Ishida, Junko; Kiyoko, Kanda

    2015-01-01

    This study aims to clarify the psychosocial reactions of female patients with gynecological cancer undergoing chemotherapy and in the process of suffering from alopecia and to examine their nursing support. The target group comprised female patients who had received two or more cycles of chemotherapy, were suffering from alopecia, and were aged 30-65. Data were collected from semi-structured interviews, conducted from the time the patients were informed by their doctors that they might experience alopecia due to chemotherapy to the time they actually experienced alopecia and until they were able to accept the change. Inductive qualitative analysis was employed to close in on the subjective experiences of the cancer patients. The results showed the existence of six phases in the psychosocial reactions in the process of alopecia: phase one was the reaction after the doctor's explanation; phase two was the reaction when the hair starts to fall out; phase three was the reaction when the hair starts to intensely fall out; phase four was the reaction when the hair has completely fallen out; phase five was the reaction to behavior for coping with alopecia; and phase six was the reaction to change in interpersonal human relationships. The results also made it clear that there are five types of reaction patterns as follows: 1) treatment priority interpersonal relationship maintenance type; 2) alopecia agitated interpersonal relationship maintenance type; 3) alopecia agitated interpersonal relationship reduction type; 4) alopecia denial interpersonal relationship reduction type; and 5) alopecia denial treatment interruption type. It is important to find out which of the five types the patients belong to early during treatment and provide support so that nursing intervention that suits each individual can be practiced. The purpose of this study is to make clear the process in which patients receiving chemotherapy come to accept alopecia and to examine evidence-based nursing

  12. Effects of field parameters on IMRT plan quality for gynecological cancer: a case study.

    PubMed

    Fung, Albert Y C; Enke, Charles A; Ayyangar, Komanduri M; Thompson, Robert B; Zhen, Weining; Raman, Natarajan V; Djajaputra, David; Li, Sicong; Nehru, Ramasamy M; Pillai, Sushakumari; Sourivong, Paul; Headley, Mary; Yager, Ann L

    2005-01-01

    Traditional external beam radiotherapy of gynecological cancer consists of a 3D, four-field-box technique. The radiation treatment area is a large region of normal tissue, with greater inhomogeneity over the treatment volume, which could benefit more with intensity-modulated radiation therapy (IMRT). This is a case report of IMRT planning for a patient with endometrial cancer. The planning target volume (PTV) spanned the intrapelvic and periaortic lymph nodes to a 33-cm length. Planning and treatment were accomplished using double isocenters. The IMRT plan was compared with a 3D plan, and the effects of field parameters were studied. Delineated anatomical contours included the intrapelvic nodes (PTV), bone marrow, small bowel, bladder, rectum, sigmoid colon, periaortic nodes (PTV), spinal cord, left kidney, right kidney, large bowel, liver, and tissue (excluding the PTVs). Comparisons were made between IMRT and 3D plans, 23-MV and 6-MV energies, zero and rotated collimator angles, different numbers of segments, and opposite gantry angle configurations. The plans were evaluated based on dosevolume histograms (DVHs). Compared with the 3D plan, the IMRT plan had superior dose conformity and spared the bladder and sigmoid colon embedded in the intrapelvic nodes. The higher energy (23 MV) reduced the dose to most critical organs and delivered less integral dose. Zero collimator angles resulted in a better plan than "optimized" collimator angles, with lower dose to most of the normal structures. The number of segments did not have much effect on isodose distribution, but a reasonable number of segments was necessary to keep treatment time from being prohibitively long. Gantry angles, when evenly spaced, had no noticeable effect on the plan. The patient tolerated the treatment well, and the initial complete blood count was favorable. Our results indicated that large-volume tumor sites may also benefit from precise conformal delivery of IMRT.

  13. Effect of a 12-week integrative oncology intervention on gastro-intestinal concerns in patients with gynecological and breast cancer undergoing chemotherapy.

    PubMed

    Shalom-Sharabi, Ilanit; Keinan-Boker, Lital; Samuels, Noah; Lavie, Ofer; Lev, Efraim; Ben-Arye, Eran

    2017-09-01

    Research on the long-term effects of complementary and integrative medicine (CIM) is limited. In this study, we explore the impact of a CIM intervention on gastro-intestinal (GI)-related concerns in patients with breast/gynecological cancer undergoing chemotherapy. Patients reporting chemotherapy-related GI concerns were referred by their cancer care providers to a CIM consultation and treatments and assessed at baseline and at 12 weeks. The following tools were used: Edmonton Symptom Assessment Scale (ESAS), Measure Yourself Concerns and Wellbeing (MYCAW) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). The intervention group was subdivided according to adherence to the integrative care program (AIC), defined as attending ≥4 CIM treatments with ≤30 days between each session. Controls chose not to undergo the CIM consultation or treatments. Of 289 patients reporting GI-related concerns, 42 were treated with CIM and optimally assessed (intervention arm; AIC = 33), as were 32 of controls. ESAS scores for appetite and nausea improved more significantly in the intervention group, more so in the AIC subgroup (appetite, p = 0.025; nausea, p = 0.033). MYCAW scores for GI-related concerns also improved in the intervention group, again more so in the adherent subgroup. EORTC scores improved more significantly with respect to global health (p = 0.021) and cognitive functioning (p = 0.031) in the intervention group, when compared to controls. The integration of a 12-week CIM intervention in conventional supportive cancer care may reduce nausea and improve appetite in patients with breast/gynecological cancer undergoing chemotherapy.

  14. Defecation into clothing without forewarning and mean radiation dose to bowel and anal-sphincter among gynecological cancer survivors.

    PubMed

    Lind, Helena; Alevronta, Eleftheria; Steineck, Gunnar; Waldenström, Ann-Charlotte; Nyberg, Tommy; Olsson, Caroline; Wilderäng, Ulrica; Dunberger, Gail; Al-Abany, Massoud; Åvall-Lundqvist, Elisabeth

    2016-11-01

    To analyze the relationship between mean radiation dose to the bowels and the anal-sphincter and occurrence of 'defecation into clothing without forewarning', a specific and serious fecal incontinence symptom after gynecological radiotherapy. Additional potential risk factors associated with the symptom are explored. Data were collected for 519 eligible gynecological cancer survivors, treated with pelvic radiotherapy, with a median follow-up of 5.8 years, using a study-specific questionnaire and medical records. Correlations between defecation into clothing without forewarning and mean dose to organs at risk; the anal-sphincter region, the rectum, the sigmoid and the small intestines were investigated, also taking other risk factors into account. Twelve percent reported having had the symptom at least once in the preceding six months. Mean doses >50 Gy to the anal-sphincter region, the rectum, the sigmoid and the small intestines were related to the occurrence of the symptom. Significantly associated risk factors were deliveries with high birth weight, heart failure and lactose and/or gluten intolerance. After adjusting for these factors, mean doses >50 Gy to the anal-sphincter region, the sigmoid and the small intestines remained related to the occurrence of the symptom. Mean doses to the bowels and anal-sphincter region are related to the risk of defecation into clothing without forewarning in long-term gynecological cancer survivors treated with pelvic radiotherapy. Further radiobiological modeling may distinguish which organ(s) contribute most to development of the symptom.

  15. [Perioperational management of gynecological cancer patients with severe internal medical complications: a serial of 37 clinical cases].

    PubMed

    Hu, J; Lyu, W Q; Guo, Y L; Wen, H W; Qiao, H; Qu, Y

    2016-11-25

    Objective: To evaluate the effectiveness and safety of perioperational management of gynecological cancer patients with severe internal medical complications. Methods: We collected 37 cases of gynecological cancer patients with severe internal medical complications who were hospitalized in Peking University First Hospital from Jan. 2010 to Nov. 2014. All of the cases were planned to move to ICU right after operation based on the preoperational assessment of anesthetist and physician. The median age was 69.4 years, and 25 cases (68%,25/37) of them were over 70 years old. The pathological types, preoperational complications, preoperational preparation, process of anesthesia and surgery, post-operational short-term morbidity were retrospectively analyzed. Results: (1) Pathological type: among 37 cases of gynecological cancer patients, 16 cases of endometrial cancer, 12 cases of ovarian cancer, 5 cases of vulvar cancer, 3 cases of uterine sarcoma and 1 case of fallopian cancer. (2) Preoperational complication: all the patients had more than 2 types of internal complications, 34 cases (92%, 34/37)of them had no less than 3 types of internal complications. The preoperational complications mainly included 25 cases of hypertension, 13 cases of coronary heart disease and 5 cases of arrhythmia, 5 cases of history of cerebral infarction or hemorrhage, 19 cases of diabetes and 1 case of obesity, 6 cases of allergic asthma and history of pulmonary embolism. (3) Preoperational preparation: medication were taken according to internal physicians to make blood pressure lower than 140/90 mmHg(1 mmHg=0.133 kPa), fasting blood glucose lower than 8.0 mmol/L, postprandial blood glucose lower than 10.0 mmol/L and cardiac function return to a generally normal status. (4) Process of anesthesia and surgery: 37 cases completed operation successfully after preoperational anesthetic assessment and internal medication. No perioperational death was observed. (5) Post-operational morbidity: 17

  16. Attitudes Toward Research During Residency: A Survey of Canadian Residents in Obstetrics and Gynecology.

    PubMed

    Clancy, Aisling A; Posner, Glenn

    2015-01-01

    Obstetrics and Gynecology (Ob/Gyn) residency programs in Canada mandate participation in scholarly research activity, yet there remains a lack of literature on trainees' opinions regarding its value, feasibility, and perceived effect on future practice. An understanding of resident attitudes toward research during residency is essential in effectively engaging trainees and fostering a robust research community in the field. We sought to identify factors reported to influence involvement in resident research, including perceived barriers. Anonymous data were collected via an online survey distributed to all residents enrolled in accredited Ob/Gyn residency programs throughout Canada. The 10-minute, previously piloted questionnaire covered questions related to demographic information, research experience, career goals, current research activities, opinions on research environment, and opinions regarding the effect of research on future practice. Descriptive statistics were used to describe demographics, research background, and current research activities. Categorical variables were compared using the chi-square analysis and continuous variables were compared using the Mann-Whitney rank sum tests. A total of 175 residents completed the survey; 61% agreed/strongly agreed that they participate in research solely because it is mandated by their program, 22% felt that their training environment did not promote research, 19% disagreed/strongly disagreed that research is a positive experience, while 70% agreed/strongly agreed that they would prefer to complete another educational activity other than a research project. Time constraints owing to residency duties, time constraints owing to personal reasons, and lack of statistical knowledge were reported as barriers to research involvement by 97%, 90%, and 74% of trainees, respectively. Residents with graduate degrees were less likely to report lack of training on research design as a moderate/extreme barrier (7% vs 32%, p

  17. Scripted Sexual Health Informational Intervention in Improving Sexual Function in Patients With Gynecologic Cancer

    ClinicalTrials.gov

    2016-11-02

    Anxiety Disorder; Cervical Cancer; Endometrial Cancer; Female Reproductive Cancer; Gestational Trophoblastic Tumor; Ovarian Epithelial Cancer; Ovarian Germ Cell Tumor; Sexual Dysfunction; Uterine Sarcoma; Vaginal Cancer; Vulvar Cancer

  18. Cryopreservation of in vitro matured oocytes after ex vivo oocyte retrieval from gynecologic cancer patients undergoing radical surgery

    PubMed Central

    Park, Chan Woo; Lee, Sun Hee; Yang, Kwang Moon; Lee, In Ho; Lim, Kyung Teak; Lee, Ki Heon

    2016-01-01

    Objective The aim of this study was to report a case series of in vitro matured (IVM) oocyte freezing in gynecologic cancer patients undergoing radical surgery under time constraints as an option for fertility preservation (FP). Methods Case series report. University-based in vitro fertilization center. Six gynecologic cancer patients who were scheduled to undergo radical surgery the next day were referred for FP. The patients had endometrial (n=2), ovarian (n=3), and double primary endometrial and ovarian (n=1) cancer. Ex vivo retrieval of immature oocytes from macroscopically normal ovarian tissue was followed by mature oocyte freezing after IVM or embryo freezing with intracytoplasmic sperm injection. Results A total of 53 oocytes were retrieved from five patients, with a mean of 10.6 oocytes per patient. After IVM, a total of 36 mature oocytes were obtained, demonstrating a 67.9% maturation rate. With regard to the ovarian cancer patients, seven IVM oocytes were frozen from patient 3, who had stage IC cancer, whereas one IVM oocyte was frozen from patient 4, who had stage IV cancer despite being of a similar age. With regard to the endometrial cancer patients, 15 IVM oocytes from patient 1 were frozen. Five embryos were frozen after the fertilization of IVM oocytes from patient 6. Conclusion Immature oocytes can be successfully retrieved ex vivo from macroscopically normal ovarian tissue before radical surgery. IVM oocyte freezing provides a possible FP option in patients with advanced-stage endometrial or ovarian cancer without the risk of cancer cell spillage or time delays. PMID:27358831

  19. Part I: cancer in Sudan—burden, distribution, and trends breast, gynecological, and prostate cancers

    PubMed Central

    Elamin, Amany; Ibrahim, Muntaser E; Abuidris, Dafalla; Mohamed, Kamal Eldin H; Mohammed, Sulma Ibrahim

    2015-01-01

    Despite the growing burden of cancer worldwide, it continues to receive low priority in Africa, across the continent and specifically in Sudan. This is due to political unrest, limited health resources, and other pressing public health issues such as infectious diseases. Lack of awareness about the magnitude of the current and future cancer burden among policy makers play a major role as well. Although, the real scope of cancer in Sudan is not known, the reported cases have increased from 303 in 1967–6303 in 2010. According to Globocan estimates, the top most common cancers in both sexes are breast, non-Hodgkin lymphoma, leukemia, esophagus, and colorectum. This review is the first of four papers that focuses on cancer, its distribution and trend as well as the risk factors most common in Sudan. It is expected that cancer will increase in Sudan as a result of migration of people from rural areas to urban cities in the pursuit of a better standard of living, which has resulted in lifestyle and behavioral changes that include tobacco chewing and smoking, unhealthy dieting, and a lack of physical activity. These changes are further exacerbated by the aging population and have made the country vulnerable to many diseases including cancer. These reviews are meant to provide a better understanding and knowledge required to plan appropriate cancer-control and prevention strategies in the country. PMID:25641872

  20. Part I: cancer in Sudan—burden, distribution, and trends breast, gynecological, and prostate cancers.

    PubMed

    Elamin, Amany; Ibrahim, Muntaser E; Abuidris, Dafalla; Mohamed, Kamal Eldin H; Mohammed, Sulma Ibrahim

    2015-03-01

    Despite the growing burden of cancer worldwide, it continues to receive low priority in Africa, across the continent and specifically in Sudan. This is due to political unrest, limited health resources, and other pressing public health issues such as infectious diseases. Lack of awareness about the magnitude of the current and future cancer burden among policy makers play a major role as well. Although, the real scope of cancer in Sudan is not known, the reported cases have increased from 303 in 1967-6303 in 2010. According to Globocan estimates, the top most common cancers in both sexes are breast, non-Hodgkin lymphoma, leukemia, esophagus, and colorectum. This review is the first of four papers that focuses on cancer, its distribution and trend as well as the risk factors most common in Sudan. It is expected that cancer will increase in Sudan as a result of migration of people from rural areas to urban cities in the pursuit of a better standard of living, which has resulted in lifestyle and behavioral changes that include tobacco chewing and smoking, unhealthy dieting, and a lack of physical activity. These changes are further exacerbated by the aging population and have made the country vulnerable to many diseases including cancer. These reviews are meant to provide a better understanding and knowledge required to plan appropriate cancer-control and prevention strategies in the country.

  1. Identifying radiation-induced survivorship syndromes affecting bowel health in a cohort of gynecological cancer survivors

    PubMed Central

    Steineck, Gunnar; Skokic, Viktor; Bull, Cecilia; Alevronta, Eleftheria; Dunberger, Gail; Bergmark, Karin; Wilderäng, Ulrica; Oh, Jung Hun; Deasy, Joseph O.; Jörnsten, Rebecka

    2017-01-01

    Background During radiotherapy unwanted radiation to normal tissue surrounding the tumor triggers survivorship diseases; we lack a nosology for radiation-induced survivorship diseases that decrease bowel health and we do not know which symptoms are related to which diseases. Methods Gynecological-cancer survivors were followed-up two to 15 years after having undergone radiotherapy; they reported in a postal questionnaire the frequency of 28 different symptoms related to bowel health. Population-based controls gave the same information. With a modified factor analysis, we determined the optimal number of factors, factor loadings for each symptom, factor-specific factor-loading cutoffs and factor scores. Results Altogether data from 623 survivors and 344 population-based controls were analyzed. Six factors best explain the correlation structure of the symptoms; for five of these a statistically significant difference (P< 0.001, Mann-Whitney U test) was found between survivors and controls concerning factor score quantiles. Taken together these five factors explain 42 percent of the variance of the symptoms. We interpreted these five factors as radiation-induced syndromes that may reflect distinct survivorship diseases. We obtained the following frequencies, defined as survivors having a factor loading above the 95 percent percentile of the controls, urgency syndrome (190 of 623, 30 percent), leakage syndrome (164 of 623, 26 percent), excessive gas discharge (93 of 623, 15 percent), excessive mucus discharge (102 of 623, 16 percent) and blood discharge (63 of 623, 10 percent). Conclusion Late effects of radiotherapy include five syndromes affecting bowel health; studying them and identifying the underlying survivorship diseases, instead of the approximately 30 long-term symptoms they produce, will simplify the search for prevention, alleviation and elimination. PMID:28158314

  2. Opioid consumption and pain in gynecological cancer patients treated with interstitial brachytherapy.

    PubMed

    Mendez, Lucas C; Choi, Stephen; D'Alimonte, Laura; Barnes, Elizabeth; Barbera, Lisa; Leung, Eric

    Interstitial brachytherapy (ISBT) has advantages over the intracavitary techniques in the treatment of gynecological malignancies. The insertion of catheters into tumor enables higher dose conformality and normal tissue sparing. However ISBT can be associated with pain due its invasiveness. The goal of this study is to assess pain and opioid consumption of patients implanted with a perineal ISBT applicator. Forty-eight patients were treated with ISBT from September 2014 to April 2016. Mean age was 63. Malignancies included 18 cervical cancers, 12 vaginal, 14 recurrent endometrial, and four others. Patient characteristics and technical ISBT data were collected. Opioid consumption was quantified as oral morphine equivalent per day (OMEq/day) from postimplant until removal. Pain score levels were collected by using an 11-point scoring system. Twenty-three patients had a single ISBT implantation, whereas 25 had a second. Twenty-eight patients required IV-patient-controlled analgesia. Mean OMEq/day for the first insertion was 55 mg. In the second insertion, an increase of 22 mg was seen (p = 0.0004). Patients with IV-patient-controlled analgesia had higher opioid consumption (OMEq/day 69.8 mg vs 32.1 mg, p = 0.001) and maximum pain scores (5.5 vs 3.4, p = 0.007) as compared with patients on oral opioids. Higher levels of pain were detected in the first hours postimplant. Previous opioids and age were associated with increased opioid consumption. Pain from perineal-ISBT can be managed with oral opioids in a select group of patients. For repeat insertions, there may be an increase in opioid consumption. While age and previous opioids affected opioid requirements, other factors such as number of needles and insertion depth were not associated factors. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  3. Extraperitoneal Robotic-Assisted Para-Aortic Lymphadenectomy in Gynecologic Cancer Staging: Current Evidence.

    PubMed

    Bogani, Giorgio; Ditto, Antonino; Martinelli, Fabio; Signorelli, Mauro; Chiappa, Valentina; Sabatucci, Ilaria; Scaffa, Cono; Lorusso, Domenica; Raspagliesi, Francesco

    2016-01-01

    We reviewed the current evidence on the safety, effectiveness, and applicability of extraperitoneal robotic-assisted para-aortic lymphadenectomy (ExtRA-PAL) as the staging procedure of gynecologic malignancies. PubMed (MEDLINE), Scopus, Web of Science databases, and ClinicalTrials.gov were searched for original studies reporting outcomes of ExtRA-PAL. Quality of the included studies and their level of recommendation were assessed using the Grading of Recommendations, Assessment, Development, and Evaluation and the American College of Obstetricians and Gynecologists guidelines, respectively. Overall, 62 studies were identified; after a process of evidence acquisition 5 original investigations were available for this review that included 98 patients undergoing ExtRA-PAL. The main surgical indication was staging for cervical cancer (n = 71, 72%). The mean (SD) number of para-aortic node yielded was 15.4 (±4.7) nodes. Blood transfusion and intraoperative complication rates were 2% and 6%, respectively. ExtRA-PAL was completed in 88 patients (90%). Six (6%) and 4 (4%) patients had conversion to other minimally invasive procedures and open surgery, respectively. Success rate was 99% among patients undergoing ExtRA-PAL without concomitant procedures. Overall, mean (SD) length of hospital stay was 2.8 (±0.5) days. Twenty-four patients (24%) developed postoperative events. According to the Clavien-Dindo grading system, grades IIIa and IIIb morbidity rates were 12% and 2%, respectively. No grades IV and V morbidity occurred. ExtRA-PAL is associated with a high success rate and a relative low morbidity rate. However, because of the limited data on this issue, further studies are warranted to assess the long-term effectiveness of this procedure.

  4. Escalation of oncologic services at the end of life among patients with gynecologic cancer at an urban, public hospital.

    PubMed

    Wu, Eijean; Rogers, Anna; Ji, Lingyun; Sposto, Richard; Church, Terry; Roman, Lynda; Tripathy, Debu; Lin, Yvonne G

    2015-03-01

    Use of oncology-related services is increasingly scrutinized, yet precisely which services are actually rendered to patients, particularly at the end of life, is unknown. This study characterizes the end-of-life use of medical services by patients with gynecologic cancer at a safety-net hospital. Oncologic history and metrics of medical use (eg, hospitalizations, chemotherapy infusions, procedures) for patients with gynecologic oncology who died between December 2006 and February 2012 were evaluated. Mixed-effect regression models were used to test time effects and construct usage summaries. Among 116 subjects, cervical cancer accounted for the most deaths (42%). The median age at diagnosis was 55 years; 63% were Hispanic, and 65% had advanced disease. Only 34% died in hospice care. The median times from do not resuscitate/do not intubate documentation and from last therapeutic intervention to death were 9 days and 55 days, respectively. Significant time effects for all services (eg, hospitalizations, diagnostics, procedures, treatments, clinic appointments) were detected during the patient's final year (P < .001), with the most dramatic changes occurring during the last 2 months. Patients with longer duration of continuity of care used significantly fewer resources toward the end of life. To our knowledge, this is the first report enumerating medical services obtained by patients with gynecologic cancer in a large, public hospital during the end of life. Marked changes in interventions in the patient's final 2 months highlight the need for cost-effective, evidence-based metrics for delivering cancer care. Our data emphasize continuity of care as a significant determinant of oncologic resource use during this critical period. Copyright © 2015 by American Society of Clinical Oncology.

  5. New Screening Proposals: the Federal Joint Commission Defines the Parameters for Cervical Cancer Screening from 2018: Statement of the Gynecology Oncology Working Group (AGO).

    PubMed

    Hillemanns, P; Mallmann, P; Beckmann, M W

    2016-02-01

    The Gynecology Oncology Working Group (AGO e. V.) unequivocally welcomes the decision taken by the German Federal Joint Commission (Gemeinsamer Bundesausschuss, G-BA) on March 19, 2015 regarding screening for cervical cancer. AGO is convinced that, in view of recent medical advances, this evidence-based decision will improve screening for cervical cancer.

  6. Factors associated with cancer-specific and overall survival among Indigenous and non-Indigenous gynecologic cancer patients in Queensland, Australia: a matched cohort study.

    PubMed

    Diaz, Abbey; Moore, Suzanne P; Martin, Jennifer H; Green, Adele C; Garvey, Gail; Valery, Patricia C

    2015-03-01

    Aboriginal and Torres Strait Islander women have a higher mortality rate due to gynecologic cancer compared with non-Indigenous women. For cervical cancer, Australian Indigenous women are less likely to survive 5 years following diagnoses than non-Indigenous women. This study investigates the factors associated with gynecologic cancer treatment and survival among Queensland indigenous and non-Indigenous women. Australian Indigenous women diagnosed with uterine, cervical, ovarian, or other gynecologic cancers during 1998-2004 in the public hospital system were included. They were frequency matched on age (±5 years), residential remoteness, and cancer type to a random sample of non-Indigenous women. One- and 5-year cancer-specific survival was examined according to Indigenous status using Cox proportional hazards regression. Indigenous women (n = 137) compared with non-Indigenous women (n = 120) were less likely to be diagnosed with localized disease (49% vs 65%, P = 0.02) and had more comorbidities (52% vs 21%, P < 0.001). Indigenous women were less likely to receive any cancer treatment compared with non-Indigenous women (91% vs 98%, P = 0.01), although when excluding those with metastatic cancer, there was no significant difference in uptake of treatment (95% vs 91%, respectively, P = 0.31). Among those who did undergo treatment, there was no difference in time to treatment (median difference 0.5 days, P = 0.98). Gynecologic cancer-specific survival differences between Indigenous and non-Indigenous women were most prominent in the first year following diagnosis (hazard ratio [HR], 1.89; 95% confidence interval [CI], 1.06-3.38) and were no longer significant 5 years after diagnosis (HR, 1.47 [95% CI, 0.97-2.25]). For cervical cancer, crude 1-year survival was poorer for Indigenous women compared with non-Indigenous women (HR, 2.46 [95% CI, 1.03-5.90]), but was no different when adjusted for stage and treatment of cancer (HR, 1.00 [95% CI, 0.45-2.24]). Improving

  7. Primary Caregivers' Support for Female Family Members With Breast or Gynecologic Cancer.

    PubMed

    Han, Jung-Hee; Han, Song-Hee; Lee, Myo-Suk; Kwon, Hye-Jin; Choe, Kwisoon

    2016-01-01

    Female patients with cancer depend on loved ones; thus, family support is pivotal to assist patients in successfully adjusting to life with treatment routines. Our study explored the experiences of primary caregivers who provide care and support for female family members with cancer. This study used a qualitative phenomenological research approach. Interviews and journaling about the caregiving experience were conducted with the family members of female cancer patients-6 spouses, 11 daughters, 1 son, and 1 younger sister. Data analysis involved Giorgi's 3-step phenomenological analysis method. The central theme of the primary caregivers' supportive care for their female family member with cancer was "being with" her. This was composed of the following themes: "being there for her via efforts," "living through feelings of guilt and anxiety," and "lessons learned from cancer in the family." This study reveals an integrated picture of family caregivers' supportive caring experiences. By providing both positive and negative aspects of the caregiving experience, the findings in this study will provide a theoretical foundation to develop more successful support programs for family caregivers of female patients with cancer. Family-oriented education programs need to be developed to include both the family and the patient in the long journey of cancer. The family caregivers' feelings of guilt regarding the cause of the illness and feelings of anxiety about the uncertainty of the illness should be assessed and managed during the course of the patients' treatment and care.

  8. Japan Society of Gynecologic Oncology guidelines 2015 for the treatment of ovarian cancer including primary peritoneal cancer and fallopian tube cancer.

    PubMed

    Komiyama, Shinichi; Katabuchi, Hidetaka; Mikami, Mikio; Nagase, Satoru; Okamoto, Aikou; Ito, Kiyoshi; Morishige, Kenichiro; Suzuki, Nao; Kaneuchi, Masanori; Yaegashi, Nobuo; Udagawa, Yasuhiro; Yoshikawa, Hiroyuki

    2016-06-01

    The fourth edition of the Japan Society of Gynecologic Oncology guidelines for the treatment of ovarian cancer including primary peritoneal cancer and fallopian tube cancer was published in 2015. The guidelines contain seven chapters and six flow charts. The major changes in this new edition are as follows-(1) the format has been changed from reviews to clinical questions (CQ), and the guidelines for optimal clinical practice in Japan are now shown as 41 CQs and answers; (2) the 'flow charts' have been improved and placed near the beginning of the guidelines; (3) the 'basic points', including tumor staging, histological classification, surgical procedures, chemotherapy, and palliative care, are described before the chapter; (4) the FIGO surgical staging of ovarian cancer, fallopian tube cancer, and primary peritoneal cancer was revised in 2014 and the guideline has been revised accordingly to take the updated version of this classification into account; (5) the procedures for examination and management of hereditary breast and ovarian cancer are described; (6) information on molecular targeting therapy has been added; (7) guidelines for the treatment of recurrent cancer based on tumor markers alone are described, as well as guidelines for providing hormone replacement therapy after treatment.

  9. Three-Dimensional Printing of a Hemorrhagic Cervical Cancer Model for Postgraduate Gynecological Training

    PubMed Central

    Ryan, Stephen; Doucet, Gregory; Murphy, Deanna; Turner, Jacqueline

    2017-01-01

    Introduction A realistic hemorrhagic cervical cancer model was three-dimensionally (3D) printed and used in a postgraduate medical simulation training session. Materials and methods Computer-assisted design (CAD) software was the platform of choice to create and refine the cervical model. Once the prototype was finalized, another software allowed for the addition of a neoplastic mass, which included openings for bleeding from the neoplasm and cervical os. 3D printing was done using two desktop printers and three different materials. An emergency medicine simulation case was presented to obstetrics and gynecology residents who were at varying stages of their training. The scenario included history taking and physical examination of a standardized patient. This was a hybrid simulation; a synthetic pelvic task trainer that allowed the placement of the cervical model was connected to the standardized patient. The task trainer was placed under a drape and appeared to extend from the standardized patient’s body. At various points in the simulation, the standardized patient controlled the cervical bleeding through a peripheral venous line. Feedback forms were completed, and the models were discussed and evaluated with staff. Results A final cervical model was created and successfully printed. Overall, the models were reported to be similar to a real cervix. The models bled well. Most models were not sutured during the scenarios, but overall, the value of the printed cervical models was reported to be high. Discussion The models were well received, but it was suggested that more colors be integrated into the cervix in order to better emphasize the intended pathology. The model design requires further improvement, such as the addition of a locking mechanism, in order to ensure that the cervix stays inside the task trainer throughout the simulation. Adjustments to the simulated blood product would allow the bleeding to flow more vigorously. Additionally

  10. Three-Dimensional Printing of a Hemorrhagic Cervical Cancer Model for Postgraduate Gynecological Training.

    PubMed

    Bartellas, Michael; Ryan, Stephen; Doucet, Gregory; Murphy, Deanna; Turner, Jacqueline

    2017-01-01

    A realistic hemorrhagic cervical cancer model was three-dimensionally (3D) printed and used in a postgraduate medical simulation training session. Computer-assisted design (CAD) software was the platform of choice to create and refine the cervical model. Once the prototype was finalized, another software allowed for the addition of a neoplastic mass, which included openings for bleeding from the neoplasm and cervical os. 3D printing was done using two desktop printers and three different materials. An emergency medicine simulation case was presented to obstetrics and gynecology residents who were at varying stages of their training. The scenario included history taking and physical examination of a standardized patient. This was a hybrid simulation; a synthetic pelvic task trainer that allowed the placement of the cervical model was connected to the standardized patient. The task trainer was placed under a drape and appeared to extend from the standardized patient's body. At various points in the simulation, the standardized patient controlled the cervical bleeding through a peripheral venous line. Feedback forms were completed, and the models were discussed and evaluated with staff. A final cervical model was created and successfully printed. Overall, the models were reported to be similar to a real cervix. The models bled well. Most models were not sutured during the scenarios, but overall, the value of the printed cervical models was reported to be high. The models were well received, but it was suggested that more colors be integrated into the cervix in order to better emphasize the intended pathology. The model design requires further improvement, such as the addition of a locking mechanism, in order to ensure that the cervix stays inside the task trainer throughout the simulation. Adjustments to the simulated blood product would allow the bleeding to flow more vigorously. Additionally, a different simulation scenario might be more suitable to

  11. Breast Cancer Risk in American Women

    MedlinePlus

    ... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Risk in American Women On This Page What ... risk of developing the disease. Personal history of breast cancer : Women who have had breast cancer are more ...

  12. Risk factors contributing to the development of carboplatin-related delayed hypersensitivity reactions in Japanese patients with gynecologic cancers.

    PubMed

    Sugimoto, Hiroko; Iwamoto, Takuya; Murashima, Yukiko; Tabata, Tsutomu; Sagawa, Norimasa; Okuda, Masahiro

    2011-02-01

    The rate of hypersensitivity reactions in patients receiving carboplatin (CBDCA) has been reported to increase after multiple doses of the agent. However, risk factors for these onsets have not been well described. In this study, we investigated the contribution of the reported risk factors to the onset of CBDCA-related delayed hypersensitivity reactions. We reviewed the records of gynecologic cancer patients receiving CBDCA of more than 7 cycles in Mie University Hospital from March 2006 to July 2009. The patients were divided into two groups on the basis of whether hypersensitivity reactions developed (13 patients) or not (43 patients). Thereafter, the potential influences of the patients' characteristics on the development of CBDCA-related delayed hypersensitivity reactions were explored using logistic regression analyses. The median CBDCA-free interval (10 months) in patients with hypersensitivity reactions was significantly higher than that (3 months) in patients without hypersensitivity reactions. Logistic regression analyses revealed a CBDCA-free interval >13 months (odds ratio 22.2, 95% confidence interval 2.57-192, p < 0.01) and a maximum dose of CBDCA > 650 mg (odds ratio 9.52, 95% confidence interval 1.04-93.9; p < 0.05) were significantly correlated with the incidence of CBDCA-related delayed hypersensitivity reactions. Careful attention should be paid to the onset of delayed hypersensitivity reactions for recurrent gynecologic cancer patients receiving CBDCA > 650 mg after an interval of more than 13 months from the previous CBDCA administration.

  13. Obstetrics and gynecology outpatient scenario of an Indian homeopathic hospital: A prospective, research-targeted study

    PubMed Central

    Saha, Subhranil; Koley, Munmun; Saha, Sangita; Singh, Rakesh; Hossain, Md. Monowar; Pramanik, Indrani

    2015-01-01

    The authors aimed to document prescriptions and clinical outcomes in routine homeopathic practice to short list promising areas of targeted research and efficacy trials of homeopathy in obstetrics and gynecology (O&G). Three homeopathic physicians participated in methodical data collection over a 3-month period in the O&G outpatient setting of The Calcutta Homeopathic Medical College and Hospital, West Bengal, India. A specifically designed Excel spreadsheet was used to record data on consecutive appointments, including date, patient identity, socioeconomic status, place of abode, religion, medical condition/complaint, whether chronic/acute, new/follow-up case, patient-assessed outcome (7-point Likert scale: −3 to +3), prescribed homeopathic medication, and whether other medication/s was being taken for the condition. These spreadsheets were submitted monthly for data synthesis and analysis. Data on 878 appointments (429 patients) were collected, of which 61% were positive, 20.8% negative, and 18.2% showed no change. Chronic conditions (93.2%) were chiefly encountered. A total of 434 medical conditions and 52 varieties were reported overall. The most frequently treated conditions were leucorrhea (20.5%), irregular menses (13.3%), dysmenorrhea (10%), menorrhagia (7.5%), and hypomenorrhea (6.3%). Strongly positive outcomes (+3/+2) were mostly recorded in oligomenorrhea (41.7%), leucorrhea (34.1%), polycystic ovary (33.3%), dysmenorrhea (28%), and irregular menses (22.2%). Individualized prescriptions predominated (95.6%). A total of 122 different medicines were prescribed in decimal (2.9%), centesimal (87.9%), and 50 millesimal potencies (4.9%). Mother tinctures and placebo were prescribed in 3.4% and 30.4% instances, respectively. Several instances of medicine-condition pairings were detected. This systematic recording cataloged the frequency and success rate of treating O&G conditions using homeopathy. PMID:27114940

  14. Stress Reduction in Improving Quality of Life in Patients With Recurrent Gynecologic or Breast Cancer

    ClinicalTrials.gov

    2015-10-08

    Anxiety Disorder; Depression; Fatigue; Leydig Cell Tumor; Ovarian Sarcoma; Ovarian Stromal Cancer; Pain; Peritoneal Carcinomatosis; Pseudomyxoma Peritonei; Recurrent Breast Cancer; Recurrent Cervical Cancer; Recurrent Endometrial Carcinoma; Recurrent Fallopian Tube Cancer; Recurrent Gestational Trophoblastic Tumor; Recurrent Ovarian Epithelial Cancer; Recurrent Ovarian Germ Cell Tumor; Recurrent Primary Peritoneal Cavity Cancer; Recurrent Uterine Sarcoma; Recurrent Vaginal Cancer; Recurrent Vulvar Cancer

  15. Psychosexual Intervention in Patients With Stage I-III Gynecologic or Breast Cancer

    ClinicalTrials.gov

    2017-04-12

    Ovarian Sarcoma; Ovarian Stromal Cancer; Stage I Uterine Sarcoma; Stage I Vaginal Cancer; Stage I Vulvar Cancer; Stage IA Cervical Cancer; Stage IA Endometrial Carcinoma; Stage IA Fallopian Tube Cancer; Stage IA Ovarian Epithelial Cancer; Stage IA Ovarian Germ Cell Tumor; Stage IA Primary Peritoneal Cavity Cancer; Stage IB Cervical Cancer; Stage IB Endometrial Carcinoma; Stage IB Fallopian Tube Cancer; Stage IB Ovarian Epithelial Cancer; Stage IB Ovarian Germ Cell Tumor; Stage IB Primary Peritoneal Cavity Cancer; Stage IC Fallopian Tube Cancer; Stage IC Ovarian Epithelial Cancer; Stage IC Ovarian Germ Cell Tumor; Stage IC Primary Peritoneal Cavity Cancer; Stage II Endometrial Carcinoma; Stage II Gestational Trophoblastic Tumor; Stage II Uterine Sarcoma; Stage II Vaginal Cancer; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Epithelial Cancer; Stage IIA Ovarian Germ Cell Tumor; Stage IIA Primary Peritoneal Cavity Cancer; Stage IIB Cervical Cancer; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Epithelial Cancer; Stage IIB Ovarian Germ Cell Tumor; Stage IIB Primary Peritoneal Cavity Cancer; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Epithelial Cancer; Stage IIC Ovarian Germ Cell Tumor; Stage IIC Primary Peritoneal Cavity Cancer; Stage III Gestational Trophoblastic Tumor; Stage III Uterine Sarcoma; Stage III Vaginal Cancer; Stage III Vulvar Cancer; Stage IIIA Cervical Cancer; Stage IIIA Endometrial Carcinoma; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Epithelial Cancer; Stage IIIA Ovarian Germ Cell Tumor; Stage IIIA Primary Peritoneal Cavity Cancer; Stage IIIB Cervical Cancer; Stage IIIB Endometrial Carcinoma; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Epithelial Cancer; Stage IIIB Ovarian Germ Cell Tumor; Stage IIIB Primary Peritoneal Cavity Cancer; Stage IIIC Endometrial Carcinoma; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Epithelial Cancer; Stage IIIC Ovarian Germ Cell

  16. Comprehensive Patient Questionnaires in Predicting Complications in Older Patients With Gynecologic Cancer Undergoing Surgery

    ClinicalTrials.gov

    2016-10-25

    Endometrial Serous Adenocarcinoma; Fallopian Tube Carcinoma; Ovarian Carcinoma; Primary Peritoneal Carcinoma; Stage IIIA Uterine Corpus Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC Uterine Corpus Cancer; Stage IVA Uterine Corpus Cancer; Stage IVB Uterine Corpus Cancer

  17. Fifth Ovarian Cancer Consensus Conference of the Gynecologic Cancer InterGroup: Recommendations on incorporating patient-reported outcomes in clinical trials in epithelial ovarian cancer.

    PubMed

    Joly, Florence; Hilpert, Felix; Okamoto, Aikou; Stuart, Gavin; Ochiai, Kasunori; Friedlander, Michael

    2017-06-01

    Despite the support for including patient-reported outcomes (PROs) and health-related quality of life in clinical trials, there have been deficiencies in how these have been assessed and reported in epithelial ovarian cancer (EOC) clinical trials. To redress this, the 5th Ovarian Cancer Consensus Conference, included a plenary session entitled 'How to include PROs in clinical trials'. The perspective is a summary of the recommendations made by the Gynecologic Cancer InterGroup unanimously agreed on the importance of PROs and PRO end-points in EOC clinical trials. They recognised that effort must be made to ensure the integrity of collection of PRO data and to avoid missing data. PRO end-points should be based on the PRO hypotheses, be context specific and reflect the patient population and the objectives of treatment (e.g. first line, maintenance therapy, early or late relapse). The PRO end-points inform the choice of PRO measures used in the trial and how the results are analysed and reported. There was agreement that progression-free survival should be supported by PROs among patients with late relapse (platinum sensitive) and that progression-free survival alone was not sufficient as the primary end-point of clinical trials in patients with platinum resistant/refractory EOC and PROs should be included as either the primary/co-primary end-point in this subset of patients. Novel approaches to measure the benefit of palliative chemotherapy such as time until definitive deterioration of Health-Related Quality of Life were recommended. There was consensus to endorse the ISOQOL and CONSORT-PRO guidelines on the inclusion and reporting of PRO endpoints in protocols and that all future EOC Gynecologic Cancer InterGroup trials should adhere to these. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Breast and gynecologic cancer-related extremity lymphedema: a review of diagnostic modalities and management options

    PubMed Central

    2013-01-01

    Lymphedema remains a poorly understood entity that can occur after lymphadenectomy. Herein, we will review the pathogenesis of lymphedema, diagnostic modalities and the natural history of extremity involvement. We will review the incidence of upper extremity lymphedema in patients treated for breast malignancies and lower extremity lymphedema in those treated for gynecologic malignancy. Finally, we will review traditional treatment modalities for lymphedema, as well as introduce new surgical treatment modalities that are under active investigation. PMID:24053624

  19. Carboplatin, Gemcitabine Hydrochloride, and Stereotactic Body Radiation Therapy in Gynecological Cancer

    ClinicalTrials.gov

    2015-08-03

    Leydig Cell Tumor; Ovarian Sarcoma; Ovarian Stromal Cancer; Pseudomyxoma Peritonei; Recurrent Cervical Cancer; Recurrent Endometrial Carcinoma; Recurrent Fallopian Tube Cancer; Recurrent Ovarian Epithelial Cancer; Recurrent Ovarian Germ Cell Tumor; Recurrent Primary Peritoneal Cavity Cancer; Recurrent Uterine Sarcoma; Recurrent Vaginal Cancer; Recurrent Vulvar Cancer

  20. The role of neoadjuvant chemotherapy in the management of patients with advanced stage ovarian cancer: survey results from members of the Society of Gynecologic Oncologists.

    PubMed

    Dewdney, Summer B; Rimel, B J; Reinhart, Andrew J; Kizer, Nora T; Brooks, Rebecca A; Massad, L Stewart; Zighelboim, Israel

    2010-10-01

    Recent randomized controlled data suggest that neoadjuvant chemotherapy (NACT) with interval debulking (ID) may produce similar overall survival and progression free survival compared to standard primary cytoreduction followed by chemotherapy. The object of our study was to assess current patterns of care among members of the Society of Gynecologic Oncologists (SGO), specifically collating their opinions on and use of NACT for advanced stage ovarian cancer. A 20-item questionnaire was sent to all working e-mail addresses of SGO members (n=1137). The data was collected and analyzed using descriptive statistics with commercially available online survey software. The Chi-square test for independence was used to determine differences in responses between groups. Of 339 (30%) responding members, most rarely employ NACT, with 60% of respondents using NACT in less than 10% of advanced stage ovarian cancer cases. Respondents did not consider available evidence sufficient to justify NACT followed by ID (82%), nor did most think it should be preferred (74%). Sixty-two percent of respondents thought it was impossible to accurately predict preoperatively whether an optimal cytoreduction is possible. Thirty-nine percent believed that women with bulky upper abdominal disease on preoperative imaging would benefit from NACT versus primary debulking. If gross disease were found at ID, 43% would continue to treat with IV chemotherapy, and 42% would place an IP port if optimally cytoreduced. When ID reveals microscopic disease, 51% would continue IV treatment and the remaining IP therapy. Eighty-six percent of the respondents believed that both biological and surgical factors determine patient outcomes. The majority of responding SGO members do not treat patients with NACT followed by ID. Currently available studies of NACT/ID have been insufficient to convince most gynecologic oncologists to incorporate it into practice. Our results provide a benchmark against which further research

  1. Correlates of underutilization of gynecological cancer screening among lesbian and heterosexual women.

    PubMed

    Matthews, Alicia K; Brandenburg, Dana L; Johnson, Timothy P; Hughes, Tonda L

    2004-01-01

    Study aims were to examine cervical cancer risk factors, screening patterns, and predictors of screening adherence in demographically similar samples of lesbian (N=550) and heterosexual women (N=279). Data are from a multisite survey study of women's health conducted from 1994 to 1996. Differences in sexual behavior risk factors for cervical cancer were observed with lesbians reporting earlier onset of sexual activity (P<0.05), more sexual partners (P<0.001), and lower use of safer sex activities (P<0.01). Lesbian and heterosexual women were equally likely to have ever had a Pap test; however, lesbians were less likely to report annual (P<0.001) or routine (P<0.001) testing. Multivariate analyses were used to determine the associations between demographics, health care factors, health behaviors, and worry about health and screening behaviors. Individual predictors of never screening included younger age, lower income, and lack of annual medical visits. Independent predictors of both recent and annual screenings included history of an abnormal Pap test, being heterosexual, and annual medical visits. Data indicate that lesbians are at risk for cervical cancer, yet underutilize recommended screening tests. Findings have implications for research, education, and cancer control among lesbians.

  2. RTOG Gynecologic Oncology Working Group: Comprehensive Results

    PubMed Central

    Gaffney, David K.; Jhingran, Anuja; Portelance, Lorraine; Viswanathan, Akila; Schefter, Tracey; Weidhaas, Joanne; Small, William

    2016-01-01

    The purpose of this report is to comprehensively describe the activities of the Gynecologic Oncology Working Group within the RTOG. Clinical trials will be reviewed as well as translational science and ancillary activities. Over the past 40 years, a myriad of clinical trials have been performed within the RTOG with the aim of improving overall survival and decreasing morbidity in women with cervical or endometrial cancer. Major study questions have included hyperbaric oxygen, neutron radiotherapy, altered fractionation, hypoxic cell sensitization, chemosensitization, and volume directed radiotherapy. RTOG 7920 demonstrated improvement in overall survival in patients with stages IB through IIB cervical carcinoma receiving prophylactic paraaortic irradiation compared to pelvic radiation alone. RTOG 9001 demonstrated that cisplatin and 5-FU chemoradiotherapy to the pelvis for advanced cervix cancer markedly improved overall survival compared to extended field radiotherapy alone. More recent trials have employed radioprotectors, molecular targeted therapy, and intensity modulated radiation therapy. Ancillary studies have developed CTV atlases for research protocols and routine clinical use. Worldwide practice patterns have been investigated in cervix, endometrial, and vulvar cancer thru the Gynecologic Cancer Intergroup (GCIG). Translational studies have focused on immunohistochemical markers, changes in gene expression, and miRNA patterns impacting prognosis. The RTOG gynecologic working group has performed clinical trials that have defined the standard of care, improved survival, and added to our understanding of the biology of cervical and endometrial cancers. PMID:24819663

  3. Robotic Surgery in Gynecologic Oncology

    PubMed Central

    DeBernardo, Robert; Starks, David; Barker, Nichole; Armstrong, Amy; Kunos, Charles A.

    2011-01-01

    Robotic surgery for the management of gynecologic cancers allows for minimally invasive surgical removal of cancer-bearing organs and tissues using sophisticated surgeon-manipulated, robotic surgical instrumentation. Early on, gynecologic oncologists recognized that minimally invasive surgery was associated with less surgical morbidity and that it shortened postoperative recovery. Now, robotic surgery represents an effective alternative to conventional laparotomy. Since its widespread adoption, minimally invasive surgery has become an option not only for the morbidly obese but for women with gynecologic malignancy where conventional laparotomy has been associated with significant morbidity. As such, this paper considers indications for robotic surgery, reflects on outcomes from initial robotic surgical outcomes data, reviews cost efficacy and implications in surgical training, and discusses new roles for robotic surgery in gynecologic cancer management. PMID:22190946

  4. Antiprogestins in gynecological diseases

    PubMed Central

    Goyeneche, Alicia A; Telleria, Carlos M

    2015-01-01

    Antiprogestins constitute a group of compounds, developed since the early 1980s, that bind progesterone receptors with different affinities. The first clinical uses for antiprogestins were in reproductive medicine, e.g., menstrual regulation, emergency contraception, and termination of early pregnancies. These initial applications, however, belied the capacity for these compounds to interfere with cell growth. Within the context of gynecological diseases, antiprogestins can block the growth of and kill gynecological-related cancer cells, such as those originating in the breast, ovary, endometrium, and cervix. They can also interrupt the excessive growth of cells giving rise to benign gynecological diseases such as endometriosis and leiomyomata (uterine fibroids). In this article, we present a review of the literature providing support for the antigrowth activity that antiprogestins impose on cells in various gynecological diseases. We also provide a summary of the cellular and molecular mechanisms reported for these compounds that lead to cell growth inhibition and death. The preclinical knowledge gained during the past few years provides robust evidence to encourage the use of antiprogestins in order to alleviate the burden of gynecological diseases, either as monotherapies or as adjuvants of other therapies with the perspective of allowing for long-term treatments with tolerable side effects. The key to the clinical success of antiprogestins in this field probably lies in selecting those patients who will benefit from this therapy. This can be achieved by defining the genetic makeup required – within each particular gynecological disease – for attaining an objective response to antiprogestin-driven growth inhibition therapy. Free Spanish abstract A Spanish translation of this abstract is freely available at http://www.reproduction-online.org/content/149/1/15/suppl/DC1. PMID:25252652

  5. Effects of coffee consumption on gut recovery after surgery of gynecological cancer patients: a randomized controlled trial.

    PubMed

    Güngördük, Kemal; Özdemir, İsa Aykut; Güngördük, Özgü; Gülseren, Varol; Gokçü, Mehmet; Sancı, Muzaffer

    2017-02-01

    Paralytic ileus that develops after elective surgery is a common and uncomfortable complication and is considered inevitable after an intraperitoneal operation. The purpose of this study was to investigate whether coffee consumption accelerates the recovery of bowel function after complete staging surgery of gynecologic cancers. In this randomized controlled trial, 114 patients were allocated preoperatively to either postoperative coffee consumption with 3 times daily (n=58) or routine postoperative care without coffee consumption (n=56). Total abdominal hysterectomy and bilateral salpingo-oophorectomy with systematic pelvic and paraaortic lymphadenectomy were performed on all patients as part of complete staging surgery for endometrial, ovarian, cervical, or tubal cancer. The primary outcome measure was the time to the first passage of flatus after surgery. Secondary outcomes were the time to first defecation, time to first bowel movement, and time to tolerance of a solid diet. The mean time to flatus (30.2±8.0 vs 40.2±12.1 hours; P<.001), mean time to defecation (43.1±9.4 vs 58.5±17.0 hours; P<.001), and mean time to the ability to tolerate food (3.4±1.2 vs 4.7±1.6 days; P<.001) were reduced significantly in patients who consumed coffee compared with control subjects. Mild ileus symptoms were observed in 17 patients (30.4%) in the control group compared with 6 patients (10.3%) in the coffee group (P=.01). Coffee consumption was well-tolerated and well-accepted by patients, and no intervention-related side-effects were observed. Coffee consumption after total abdominal hysterectomy and systematic paraaortic lymphadenectomy expedites the time to bowel motility and the ability to tolerate food. This simple, cheap, and well-tolerated treatment should be added as an adjunct to the postoperative care of gynecologic oncology patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Factors Predictive of Improved Survival in Patients With Brain Metastases From Gynecologic Cancer: A Single Institution Retrospective Study of 47 Cases and Review of the Literature.

    PubMed

    Gressel, Gregory M; Lundsberg, Lisbet S; Altwerger, Gary; Katchi, Tasleem; Azodi, Masoud; Schwartz, Peter E; Ratner, Elena S; Damast, Shari

    2015-11-01

    The reported incidence of brain metastasis from epithelial ovarian cancer (EOC), endometrial cancer (EC), and cervical cancer (CC) is exceedingly rare. As the long-term survival for patients with gynecologic cancer increases, there has been a corresponding increase in the number of diagnosed intracranial metastases. We seek to report our experience with managing brain metastatic disease (BMD) in patients with gynecologic cancer. A retrospective review of all patients with EOC, EC, and CC at our institution revealed 47 patients with concurrent BMD between 2000 and 2013. Demographic data, risk factors, treatment modalities, progression-free data, and overall survival data were collected. Median survival time in patients with brain metastasis from EOC, EC, and CC was 9.0, 4.5, and 3.0 months, respectively. Two-year overall survival rates were 31.6%, 13.6%, and 0%, respectively. Patients received surgery, radiation therapy alone, palliative care, or radiation plus surgery. Radiation combined with surgical resection resulted in a significant hazards ratio of 0.36 (95% confidence interval, 0.15-0.86), compared with radiation alone. Our report provides a large single-institution experience of brain metastases from gynecologic cancer. Patients with BMD have poor prognoses; however, treatment with multimodal therapy including surgical resection and radiation may prolong overall survival.

  7. Physician-scientists in obstetrics and gynecology: predictors of success in obtaining independent research funding.

    PubMed

    Okeigwe, Ijeoma; Wang, Cynthia; Politch, Joseph A; Heffner, Linda J; Kuohung, Wendy

    2017-07-01

    Obstetrics and gynecology departments receive the smallest amount of National Institutes of Health research funding and have significantly lower application success rates compared to pediatric, internal medicine, and surgery departments. The development of mentored early career development training grants (K awards) has been one strategy implemented by the National Institutes of Health to help aspiring physician-scientists establish independent research careers. The purpose of this study is to describe the cohort of obstetrics and gynecology physician-scientists who were K08, K12, and K23 recipients from 1988 through 2015 and to identify predictors of success in obtaining independent federal funding, as defined by acquisition of an R01, R21, R34, U01, U54, P01, or P50 award. We hypothesized that sex, subspecialty, type of K award, and dual MD/PhD would impact success rates. K08, K12, and K23 recipients from 1988 through 2015 were identified from the National Institutes of Health Research Portfolio Online Reporting Tools, the office of the National Institutes of Health Freedom of Information Act, and the website of the Reproductive Scientist Development Program. Data were stratified by sex, educational degree, subspecialty, and type of K award. Data were analyzed using the Pearson χ(2) and Fisher exact tests. The Kaplan-Meier estimator was used to determine rates of conversion to independent funding over time. A total of 388 K recipients were identified. Women accounted for 66% of K awards while men accounted for 34%. Among K recipients, 82% were MDs, while 18% were MD/PhDs. K12 awards accounted for 82% of all K awards, while K08 and K23 awards accounted for 10% and 8%, respectively. Subspecialists in maternal-fetal medicine and reproductive endocrinology and infertility received the highest proportion of K awards, followed by generalists and gynecologic oncologists. Altogether, the 3 subspecialty groups accounted for 68% of all K awards. R01 awards made up the

  8. Pretreatment malnutrition and quality of life - association with prolonged length of hospital stay among patients with gynecological cancer: a cohort study

    PubMed Central

    2010-01-01

    Background Length of hospital stay (LOS) is a surrogate marker for patients' well-being during hospital treatment and is associated with health care costs. Identifying pretreatment factors associated with LOS in surgical patients may enable early intervention in order to reduce postoperative LOS. Methods This cohort study enrolled 157 patients with suspected or proven gynecological cancer at a tertiary cancer centre (2004-2006). Before commencing treatment, the scored Patient Generated - Subjective Global Assessment (PG-SGA) measuring nutritional status and the Functional Assessment of Cancer Therapy-General (FACT-G) scale measuring quality of life (QOL) were completed. Clinical and demographic patient characteristics were prospectively obtained. Patients were grouped into those with prolonged LOS if their hospital stay was greater than the median LOS and those with average or below average LOS. Results Patients' mean age was 58 years (SD 14 years). Preoperatively, 81 (52%) patients presented with suspected benign disease/pelvic mass, 23 (15%) with suspected advanced ovarian cancer, 36 (23%) patients with suspected endometrial and 17 (11%) with cervical cancer, respectively. In univariate models prolonged LOS was associated with low serum albumin or hemoglobin, malnutrition (PG-SGA score and PG-SGA group B or C), low pretreatment FACT-G score, and suspected diagnosis of cancer. In multivariable models, PG-SGA group B or C, FACT-G score and suspected diagnosis of advanced ovarian cancer independently predicted LOS. Conclusions Malnutrition, low quality of life scores and being diagnosed with advanced ovarian cancer are the major determinants of prolonged LOS amongst gynecological cancer patients. Interventions addressing malnutrition and poor QOL may decrease LOS in gynecological cancer patients. PMID:20497581

  9. Pretreatment malnutrition and quality of life - association with prolonged length of hospital stay among patients with gynecological cancer: a cohort study.

    PubMed

    Laky, Brenda; Janda, Monika; Kondalsamy-Chennakesavan, Srinivas; Cleghorn, Geoffrey; Obermair, Andreas

    2010-05-25

    Length of hospital stay (LOS) is a surrogate marker for patients' well-being during hospital treatment and is associated with health care costs. Identifying pretreatment factors associated with LOS in surgical patients may enable early intervention in order to reduce postoperative LOS. This cohort study enrolled 157 patients with suspected or proven gynecological cancer at a tertiary cancer centre (2004-2006). Before commencing treatment, the scored Patient Generated - Subjective Global Assessment (PG-SGA) measuring nutritional status and the Functional Assessment of Cancer Therapy-General (FACT-G) scale measuring quality of life (QOL) were completed. Clinical and demographic patient characteristics were prospectively obtained. Patients were grouped into those with prolonged LOS if their hospital stay was greater than the median LOS and those with average or below average LOS. Patients' mean age was 58 years (SD 14 years). Preoperatively, 81 (52%) patients presented with suspected benign disease/pelvic mass, 23 (15%) with suspected advanced ovarian cancer, 36 (23%) patients with suspected endometrial and 17 (11%) with cervical cancer, respectively. In univariate models prolonged LOS was associated with low serum albumin or hemoglobin, malnutrition (PG-SGA score and PG-SGA group B or C), low pretreatment FACT-G score, and suspected diagnosis of cancer. In multivariable models, PG-SGA group B or C, FACT-G score and suspected diagnosis of advanced ovarian cancer independently predicted LOS. Malnutrition, low quality of life scores and being diagnosed with advanced ovarian cancer are the major determinants of prolonged LOS amongst gynecological cancer patients. Interventions addressing malnutrition and poor QOL may decrease LOS in gynecological cancer patients.

  10. Clinicopathological Characteristics of Gynecological Cancer Associated with Hypoxia-Inducible Factor 1α Expression: A Meta-Analysis Including 6,612 Subjects

    PubMed Central

    Ma, Xiaowei; Liang, Xiaowen; Liu, Xin; Wang, Yu

    2015-01-01

    Background Gynecological cancer is characterized by tumor hypoxia. However, the role of hypoxia-inducible factor 1α (HIF-1α) in gynecological cancer remains unclear. Method Electronic databases including Cochrane Library, PUBMED, Web of Knowledge and clinical trial registries were searched from inception through October 2014 for published, case-control studies assessing the association between HIF-1α and the clinicopathological characteristics of gynecological cancer. We pooled results from 59 studies using fixed or random-effects models and present results as odds ratios (ORs) following the PRISMA guidelines. Results Our meta-analysis, which included 6,612 women, demonstrated that the expression of HIF-1α was associated with the clinicopathological characteristics of gynecological cancer. The expression of HIF-1α in cancer or borderline tissue was significantly higher than that in normal tissue (cancer vs. normal: odds ratio (OR) =9.59, 95% confidence interval (CI): 5.97, 15.39, p<0.00001; borderline vs. normal: OR=4.13, 95% (CI): 2.43, 7.02, p<0.00001; cancer vs. borderline: OR=2.70, 95% (CI): 1.69, 4.31, p<0.0001). The expression of HIF-1α in III‒IV stage or lymph node metastasis was significantly higher than that in I‒II stage or that without lymph node metastasis, respectively (OR=2.66, 95% (CI): 1.87,3.79, p<0.00001; OR= 3.98, 95% (CI): 2.10,12.89, p<0.0001). HIF-1α was associated with histological grade of cancer (Grade 3 vs. Grade 1: OR=3.77, 95% (CI): 2.76,5.16, p<0.00001; Grade 3 vs. Grade 2: OR=1.62, 95% (CI): 1.20,2.19, p=0.002; Grade 2 vs. Grade 1: OR=2.34, 95% (CI): 1.82,3.00, p<0.00001),5-years disease free survival (DFS) rates (OR=2.93, 95% (CI):1.43,6.01, p=0.001) and 5-years overall survival (OS) rates (OR=5.53, 95% (CI): 2.48,12.31, p<0.0001). Conclusion HIF-1α is associated with the malignant degree, FIGO stage, histological grade, lymph node metastasis, 5-years survival rate and recurrence rate of gynecological cancer. It may play

  11. Barriers for the inclusion of sexuality in nursing care for women with gynecological and breast cancer: perspective of professionals 1

    PubMed Central

    Ferreira, Simone Mara de Araújo; Gozzo, Thais de Oliveira; Panobianco, Marislei Sanches; dos Santos, Manoel Antônio; de Almeida, Ana Maria

    2015-01-01

    AIM: qualitative study, which aimed to identify the barriers that influence nursing care practices related to the sexuality of women with gynecological and breast cancer. METHODS: the study was conducted with 16 professionals of the nursing area (nurses, nursing technicians and nursing assistants) from two sectors of a university hospital situated in the state of São Paulo, Brazil. The data was collected using semi-structured, in-depth individual interviews. All the interviews were recorded and the participants' responses were identified and categorized using Content Analysis. RESULTS: three major themes were identified. These are as follows: 1) barriers related to the biomedical model; 2) barriers related to institutional dynamics and 3) barriers related to the social interpretations of sexuality. CONCLUSIONS: the results of this study showed that the systematized inclusion of this issue in nursing care routines requires changes in the health paradigm and in the work dynamic, as well as reflection on the personal values and social interpretations related to the topic. A major challenge is to divest sexuality of the taboos and prejudices which accompany it, as well as to contribute to the nursing team being more aware of the difficulties faced by women with gynaecological and breast cancer. PMID:25806635

  12. How to research cancer

    MedlinePlus

    ... wonder where to start. What are the most up-to-date, reliable sources for information about cancer? The guidelines ... sources and medical associations. They provide research-based, up-to-date information about all types of cancer. Here are ...

  13. Oral contraceptives and gynecologic cancer: an update for the 1990s.

    PubMed

    Kaunitz, A M

    1992-10-01

    The most recent statistical evidence confirms a protective effect of oral contraceptive use against ovarian and endometrial cancers. Studies of the association between oral contraceptive use and cervical cancer continue to be hampered by confounding factors; however, results suggest that the overall risk of invasive cervical neoplasia is not increased. Although the association between oral contraceptive use and breast cancer remains controversial, existing data strongly suggest that overall risk of breast cancer is not increased by the use of oral contraceptives. In most candidates for oral contraceptive use, the benefits greatly outweigh the risks.

  14. Associations between etiologic factors and mortality after endometrial cancer diagnosis: The NRG Oncology/Gynecologic Oncology Group 210 Trial

    PubMed Central

    Felix, Ashley S; McMeekin, D Scott; Mutch, David; Walker, Joan L; Creasman, William T; Cohn, David E; Ali, Shamshad; Moore, Richard G; Downs, Levi S; Ioffe, Olga B; Park, Kay J; Sherman, Mark E; Brinton, Louise A

    2015-01-01

    Background Few studies have analyzed relationships between risk factors for endometrial cancer, especially with regard to aggressive (non-endometrioid) histologic subtypes, and prognosis. We examined these relationships in the prospective NRG Oncology/Gynecologic Oncology Group 210 trial. Methods Prior to surgery, participants completed a questionnaire assessing risk factors for gynecologic cancers. Pathology data were derived from clinical reports and central review. We used the Fine and Gray subdistribution hazards model to estimate subhazard ratios (HRs) and 95% confidence intervals (CIs) for associations between etiologic factors and cause-specific subhazards in the presence of competing risks. These models were stratified by tumor subtype and adjusted for stage and socioeconomic status indicators. Results Median follow-up was 60 months after enrollment (range: 1 day – 118 months). Among 4,609 participants, a total of 854 deaths occurred, of which, 582 deaths were attributed to endometrial carcinoma. Among low-grade endometrioid cases, endometrial carcinoma-specific subhazards were significantly associated with age at diagnosis (HR=1.04, 95% CI=1.01–1.06 per year, P-trend) and BMI (class II obesity vs. normal BMI: HR=2.29, 95% CI=1.06–4.98, P-trend=0.01). Among high-grade endometrioid cases, endometrial carcinoma-specific subhazards were associated with age at diagnosis (HR=1.05, 95% CI=1.02–1.07 per year, P-trend<0.001). Among non-endometrioid cases, endometrial carcinoma-specific subhazards were associated with parity relative to nulliparity among serous (HR=0.55, 95% CI=0.36–0.82) and carcinosarcoma cases (HR=2.01, 95% CI=1.00–4.05). Discussion Several endometrial carcinoma risk factors are associated with prognosis, which occurs in a tumor-subtype specific context. If confirmed, these results would suggest that factors beyond histopathologic features and stage are related to prognosis. PMID:26341710

  15. Profiles in Cancer Research

    Cancer.gov

    These articles put a face to some of the thousands of individuals who contribute to NCI’s cancer research efforts. The profiles highlight the work of scientists and clinicians and describe the circumstances and motivation behind their work.

  16. Nanotechnology in Cancer Research

    Cancer.gov

    The NCI Office of Cancer Nanotechnology Research has had a major impact on bringing novel nano-enabled solutions through the pre-clinical space. The strategic framework of this effort is presented here.

  17. From "sex toy" to intrusive imposition: a qualitative examination of women's experiences with vaginal dilator use following treatment for gynecological cancer.

    PubMed

    Cullen, Kimberley; Fergus, Karen; Dasgupta, Tracey; Fitch, Marg; Doyle, Catherine; Adams, Lauran

    2012-04-01

    Regular use of vaginal dilators has been recommended as a prophylactic measure following radiation treatment for gynecological cancers in order to minimize vaginal stenosis and promote optimal healing of the vagina. Despite the well-established reluctance of women to adopt this practice, little is known about the difficulties and concerns associated with vaginal dilator use. To investigate women's experiences with the vaginal dilator and to understand the psychosocial factors that influence women's adoption of rehabilitative dilator use. This is an exploratory qualitative study using semi-structured interviews with a sample of 10 women with a history of gynecological cancer and who were prescribed a vaginal dilator. Interviews were analyzed using the grounded theory method and examined for recurrent themes. The main outcome measure was a semi-structured interview comprised of open-ended questions designed to elicit information concerning topic areas relevant to gynecological cancer, vaginal dilator use, and sexuality. The analysis resulted in five main categories underlying the core category of "From 'sex toy' to intrusive imposition." These were: (i) embarrassing sex toy; (ii) reliving the invasion of treatment; (iii) aversive "hands-on" experience; (iv) not at the forefront of my recovery; and (v) minimizing the resistance. Rehabilitative vaginal dilator use is a complex, multifaceted, and personal phenomenon that carries deep psychological and emotional implications that make it intrusive. These findings may enhance the way in which vaginal dilators are introduced and help healthcare providers address better women's difficulties and concerns with the dilators. Ultimately, it may also lead to improved health maintenance and quality of life for women recovering from gynecological cancer. © 2012 International Society for Sexual Medicine.

  18. My Kite Will Fly: Improving Communication and Understanding in Young Children When a Mother Is Diagnosed with Life-Threatening Gynecological Cancer.

    PubMed

    Holland, Cynthia; Hocking, Alison; Joubert, Lynette; McDermott, Fiona; Niski, Marcus D; Thomson Salo, Frances; Quinn, Michael A

    2017-08-04

    The My Kite Will Fly (MKWF) research program is built on the well-documented need for effective clinical communication tools and therapeutic interventions where a child's mother is diagnosed with life-threatening gynecological cancer. The Dignity Model and Child-Centered approach were two key study foundations in this pilot cohort. Quantitative survey and qualitative semistructured methods were employed to gather data from patient families at three distinct phases: Diagnosis, Treatment, and Palliative care. Participants were identified from patient groups at The Royal Women's Hospital and Peter MacCallum Cancer Center, Melbourne, Australia. A purposive sample (n = 36 children) (24 girls and 12 boys aged between 3 and 12 years) drawn from 19 families completed structured art therapy workbook activities. The principal researcher and a specialist educational assistant undertook cross-case thematic analysis of all interviews and children's drawings. Five central themes were profiled in six illustrative case studies. Interviews with all families (n = 19) showed 86.1% positive evaluation of the MKWF workbook template at diagnosis. During treatments, 66.6% of parents reported better understanding of the chemotherapy process and better communication with younger family members. At palliative care, 97.3% of families reported stabilization of family routines and improved illness coping. Exit interviews with six children and surviving parents (n = 4) showed that the program substantially prepared them for parental bereavement. Results from this pilot cohort confirm the importance of enhanced parent-child communication and stabilized family routines. Current results provide an important platform for future evaluative research among larger patient-family populations across multisite oncology settings.

  19. Combination of Aprepitant, Azasetron, and Dexamethasone as Antiemetic Prophylaxis in Women with Gynecologic Cancers Receiving Paclitaxel/Carboplatin Therapy

    PubMed Central

    Koshiyama, Masafumi; Matsumura, Noriomi; Imai, Saeko; Yamanoi, Koji; Abiko, Kaoru; Yoshioka, Yumiko; Yamaguchi, Ken; Hamanishi, Junzo; Baba, Tsukasa; Konishi, Ikuo

    2017-01-01

    Background The aim of this study was to evaluate the antiemetic effect of aprepitant and to determine how to provide triple combination therapy (aprepitant/azasetron/dexamethasone) to women receiving paclitaxel/carboplatin moderately emetogenic chemotherapy (MEC). Material/Methods The current study was a prospective study of 163 women with gynecologic cancers. We compared the digestive symptoms scores (nausea, vomiting, appetite loss, and dietary intake) of 37 women with ovarian cancers before and after aprepitant administration. We also compared these symptoms in women who underwent 193 cycles of triple combination therapy with symptoms of women who underwent 226 cycles of double combination therapy. For triple combination therapy, azasetron, dexamethasone (reduced dose: 40% of 20 mg), and aprepitant (125 mg) were administered on Day 1, followed by only aprepitant (80 mg) administration on Days 2 and Day 3. Results In 37 women with ovarian cancer, three symptoms, nausea, appetite loss, and dietary intake, were significantly improved by primarily adding aprepitant to double combination therapy in the delayed phase of MEC. Upon comparing their digestive symptoms in all cycles, however, these three symptoms were not significantly different in the delayed phase. Furthermore, all four symptoms in all cycles were worse following triple combination therapy than following double combination therapy in the acute phase (p<0.02). The control of digestive symptoms was generally insufficient without the administration of dexamethasone. Conclusions Primary aprepitant as an addition to MEC demonstrated efficacy in improving digestive symptoms in the delayed phase. However, its effect may decrease with repeated use. To improve the antiemetic effect, the dose reduction of dexamethasone should be restricted on Day 1 and dexamethasone should be used throughout the delayed phase as well. PMID:28198358

  20. Developing and implementing a complex Complementary and Alternative (CAM) nursing intervention for breast and gynecologic cancer patients undergoing chemotherapy--report from the CONGO (complementary nursing in gynecologic oncology) study.

    PubMed

    Klafke, Nadja; Mahler, Cornelia; von Hagens, Cornelia; Blaser, Gisela; Bentner, Martina; Joos, Stefanie

    2016-05-01

    The purpose of this study was to develop a complex nursing intervention including complementary and alternative medicine (CAM) for breast and gynecologic cancer patients during chemotherapy to improve quality of life. Data sources Theoretical framework and concepts, practical nursing knowledge, and evidence-based studies were compiled in interprofessional meetings. Data synthesis The final complex intervention consists of three autonomous, but interacting components: (1) CAM nursing package, (2) resource-oriented counseling, and (3) evidence-based information material on CAM. CAM interventions include acupressure, aromatherapy, compress, and massage, targeting 14 clinically relevant symptoms during chemotherapy. Participants receive these interventions during chemotherapy with instructions for self care. During a counseling interview, the patient's needs and preferences are assessed by trained nurses. Furthermore, participants are equipped with evidence-based information material (booklet and DVD). Prior to study start, nurses attended training modules for administering CAM therapies and for communicating and counseling within the salutogenic approach. It was possible to design a multimodal CAM nursing intervention based on a theoretical concept, evidence-based studies, and practical nursing experience targeting the prevention or relief of side-effects women suffer during chemotherapy. The systematic analysis of the CONGO study will contribute to evidence-based CAM nursing care within supportive cancer care. Oncology nurses play an important role in supportive CAM care of breast and gynecologic cancer patients in daily clinical practice. Within oncology outpatient services, the implementation of evidence-based CAM nursing interventions and counseling may contribute to understand the impact of nursing on patient quality of life and symptom relief. This can lead to a new understanding of the nurse's professional role.

  1. Gynecological cancers in developing countries: the challenge of chemotherapy in low-resources setting.

    PubMed

    Basile, S; Angioli, R; Manci, N; Palaia, I; Plotti, F; Benedetti Panici, P

    2006-01-01

    The epidemiologic pattern of cancers in developing countries differs in many aspects from that of industrialized nations. Cancer natural history, microbiologic environment, patient's immune system, and drug availability may differ as well. Four of five new cases of cervical cancer and most of cervical cancer deaths occur in developing countries. Where chemoradiation and supportive care facilities are unavailable, it would be logical to consider an inexpensive effective drug. In locally advanced cases, neoadjuvant chemotherapy followed by surgery should be considered the treatment of choice. For ovarian cancer, it may be reasonable to maintain a secure supply of platinum and/or taxanes. For endometrial cancer, platinum compounds are proved active chemotherapic single agents. Oral medroxyprogesterone acetate (MPA) may represent a good chance for treating an advanced or recurrent disease. For vulvar/vaginal cancer, the role of chemotherapy alone is currently considered limited, and it is mostly used as palliative treatment in advanced or recurrent cases. Whenever possible, standard western chemotherapic regimens should be applied in developing countries as well. When standard therapies are unavailable, drugs of choice should be easily accessible, inexpensive, and effective. The most commonly used drugs are cisplatin, cyclophosphamide, and MPA.

  2. Towards precision medicine: discovering novel gynecological cancer biomarkers and pathways using linked data.

    PubMed

    Jha, Alokkumar; Khan, Yasar; Mehdi, Muntazir; Karim, Md Rezaul; Mehmood, Qaiser; Zappa, Achille; Rebholz-Schuhmann, Dietrich; Sahay, Ratnesh

    2017-09-19

    Next Generation Sequencing (NGS) is playing a key role in therapeutic decision making for the cancer prognosis and treatment. The NGS technologies are producing a massive amount of sequencing datasets. Often, these datasets are published from the isolated and different sequencing facilities. Consequently, the process of sharing and aggregating multisite sequencing datasets are thwarted by issues such as the need to discover relevant data from different sources, built scalable repositories, the automation of data linkage, the volume of the data, efficient querying mechanism, and information rich intuitive visualisation. We present an approach to link and query different sequencing datasets (TCGA, COSMIC, REACTOME, KEGG and GO) to indicate risks for four cancer types - Ovarian Serous Cystadenocarcinoma (OV), Uterine Corpus Endometrial Carcinoma (UCEC), Uterine Carcinosarcoma (UCS), Cervical Squamous Cell Carcinoma and Endocervical Adenocarcinoma (CESC) - covering the 16 healthy tissue-specific genes from Illumina Human Body Map 2.0. The differentially expressed genes from Illumina Human Body Map 2.0 are analysed together with the gene expressions reported in COSMIC and TCGA repositories leading to the discover of potential biomarkers for a tissue-specific cancer. We analyse the tissue expression of genes, copy number variation (CNV), somatic mutation, and promoter methylation to identify associated pathways and find novel biomarkers. We discovered twenty (20) mutated genes and three (3) potential pathways causing promoter changes in different gynaecological cancer types. We propose a data-interlinked platform called BIOOPENER that glues together heterogeneous cancer and biomedical repositories. The key approach is to find correspondences (or data links) among genetic, cellular and molecular features across isolated cancer datasets giving insight into cancer progression from normal to diseased tissues. The proposed BIOOPENER platform enriches mutations by filling in

  3. Is there any predictor for hypersensitivity reactions in gynecologic cancer patients treated with paclitaxel-based therapy?

    PubMed

    Aoyama, Tadashi; Takano, Masashi; Miyamoto, Morikazu; Yoshikawa, Tomoyuki; Soyama, Hiroaki; Kato, Kento; Ishibashi, Hiroki; Iwahashi, Hideki; Nakatsuka, Masaya; Yajima, Isao; Shimizu, Yukihiro; Aizawa, Yusuke; Suguchi, Yuki; Moriiwa, Miki; Goto, Tomoko; Sasa, Hidenori; Nagaoka, Isao; Tsuda, Hitoshi; Furuya, Kenichi

    2017-07-01

    Recently, generic drugs of paclitaxel have been commonly used mainly by economic reasons; however, predictive factors for toxicities are not fully determined. Hypersensitivity reaction (HSR) is one of the most important adverse events in the paclitaxel-based therapy, and sometimes leads to lethal condition. The aim of the study was to identify predictors for HSR in patients treated with paclitaxel-based regimens. All the patients treated with chemotherapy including paclitaxel at our hospital between 1998 and 2013 were retrospectively evaluated. Clinicopathological factors of the patients that developed HSR and those without HSR were compared, and predictive factors for HSR were identified. Among 414 patients enrolled in the study, 26 patients (6.3%) developed HSR. Multivariate analyses showed that younger age (odds ratio 6.31), a history of allergy (odds ratio 3.79), and short-course premedication (odds ratio 14.1) were identified as predictive factors for HSR. There was no significant difference in the incidence of HSR between original paclitaxel and generic drug. The incidence of HSR was higher as the number of these predictors was accumulated. Three factors were identified as predictive factors for HSR: younger age, a history of allergy, and short-course premedication. Accumulation of these factors increased the incidence of HSR; however, the use of generic drug was not associated HSR in gynecologic cancer patients.

  4. Hematologic Toxicity in RTOG 0418: A Phase 2 Study of Postoperative IMRT for Gynecologic Cancer

    SciTech Connect

    Klopp, Ann H.; Moughan, Jennifer; Portelance, Lorraine; Miller, Brigitte E.; Salehpour, Mohammad R.; Hildebrandt, Evangeline; Nuanjing, Jenny; D'Souza, David; Souhami, Luis; Small, William; Gaur, Rakesh; Jhingran, Anuja

    2013-05-01

    Purpose: Intensity modulated radiation therapy (IMRT), compared with conventional 4-field treatment, can reduce the volume of bone marrow irradiated. Pelvic bone marrow sparing has produced a clinically significant reduction in hematologic toxicity (HT). This analysis investigated HT in Radiation Therapy Oncology Group (RTOG) 0418, a prospective study to test the feasibility of delivering postoperative IMRT for cervical and endometrial cancer in a multiinstitutional setting. Methods and Materials: Patients in the RTOG 0418 study were treated with postoperative IMRT to 50.4 Gy to the pelvic lymphatics and vagina. Endometrial cancer patients received IMRT alone, whereas patients with cervical cancer received IMRT and weekly cisplatin (40 mg/m{sup 2}). Pelvic bone marrow was defined within the treatment field by using a computed tomography density-based autocontouring algorithm. The volume of bone marrow receiving 10, 20, 30, and 40 Gy and the median dose to bone marrow were correlated with HT, graded by Common Terminology Criteria for Adverse Events, version 3.0, criteria. Results: Eighty-three patients were eligible for analysis (43 with endometrial cancer and 40 with cervical cancer). Patients with cervical cancer treated with weekly cisplatin and pelvic IMRT had grades 1-5 HT (23%, 33%, 25%, 0%, and 0% of patients, respectively). Among patients with cervical cancer, 83% received 5 or more cycles of cisplatin, and 90% received at least 4 cycles of cisplatin. The median percentage volume of bone marrow receiving 10, 20, 30, and 40 Gy in all 83 patients, respectively, was 96%, 84%, 61%, and 37%. Among cervical cancer patients with a V40 >37%, 75% had grade 2 or higher HT compared with 40% of patients with a V40 less than or equal to 37% (P =.025). Cervical cancer patients with a median bone marrow dose of >34.2 Gy also had higher rates of grade ≥2 HT than did those with a dose of ≤34.2 Gy (74% vs 43%, P=.049). Conclusions: Pelvic IMRT with weekly cisplatin is

  5. Preoperative assessment of lymph node metastasis in endometrial cancer: A Korean Gynecologic Oncology Group study.

    PubMed

    Kang, Sokbom; Nam, Joo-Hyun; Bae, Duk-Soo; Kim, Jae-Weon; Kim, Moon-Hong; Chen, Xiaojun; No, Jae-Hong; Lee, Jong-Min; Kim, Jae-Hoon; Watari, Hidemich; Kim, Seok Mo; Kim, Sung Hoon; Seong, Seok Ju; Kim, Ki Tae; Kim, Seung Cheol; Kim, Jong-Hyeok; Lim, Myung-Cheol; Lee, Jung-Yun; Ryu, Sang-Young; Yang, Bingyi; Kim, Byoung-Gie

    2017-01-01

    Previously proposed criteria for preoperatively identifying endometrial cancer patients at low risk for lymph node metastasis remain to be verified. For this purpose, a prospective, multicenter observational study was performed. Eligible patients with histologically confirmed endometrial cancer underwent magnetic resonance imaging (MRI) and serum cancer antigen 125 (CA 125) testing before surgery. The following criteria were used to identify low-risk patients: 1) endometrioid-type cancer, 2) no evidence of deep myometrial invasion on MRI, 3) no enlarged lymph nodes on MRI, 4) no suspicious metastasis out of the uterine corpus, and 5) serum CA 125 levels less than 35 U/mL. Systematic pelvic and/or para-aortic lymphadenectomy was performed for all patients. The primary endpoint was estimation of the negative predictive value (NPV). From January 2012 to December 2014, 529 patients from 20 hospitals in 3 Asian countries were consecutively enrolled. According to our criteria, 272 patients (51.4%) were categorized into the low-risk group. Fifty-three of the 529 patients (10.0%) had lymph node metastases; these patients included 8 (2.9%) falsely categorized as low-risk. The sensitivity and specificity of the criteria were 84.9% and 55.5%, respectively. The NPV of 97.1% was higher than the predefined target endpoint of 96%. The low-risk criteria based on preoperative tests were confirmed to be reliable and accurate for identifying patients at low risk for lymph node metastasis. These criteria may facilitate patient counseling and surgical decision making. Cancer 2017;123:263-272. © 2016 American Cancer Society. © 2016 American Cancer Society.

  6. Global cancer research initiative

    PubMed Central

    Love, Richard R

    2010-01-01

    Cancer is an increasing problem for low- and middle-income countries undergoing an epidemiologic transition from dominantly acute communicable disease to more frequent chronic disease with increased public health successes in the former domain. Progress against cancer in high-income countries has been modest and has come at enormous expense. There are several well-conceived global policy and planning initiatives which, with adequate political will, can favorably impact the growing global cancer challenges. Most financial resources for cancer, however, are spent on diagnosis and management of patients with disease in circumstances where specific knowledge about effective approaches is significantly limited, and the majority of interventions, other than surgery, are not cost-effective in resource-limited countries by global standards. In summary, how to intervene effectively on a global scale for the majority of citizens who develop cancer is poorly defined. In contrast to technology-transfer approaches, markedly increased clinical research activities are more likely to benefit cancer sufferers. In these contexts, a global cancer research initiative is proposed, and mechanisms for realizing such an effort are suggested. PMID:21188101

  7. Survey on gynecological cancer treatment by Piedmont, Liguria, and Valle d'Aosta group of AIRO (Italian Association of Radiation Oncology)

    PubMed Central

    Cattari, Gabriella; Delmastro, Elena; Bresciani, Sara; Gribaudo, Sergio; Melano, Antonella; Giannelli, Flavio; Tessa, Maria; Chiarlone, Renato; Scolaro, Tindaro; Krengli, Marco; Urgesi, Alessandro

    2016-01-01

    Purpose We focused the attention on radiation therapy practices about the gynecological malignancies in Piedmont, Liguria, and Valle d'Aosta to know the current treatment practice and to improve the quality of care. Material and methods We proposed a cognitive survey to evaluate the standard practice patterns for gynecological cancer management, adopted from 2012 to 2014 by radiotherapy (RT) centers with a large amount of gynecological cancer cases. There were three topics: 1. Taking care and multidisciplinary approach, 2. Radiotherapy treatment and brachytherapy, 3. Follow-up. Results Nineteen centers treated gynecological malignancies and 12 of these had a multidisciplinary dedicated team. Radiotherapy option has been used in all clinical setting: definitive, adjuvant, and palliative. In general, 1978 patients were treated. There were 834 brachytherapy (BRT) treatments. The fusion between diagnostic imaging (magnetic resonance imaging – MRI, positron emission tomography – PET) and computed tomography (CT) simulation was used for contouring in all centers. Conformal RT and intensity modulated radiation therapy (IMRT) were the most frequent techniques. The image guided radiation therapy (IGRT) was used in 10/19 centers. There were 8 active BRT centers. Brachytherapy was performed both with radical intent and as boost, mostly by HDR (6/8 centers). The doses for exclusive BRT were between 20 to 30 Gy. The doses for BRT boost were between 10 and 20 Gy. Four centers used CT-MRI compatible applicators but only one used MRI for planning. The BRT plans on vaginal cuff were still performed on traditional radiographies in 2 centers. The plan sum was evaluated in only 1 center. Only 1 center performed in vivo dosimetry. Conclusions In the last three years, multidisciplinary approach, contouring, treatment techniques, doses, and control systems were similar in Liguria-Piedmont and Valle d'Aosta. However, the technology implementation didn't translate in a real treatment

  8. Targeting luteinizing hormone-releasing hormone: A potential therapeutics to treat gynecological and other cancers.

    PubMed

    Ghanghoria, Raksha; Kesharwani, Prashant; Tekade, Rakesh K; Jain, Narendra K

    2016-11-10

    Cancer is a prime healthcare problem that is significantly responsible for universal mortality. Despite distinguished advancements in medical field, chemotherapy is still the mainstay for the treatment of cancers. During chemotherapy, approximately 90% of the administered dose goes to normal tissues, with mere 2-5% precisely reaching the cancerous tissues. Subsequently, the resultant side effects and associated complications lead to dose reduction or even discontinuance of the therapy. Tumor directed therapy therefore, represents a fascinating approach to augment the therapeutic potential of anticancer bioactives as well as overcomes its side effects. The selective overexpression of LHRH receptors on human tumors compared to normal tissues makes them a suitable marker for diagnostics, molecular probes and targeted therapeutics. These understanding enabled the rational to conjugate LHRH with various cytotoxic drugs (doxorubicin, DOX; camptothecin etc.), cytotoxic genes [small interfering RNA (siRNA), micro RNA (miRNA)], as well as therapeutic nanocarriers (nanoparticles, liposomes or dendrimers) to facilitate their tumor specific delivery. LHRH conjugation enhances their delivery via LHRH receptor mediated endocytosis. Numerous cytotoxic analogs of LHRH were developed over the past two decades to target various types of cancers. The potency of LHRH compound were reported to be as high as 5,00-10,00 folds compared to parent molecules. The objective of this review article is to discuss reports on various LHRH analogs with special emphasis on their prospective application in the medical field. The article also focuses on the attributes that must be taken into account while designing a LHRH therapeutics with special account to the biochemistry and applications of these conjugates. The record on various cytotoxic analogs of LHRH are also discussed. It is anticipated that the knowledge of therapeutic and toxicological aspects of LHRH compounds will facilitate the

  9. Evidence for the use of robotically assisted surgery in gynecologic cancers.

    PubMed

    Ngô, Charlotte; Cornou, Caroline; Rossi, Léa; Bats, Anne-Sophie; Bensaid, Chérazade; Frati, Albane; Nos, Claude; Lécuru, Fabrice

    2016-09-01

    Robotically assisted laparoscopy has been introduced in the armamentarium of gynaecologic oncology surgeons. A lot of studies compared robotic surgery and laparotomy when the real issue is to demonstrate the interest and added value of robotically assisted laparoscopy versus standard laparoscopy. In this review, we will describe the most meaningful indications and advantages of robotically assisted laparoscopy in gynaecologic oncology. The learning curve for advanced procedures in robot-assisted laparoscopy is shorter and easier than with the standard laparoscopy, especially for beginners. In most of the series, operating time is longer with robot, but complication rates are often decreased, especially in obese patients with a conversion rate to laparotomy that is decreased compared with standard laparoscopy. Robot-assisted laparoscopy can be used for surgery of high-risk endometrial cancer, staging of early-ovarian cancer, and pelvic exenteration in case of recurrent malignancies. Furthermore, more recent robots allow performing sentinel node biopsy in endometrial or cervical cancer using fluorescence detection with indocyanine green. The spreading of robotic surgery led to an enhancement of minimal invasive surgical approach in general, and to the development of new indications in gynaecologic oncology. The superiority of robot-assisted laparoscopy still has to be demonstrated with properly designed trials.

  10. Cancer Survivors Day | Center for Cancer Research

    Cancer.gov

    CCR Celebrates Cancer Survivors #NCSD2016 At the Center for Cancer Research, we are home to an extraordinary group of practicing physicians and scientists who passionately explore the boundaries of research to unlock the mysteries of cancer, a disease that touches nearly every American.

  11. Characterization of Ciprofloxacin-Resistant and Ciprofloxacin-Susceptible Uropathogenic Escherichia coli Obtained from Patients with Gynecological Cancer.

    PubMed

    Capett, Muniqui S; Vollú-Silva, Patricia; Melchiades, Vanessa A; Bokehi, Luciana C; Araújo, Fernanda M; Martins, Ianick Souto; Neves, Felipe P G; Gonzalez, Alice G M; Oswald, Eric; de Paula, Geraldo R; Teixeira, Lenise A

    2016-11-01

    The objective of this work was to assess the genetic characteristics of uropathogenic Escherichia coli, ciprofloxacin resistance or susceptibility, obtained from patients with gynecological cancer and urinary tract infection (UTI). Seventy-seven E. coli ciprofloxacin-resistant isolates and 38 ciprofloxacin-susceptible were analyzed by polymerase chain reaction (PCR) to determine the phylogenetic groups, virulence factors as iucC, fyuA, hlyC, cnf1 genes, and pks pathogenicity island. The presence of genes related to ciprofloxacin resistance such as qnrA, qnrB, qnrS, aac(6')-Ib-cr, and qepA, and the sequencing of DNA gyrase genes and topoisomerase IV were determined. The genetic profile of the isolates was determined by pulsed-field gel electrophoresis (PFGE). Statistical analysis was performed using Fisher's exact test and Chi-square test. Phylogenetic group B2 was the most prevalent although a great genetic diversity was observed by PFGE. Only genes associated to siderophores were found in ciprofloxacin-resistant isolates; however, in ciprofloxacin-susceptible isolates, genes related to siderophores and toxin, were detected. Additionally qnrB was detected in both populations, ciprofloxacin resistant and susceptible. DNA mutations in gyrA were Ser-83-Leu and Asp-87-Asn and in parC were Ser-80-Ile and Glu-84-Val, Glu-84-Lys. In conclusion, it was observed a high prevalence of qnrB in the population studied; in addition, it was the first time the pks island was observed only in ciprofloxacin-susceptible isolates.

  12. Neoadjuvant Chemotherapy for Newly Diagnosed, Advanced Ovarian Cancer: Society of Gynecologic Oncology and American Society of Clinical Oncology Clinical Practice Guideline.

    PubMed

    Wright, Alexi A; Bohlke, Kari; Armstrong, Deborah K; Bookman, Michael A; Cliby, William A; Coleman, Robert L; Dizon, Don S; Kash, Joseph J; Meyer, Larissa A; Moore, Kathleen N; Olawaiye, Alexander B; Oldham, Jessica; Salani, Ritu; Sparacio, Dee; Tew, William P; Vergote, Ignace; Edelson, Mitchell I

    2016-10-01

    To provide guidance to clinicians regarding the use of neoadjuvant chemotherapy and interval cytoreduction among women with stage IIIC or IV epithelial ovarian cancer. The Society of Gynecologic Oncology and the American Society of Clinical Oncology convened an Expert Panel and conducted a systematic review of the literature. Four phase III clinical trials form the primary evidence base for the recommendations. The published studies suggest that for selected women with stage IIIC or IV epithelial ovarian cancer, neoadjuvant chemotherapy and interval cytoreduction are noninferior to primary cytoreduction and adjuvant chemotherapy with respect to overall and progression-free survival and are associated with less perioperative morbidity and mortality. All women with suspected stage IIIC or IV invasive epithelial ovarian cancer should be evaluated by a gynecologic oncologist prior to initiation of therapy. The primary clinical evaluation should include a CT of the abdomen and pelvis, and chest imaging (CT preferred). Women with a high perioperative risk profile or a low likelihood of achieving cytoreduction to < 1 cm of residual disease (ideally to no visible disease) should receive neoadjuvant chemotherapy. Women who are fit for primary cytoreductive surgery, and with potentially resectable disease, may receive either neoadjuvant chemotherapy or primary cytoreductive surgery. However, primary cytoreductive surgery is preferred if there is a high likelihood of achieving cytoreduction to < 1 cm (ideally to no visible disease) with acceptable morbidity. Before neoadjuvant chemotherapy is delivered, all patients should have confirmation of an invasive ovarian, fallopian tube, or peritoneal cancer. Additional information is available at www.asco.org/NACT-ovarian-guideline and www.asco.org/guidelineswiki. © 2016 Society of Gynecologic Oncology and American Society of Clinical Oncology.

  13. Possible relationship between endocrine disrupting chemicals and hormone dependent gynecologic cancers.

    PubMed

    Dogan, Selen; Simsek, Tayup

    2016-07-01

    The effects of the natural and synthetic estrogens have been studied for a long time but the data regarding estrogen related chemicals (endocrine disrupting chemicals, EDCs) and their effects on reproductive system are scarce. EDCs are hormone like agents that are readily present in the environment, which may alter the endocrine system of humans and animals. Approximately 800 chemicals are known or suspected to have the potential to function as EDC. Potential role of EDCs on reproductive disease has gained attention in medical literature in recent years. We hypothesize that exposure to low doses of EDCs in a chronic manner could cause hormone dependent genital cancers including ovarian and endometrial cancer. Long term exposure to low concentrations of EDCs may exert potentiation effect with each other and even with endogenous estrogens and could inhibit enzymes responsible for estrogen metabolism. Exposure time to these EDCs is essential as we have seen from Diethylstilbestrol experience. Dose-response curves of EDCs are also unpredictable. Hence mode of action of EDCs are more complex than previously thought. In the light of these controversies lower doses of EDCs in long term exposure is not harmless. Possibility of this relationship and this hypothesis merit further investigation especially through in vivo studies that could better show the realistic environmental exposure. With the confirmation of our hypothesis, possible EDCs could be identified and eliminated from general use as a public health measure. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. OCT in Gynecology

    NASA Astrophysics Data System (ADS)

    Kuznetsova, Irina A.; Gladkova, Natalia D.; Gelikonov, Valentin M.; Belinson, Jerome L.; Shakhova, Natalia M.; Feldchtein, Felix I.

    Timely and efficient diagnosis of diseases of the female reproductivesystem is very important from the social viewpoint [1, 2]. Diagnosticefficacy of the existing techniques still needs improvement sincemalignant neoplasms of the female reproductive system organs are stableleaders among causes of death (over 35.9 %) [3]. Each year, 851.9 thousand genital cancer cases are recorded worldwide [1, 2]. However, the diagnostic efficacy of the visual examination with biopsy is limited. Correct interpretation of colposcopic features requires high skills and long-term clinical experience, which makes colposcopy very subjective and limits interobserver agreement [8-10]. OCT is known to visualize in vivo and noninvasively tissue microstructure with spatial resolution approaching the histologic level and therefore can be expected to guide biopsies and to provide real-time tissue structure information when biopsies are contraindicated or impractical. Although thorough clinical studies are required to determine if OCT can be suitable for this purpose in gynecology in general and for cervical cancer in particular, the early results look encouraging. In this chapter, we present a wide spectrum of the OCT studies of different partsof the female reproductive system and demonstrate the potential of the clinical use of this new visualization method in gynecological practice.

  15. Evaluation of a one-parameter flow analysis of cervical samples for gynecology cancer screening.

    PubMed

    Tsou, K C; Pearson, S; Atkinson, B F; Giuntoli, R; Mangan, C

    1983-06-01

    A total of 246 endocervical samples were collected for Papanicolaou staining and one-parameter flow cytometric DNA analysis (FCDA) using 4',6-diamidino-2-phenylindole as a DNA stain. Typical histograms derived from FCDA analysis were designated class I, II, III, and V. Two groups of patients were studied: 135 women referred for colposcopy (COLPO), and 79 women exposed to diethylstilbestrol (DES). The remaining 32 samples were evaluated and found unsatisfactory. In the colposcopy group FCDA assigned 38 patients normal, 62 mild to moderate dysplasia, 33 moderate to severe dysplasia, and 2 carcinoma in situ and invasive carcinoma. Agreement of Pap smear and FCDA occurred in 56, 59, 72, and 100%, respectively. In the diethylstilbestrol group 57 patients were normal and 12 had mild to moderate dysplasia according to Pap diagnosis. Agreement between FCDA and Pap diagnosis were 45 and 58%, respectively. However, FCDA did not falsely assign severe dysplasia or carcinoma in situ to any DES patient. This preliminary study based on FCDA appears to clearly differentiate patients with normal Pap smears from those patients with invasive cancer.

  16. Relative Importance of Hip and Sacral Pain Among Long-Term Gynecological Cancer Survivors Treated With Pelvic Radiotherapy and Their Relationships to Mean Absorbed Doses

    SciTech Connect

    Waldenstroem, Ann-Charlotte; Olsson, Caroline; Wilderaeng, Ulrica; Dunberger, Gail; Lind, Helena; Alevronta, Eleftheria; Al-Abany, Massoud; Tucker, Susan; Avall-Lundqvist, Elisabeth; Johansson, Karl-Axel; Steineck, Gunnar

    2012-10-01

    Purpose: To investigate the relative importance of patient-reported hip and sacral pain after pelvic radiotherapy (RT) for gynecological cancer and its relationship to the absorbed doses in these organs. Methods and Materials: We used data from a population-based study that included 650 long-term gynecological cancer survivors treated with pelvic RT in the Gothenburg and Stockholm areas in Sweden with a median follow-up of 6 years (range, 2-15) and 344 population controls. Symptoms were assessed through a study-specific postal questionnaire. We also analyzed the hip and sacral dose-volume histogram data for 358 of the survivors. Results: Of the survivors, one in three reported having or having had hip pain after completing RT. Daily pain when walking was four times as common among the survivors compared to controls. Symptoms increased in frequency with a mean absorbed dose >37.5 Gy. Also, two in five survivors reported pain in the sacrum. Sacral pain also affected their walking ability and tended to increase with a mean absorbed dose >42.5 Gy. Conclusions: Long-term survivors of gynecological cancer treated with pelvic RT experience hip and sacral pain when walking. The mean absorbed dose was significantly related to hip pain and was borderline significantly related to sacral pain. Keeping the total mean absorbed hip dose below 37.5 Gy during treatment might lower the occurrence of long-lasting pain. In relation to the controls, the survivors had a lower occurrence of pain and pain-related symptoms from the hips and sacrum compared with what has previously been reported for the pubic bone.

  17. Palliative Care Education in Gynecologic Oncology: a Survey of Gynecologic Oncologists and Gynecologic Oncology Fellows in Thailand.

    PubMed

    Ratanakaaew, A; Khemapech, N; Laurujisawat, P

    2015-01-01

    The main purpose of this study was to survey the education and training of certified gynecologic oncologists and fellows in Thailand. A secondary objective was to study the problems in fellowship training regarding palliative care for gynecologic cancer patients. A descriptive study was conducted by sending a questionnaire regarding palliative care education to all certified gynecologic oncologists and gynecologic oncology fellows in Thailand. The contents of the survey included fellowship training experience, caring for the dying, patient preparation, attitudes and respondent characteristics. Statistics were analyzed by percentage, mean and standard deviation and chi-square. One hundred seventy completed questionnaires were returned; the response rate was 66%. Most certified gynecologic oncologists and fellows in gynecologic oncology have a positive attitude towards palliative care education, and agree that "psychological distress can result in severe physical suffering". It was found that the curriculum of gynecologic oncology fellowship training equally emphasizes three aspects, namely managing post-operative complications, managing a patient at the end of life and managing a patient with gynecologic oncology. As for experiential training during the fellowship of gynecologic oncology, education regarding breaking bad news, discussion about goals of care and procedures for symptoms control were mostly on-the-job training without explicit teaching. In addition, only 42.9% of respondents were explicitly taught the coping skill for managing their own stress when caring for palliative patients during fellowship training. Most of respondents rated their clinical competency for palliative care in the "moderately well prepared" level, and the lowest score of the competency was the issue of spiritual care. Almost all certified gynecologic oncologists and fellows in gynecologic oncology have a positive attitude towards learning and teaching in palliative care. In this

  18. Integrated Cancer Repository for Cancer Research

    ClinicalTrials.gov

    2017-05-05

    Pancreatic Cancer; Thyroid Cancer; Lung Cancer; Esophageal Cancer; Thymus Cancer; Colon Cancer; Rectal Cancer; GIST; Anal Cancer; Bile Duct Cancer; Duodenal Cancer; Gallbladder Cancer; Gastric Cancer; Liver Cancer; Small Intestine Cancer; Peritoneal Surface Malignancies; Familial Adenomatous Polyposis; Lynch Syndrome; Bladder Cancer; Kidney Cancer; Penile Cancer; Prostate Cancer; Testicular Cancer; Ureter Cancer; Urethral Cancer; Hypopharyngeal Cancer; Laryngeal Cancer; Lip Cancer; Oral Cavity Cancer; Nasopharyngeal Cancer; Oropharyngeal Cancer; Paranasal Sinus Cancer; Nasal Cavity Cancer; Salivary Gland Cancer; Skin Cancer; CNS Tumor; CNS Cancer; Mesothelioma; Breastcancer; Leukemia; Melanoma; Sarcoma; Unknown Primary Tumor; Multiple Myeloma; Ovarian Cancer; Endometrial Cancer; Vaginal Cancer

  19. Improving quality and decreasing cost in gynecologic oncology care. Society of gynecologic oncology recommendations for clinical practice.

    PubMed

    Rimel, B J; Burke, William M; Higgins, Robert V; Lee, Paula S; Lutman, Christopher V; Parker, Lynn

    2015-05-01

    To identify potential cost savings in gynecologic oncology care without sacrificing quality. Members of the Clinical Practice Committee of the Society of Gynecologic Oncology were asked to review current practice patterns in gynecologic oncology and assess the potential for cost savings founded on evidence-based medicine and current guidelines. Five clinical practices were identified including the following: vaginal cytology for endometrial cancer survivors; colposcopy for low grade cytologic abnormalities for cervical cancer survivors; routine imaging studies for gynecologic cancer survivors; screening for ovarian cancer with serum biomarkers and ultrasound; and improving palliative care for gynecologic cancer patients. Review of the published literature and guidelines were performed to make evidence-based recommendations for cost effective quality gynecologic oncology care. • Do not perform Pap tests of the vaginal cuff in patients with a history of endometrial cancer. • Do not perform colposcopy for low grade Pap tests in women with a history of cervical cancer. • Avoid routine imaging for cancer surveillance in asymptomatic women with gynecologic cancer, specifically ovarian, endometrial, cervical, vulvar and vaginal cancer. • Do not screen women at low risk for ovarian cancer with ultrasound or CA-125 or other biomarkers. • Do not delay basic level palliative care for women with advanced or relapsed gynecologic cancer, do refer to a palliative care specialist when needed, and avoid unnecessary treatments at life's end. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Comparison of IPSA with dose-point optimization and manual optimization for interstitial template brachytherapy for gynecologic cancers.

    PubMed

    Jamema, Swamidas V; Sharma, Smriti; Mahantshetty, Umesh; Engineer, Reena; Shrivastava, Shyam K; Deshpande, Deepak D

    2011-01-01

    To compare inverse planning simulated annealing (IPSA) algorithm with the dose-point optimized (DPO) plan and manual/graphically optimized (GrO) plan for interstitial template brachytherapy for gynecologic cancers. The data set of 10 consecutive patients was selected for this dosimetric study. For each patient, three plans were calculated: DPO, GrO, and IPSA. Dose-volume parameters from the three plans were compared to analyze the dosimetric outcome. Coverage of the clinical target volume (CTV) with GrO plan and IPSA algorithm was significantly better (mean V(100) of 88.8% and 89.1%; p=0.006) as compared with DPO plan (83.7%; p=0.62). Similarly, mean D(90) was same in both GrO plan and IPSA, 3.96±0.23 and 3.96±0.15Gy, respectively. DPO plans were homogeneous with homogeneity index being 0.82 as compared with 0.68±0.05 of GrO plan and 0.71±0.04 of IPSA. However, IPSA resulted in high conformity with conformity index of 0.78 as compared with 0.72 (p=0.001) and 0.68 (p≤0.001) for GrO and DPO plans, respectively. The dose to rectum (3.3±1.06Gy) and bladder (3.17±0.5Gy) was generally high for DPO plan. GrO plan reduced the dose to the rectum (2.91±0.63; p=0.011) and bladder (2.89±0.63Gy; p=0.003) significantly. IPSA resulted in a further reduction of the dose to rectum (2.79±0.67Gy; p=0.046) and bladder (2.81±0.67Gy; p=0.035), however with no statistical significance as compared with GrO plan. IPSA resulted in significant sparing of normal tissues without compromising CTV coverage as compared with DPO plan. However, IPSA did not show any significant improvement either in CTV coverage or in normal tissue sparing as compared with GrO plan. IPSA was found to be superior in terms of homogeneity and conformity as compared with GrO plan. Copyright © 2011 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  1. Surgical education and training program development for gynecologic oncology: American perspective.

    PubMed

    Hoffman, Mitchel S; Bodurka, Diane C

    2009-08-01

    The purpose of this paper is to provide information about gynecologic oncology fellowship training and guidance in program development. The characteristics necessary for a physician to develop into a successful gynecologic oncologist include an extensive fund of knowledge related to the subspecialty, strong interpersonal skills, the ability to practice within the complex systems required for management of gynecologic cancer patients, surgical expertise, and the clinical ability to provide comprehensive oncologic care for these women. In order for a trainee to acquire these skills, a gynecologic oncology training program must accept only highly qualified individuals as fellows, have a dedicated core faculty, practice in a supportive environment that has appropriate facilities, and provide adequate clinical material. The gynecologic oncology training program must be organized with an emphasis on education of the fellows. Part of the educational program is formal (lectures, assigned reading, basic skill sets, etc.). Training in clinical and surgical skills is a day-to-day process that occurs during the course of patient care. One requirement of The American Board of Obstetrics and Gynecology (ABOG) is that the fellow spends 12 months of protected time doing research. Fellows are also required to take 2 courses, one in biostatistics and one in cancer biology. A thesis of publishable quality is also required. All programs must perform ongoing quality assurance and reassessment of potential areas for improvement. ABOG is responsible for the accreditation and ongoing monitoring of the fellowship programs.

  2. Hope, quality of life, and benefit from treatment in women having chemotherapy for platinum-resistant/refractory recurrent ovarian cancer: the gynecologic cancer intergroup symptom benefit study.

    PubMed

    Sjoquist, Katrin M; Friedlander, Michael L; O'Connell, Rachel L; Voysey, Merryn; King, Madeleine T; Stockler, Martin R; Oza, Amit M; Gillies, Kim; Martyn, Julie K; Butow, Phyllis N

    2013-01-01

    Chemotherapy for platinum-resistant/refractory ovarian cancer is motivated by the hope of benefit. We sought to determine the relationships between: (a) trait hope, expectation of symptom benefit from chemotherapy, and anxiety and depression; (b) hope and perceived efficacy of chemotherapy; and (c) unfulfilled hope (where expectations for benefit are not fulfilled) and depression. Methods. Adult patients enrolled within stage 1 of the Gynecologic Cancer Intergroup Symptom Benefit Study were included. Patient. Reported outcomes were collected from 126 women with predominantly platinum-resistant ovarian cancer at baseline, prior to the first four treatment cycles (12-16 weeks), and four weeks after completing chemotherapy or at disease progression, whichever came first. Associations were assessed with Spearman rank correlation coefficient (r) and odds ratio. Results. Trait hope and expectation of symptom benefit from chemotherapy were weakly correlated with each other (r = 0.25). Trait hope, but not expectation of symptom benefit, was negatively correlated with anxiety (r = -0.43) and depression (r = -0.50). The smaller the discrepancy between perceived and expected symptom benefit, the less likely the patient was to have scores indicative of depression (odds ratio: 0.68; 95% confidence interval: 0.49-0.96; p = .026). Conclusion. Trait hope and expectation of symptom benefit from chemotherapy appear to be distinct and independent of the aspects of quality of life and scores for depression. Hope did not appear to affect perceived efficacy of chemotherapy in alleviating symptoms, but women whose expectation of symptom benefit from chemotherapy was not fulfilled were more likely to have scores indicative of depression. It may be preferable to encourage hope toward achievable goals rather than toward benefits from chemotherapy.

  3. Management of gynecologic oncology emergencies

    SciTech Connect

    Harwood-Nuss, A.L.; Benrubi, G.I.; Nuss, R.C.

    1987-08-01

    Gynecologic malignancies are the third most common cancer among women in the United States. Because of often subtle early findings, the diagnosis may not be made before the widespread dissemination of the disease. The Emergency Department physician will commonly encounter a woman with vaginal bleeding, pelvic pain, or a symptomatic abdominal mass. In this article, we have described the epidemiology, recognized patterns of spread, and associated findings of gynecologic tumors. The proper Emergency Department evaluation and management of these problems is emphasized with guidelines for the timing of referrals and consultation with the gynecologic oncologist. The treatment of gynecologic malignancies is often complicated and responsible for Emergency Department visits. The various modalities are addressed according to the organ systems affected and include sections on postoperative problems, gastrointestinal complaints, urologic complications of therapy, radiation therapy and its complications, with an emphasis on the most serious complications necessitating either careful outpatient management or hospital admission. As cost-containment pressure grows, we have included sections on chemotherapy and total parenteral nutrition, both of which are becoming common outpatient events for the cancer patient. 28 references.

  4. Extended Intraarterial Cisplatin Infusion for Treatment of Gynecologic Cancer After Alteration of Intrapelvic Blood Flow and Implantation of a Vascular Access Device

    SciTech Connect

    Yamada, Tetsuhisa; Ohsugi, Fumio; Irie, Takeo; Ishii, Chikako; Sadaoka, Shunichi; Tada, Shinpei

    1996-05-15

    Purpose: Twenty-two patients with advanced gynecologic cancer underwent extended intraarterial cisplatin infusion after alteration of the intrapelvic blood flow and implantation of a vascular access device (VAD). Methods: To maximize concentrations of cisplatin at the target lesion, the superior and inferior gluteal arteries were embolized with steel coils. The tip of the catheter was inserted into the internal iliac artery; the opposite end of the catheter was connected to the VAD. Results: Intensive radioisotope accumulation was demonstrated in the anterior division of the pelvis, seen by scintigraphy performed with technetium 99m macroaggregated albumin via the VAD. Local perfusion in the tumor was well seen by ultrasonographic angiography with CO{sub 2} microbubbles via the VAD. Continuous consecutive infusion of cisplatin at a rate of 12.5 mg/day via the VAD minimized the toxicity. The overall response rate was 73%. Radical surgery was possible in 16 of the 22 patients after this intraarterial infusion. Conclusion: This method was useful for treating advanced gynecologic cancer without significant toxicity.

  5. A cost-effectiveness analysis of prophylactic surgery versus gynecologic surveillance for women from hereditary non-polyposis colorectal cancer (HNPCC) Families.

    PubMed

    Yang, Kathleen Y; Caughey, Aaron B; Little, Sarah E; Cheung, Michael K; Chen, Lee-May

    2011-09-01

    Women at risk for Lynch Syndrome/HNPCC have an increased lifetime risk of endometrial and ovarian cancer. This study investigates the cost-effectiveness of prophylactic surgery versus surveillance in women with Lynch Syndrome. A decision analytic model was designed incorporating key clinical decisions and existing probabilities, costs, and outcomes from the literature. Clinical forum where risk-reducing surgery and surveillance were considered. A theoretical population of women with Lynch Syndrome at age 30 was used for the analysis. A decision analytic model was designed comparing the health outcomes of prophylactic hysterectomy with bilateral salpingo-oophorectomy at age 30 versus annual gynecologic screening versus annual gynecologic exam. The literature was searched for probabilities of different health outcomes, results of screening modalities, and costs of cancer diagnosis and treatment. Cost-effectiveness expressed in dollars per discounted life-years. Risk-reducing surgery is the least expensive option, costing $23,422 per patient for 25.71 quality-adjusted life-years (QALYs). Annual screening costs $68,392 for 25.17 QALYs; and annual examination without screening costs $100,484 for 24.60 QALYs. Further, because risk-reducing surgery leads to both the lowest costs and the highest number of QALYs, it is a dominant strategy. Risk-reducing surgery is the most cost-effective option from a societal healthcare cost perspective.

  6. Fostering Cooperation in Cancer Research

    Cancer.gov

    Thursday, June 25, 2015 Memorandum of Understanding (MoU) was signed between US National Cancer Institute and three agencies of the Indian government - the Department of Biotechnology, the Indian Council of Medical Research, and the Indian National Cancer Institute, a part of the All India Institute of Medical Sciences to foster cooperation in cancer research.

  7. It's All How You "Spin" It: Interpretive Bias in Research Findings in the Obstetrics and Gynecology Literature.

    PubMed

    Turrentine, Mark

    2017-02-01

    Scientific publications can be subject to varying degrees of interpretive bias, also known as spin. The rate of spin in randomized controlled trials (RCTs) with nonsignificant primary outcomes in the general obstetrics and gynecology literature is unknown. A decade (January 2006 through December 2015) of the tables of contents of Obstetrics & Gynecology and the American Journal of Obstetrics & Gynecology were screened, with 503 RCTs identified. Limiting assessment to only parallel-group RCTs with a nonsignificant primary outcome (P≥.05) resulted in the identification of 194 studies. The abstracts of the articles reported the primary outcome in 93% of studies with 79% containing a precision estimate but only 25% noting an effect size. The extent of any type of spin occurred in 43% of abstracts and 50% of the main text. In articles that contained spin in the abstract, the more common types were: emphasizing statistically significant secondary results despite a nonsignificant primary outcome (40%); interpreting statistically nonsignificant primary results as showing treatment equivalence or comparable effectiveness (37%); and emphasizing the beneficial effect of the treatment despite statistically nonsignificant results (15%). Half of parallel-group RCTs with nonsignificant primary outcomes published in the two leading journals in general obstetrics and gynecology contains some level of spin. As readers of the medical literature, we should be aware of the concept of spin, the diversity and heterogeneity of spin in the reporting of conclusions, and its effects, particularly when discussing articles that may change clinical practice.

  8. Definitions of Obstetric and Gynecologic Hospitalists.

    PubMed

    McCue, Brigid; Fagnant, Robert; Townsend, Arthur; Morgan, Meredith; Gandhi-List, Shefali; Colegrove, Tanner; Stosur, Harriet; Olson, Rob; Meyer, Karenmarie; Lin, Andrew; Tessmer-Tuck, Jennifer

    2016-02-01

    The obstetric hospitalist and the obstetric and gynecologic hospitalist evolved in response to diverse forces in medicine, including the need for leadership on labor and delivery units, an increasing emphasis on quality and safety in obstetrics and gynecology, the changing demographics of the obstetric and gynecologic workforce, and rising liability costs. Current (although limited) research suggests that obstetric and obstetric and gynecologic hospitalists may improve the quality and safety of obstetric care, including lower cesarean delivery rates and higher vaginal birth after cesarean delivery rates as well as lower liability costs and fewer liability events. This research is currently hampered by the use of varied terminology. The leadership of the Society of Obstetric and Gynecologic Hospitalists proposes standardized definitions of an obstetric hospitalist, an obstetric and gynecologic hospitalist, and obstetric and gynecologic hospital medicine practices to standardize communication and facilitate program implementation and research. Clinical investigations regarding obstetric and gynecologic practices (including hospitalist practices) should define inpatient coverage arrangements using these standardized definitions to allow for fair conclusions and comparisons between practices.

  9. Why I Do Cancer Research

    Cancer.gov

    World Cancer Research Day is recognized on September 24, 2017. This day presents an opportunity for all of us to remind the world of the critically important roles research and cancer researchers play in reducing the global burden of cancer. Together with ten other global partners, NCI participated in the planning and launch of this initiative, highlighting the amplified impact of international cooperation in the clinical research arena.

  10. Breast cancer screening: updated recommendations of the Brazilian College of Radiology and Diagnostic Imaging, Brazilian Breast Disease Society, and Brazilian Federation of Gynecological and Obstetrical Associations

    PubMed Central

    Urban, Linei Augusta Brolini Dellê; Chala, Luciano Fernandes; Bauab, Selma di Pace; Schaefer, Marcela Brisighelli; dos Santos, Radiá Pereira; Maranhão, Norma Medicis de Albuquerque; Kefalas, Ana Lucia; Kalaf, José Michel; Ferreira, Carlos Alberto Pecci; Canella, Ellyete de Oliveira; Peixoto, João Emílio; de Amorim, Heverton Leal Ernesto; de Camargo Junior, Helio Sebastião Amâncio

    2017-01-01

    Objective To present the current recommendations for breast cancer screening in Brazil, as devised by the Brazilian College of Radiology and Diagnostic Imaging, the Brazilian Breast Disease Society, and the Brazilian Federation of Gynecological and Obstetrical Associations. Materials and methods We analyzed scientific studies available in the Medline and Lilacs databases. In the absence of evidence, the recommendations reflected the consensus of a panel of experts. Recommendations Annual mammography screening is recommended for women 40-74 years of age. Among women ≥ 75 years of age, annual mammography screening should be reserved for those with an expected survival > 7 years. Complementary ultrasound should be considered for women with dense breasts. Complementary magnetic resonance imaging is recommended for women at high risk. When available, an advanced form of mammography known as tomosynthesis can be considered as a means of screening for breast cancer. PMID:28894332

  11. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Dr. Harry Mahtani analyzes the gas content of nutrient media from Bioreactor used in research on human breast cancer. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cells (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunourous tissues.

  12. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Dr. Harry Mahtani analyzes the gas content of nutrient media from Bioreactor used in research on human breast cancer. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cells (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunourous tissues.

  13. Cancer Prevention Research in China.

    PubMed

    Yu, Siwang; Yang, Chung S; Li, Junyao; You, Weicheng; Chen, Jianguo; Cao, Ya; Dong, Zigang; Qiao, Youlin

    2015-08-01

    Although cancer incidence and mortality rates in the United States and some European countries have started to decrease, those in developing countries are increasing. China, the most populous developing country, is facing a serious challenge from cancer. Cancer incidence has been increasing for decades, and cancer is the leading cause of death in China. In 2012, the cancer incidence was 174.0 per 100,000, and the cancer mortality was 122.2 per 100,000 in China. In addition to the still-prevalent traditional Chinese cancers of the stomach, liver, esophagus, cervix, and nasopharynx, the incidence of "Western" cancers such those of the lung, breast, and colorectum has increased alarmingly in recent years. These increases are likely due to the lifestyle and environmental changes associated with rapid economic development and population aging. More importantly, a large portion of these cancers are preventable. Researchers in China have made important contributions to cancer prevention research, especially in the traditional Chinese cancers. More cancer prevention research and measures, especially on the major emerging cancers, are urgently needed. This review article highlights some of the past achievements and present needs in cancer prevention research in China and suggests important areas for future studies.

  14. Integrated Molecular Profiling in Advanced Cancers Trial

    ClinicalTrials.gov

    2016-08-19

    Breast Cancer; Non-small Cell Lung Cancer; Colorectal Cancer; Genitourinary Cancer; Pancreatobiliary Gastrointestinal Cancer; Upper Aerodigestive Tract Cancer; Gynecological Cancers; Melanoma Cancers; Rare Cancers; Unknown Primary Cancers

  15. Neoadjuvant chemotherapy for newly diagnosed, advanced ovarian cancer: Society of Gynecologic Oncology and American Society of Clinical Oncology Clinical Practice Guideline.

    PubMed

    Wright, Alexi A; Bohlke, Kari; Armstrong, Deborah K; Bookman, Michael A; Cliby, William A; Coleman, Robert L; Dizon, Don S; Kash, Joseph J; Meyer, Larissa A; Moore, Kathleen N; Olawaiye, Alexander B; Oldham, Jessica; Salani, Ritu; Sparacio, Dee; Tew, William P; Vergote, Ignace; Edelson, Mitchell I

    2016-10-01

    To provide guidance to clinicians regarding the use of neoadjuvant chemotherapy and interval cytoreduction among women with stage IIIC or IV epithelial ovarian cancer. The Society of Gynecologic Oncology and the American Society of Clinical Oncology convened an Expert Panel and conducted a systematic review of the literature. Four phase III clinical trials form the primary evidence base for the recommendations. The published studies suggest that for selected women with stage IIIC or IV epithelial ovarian cancer, neoadjuvant chemotherapy and interval cytoreduction are non-inferior to primary cytoreduction and adjuvant chemotherapy with respect to overall and progression-free survival and are associated with less perioperative morbidity and mortality. All women with suspected stage IIIC or IV invasive epithelial ovarian cancer should be evaluated by a gynecologic oncologist prior to initiation of therapy. The primary clinical evaluation should include a CT of the abdomen and pelvis, and chest imaging (CT preferred). Women with a high perioperative risk profile or a low likelihood of achieving cytoreduction to <1cm of residual disease (ideally to no visible disease) should receive neoadjuvant chemotherapy. Women who are fit for primary cytoreductive surgery, and with potentially resectable disease, may receive either neoadjuvant chemotherapy or primary cytoreductive surgery. However, primary cytoreductive surgery is preferred if there is a high likelihood of achieving cytoreduction to <1cm (ideally to no visible disease) with acceptable morbidity. Before neoadjuvant chemotherapy is delivered, all patients should have confirmation of an invasive ovarian, fallopian tube, or peritoneal cancer. Additional information is available at www.asco.org/NACT-ovarian-guideline and www.asco.org/guidelineswiki. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  16. High stathmin expression is a marker for poor clinical outcome in endometrial cancer: An NRG oncology group/gynecologic oncology group study.

    PubMed

    Reyes, Henry D; Miecznikowski, Jeffrey; Gonzalez-Bosquet, Jesus; Devor, Eric J; Zhang, Yuping; Thiel, Kristina W; Samuelson, Megan I; McDonald, Megan; Stephan, Jean-Marie; Hanjani, Parviz; Guntupalli, Saketh; Tewari, Krishnansu S; Backes, Floor; Ramirez, Nilsa; Fleming, Gini F; Filiaci, Virginia; Birrer, Michael J; Leslie, Kimberly K

    2017-08-01

    Gynecologic Oncology Group (GOG) 177 demonstrated that addition of paclitaxel to a backbone of adriamycin/cisplatin improves overall survival (OS) and progression-free survival (PFS) for patients with advanced or recurrent endometrial cancer. Using patient specimens from GOG-177, our objective was to identify potential mechanisms underlying the improved clinical response to taxanes. Stathmin (STMN1) is a recognized poor prognostic marker in endometrial cancer that functions as a microtubule depolymerizing protein, allowing cells to transit rapidly through mitosis. Therefore, we hypothesized that one possible mechanism underlying the beneficial effects of paclitaxel could be to counter the impact of stathmin. We analyzed the expression of stathmin by immunohistochemistry (IHC) in 69 specimens from patients enrolled on GOG-177. We also determined the correlation between stathmin mRNA expression and clinical outcomes in The Cancer Genome Atlas (TCGA) dataset for endometrial cancer. We first established that stathmin expression was significantly associated with shorter PFS and OS for all analyzed cases in both GOG-177 and TCGA. However, subgroup analysis from GOG-177 revealed that high stathmin correlated with poor PFS and OS particularly in patients who received adriamycin/cisplatin only. In contrast, there was no statistically significant association between stathmin expression and OS or PFS in patients treated with paclitaxel/adriamycin/cisplatin. Our findings demonstrate that high stathmin expression is a poor prognostic marker in endometrial cancer. Paclitaxel may help to negate the impact of stathmin overexpression when treating high risk endometrial cancer cases. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Bariatric surgery and adolescent gynecology.

    PubMed

    Miller, Rachel J; Xanthakos, Stavra A; Hillard, Paula J Adams; Inge, Thomas H

    2007-10-01

    This review summarizes the impact of bariatric surgery on gynecologic complications in the context of the extremely obese adolescent and reviews contraceptive considerations before and after adolescent bariatric surgery. Eighteen percent of children and adolescents have a body mass index greater than the 95th percentile, with 4% of adolescents being greater than the 99th percentile. Gynecologic morbidities identified in obese adolescents include anovulatory complications such as acute menorrhagia, polycystic ovary syndrome and endometrial hyperplasia, and cancer. When conventional dietary and behavioral therapy fail to result in weight loss, specific criteria have been identified to justify bariatric surgery in extremely obese adolescents. Bariatric surgery in adult women often results in resumption of ovulatory menses, resolution of clinical and laboratory evidence of hyperandrogenism, and return of fertility. Adolescents are at risk for unintended pregnancies, and there are special concerns regarding pregnancy in bariatric patients. Specific contraceptive methods have particular potential risks, benefits, and drawbacks for use in obese adolescents. Clinicians who provide care for extremely obese adolescents must be aware of the potential for gynecologic morbidities including polycystic ovary syndrome, dysfunctional bleeding and endometrial hyperplasia, expected gynecologic and fertility outcomes of weight loss surgery for teens, as well as the implications on contraceptive options.

  18. Risk factor analysis for massive lymphatic ascites after laparoscopic retroperitonal lymphadenectomy in gynecologic cancers and treatment using intranodal lymphangiography with glue embolization

    PubMed Central

    2016-01-01

    Objective To evaluate risk factors for massive lymphatic ascites after laparoscopic retroperitoneal lymphadenectomy in gynecologic cancer and the feasibility of treatments using intranodal lymphangiography (INLAG) with glue embolization. Methods A retrospective analysis of 234 patients with gynecologic cancer who received laparoscopic retroperitonal lymphadenectomy between April 2006 and November 2015 was done. In June 2014, INLAG with glue embolization was initiated to manage massive lymphatic ascites. All possible clinicopathologic factors related to massive lymphatic ascites were determined in the pre-INLAG group (n=163). Clinical courses between pre-INLAG group and post-INLAG group (n=71) were compared. Results In the pre-INLAG group (n=163), four patients (2.5%) developed massive lymphatic ascites postoperatively. Postoperative lymphatic ascites was associated with liver cirrhosis (three cirrhotic patients, p<0.001). In the post-INLAG group, one patient with massive lymphatic ascites had a congestive heart failure and first received INLAG with glue embolization. She had pelvic drain removed within 7 days after INLAG. The mean duration of pelvic drain and hospital stay decreased after the introduction of INLAG (13.2 days vs. 10.9 days, p=0.001; 15.2 days vs. 12.6 days, p=0.001). There was no evidence of recurrence after this procedure. Conclusion Underlying medical conditions related to the reduced effective circulating volume, such as liver cirrhosis and heart failure, may be associated with massive lymphatic ascites after retroperitoneal lymphadenectomy. INLAG with glue embolization can be an alternative treatment options to treat leaking lymphatic channels in patients with massive lymphatic leakage. PMID:27171674

  19. Risk factor analysis for massive lymphatic ascites after laparoscopic retroperitonal lymphadenectomy in gynecologic cancers and treatment using intranodal lymphangiography with glue embolization.

    PubMed

    Kong, Tae Wook; Chang, Suk Joon; Kim, Jinoo; Paek, Jiheum; Kim, Su Hyun; Won, Je Hwan; Ryu, Hee Sug

    2016-07-01

    To evaluate risk factors for massive lymphatic ascites after laparoscopic retroperitoneal lymphadenectomy in gynecologic cancer and the feasibility of treatments using intranodal lymphangiography (INLAG) with glue embolization. A retrospective analysis of 234 patients with gynecologic cancer who received laparoscopic retroperitonal lymphadenectomy between April 2006 and November 2015 was done. In June 2014, INLAG with glue embolization was initiated to manage massive lymphatic ascites. All possible clinicopathologic factors related to massive lymphatic ascites were determined in the pre-INLAG group (n=163). Clinical courses between pre-INLAG group and post-INLAG group (n=71) were compared. In the pre-INLAG group (n=163), four patients (2.5%) developed massive lymphatic ascites postoperatively. Postoperative lymphatic ascites was associated with liver cirrhosis (three cirrhotic patients, p<0.001). In the post-INLAG group, one patient with massive lymphatic ascites had a congestive heart failure and first received INLAG with glue embolization. She had pelvic drain removed within 7 days after INLAG. The mean duration of pelvic drain and hospital stay decreased after the introduction of INLAG (13.2 days vs. 10.9 days, p=0.001; 15.2 days vs. 12.6 days, p=0.001). There was no evidence of recurrence after this procedure. Underlying medical conditions related to the reduced effective circulating volume, such as liver cirrhosis and heart failure, may be associated with massive lymphatic ascites after retroperitoneal lymphadenectomy. INLAG with glue embolization can be an alternative treatment options to treat leaking lymphatic channels in patients with massive lymphatic leakage.

  20. Efficacy and safety of cell-free and concentrated ascites reinfusion therapy (CART) in gynecologic cancer patients with a large volume of ascites.

    PubMed

    Wang, Liangcheng; Okubo, Takashi; Shinsaka, Mamiko; Kobayashi, Akiko; Ogasawara, Miwa; Sakaguchi, Riko; Nagai, Tomonori; Seki, Hiroyuki

    2015-10-01

    The aim of this study was to evaluate the efficacy and safety of cell-free concentrated ascites reinfusion therapy (CART) on a large amount of ascites. Fifty-eight CART procedures were performed in nine patients with ovarian, endometrial, or cervical cancer from February 2013 to September 2014. The medical records were retrospectively reviewed for the amount of collected ascites, vital signs, and laboratory results before and after CART. No obvious change in the plasma protein and plasma albumin concentration was found after CART for < 5 L of ascites; however, obvious increases in both were observed in CART for ≥ 5 L of ascites (P < 0.001). The optimum cut-off value for obtaining a positive variant of plasma protein and plasma albumin after CART was 7.9 L. CART for ≥ 5 L of ascites did not increase the risk of transient water retention in the body (odds ratio = 2.2; 95% confidence interval: 0.35-13.83; P = 0.38); however, CART for ≥ 7.9 L of ascites increased the risk of water retention (odds ratio = 8.4; 95% confidence interval: 1.91-44.09; P = 0.004). The optimal cut-off value of ascites for predicting water retention due to CART was 9.2 L. Massive ascites collection in CART < 9.2 L appears to be a safe and effective treatment for improving general condition, plasma protein, and electrolytes in gynecologic cancer patients. © 2015 Japan Society of Obstetrics and Gynecology.

  1. Ontario-wide Cancer TArgeted Nucleic Acid Evaluation

    ClinicalTrials.gov

    2016-09-14

    Breast Cancer; Lung Cancer; Colorectal Cancer; Melanoma; Gynecological Cancer; Genitourinary Cancer; Pancreatobiliary Cancer; Gastrointestinal Cancer; Head and Neck Cancer; Rare Cancer; Unknown Primary Cancer

  2. Cost-effectiveness of robotic surgery in gynecologic oncology.

    PubMed

    Xie, Yue

    2015-02-01

    Robotically assisted surgeries have flourished in the United States, especially in gynecological procedures. Current robotic systems have high upfront and procedure costs that have led many in the medical community to question the new technology's cost-effectiveness. Recent research continues to find that robotically assisted gynecological cancer treatments have comparable outcomes to traditional laparoscopy and similar or better outcomes than that of laparotomy in the cases studied. However, robotic surgery costs remain higher than that of traditional laparoscopy. Under the current reimbursement climate, practicing physicians and hospitals should collaborate on identifying cost-effective uses of robotic systems and pushing manufacturers to lower purchase and procedure costs to a level that may be accepted by all stakeholders.

  3. The association between timing of initiation of adjuvant therapy and the survival of early stage ovarian cancer patients - An analysis of NRG Oncology/Gynecologic Oncology Group trials.

    PubMed

    Chan, John K; Java, James J; Fuh, Katherine; Monk, Bradley J; Kapp, Daniel S; Herzog, Thomas; Bell, Jeffrey; Young, Robert

    2016-12-01

    To determine the association between timing of adjuvant therapy initiation and survival of early stage ovarian cancer patients. Data were obtained from women who underwent primary surgical staging followed by adjuvant therapy from two Gynecologic Oncology Group trials (protocols # 95 and 157). Kaplan-Meier estimates and Cox proportional hazards model adjusted for covariates were used for analyses. Of 497 stage I-II epithelial ovarian cancer patients, the median time between surgery and initiation of adjuvant therapy was 23days (25th-75th%: 12-33days). The time interval from surgery to initiation of adjuvant therapy was categorized into three groups: <2weeks, 2-4weeks, and >4weeks. The corresponding 5-year recurrence-free survival rates were 72.8%, 73.9%, and 79.5% (p=0.62). The 5-year overall survival rates were 79.4%, 81.9%, and 82.8%, respectively (p=0.51; p=0.33 - global test). As compared to <2weeks, the hazard ratio for recurrence-free survival was 0.90 (95%CI=0.59-1.37) for 2-4weeks and 0.72 (95%CI=0.46-1.13) for >4weeks. Age, stage, grade, and cytology were important prognostic factors. Timing of adjuvant therapy initiation was not associated with survival in early stage epithelial ovarian cancer patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Dr. Robert Richmond extracts breast cell tissue from one of two liquid nitrogen dewars. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cells (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunourous tissues.

  5. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Breast tissue specimens in traditional sample dishes. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cells (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunourous tissues.

  6. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Time-lapse exposure depicts Bioreactor rotation. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cells (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunourous tissues.

  7. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Breast tissue specimens in traditional sample dishes. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cells (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunourous tissues.

  8. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Time-lapse exposure depicts Bioreactor rotation. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cells (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunourous tissues.

  9. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Dr. Robert Richmond extracts breast cell tissue from one of two liquid nitrogen dewars. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cells (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunourous tissues.

  10. A prospective study of the feasibility and acceptability of a Web-based, electronic patient-reported outcome system in assessing patient recovery after major gynecologic cancer surgery.

    PubMed

    Andikyan, Vaagn; Rezk, Youssef; Einstein, M Heather; Gualtiere, Gina; Leitao, Mario M; Sonoda, Yukio; Abu-Rustum, Nadeem R; Barakat, Richard R; Basch, Ethan M; Chi, Dennis S

    2012-11-01

    The purposes of this study are to evaluate the feasibility of capturing patient-reported outcomes (PROs) electronically and to identify the most common distressing symptoms in women recovering from major gynecologic cancer surgery. This was a prospective, single-arm pilot study. Eligible participants included those scheduled for a laparotomy for presumed or known gynecologic malignancy. Patients completed a Web-based "STAR" (Symptom Tracking and Reporting for Patients) questionnaire once preoperatively and weekly during the 6-week postoperative period. The questionnaire consisted of the patient adaptation of the NCI CTCAE 3.0 and EORTC QLQ-C30 3.0. When a patient submitted a response that was concerning, an automated email alert was sent to the clinician. The patient's assessment of STAR's usefulness was measured via an exit survey. Forty-nine patients completed the study. The procedures included the following: hysterectomy±staging (67%), resection of tumor (22%), salpingo-oophorectomy (6%), and other (4%). Most patients (82%) completed at least 4 sessions in STAR. The CTC generated 43 alerts. These alerts resulted in 25 telephone contacts with patients, 2 ER referrals, one new appointment, and one pharmaceutical prescription. The 3 most common patient-reported symptoms generating an alert were as follows: poor performance status (19%), nausea (18%), and fatigue (17%). Most patients found STAR useful (80%) and would recommend it to others (85%). Application of a Web-based, electronic STAR system is feasible in the postoperative period, highly accepted by patients, and warrants further study. Poor performance status, nausea, and fatigue were the most common distressing patient-reported symptoms. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Accomplishments in cancer research. 1986

    SciTech Connect

    Fortner, J.G. . Medical Coll.); Rhoads, J.E. . School of Medicine)

    1987-01-01

    This book contains several papers on cancer research. Some of the titles are: Controlled DNA Replication Once and Only Once Per Cell Cycle; Tumor Growth Factors; Improvement in Radiotherapy Through Innovative Dose Fractionation; The Role of Surgery in the Treatment of Cancer Metastase; Tumor Promotion; and Molecular Cloning of Protein Kinase C and the Role of PKC in Signal Transduction and Tumor Promotion.

  12. Improving the Utilization of Human Papillomavirus and Cervical Cytology Co-testing for Cervical Cancer Screening in an Obstetrics and Gynecology Resident Clinic.

    PubMed

    Yoshino, Kurt; Karimoto, Maxine; Marzo, Christina; Kaneshiro, Bliss; Hiraoka, Mark

    2015-08-01

    Human Papillomavirus (HPV) testing in combination with cervical cytology (HPV co-testing) has been recommended for cervical cancer screening for women 30 to 65 years of age. In several studies, HPV co-testing increased sensitivity for detecting high grade dysplasia and resulted in cost-savings. This retrospective cohort study assessed the prevalence of HPV co-testing in an obstetrics and gynecology resident clinic before and after a brief educational intervention which was designed to reinforce current cervical cancer screening recommendations. The intervention consisted of a short presentation that was given to all residents and medical assistants in October 2011. The proportion of women age 30-65 years of age who had cervical cancer screening with HPV co-testing as compared to cervical cytology alone was compared before and after the intervention using chi-square tests. The goal of the intervention was to increase the percentage of patients receiving co-testing from 0.5% to 7.8%. Each arm (pre- and post-intervention) required 130 subjects to achieve 80% power with a significance of P = .05. No significant differences in demographics including age, insurance type, and cytology were noted. HPV co-testing increased from 0% to 55% (P < .001). Of the 72 subjects who had co-testing, 58 (80%) will not need cervical cancer screening for another 5 years. HPV co-testing represents an underutilized cervical cancer screening modality for women 30 years and older. This brief educational intervention, adaptable to any clinical setting, significatnly increased co-testing at the clinical site.

  13. Use of stereotactic radiosurgery in the treatment of gynecologic malignancies: A review

    PubMed Central

    Long, Beverly; Eskander, Ramez N; Tewari, Krishnansu S

    2014-01-01

    Recent retrospective studies have reported the use of stereotactic radiosurgery (SRS) in the treatment of gynecologic cancers. SRS uses real-time imaging and high dose radiation beams attached to precise robotic arms to target malignant lesions while sparing normal tissue. The purpose of this review is to examine the indications for SRS in gynecologic oncology, review the current literature regarding the use of SRS in gynecologic cancers, and identify future directions for research in this area. Literature on stereotactic radiosurgery was reviewed using the PubMed search engine. Articles written in English from 1993-2013 were reviewed, and 20 case series and clinical trials were included. The safety and efficacy SRS has been demonstrated in all gynecologic disease sites including cervical, endometrial, vulvar, vaginal, and ovarian cancers. Indications for its use include non-central pelvic recurrences in previously irradiated patients, complex or non-resectable disease recurrence, and solitary brain metastases. Toxicities are usually mild, though grade 3-4 toxicities have been reported. SRS is a promising second line treatment modality for patients with primary or recurrent disease who cannot undergo standard surgical or radiation therapy. Further research is required to determine optimal dosing and fractionation schedules, delineate appropriate patient populations, and assess longterm morbidity and survival. PMID:24976937

  14. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    High magnification view of human primary breast tumor cells after 56 days of culture in a NASA Bioreactor. The arrow points to bead surface indicating breast cancer cells (as noted by the staining of tumor cell intermediate filaments). NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cell (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunorous tissue. Credit: Dr. Jearne Becker, University of South Florida

  15. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    High magnification view of human primary breast tumor cells after 56 days of culture in a NASA Bioreactor. The arrow points to bead surface indicating breast cancer cells (as noted by the staining of tumor cell intermediate filaments). NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cell (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunorous tissue. Credit: Dr. Jearne Becker, University of South Florida

  16. Nebraska Prostate Cancer Research Program

    DTIC Science & Technology

    2012-05-01

    Expression in Prostate Cancer Cells Exposed to Heavy Metal Carcinogen. UNMC Summer Undergraduate Research Program, August 2010. • Keidra A. Bryant...Joseph R. Wheeler, Michelle A. Montgomery, and Richard G. MacDonald. (2010). Effect of Metal Ion Chelators on Mannose 6-Phosphate/Insulin-like... Effect of 4’-Bis-Thiosemicarbazide, a New Ribonucleotide Reductase Inhibitor, on Prostate Cancer Cell Proliferation. UNMC Summer Undergraduate Research

  17. Subspecialist training in surgical gynecologic oncology in the Nordic countries.

    PubMed

    Antonsen, Sofie L; Avall-Lundqvist, Elisabeth; Salvesen, Helga B; Auranen, Annika; Salvarsdottir, Anna; Høgdall, Claus

    2011-08-01

    To survey the centers that can provide subspecialty surgical training and education in gynecological oncology in the Nordic countries, we developed an online questionnaire in co-operation with the Nordic Society of Gynecological Oncology. The link to the survey was mailed to 22 Scandinavian gynecological centers in charge of surgical treatment of cancer patients. Twenty (91%) centers participated. Four centers reported to be accredited European subspecialty training centers, a further six were interested in being accredited, and 11 centers were accredited by the respective National Board. Fourteen (74%) centers were interested in being listed for exchange of fellows. Our data show a large Nordic potential and interest in improving the gynecologic oncology standards and can be used to enhance the awareness of gynecologic oncology training in Scandinavia and to facilitate the exchange of fellows between Nordic countries. © 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.

  18. About Foregut Cancers | Center for Cancer Research

    Cancer.gov

    About Foregut Cancers The foregut is the section of the upper gastrointestinal tract that includes the esophagus, stomach, pancreas, liver and bile ducts. The focus of the NIH Foregut Team is clinical research and care of patients with tumors of the foregut, including:

  19. A brief mindfulness-based cognitive behavioral intervention improves sexual functioning versus wait-list control in women treated for gynecologic cancer

    PubMed Central

    Brotto, Lori A.; Erskine, Yvonne; Carey, Mark; Ehlen, Tom; Finlayson, Sarah; Heywood, Mark; Kwon, Janice; McAlpine, Jessica; Stuart, Gavin; Thomson, Sydney; Miller, Dianne

    2012-01-01

    Goal The goal of this study was to evaluate a mindfulness-based cognitive behavioral intervention for sexual dysfunction in gynecologic cancer survivors compared to a wait-list control group. Methods Thirty-one survivors of endometrial or cervical cancer (mean age 54.0, range 31–64) who self-reported significant and distressing sexual desire and/or sexual arousal concerns were assigned either to three, 90-minute mindfulness-based cognitive behavior therapy sessions or two months of wait-list control prior to entering the treatment arm. Validated measures of sexual response, sexual distress, and mood, as well as laboratory-evoked physiological and subjective sexual arousal were assessed at pre-, one month post-, and 6-months following treatment. Results There were no significant effects of the wait-list condition on any measure. Treatment led to significant improvements in all domains of sexual response, and a trend towards significance for reducing sexual distress. Perception of genital arousal during an erotic film was also significantly increased following the intervention despite no change in physiologically-measured sexual arousal. Conclusions A brief mindfulness-based intervention was effective for improving sexual functioning. Geographic restrictions permitted only a select sample of survivors to participate, thus, the generalizability of the findings is limited. Future studies should aim to develop online modalities for treatment administration to overcome this limitation. PMID:22293042

  20. Phase II trial of nab-paclitaxel in the treatment of recurrent or persistent advanced cervix cancer: A gynecologic oncology group study

    PubMed Central

    Alberts, David S.; Blessing, John A.; Landrum, Lisa M.; Warshal, David P.; Martin, Lainie P.; Rose, Stephen L.; Bonebrake, Albert J.; Ramondetta, Lois M.

    2013-01-01

    Background Metastatic and recurrent, platinum resistant cervix cancer has an extremely poor prognosis. The Gynecologic Oncology Group has studied >20 cytotoxic drugs or drug combinations in the second-line, phase II setting of advanced, drug resistant cervix cancer. Methods Nanoparticle, albumin-bound paclitaxel (nab-paclitaxel) was administered at 125 mg/m2 IV over 30 minutes on days 1, 8 and 15 of each 28 day cycle to 37 women with metastatic or recurrent cervix cancer that had progressed or relapsed following first-line cytotoxic drug treatment. A flexible, 2-stage accrual design that allowed stopping early for lack of treatment activity was utilized. Because of slow patient accrual, the second stage was not completed. Results Of 37 patients enrolled, 2 were ineligible due to no prior cytotoxic chemotherapy, which left 35 eligible patients evaluable for response and tolerability. All of the eligible patients had 1 prior chemotherapy regimen and 27 of them had prior radiation therapy with concomitant cisplatin. The median number of nab-paclitaxel cycles were 4 (range 1–15). Ten (28.6%; CI 14.6%–46.3%) of the 35 patients had a partial response and another 15 patients (42.9%) had stable disease. The median progression-free and overall survival were 5.0 and 9.4 months, respectively. The only NCI CTCAE grade 4 event was neutropenia in 2 patients (5.7%) which resolved following dose reduction. Grade 3 neurotoxicity was reported in 1 (2.9%) patient and resolved to grade 2 following dose discontinuation. Conclusions Nab-paclitaxel has considerable activity and moderate toxicity in the treatment of drug resistant, metastatic and recurrent cervix cancer. PMID:22986144

  1. SU-F-E-02: A Feasibility Study for Application of Metal Artifact Reduction Techniques in MR-Guided Brachytherapy Gynecological Cancer with Titanium Applicators

    SciTech Connect

    Kadbi, M

    2016-06-15

    Purpose: Utilization of Titanium Tandem and Ring (T&R) applicators in MR-guided brachytherapy has become widespread for gynecological cancer treatment. However, Titanium causes magnetic field disturbance and susceptibility artifact, which complicate image interpretation. In this study, metal artifact reduction techniques were employed to improve the image quality and reduce the metal related artifacts. Methods: Several techniques were employed to reduce the metal artifact caused by titanium T&R applicator. These techniques include Metal Artifact Reduction Sequence (MARS), View Angle Tilting (VAT) to correct in-plane distortion, and Slice Encoding for Metal Artifact Correction (SEMAC) for through-plane artifact correction. Moreover, MARS can be combined with VAT to further reduce the in-plane artifact by reapplying the selection gradients during the readout (MARS+VAT). SEMAC uses a slice selective excitation but acquires additional z-encodings in order to resolve off-resonant signal and to reduce through-plane distortions. Results: Comparison between the clinical sequences revealed that increasing the bandwidth reduces the error in measured diameter of T&R. However, the error is larger than 4mm for the best case with highest bandwidth and spatial resolution. MARS+VAT with isotropic resolution of 1mm reduced the error to 1.9mm which is the least among the examined 2D sequences. The measured diameter of tandem from SEMAC+VAT has the closest value to the actual diameter of tandem (3.2mm) and the error was reduced to less than 1mm. In addition, SEMAC+VAT significantly reduces the blooming artifact in the ring compared to clinical sequences. Conclusion: A higher bandwidth and spatial resolution sequence reduces the artifact and diameter of applicator with a slight compromise in SNR. Metal artifact reduction sequences decrease the distortion associated with titanium applicator. SEMAC+VAT sequence in combination with VAT revealed promising results for titanium imaging and

  2. Gynecological Care and Information

    ERIC Educational Resources Information Center

    Cibley, Leonard

    1978-01-01

    Based upon his experience as gynecologist at the Fernald School, the author suggests a set of criteria for establishing and running a gynecology program at an institution for the mentally retarded. (SBH)

  3. Microarrays in cancer research.

    PubMed

    Grant, Geraldine M; Fortney, Amanda; Gorreta, Francesco; Estep, Michael; Del Giacco, Luca; Van Meter, Amy; Christensen, Alan; Appalla, Lakshmi; Naouar, Chahla; Jamison, Curtis; Al-Timimi, Ali; Donovan, Jean; Cooper, James; Garrett, Carleton; Chandhoke, Vikas

    2004-01-01

    Microarray technology has presented the scientific community with a compelling approach that allows for simultaneous evaluation of all cellular processes at once. Cancer, being one of the most challenging diseases due to its polygenic nature, presents itself as a perfect candidate for evaluation by this approach. Several recent articles have provided significant insight into the strengths and limitations of microarrays. Nevertheless, there are strong indications that this approach will provide new molecular markers that could be used in diagnosis and prognosis of cancers. To achieve these goals it is essential that there is a seamless integration of clinical and molecular biological data that allows us to elucidate genes and pathways involved in various cancers. To this effect we are currently evaluating gene expression profiles in human brain, ovarian, breast and hematopoetic, lung, colorectal, head and neck and biliary tract cancers. To address the issues we have a joint team of scientists, doctors and computer scientists from two Virginia Universities and a major healthcare provider. The study has been divided into several focus groups that include; Tissue Bank Clinical & Pathology Laboratory Data, Chip Fabrication, QA/QC, Tissue Devitalization, Database Design and Data Analysis, using multiple microarray platforms. Currently over 300 consenting patients have been enrolled in the study with the largest number being that of breast cancer patients. Clinical data on each patient is being compiled into a secure and interactive relational database and integration of these data elements will be accomplished by a common programming interface. This clinical database contains several key parameters on each patient including demographic (risk factors, nutrition, co-morbidity, familial history), histopathology (non genetic predictors), tumor, treatment and follow-up information. Gene expression data derived from the tissue samples will be linked to this database, which

  4. Psychometric properties of the Chinese version of Sexual Function After Gynecologic Illness Scale (SFAGIS).

    PubMed

    Chow, Ka Ming; Chan, C W H; Choi, K C; Shiu, A T Y; Cheng, K K F; Ip, W Y; Wong, C M W

    2013-11-01

    This study aims to develop the Chinese version of the Sexual Function after Gynecologic Illness Scale (SFAGIS) and to establish its psychometric properties in Hong Kong Chinese patients with gynecological cancer. A Chinese version of SFAGIS was developed using the Brislin model of translation and guidelines for cross-cultural adaptation of scales. The content validity and semantic equivalence were assessed by an expert panel. The translated version of SFAGIS was administered to 150 Hong Kong Chinese women with gynecological cancer to test the scale's psychometric properties and to assess its feasibility. The convergent validity of the Chinese scale was tested by correlating it with the Chinese version of the sex relations subscale of the Psychosocial Adjustment to Illness Scale Self-Report (PAIS-SR). The average completion time for the Chinese SFAGIS was 16.2 ± 6.6 min. The internal consistency of the Chinese SFAGIS was 0.93. Test-retest reliability was also high with an interclass correlation coefficient 0.76. A Pearson product-moment correlation found strong correlations among the Chinese SFAGIS and the Chinese version of the sex relations subscale of the PAIS-SR, indicating that both scales measure the same as or has a similar construct. The Chinese version of SFAGIS is a reliable and valid instrument which can be used in clinical practice and research for assessing sexual function problems in Chinese patients with gynecological cancer and to identify those in need of attention.

  5. United We Stand? The Effects of a Couple-Coping Intervention on Adjustment to Early Stage Breast or Gynecological Cancer

    ERIC Educational Resources Information Center

    Scott, Jennifer L.; Halford, W. Kim; Ward, Bruce G.

    2004-01-01

    Cancer diagnosis affects the psychological well-being of both patients and their partners, and effective coping has been suggested to be a conjoint process of mutual support. Ninety-four married women with early stage cancer and their partners were randomly assigned to couples-based coping training (CanCOPE), individual coping training for the…

  6. United We Stand? The Effects of a Couple-Coping Intervention on Adjustment to Early Stage Breast or Gynecological Cancer

    ERIC Educational Resources Information Center

    Scott, Jennifer L.; Halford, W. Kim; Ward, Bruce G.

    2004-01-01

    Cancer diagnosis affects the psychological well-being of both patients and their partners, and effective coping has been suggested to be a conjoint process of mutual support. Ninety-four married women with early stage cancer and their partners were randomly assigned to couples-based coping training (CanCOPE), individual coping training for the…

  7. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Human primary breast tumor cells after 56 days of culture in a NASA Bioreactor. A cross-section of a construct, grown from surgical specimens of brease cancer, stained for microscopic examination, reveals areas of tumor cells dispersed throughout the non-epithelial cell background. The arrow denotes the foci of breast cancer cells. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cell (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunorous tissue. Credit: Dr. Jearne Becker, University of South Florida

  8. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Human primary breast tumor cells after 56 days of culture in a NASA Bioreactor. A cross-section of a construct, grown from surgical specimens of brease cancer, stained for microscopic examination, reveals areas of tumor cells dispersed throughout the non-epithelial cell background. The arrow denotes the foci of breast cancer cells. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cell (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunorous tissue. Credit: Dr. Jearne Becker, University of South Florida

  9. Cancer Research Center Hotline

    PubMed Central

    Cassel, Kevin D

    2010-01-01

    The rates of melanomas and skin cancers are increasing in the United States. Children attending elementary schools are in the most danger of acquiring these diseases later in life, and elementary school children in Hawai‘i have the greatest risk of all children in the United States. The parents and educators of Hawai‘i's elementary school age children are unaware of the potential risks for cancer that young children experience every day at school. Effective sun protection policies have been implemented in other jurisdictions, including Australia, that have similar risks for over-exposure to solar ultraviolet radiation in children. These proven policy models can inform sun protection practices in Hawai‘i. A simple policy whereby public elementary schools require that children wear ordinary long sleeves shirts and hats during the school's outdoor activities will protect Hawai‘i's children from overexposure to sun's ultraviolet radiation. Establishment of a state law codifying the implementation of this simple, yet scientifically proven strategy into the policies of Hawai‘i's public elementary schools can significantly reduce the incidence and deaths from melanoma and skin cancer in the state. PMID:21218379

  10. [Robotic surgery in gynecology].

    PubMed

    Csorba, Roland

    2012-06-24

    Minimally invasive surgery has revolutionized gynecological interventions over the past 30 years. The introduction of the da Vinci robotic surgery in 2005 has resulted in large changes in surgical management. The robotic platform allows less experienced laparoscopic surgeons to perform more complex procedures. It can be utilized mainly in general gynecology and reproductive gynecology. The robot is being increasingly used for procedures such as hysterectomy, myomectomy, adnexal surgery, and tubal anastomosis. In urogynecology, the robot is being utilized for sacrocolopexy as well. In the field of gynecologic oncology, the robot is being increasingly used for hysterectomy and lymphadenectomy in oncologic diseases. Despite the rapid and widespread adaption of robotic surgery in gynecology, there are no randomized trials comparing its efficacy and safety to other traditional surgical approaches. This article presents the development, technical aspects and indications of robotic surgery in gynecology, based on the previously published reviews. Robotic surgery can be highly advantageous with the right amount of training, along with appropriate patient selection. Patients will have less blood loss, less post-operative pain, faster recovery, and fewer complications compared to open surgery and laparoscopy. However, until larger randomized control trials are completed which report long-term outcomes, robotic surgery cannot be stated to have priority over other surgical methods.

  11. Comparisons of late vaginal mucosal reactions between interstitial and conventional intracavitary brachytherapy in patients with gynecological cancer: speculation on the relation between pallor reaction and stenosis.

    PubMed

    Yoshida, Ken; Yamazaki, Hideya; Nakamura, Satoaki; Masui, Koji; Kotsuma, Tadayuki; Baek, Sung Jae; Akiyama, Hironori; Tanaka, Eiichi; Yoshioka, Yasuo

    2013-09-01

    To examine late vaginal mucosal reactions in patients following interstitial brachytherapy (ISBT) compared with that of intracavitary brachytherapy (ICBT). We introduced a modified Dische score to examine late reactions in vaginal mucosa of patients with gynecological cancer who underwent vaginal brachytherapy at 6, 12, 18, 24, 36, and 60 months after treatment. A comparison was made between patients who underwent ISBT (n=37) and those under conventional ICBT (n=63) with a median follow-up time of 41 months. The ICBT group included only patients with newly diagnosed cervical cancer, whereas the ISBT group included 17 patients with recurrent and 20 with newly-diagnosed cancer. Grade 1 reactions of bleeding and discharge were exhibited by <12% of patients. Erythema was detected in approximately 30% (mainly grade 1) of the patients. A total of two (3%) patients developed superficial ulceration after ICBT, whereas three (8%) grade 1 ulcers were detected in patients after ISBT. Telangiectasias were detected in approximately 70% (60% grade 1 and 10% grade 2) of patients. No statistically significant difference was found between the patients after ISBT and ICBT. After ISBT, patients have a higher stenosis rate than after ICBT (p=0.003). The pallor scores showed a strong correlation with stenosis (p<0.0001) and were higher in patients after ICBT than in patients after ISBT (p=0.006). After ISBT, patients exhibited milder but similar late mucosal reactions compared to those after ICBT, except the fact that the stenosis was more severe and the pallor reaction was milder in these patients. It can be, therefore, concluded that the pallor reaction is related to stenosis.

  12. International Cancer Proteogenome Consortium | Office of Cancer Clinical Proteomics Research

    Cancer.gov

    The International Cancer Proteogenome Consortium (ICPC), is a voluntary scientific organization that provides a forum for collaboration among some of the world's leading cancer and proteogenomic research centers.

  13. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Human primary breast tumor cells after 49 days of growth in a NASA Bioreactor. Tumor cells aggregate on microcarrier beads (indicated by arrow). NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cell (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunorous tissue. Credit: Dr. Jearne Becker, University of South Florida

  14. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    High magnification of view of tumor cells aggregate on microcarrier beads, illustrting breast cells with intercellular boundaires on bead surface and aggregates of cells achieving 3-deminstional growth outward from bead after 56 days of culture in a NASA Bioreactor. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cell (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunorous tissue. Credit: Dr. Jearne Becker, University of South Florida.

  15. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    High magnification of view of tumor cells aggregate on microcarrier beads, illustrting breast cells with intercellular boundaires on bead surface and aggregates of cells achieving 3-deminstional growth outward from bead after 56 days of culture in a NASA Bioreactor. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cell (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunorous tissue. Credit: Dr. Jearne Becker, University of South Florida.

  16. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Human primary breast tumor cells after 49 days of growth in a NASA Bioreactor. Tumor cells aggregate on microcarrier beads (indicated by arrow). NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cell (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunorous tissue. Credit: Dr. Jearne Becker, University of South Florida

  17. A quantitative analysis of intensity-modulated radiation therapy plans and comparison of homogeneity indices for the treatment of gynecological cancers

    PubMed Central

    Pathak, Pushpraj; Vashisht, Sanjeev

    2013-01-01

    The aim of present study was to evaluate the intensity-modulated radiation therapy (IMRT) plans using different homogeneity and conformity indices in gynecological cancers, as well as to compare and find out the most reliable and accurate measure of the dose homogeneity among the available indices. In this study, a cohort of 12 patients were registered for evaluation, those receiving dynamic IMRT treatment on Clinac-2300C/D linear accelerator with 15-Mega Voltage (MV) photon beam. Dynamic IMRT plans were created on Eclipse treatment planning system with Helios dose volume optimization software. Homogeneity indices (HI) such as H index, modified H index, HI index, modified HI index, and S-index (sigma-index) proposed by M Yoon et al. (2007) were calculated and compared. The values of S-index vary from 1.63 to 2.99. The results indicate that the H and HI indices and their modified versions may not provide the correct dose homogeneity information, but the S-index provides accurate information about the dose homogeneity in the Planning Target Volume (PTV). Each plan was compared with 6-MV photon energy on the basis of S-index and conformity index (CI). Organs at risk (OAR) doses with 6-MV and 15-MV beams were also reported. PMID:23776309

  18. Laser treatment in gynecology

    NASA Astrophysics Data System (ADS)

    de Riese, Cornelia

    2004-07-01

    This presentation is designed as a brief overview of laser use in gynecology, for non-medical researchers involved in development of new laser techniques. The literature of the past decade is reviewed. Differences in penetration, absorption, and suitable delivery media for the beams dictate clinical application. The use of CO2 laser in the treatment of uterine cervical intraepithelial lesions is well established and indications as well as techniques have not changed over 30 years. The Cochrane Systematic Review from 2000 suggests no obviously superior technique. CO2 laser ablation of the vagina is also established as a safe treatment modality for VAIN. CO2 laser permits treatment of lesions with excellent cosmetic and functional results. The treatment of heavy menstrual bleeding by destruction of the endometrial lining using various techniques has been the subject of a 2002 Cochran Database Review. Among the compared treatment modalities are newer and modified laser techniques. Conclusion by reviewers is that outcomes and complication profiles of newer techniques compare favorably with the gold standard of endometrial resection. The ELITT diode laser system is one of the new successful additions. CO2 laser is also the dominant laser type used with laparoscopy for ablation of endometriotic implants. Myoma coagulation or myolysis with Nd:Yag laser through the laparoscope or hysteroscope is a conservative treatment option. Even MRI guided percutaneous approaches have been described. No long-term data are available.

  19. What's New in Research and Treatment of Melanoma Skin Cancer?

    MedlinePlus

    ... Melanoma Skin Cancer About Melanoma Skin Cancer What’s New in Melanoma Skin Cancer Research? Research into the ... Cancer? Key Statistics for Melanoma Skin Cancer What’s New in Melanoma Skin Cancer Research? More In Melanoma ...

  20. SU-E-J-124: FDG PET Metrics Analysis in the Context of An Adaptive PET Protocol for Node Positive Gynecologic Cancer Patients

    SciTech Connect

    Nawrocki, J; Chino, J; Light, K; Vergalasova, I; Craciunescu, O

    2014-06-01

    Purpose: To compare PET extracted metrics and investigate the role of a gradient-based PET segmentation tool, PET Edge (MIM Software Inc., Cleveland, OH), in the context of an adaptive PET protocol for node positive gynecologic cancer patients. Methods: An IRB approved protocol enrolled women with gynecological, PET visible malignancies. A PET-CT was obtained for treatment planning prescribed to 45–50.4Gy with a 55– 70Gy boost to the PET positive nodes. An intra-treatment PET-CT was obtained between 30–36Gy, and all volumes re-contoured. Standard uptake values (SUVmax, SUVmean, SUVmedian) and GTV volumes were extracted from the clinician contoured GTVs on the pre- and intra-treament PET-CT for primaries and nodes and compared with a two tailed Wilcoxon signed-rank test. The differences between primary and node GTV volumes contoured in the treatment planning system and those volumes generated using PET Edge were also investigated. Bland-Altman plots were used to describe significant differences between the two contouring methods. Results: Thirteen women were enrolled in this study. The median baseline/intra-treatment primary (SUVmax, mean, median) were (30.5, 9.09, 7.83)/( 16.6, 4.35, 3.74), and nodes were (20.1, 4.64, 3.93)/( 6.78, 3.13, 3.26). The p values were all < 0.001. The clinical contours were all larger than the PET Edge generated ones, with mean difference of +20.6 ml for primary, and +23.5 ml for nodes. The Bland-Altman revealed changes between clinician/PET Edge contours to be mostly within the margins of the coefficient of variability. However, there was a proportional trend, i.e. the larger the GTV, the larger the clinical contours as compared to PET Edge contours. Conclusion: Primary and node SUV values taken from the intratreament PET-CT can be used to assess the disease response and to design an adaptive plan. The PET Edge tool can streamline the contouring process and lead to smaller, less user-dependent contours.

  1. Obstetrics and Gynecology Hospitalist Fellowships.

    PubMed

    Vintzileos, Anthony M

    2015-09-01

    This article establishes the rationale and development of an obstetrics and gynecology (OB/GYN) hospitalist fellowship program. The pool of OB/GYN hospitalists needs to be drastically expanded to accommodate the country's needs. Fellowship programs should provide extra training and confidence for recent resident graduates who want to pursue a hospitalist career. Fellowships should train physicians in a way that aligns their interests with those of the hospital with respect to patient care, teaching, and research. Research in the core measures should be a necessary component of the fellowship so as to provide long-term benefits for all stakeholders, including hospitals and patients.

  2. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Isolation of human mammary epithelial cells (HMEC) from breast cancer susceptible tissue. Same long-term growth human mammary epithelial cells (HMEC), but after 3 weeks in concinuous culture. Note attempts to reform duct elements, but this time in two dimensions in a dish rather that in three demensions in tissue. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cell (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunorous tissue. Credit: Dr. Robert Tichmond, NASA/Marshall Space Flight Center (MSFC).

  3. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Isolation of human mammary epithelial cells (HMEC) from breast cancer susceptible tissue. Isolate of long-term growth human mammary epithelial cells (HMEC) from outgrowth of duct element; cells shown soon after isolation and early in culture in a dish. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cell (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunorous tissue. Credit: Dr. Robert Tichmond, NASA/Marshall Space Flight Center (MSFC).

  4. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Isolation of human mammary epithelial cells (HMEC) from breast cancer susceptible tissue. Outgrowth of cells from duct element in upper right corner cultured in a standard dish; most cells spontaneously die during early cell divisions, but a few will establish long-term growth. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cell (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunorous tissue. Credit: Dr. Robert Tichmond, NASA/Marshall Space Flight Center (MSFC).

  5. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Isolation of human mammary epithelial cells (HMEC) from breast cancer susceptible tissue. Outgrowth of cells from duct element in upper right corner cultured in a standard dish; most cells spontaneously die during early cell divisions, but a few will establish long-term growth. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cell (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunorous tissue. Credit: Dr. Robert Tichmond, NASA/Marshall Space Flight Center (MSFC).

  6. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Isolation of human mammary epithelial cells (HMEC) from breast cancer susceptible tissue. Same long-term growth human mammary epithelial cells (HMEC), but after 3 weeks in concinuous culture. Note attempts to reform duct elements, but this time in two dimensions in a dish rather that in three demensions in tissue. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cell (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunorous tissue. Credit: Dr. Robert Tichmond, NASA/Marshall Space Flight Center (MSFC).

  7. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Isolation of human mammary epithelial cells (HMEC) from breast cancer susceptible tissue. Isolate of long-term growth human mammary epithelial cells (HMEC) from outgrowth of duct element; cells shown soon after isolation and early in culture in a dish. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cell (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunorous tissue. Credit: Dr. Robert Tichmond, NASA/Marshall Space Flight Center (MSFC).

  8. Outcome of stage IVA cervical cancer patients with disease limited to the pelvis in the era of chemoradiation: a Gynecologic Oncology Group study.

    PubMed

    Rose, Peter G; Ali, Shamshad; Whitney, Charles W; Lanciano, Rachelle; Stehman, Frederick B

    2011-06-01

    To evaluate the outcome of stage IVA cervical cancer treated with radiation and concurrent cisplatin-based chemotherapy. We conducted a retrospective study of stage IVA cervical cancer patients from four trials (Gynecologic Oncology Group protocols 56, 85, 120, and 165) treated with radiotherapy with or without concurrent cisplatin-based chemotherapy. Patient records were reviewed for demographic and tumor features, treatment, and progression-free survival (PFS) and overall survival (OS). Stage IVA patients were compared to stage IIIB patients from these same studies. Among the 51 stage IVA patients studied, 92% were stage IVA on the basis of bladder involvement. The median PFS was 10.1 months (95% CI=6.3-14.5 months) and median OS was 21.2 months (95% CI=13.3-30.5 months). The 3 year survival was 32%. On univariate analysis, only advanced age was associated with OS (p=0.0115) but age had only marginal effect on PFS (p=0.083). Pathologic proven pelvic nodal metastasis was of marginal significance for both PFS and OS, p=0.059 and 0.064, respectively. Despite similar patient characteristics, the use of cisplatin-based chemotherapy had no impact on PFS or OS but was underpowered to address this question. When compared to stage IIIB patients, stage IVA patients had a poorer performance status (p=0.0231), larger tumor size (p=0.0302), and more frequent bilateral parametrial involvement (0.0063). Patients with stage IVA disease had poor median survival of only 21 months with only 32% 3 year survival. Stage IVA patients have larger tumor size, more bilateral parametrial involvement, and poorer survival when compared to stage IIIB patients. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Ribonucleotide reductase inhibition restores platinum-sensitivity in platinum-resistant ovarian cancer: a Gynecologic Oncology Group Study.

    PubMed

    Kunos, Charles; Radivoyevitch, Tomas; Abdul-Karim, Fadi W; Fanning, James; Abulafia, Ovadia; Bonebrake, Albert J; Usha, Lydia

    2012-04-27

    The potent ribonucleotide reductase (RNR) inhibitor 3-aminopyridine-2-carboxyaldehyde-thiosemicarbazone (3-AP) was tested as a chemosensitizer for restored cisplatin-mediated cytotoxicity in platinum-resistant ovarian cancer. Preclinical in vitro platinum-resistant ovarian cancer cell survival, RNR activity, and DNA damage assays were done after cisplatin or cisplatin plus 3-AP treatments. Six women with platinum-resistant ovarian cancer underwent four-day 3-AP (96 mg/m(2), day one to four) and cisplatin (25 mg/m(2), day two and three) infusions every 21 days until disease progression or adverse effects prohibited further therapy. Pre-therapy ovarian cancer tissues were analyzed by immunohistochemistry for RNR subunit expression as an indicator of cisplatin plus 3-AP treatment response. 3-AP preceding cisplatin exposure in platinum-resistant ovarian cancer cells was not as effective as sequencing cisplatin plus 3-AP together in cell survival assays. Platinum-mediated DNA damage (i.e., γH2AX foci) resolved quickly after cisplatin-alone or 3-AP preceding cisplatin exposure, but persisted after a cisplatin plus 3-AP sequence. On trial, 25 four-day overlapping 3-AP and cisplatin cycles were administered to six women (median 4.2 cycles per patient). 3-AP-related methemoglobinemia (range seven to 10%) occurred in two (33%) of six women, halting trial accrual. When sequenced cisplatin plus 3-AP, RNR inhibition restored platinum-sensitivity in platinum-resistant ovarian cancers. 3-AP (96 mg/m(2)) infusions produced modest methemoglobinemia, the expected consequence of ribonucleotide reductase inhibitors disrupting collateral proteins containing iron. ClinicalTrials.gov NCT00081276.

  10. Ribonucleotide reductase inhibition restores platinum-sensitivity in platinum-resistant ovarian cancer: a Gynecologic Oncology Group Study

    PubMed Central

    2012-01-01

    Background The potent ribonucleotide reductase (RNR) inhibitor 3-aminopyridine-2-carboxyaldehyde-thiosemicarbazone (3-AP) was tested as a chemosensitizer for restored cisplatin-mediated cytotoxicity in platinum-resistant ovarian cancer. Methods Preclinical in vitro platinum-resistant ovarian cancer cell survival, RNR activity, and DNA damage assays were done after cisplatin or cisplatin plus 3-AP treatments. Six women with platinum-resistant ovarian cancer underwent four-day 3-AP (96 mg/m2, day one to four) and cisplatin (25 mg/m2, day two and three) infusions every 21 days until disease progression or adverse effects prohibited further therapy. Pre-therapy ovarian cancer tissues were analyzed by immunohistochemistry for RNR subunit expression as an indicator of cisplatin plus 3-AP treatment response. Results 3-AP preceding cisplatin exposure in platinum-resistant ovarian cancer cells was not as effective as sequencing cisplatin plus 3-AP together in cell survival assays. Platinum-mediated DNA damage (i.e., γH2AX foci) resolved quickly after cisplatin-alone or 3-AP preceding cisplatin exposure, but persisted after a cisplatin plus 3-AP sequence. On trial, 25 four-day overlapping 3-AP and cisplatin cycles were administered to six women (median 4.2 cycles per patient). 3-AP-related methemoglobinemia (range seven to 10%) occurred in two (33%) of six women, halting trial accrual. Conclusions When sequenced cisplatin plus 3-AP, RNR inhibition restored platinum-sensitivity in platinum-resistant ovarian cancers. 3-AP (96 mg/m2) infusions produced modest methemoglobinemia, the expected consequence of ribonucleotide reductase inhibitors disrupting collateral proteins containing iron. Trial registry ClinicalTrials.gov NCT00081276 PMID:22541066

  11. Effects of Anma massage therapy (Japanese massage) for gynecological cancer survivors: study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Cancer patients and survivors regularly feel anxious about cancer recurrence or death, even after the conclusion of medical treatment, and they are often highly physiologically and psychologically stressed. Massage therapy is one of the most widely used complementary and alternative therapies used in the hope of alleviating such stress and physical and psychological complaints and to improve health-related quality of life. This randomized phase III, two-armed, parallel group, clinical trial was designed after obtaining positive findings in a preliminary study. The primary objective is to verify the effects of continuous Japanese massage therapy, referred to as Anma therapy, for cancer survivors. The secondary objective is to confirm the immediate effects of a single Anma massage session for cancer survivors. Methods/Design Sixty cancer survivors older than 20 years of age who have had histologically confirmed uterine cervical, endometrial, ovarian, fallopian tube or peritoneal cancer in the past, but with no recurrence for more than 3 years since receiving standard medical treatment, are being recruited by gynecologists in medical facilities. In the coordinating office, they are randomly allocated to two groups (n = 30 each): an Anma massage group receiving a 40-min Anma massage session once weekly over a 2-month intervention period (total of eight Anma massage sessions) and a control group being followed by medical doctors and receiving no Anma massage sessions. The primary end point is the severity of physical subjective symptoms that cancer survivors report in daily life, assessed using a Visual Analogue Scale. Secondary end points are urine and saliva analyses, psychological condition and health-related quality-of-life scores as determined on the basis of a self-report questionnaire. Discussion Using the evidence-based findings of this trial, medical professionals should be able to explain the benefits conferred by Anma massage to cancer survivors

  12. Detroit Research on Cancer Survivors Study

    Cancer.gov

    An NCI press release about the launch of the Detroit Research on Cancer Survivors (ROCS) study, which will look at factors affecting cancer progression, recurrence, mortality, and quality of life among African-American cancer survivors.

  13. What's New in Prostate Cancer Research and Treatment?

    MedlinePlus

    ... Cancer Research? Prostate Cancer About Prostate Cancer What’s New in Prostate Cancer Research? Research into the causes, ... in many medical centers throughout the world. Genetics New research on gene changes linked to prostate cancer ...

  14. What is the role of retroperitoneal exploration in optimally debulked stage IIIC epithelial ovarian cancer? An NRG Oncology/Gynecologic Oncology Group ancillary data study.

    PubMed

    Rungruang, Bunja J; Miller, Austin; Krivak, Thomas C; Horowitz, Neil S; Rodriguez, Noah; Hamilton, Chad A; Backes, Floor J; Carson, Linda F; Friedlander, Michael; Mutch, David G; Goodheart, Michael J; Tewari, Krishnansu S; Wenham, Robert M; Bookman, Michael A; Maxwell, G Larry; Richard, Scott D

    2017-05-15

    The purpose of this study was to determine the effect of retroperitoneal (RP) exploration on progression-free survival (PFS) and overall survival (OS) in epithelial ovarian cancer (EOC) patients with stage IIIC disease who underwent optimal debulking surgery. Data were collected from records of the Gynecologic Oncology Group 182 (GOG-182) study of stage IIIC EOC patients cytoreduced to no gross residual disease (R0) or minimal gross residual (<1 cm) disease (MGRD) at primary surgery. Patients with stage IIIC disease by intraperitoneal (IP) tumor were included and divided into 3 groups: 1) > 2 cm IP tumor without lymph node involvement (IP/RP-), 2) > 2 cm IP tumor with lymph node involvement (IP/RP+), and 3) > 2 cm IP tumor with no RP exploration (IP/RP?). The effects of disease distribution and RP exploration on PFS and OS were assessed using Kaplan-Meier and proportional hazards methods. There were 1871 stage IIIC patients in GOG-182 who underwent optimal primary debulking surgery. Of these, 689 (36.8%) underwent RP exploration with removal of lymph nodes from at least 1 para-aortic site, and 1182 (63.2%) did not. There were 269 patients in the IP/RP- group, 420 patients in the IP/RP + group, and 1182 patients in the IP/RP? group. Improved PFS (18.5 vs 16.0 months; P < .0001) and OS (53.3 vs 42.8 months; P < .0001) were associated with RP exploration versus no exploration. Patients with MGRD had improved PFS (16.8 vs 15.1 months, P = 0.0108) and OS (44.9 vs 40.5 months, P = 0.0076) versus no exploration. RP exploration at the time of primary surgery in patients with optimally debulked stage IIIC EOC is associated with a survival benefit. Cancer 2017;123:985-93. © 2016 American Cancer Society. © 2016 American Cancer Society.

  15. World gynecologic oncology publications and the Turkish contribution to the literature between 2000 and 2007.

    PubMed

    Dursun, Polat; Gultekin, Murat; Ayhan, Ali

    2011-01-01

    To investigate the number of publications and the contribution from top-ranking countries, institutions, and authors in 3 gynecologic oncology journals (Gynecologic Oncology [GO], International Journal of Gynecological Cancer [IJGC], and European Journal of Gynaecological Oncology [EJGO]),as well as the degree of Turkish contribution between 2000 and 2007. Articles published between 2000 and 2007 in 3 gynecologic oncology journals indexed by the Science Citation Index were accessed via the ISI-Thomson website. Additionally, PubMed, Sciencedirect, and Blackwell-Synergy databases were used to identify the originating countries and institutions of the published articles. The types of articles, originating countries, and names of the institutions and authors were determined. Furthermore, the number of articles affiliated with Turkish institutions and the publication year were also determined. We located 6,851 articles published in the 3 journals. During this period 36.1%, 7.7%, 7.2%, 5.8% and 4.8% of the papers originated from the USA, Japan, Italy, Turkey, and England, respectively. The 5 most productive institutions were the University of Texas, Memorial Sloan-Kettering Cancer Center, Roswell Park Cancer Institute, University of Alabama, and University of Athens. The 5 most productive authors were Markman (USA), Chi (USA), Ayhan (Turkey), Barakat (USA), and Vergote (Belgium), respectively. In all, 36.1% of the papers originated from the USA, while 44% originated from 17 European countries. The USA was the first-ranked country of origin in GO and IJGC, while Turkey was the first-ranked country of origin in EJGO. Overall, 399 (5.8%) papers originated from Turkish institutions. Most of the gynecologic oncology publications originated from the USA and Western European countries, where gynecologic oncology training is available and surgical and research traditions are well established. On the other hand, Turkish researchers made an important contribution to gynecologic

  16. Update on adolescent gynecology.

    PubMed

    Granada, Catalina; Omar, Hatim; Loveless, Meredith Buonanno

    2013-04-01

    Adolescent gynecology is an important part of clinical care of adolescent females. This discussion provides a basic review of current issues in adolescent gynecology, including consideration of current pubertal concepts with attention also given to delayed and precocious puberty. Causes of breast masses are reviewed, including discussion of the ANDI classification. It is recommended that physicians provide sexuality education to their adolescent patients, in addition to the community, to reduce the high rates of unintended adolescent pregnancy and STIs in teens that continue in the United States. Finally, attention is provided to ovarian masses and their management. Adolescent medicine physicians may have to work with a variety of specialists in their care of adolescents and the many gynecologic conditions that may arise.

  17. Hearing the Silenced Voices of Underserved Women: The Role of Qualitative Research in Gynecologic and Reproductive Care.

    PubMed

    Lawson, Angela K; Marsh, Erica E

    2017-03-01

    In order to provide effective evidence-based health care to women, rigorous research that examines women's lived experiences in their own voices is needed. However, clinical health research has often excluded the experiences of women and minority patient populations. Further, clinical research has often relied on quantitative research strategies; this provides an interesting but limited understanding of women's health experiences and hinders the provision of effective patient-centered care. This article defines qualitative research and its unique contributions to research, and provides examples of how qualitative research has given insights into the reproductive health perspectives and behaviors of underserved women. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Innovative techniques in radiation oncology. Clinical research programs to improve local and regional control in cancer

    SciTech Connect

    Brady, L.W.; Markoe, A.M.; Micaily, B.; Fisher, S.A.; Lamm, F.R. )

    1990-02-01

    There is a growing importance in failure analysis in cancer management. In these analyses locoregional failure as the cause of death emerges as a significant problem in many tumor sites, e.g., head and neck cancer, gynecologic cancer, genitourinary cancer. Because of these data, the radiation oncology community has attributed high priority to research efforts to improve locoregional control. These efforts include the following: (1) brachytherapy alone or with external beam radiation therapy or surgery; (2) intraoperative radiation therapy; (3) hyperthermia with radiation therapy; (4) particle irradiation (protons, neutrons, stripped nuclei, and pions); and (5) routes of administration of the treatment, including infusional (intravenous) chemotherapy with radiation therapy, intraarterial monoclonal antibodies with radionuclides, and intraarterial chemotherapy with radiation therapy. Each area of investigation is discussed.

  19. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cells (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunourous tissues. Here, two High-Aspect Ratio Vessels turn at about 12 rmp to keep breast tissue constructs suspended inside the culture media. Syringes allow scientists to pull for analysis during growth sequences. The tube in the center is a water bubbler that dehumidifies the air to prevent evaporation of the media and thus the appearance of destructive bubbles in the bioreactor.

  20. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cells (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunourous tissues. Here, two High-Aspect Ratio Vessels turn at about 12 rmp to keep breast tissue constructs suspended inside the culture media. Syringes allow scientists to pull for analysis during growth sequences. The tube in the center is a water bubbler that dehumidifies the air to prevent evaporation of the media and thus the appearance of destructive bubbles in the bioreactor.

  1. FGFR2 mutations are associated with poor outcomes in endometrioid endometrial cancer: An NRG Oncology/Gynecologic Oncology Group study.

    PubMed

    Jeske, Yvette W; Ali, Shamshad; Byron, Sara A; Gao, Feng; Mannel, Robert S; Ghebre, Rahel G; DiSilvestro, Paul A; Lele, Shashikant B; Pearl, Michael L; Schmidt, Amy P; Lankes, Heather A; Ramirez, Nilsa C; Rasty, Golnar; Powell, Matthew; Goodfellow, Paul J; Pollock, Pamela M

    2017-05-01

    Activating FGFR2 mutations have been identified in ~10% of endometrioid endometrial cancers (ECs). We have previously reported that mutations in FGFR2 are associated with shorter disease free survival (DFS) in stage I/II EC patients. Here we sought to validate the prognostic importance of FGFR2 mutations in a large, multi-institutional patient cohort. Tumors were collected as part of the GOG 210 clinical trial "Molecular Staging of Endometrial Cancer" where samples underwent rigorous pathological review and had more than three years of detailed clinical follow-up. DNA was extracted and four exons encompassing the FGFR2 mutation hotspots were amplified and sequenced. Mutations were identified in 144 of the 973 endometrioid ECs, of which 125 were classified as known activating mutations and were included in the statistical analyses. Consistent with FGFR2 having an association with more aggressive disease, FGFR2 mutations were more common in patients initially diagnosed with stage III/IV EC (29/170;17%) versus stage I/II EC (96/803; 12%; p=0.07, Chi-square test). Additionally, incidence of progression (progressed, recurred or died from disease) was significantly more prevalent (32/125, 26%) among patients with FGFR2 mutation versus wild type (120/848, 14%; p<0.001, Chi-square test). Using Cox regression analysis adjusting for known prognostic factors, patients with FGFR2 mutation had significantly (p<0.025) shorter progression-free survival (PFS; HR 1.903; 95% CI 1.177-3.076) and endometrial cancer specific survival (ECS; HR 2.013; 95% CI 1.096-3.696). In summary, our findings suggest that clinical trials testing the efficacy of FGFR inhibitors in the adjuvant setting to prevent recurrence and death are warranted. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Basic Research and Progress against Cancer

    Cancer.gov

    An infographic about the importance of basic research for making progress against cancer. The graphic shows the research milestones that led to the development and approval of crizotinib (Xalkori®) to treat certain non-small cell lung cancers.

  3. Gene-Environment Research and Cancer Epidemiology

    Cancer.gov

    The Epidemiology and Genomics Research Program supports extramural research that investigates both genetic and environmental factors that may contribute to the etiology of cancer and/or impact cancer outcomes.

  4. Media | Office of Cancer Clinical Proteomics Research

    Cancer.gov

    The Office of Cancer Clinical Proteomics Research (OCCPR) is committed to providing the media with timely and accurate information.  This section offers key resources for patients, cancer researchers, physicians, and media professionals.

  5. Strengthening the Cancer Research Enterprise - Annual Plan

    Cancer.gov

    NCI's expanding infrastructure, support for scientists at every career stage, and funding of small business innovation enables discoveries that advance cancer research. Read more about how NCI is strenghtening the cancer research enterprise.

  6. About the Cancer Biomarkers Research Group | Division of Cancer Prevention

    Cancer.gov

    The Cancer Biomarkers Research Group promotes research to identify, develop, and validate biological markers for early cancer detection and cancer risk assessment. Activities include development and validation of promising cancer biomarkers, collaborative databases and informatics systems, and new technologies or the refinement of existing technologies. NCI DCP News Note Consortium on Imaging and Biomarkers (CIB) Created: Eight Grants Awarded to Improve Accuracy of Cancer Screening, Detection, and Diagnosis |

  7. Basic research in kidney cancer.

    PubMed

    Oosterwijk, Egbert; Rathmell, W Kimryn; Junker, Kerstin; Brannon, A Rose; Pouliot, Frédéric; Finley, David S; Mulders, Peter F A; Kirkali, Ziya; Uemura, Hirotsugo; Belldegrun, Arie

    2011-10-01

    Advances in basic research will enhance prognosis, diagnosis, and treatment of renal cancer patients. To discuss advances in our understanding of the molecular basis of renal cancer, targeted therapies, renal cancer and immunity, and genetic factors and renal cell carcinoma (RCC). Data on recently published (2005-2011) basic science papers were reviewed. Advances in basic research have shown that renal cancers can be subdivided based on specific genetic profiles. Now that this molecular basis has been established, it is becoming clear that additional events play a major role in the development of renal cancer. For example, aberrant chromatin remodelling appears to be a main driving force behind tumour progression in clear cell RCC. A large number of potential biomarkers have emerged using various high-throughput platforms, but adequate biomarkers for RCC are still lacking. To bring the potential biomarkers and biomarker profiles to the clinical arena is a major challenge for the field. The introduction of tyrosine kinase inhibitors (TKIs) for therapy has shifted the interest away from immunologic approaches. Nevertheless, a wealth of evidence supports immunotherapy for RCC. Interestingly, studies are now appearing that suggest a combination of TKI and immunotherapy may be beneficial. Thus far, little attention has been paid to patient-specific differences. With high-throughput methods becoming cheaper and with the advances in sequencing possibilities, this situation is expected to change rapidly. Great strides have been made in the understanding of molecular mechanisms of RCC. This has led this field to the enviable position of having a range of molecularly targeted therapies. Large sequencing efforts are now revealing more and more genes responsible for tumour development and progression, offering new targets for therapy. It is foreseen that through integration of high-throughput platforms, personalised cancer treatment for RCC patients will become possible

  8. Fluorescence diagnostics in oncological gynecology

    NASA Astrophysics Data System (ADS)

    Belyaeva, Ludmila A.; Adamyan, Leila V.; Kozachenko, Vladimir P.; Stratonnikov, Alexander A.; Stranadko, Eugene F.; Loschenov, Victor B.

    2003-10-01

    The method of fluorescent diagnostics (FD) of tumors is a promising tool that may allow to increase sensitivity of tumor detection especially at initial stages. One of the most promising photosensitizers today is 5-aminolevulinic acid (5-ALA) that, actually, is not photosensitizer itself but precursor of protoporphyrin IX (PpIX). This paper deals with cancer diagnostics in gynecology by means of ALA-induced Pp IX laser-fluorescence spectroscopy. The tissue fluorescence spectra in vivo were studied in patients with various pathologies of ovaries, uterine and vulva after 5-aminolevulinic acid administration. It was shown that different pathologies varies in accumulation of Pp IX. Coefficient of fluorescence kf for normal tissue is not high, but exceptions are endometrium and mucous membrane of uterine tubes. Benign tumors of uterus and ovary have low values of kf, but polyps of endometrium exhibit high kf. Optical express-biopsy is important for diagnosis of ovarian cancer and micrometastatic spread. Coefficients of diagnostic contrast were determined for cancer of endometrium, cervical cancer, vulvar cancer.

  9. Robotic surgery in gynecology

    PubMed Central

    Sinha, Rooma; Sanjay, Madhumati; Rupa, B.; Kumari, Samita

    2015-01-01

    FDA approved Da Vinci Surgical System in 2005 for gynecological surgery. It has been rapidly adopted and it has already assumed an important position at various centers where this is available. It comprises of three components: A surgeon's console, a patient-side cart with four robotic arms and a high-definition three-dimensional (3D) vision system. In this review we have discussed various robotic-assisted laparoscopic benign gynecological procedures like myomectomy, hysterectomy, endometriosis, tubal anastomosis and sacrocolpopexy. A PubMed search was done and relevant published studies were reviewed. Surgeries that can have future applications are also mentioned. At present most studies do not give significant advantage over conventional laparoscopic surgery in benign gynecological disease. However robotics do give an edge in more complex surgeries. The conversion rate to open surgery is lesser with robotic assistance when compared to laparoscopy. For myomectomy surgery, Endo wrist movement of robotic instrument allows better and precise suturing than conventional straight stick laparoscopy. The robotic platform is a logical step forward to laparoscopy and if cost considerations are addressed may become popular among gynecological surgeons world over. PMID:25598600

  10. What's New in Colorectal Cancer Research and Treatment?

    MedlinePlus

    ... Cancer Research? Colorectal Cancer About Colorectal Cancer What’s New in Colorectal Cancer Research? Research is always going ... ways to find colorectal cancer early by studying new types of screening tests and improving the ones ...

  11. 5th Ovarian Cancer Consensus Conference of the Gynecologic Cancer InterGroup (GCIG): Clinical trial design for rare ovarian tumours.

    PubMed

    Leary, A F; Quinn, M; Fujiwara, K; Coleman, R L; Kohn, E; Sugiyama, T; Glasspool, R; Ray-Coquard, I; Colombo, N; Bacon, M; Zeimet, A; Westermann, A; Gomez-Garcia, E; Provencher, D; Welch, S; Small, W; Millan, D; Okamoto, A; Stuart, G; Ochiai, K

    2016-12-19

    This manuscript reports the consensus statements on designing clinical trials in rare ovarian tumours reached at the 5th Ovarian Cancer Consensus Conference (OCCC) held in Tokyo, November 2015. Three important questions were identified concerning rare ovarian tumours (rare epithelial ovarian cancers (eOC), sex-cord stromal tumours (SCST) and germ cell tumours (GCT)): (1) What are the research and trial issues that are unique to rare ovarian tumours? There is a lack of randomised phase III data defining standards of care which makes it difficult to define control arms, but identifies unmet needs that merit investigation. Internationally agreed upon diagnostic criteria, expert pathological review, and translational research are crucial. (2) What should be investigated in rare eOC, GCT and SCST? Trials dedicated to each rare ovarian tumour should be encouraged. Nonetheless, where the question is relevant, rare eOC can be included in eOC trials but with rigorous stratification. Although there is emerging evidence suggesting that rare eOC have different molecular profiles, trials are needed to define new type-specific standards for each rare eOC (clear cell, low grade serous and mucinous). For GCTs, a priority is reducing toxicities from treatment while maintaining cure rates. Both a robust prognostic scoring system and more effective treatments for de novo poor prognosis and relapsed GCTs are needed. For SCSTs, validated prognostic markers as well as alternatives to the current standard of bleomycin/etoposide/cisplatin (BEP) should be identified. (3) Are randomised trials feasible? Randomised controlled trials (RCT) should be feasible in any of the rare tumours through international collaboration. Ongoing trials have already demonstrated the feasibility of RCT in rare eOC and SCST. Mucinous OC may be considered for inclusion, stratified, into RCTs of non-gynaecological mucinous tumours, while RCTs in high risk or relapsed GCT may be performed as a subset of male and

  12. A Phase II Evaluation of Gefitinib in the Treatment of Persistent or Recurrent Endometrial Cancer: A Gynecologic Oncology Group Study

    PubMed Central

    Leslie, Kimberly K.; Sill, Michael W.; Fischer, Edgar; Darcy, Kathleen M.; Mannel, Robert S.; Tewari, Krishnansu S.; Hanjani, Parviz; Wilken, Jason A.; Baron, Andre T.; Godwin, Andrew K.; Schilder, Russell J.; Singh, Meenakshi; Maihle, Nita J.

    2013-01-01

    Background A phase II trial was performed to evaluate the efficacy and safety of gefitinib in patients with persistent/recurrent endometrial cancer. Methods Women with histologically confirmed persistent/recurrent endometrial cancer were treated with 500 mg oral gefitinib daily until progression or severe toxicity, with progression-free survival (PFS) at six months as the primary endpoint. Tumor expression of total epidermal growth factor receptor (EGFR), estrogen receptor (ER), progesterone receptor A (PRA) and B (PRB), Ki67, pEGFR and activated extracellular signal-regulated kinase (pERK) were examined pre- and post-treatment. EGFR was sequenced, and serum concentrations of soluble EGFR (sEGFR) at baseline also were examined. Results Of 29 patients enrolled, 26 were evaluable for efficacy and toxicity. Four patients experienced PFS ≥6 months, and one had a complete response which was not associated with an EGFR mutation. The concentration of sEGFR in pretreatment serum was positively correlated with overall survival (OS), but not with responsiveness to gefitinib in this small patient cohort. Expression of tumor biomarkers was not associated with PFS or OS. Co-expression of ER with PRA in primary and recurrent tumors, and pEGFR with pERK in primary tumors was observed. Conclusions This treatment regimen was tolerable but lacked sufficient efficacy to warrant further evaluation in this setting. The possible association between serum sEGFR concentrations and OS, and temporal changes in expression of pEGFR and pERK and the documented CR of one patient are interesting and warrant additional investigation. PMID:23438670

  13. Prostate Cancer Research Training Program

    DTIC Science & Technology

    2011-05-01

    this laboratory concentrates on the area of tumor immunology with an emphasis on immunotherapy. We have constructed microbial vaccines to be used...to the transgene product induced by the vaccine are underway. Additionally, we are carrying our "translational" research in the form of clinical...trials of our adenovirus vaccine in men with prostate cancer. Important in these trials is the safety of the vaccine and its ability to induce anti

  14. Prostate Cancer Research Training Program

    DTIC Science & Technology

    2012-05-01

    i mmunology with an emphasis on immunotherapy. We ha ve constructed microbial vaccines to be used for the investigation of gene and immunotherapy... vaccine are underway. Additionally, we are carrying our "translational" research in the fo rm of clinical trials of our adenovirus vaccine in men with...prostate cancer. Important in thes e trials is the safety of the vaccine and its ability to in duce anti-tumor immunity. We have recently completed

  15. Urinary complications of gynecologic surgery: iatrogenic urinary tract system injuries in obstetrics and gynecology operations.

    PubMed

    Ozdemir, E; Ozturk, U; Celen, S; Sucak, A; Gunel, M; Guney, G; Imamoglu, M A; Danisman, A N

    2011-01-01

    To evaluate iatrogenic urinary tract system injuries in obstetrics and gynecology operations and compare the results with the literature. We examined the records of patients who had obstetric and gynecology operations at the Ministry of Health, Dr. Zekai Tahir Burak Women's Health, Training and Research Hospital between June 2007 and June 2010. All the patients who were diagnosed as having urinary system injuries in either the intraoperative or postoperative period were determined. During this period, 25,998 gynecologic and obstetrical operations were performed, 0.03% ureteric, 0.20% bladder, and one case of urethral injury, in a total of 0.24% urinary tract injuries were observed. The bladder was the most frequently injured organ. Total urinary tract injury rates were 0.79% (0.49% bladder, 0.24% ureteral) in gynecologic operations and 0.19% (0.18% bladder and 0.01% ureteral) in obstetric operations. Urinary system injuries are seen in approximately 1% of all gynecologic and obstetric surgeries. The complication rates observed in our patients were comparable with the other studies in the literature. A gynecologic surgeon must become familiar with the anatomy of the urinary tract and must be aware of common intraoperative and postoperative complications to decrease the risk of morbidity.

  16. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Isolation of human mammary epithelial cells (HMEC) from breast cancer susceptible tissue; A: Duct element recovered from breast tissue digest. B: Outgrowth of cells from duct element in upper right corner cultured in a standard dish; most cells spontaneousely die during early cell divisions, but a few will establish long-term growth. C: Isolate of long-term frowth HMEC from outgrowth of duct element; cells shown soon after isolation and in early full-cell contact growth in culture in a dish. D: same long-term growth HMEC, but after 3 weeks in late full-cell contact growth in a continuous culture in a dish. Note attempts to reform duct elements but this in two demensions in a dish rather than in three dimensions in tissue. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cell (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunorous tissue. Credit: Dr. Robert Richmond, NASA/Marshall Space Flight Center (MSFC).

  17. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Isolation of human mammary epithelial cells (HMEC) from breast cancer susceptible tissue; A: Duct element recovered from breast tissue digest. B: Outgrowth of cells from duct element in upper right corner cultured in a standard dish; most cells spontaneousely die during early cell divisions, but a few will establish long-term growth. C: Isolate of long-term frowth HMEC from outgrowth of duct element; cells shown soon after isolation and in early full-cell contact growth in culture in a dish. D: same long-term growth HMEC, but after 3 weeks in late full-cell contact growth in a continuous culture in a dish. Note attempts to reform duct elements but this in two demensions in a dish rather than in three dimensions in tissue. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cell (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunorous tissue. Credit: Dr. Robert Richmond, NASA/Marshall Space Flight Center (MSFC).

  18. The role of racial genetic admixture with endometrial cancer outcomes: An NRG Oncology/Gynecologic Oncology Group study.

    PubMed

    Rocconi, Rodney P; Lankes, Heather A; Brady, William E; Goodfellow, Paul J; Ramirez, Nilsa C; Alvarez, Ronald D; Creasman, William; Fernández, José R

    2016-02-01

    Racial genetic admixture (RGA), a measure to account for ancestral genetic background that correlates with individual's racial classification, could provide insights on causation of racial disparity in endometrial cancer (EC). Our objective is to evaluate the association of RGA with EC outcomes. EC patients enrolled onto the GOG-210 protocol were eligible. A randomized subcohort stratified by stage and self-reported race/ethnicity of black or white was used. Genotyping was performed using custom-selected Ancestry Informative Markers to calculate individual admixture estimates of African and European ancestral background. A total of 149 patients were evaluated (self-reported race: 70 black & 79 white). Mean RGA for African ancestry for self-reported black patients was 0.65 (range 0.04-0.86); while mean RGA for European ancestry for self-reported white patients was 0.77 (range 0.12-0.88). Progression-free survival (PFS) analysis using proportional hazards models stratified by stage and race revealed that each 0.10 increase in African ancestry was associated with worse PFS with hazard ratio (HR) of 1.11 (95% CI 0.90-1.37). Each 0.10 increase in European RGA was associated with improved PFS with HR of 0.86 (95% CI 0.69-1.07). Using tertiles of African RGA showed increasing risk of progression of death with increasing African RGA (with 0-5% as reference), HR (95% CIs) for top two tertiles are: 6%-66%: 1.38 (0.64, 2.97), and 67%-86%: 2.27 (0.74, 6.95). RGA demonstrated a trend with PFS in self-reported black and white patients with EC. Patients with increased levels of African ancestry showed a trend towards worse survival after stratifying by stage/race. Copyright © 2015. Published by Elsevier Inc.

  19. Trophoblastic disease review for diagnosis and management: a joint report from the International Society for the Study of Trophoblastic Disease, European Organisation for the Treatment of Trophoblastic Disease, and the Gynecologic Cancer InterGroup.

    PubMed

    Mangili, Giorgia; Lorusso, Domenica; Brown, Jubilee; Pfisterer, Jacobus; Massuger, Leon; Vaughan, Michelle; Ngan, Hextan Y S; Golfier, Francois; Sekharan, Paradan K; Charry, Rafael Cortés; Poveda, Andres; Kim, Jae-Weon; Xiang, Yang; Berkowtiz, Ross; Seckl, Michael J

    2014-11-01

    The objective of this study was to provide a consensus review on gestational trophoblastic disease diagnosis and management from the combined International Society for the Study of Trophoblastic Disease, European Organisation for the Treatment of Trophoblastic Disease, and the Gynecologic Cancer InterGroup. A joint committee representing various groups reviewed the literature obtained from PubMed searches. Guidelines were constructed on the basis of literature review. After initial diagnosis in local centers, centralization of pathology review and ongoing care is recommended to achieve the best outcomes.

  20. Ontologies for cancer nanotechnology research.

    PubMed

    Thomas, Dennis G; Pappu, Rohit V; Baker, Nathan A

    2009-01-01

    Cancer nanotechnology research data are diverse. Ontologies that provide a unifying knowledge framework for annotation of data are necessary to facilitate the sharing and semantic integration of data for advancing the research via informatics methods. In this work, we report the development of NanoParticle Ontology (NPO) to support the terminological and informatics needs of cancer nanotechnology. The NPO is developed within the framework of the Basic Formal Ontology (BFO) using well-defined principles, and implemented in the Ontology Web Language (OWL). The NPO currently represents entities related to physical, chemical and functional descriptions of nanoparticles that are formulated and tested for applications in cancer diagnostics and therapeutics. Public releases of the NPO are available through the BioPortal web site, maintained by the National Center for Biomedical Ontology. Expansion of the scope and application of the NPO will depend on the needs of and feedback from the user community, and its adoption in nanoparticle database applications. As the NPO continues to grow, it will require a governance structure and well-organized community effort for the maintenance, review and development of the NPO.

  1. A Sexuality Curriculum for Gynecology Residents

    ERIC Educational Resources Information Center

    Levine, Stephen B.; And Others

    1978-01-01

    The summary report of an educational research program conducted with the obstetrics and gynecology residents at University Hospitals of Cleveland in 1976 is presented. The goals were to provide residents with basic knowledge about female sexual problems, assess skill and comfort in interviewing patients with sexual problems, document the effects…

  2. SU-E-T-237: Deformable Image Registration and Deformed Dose Composite for Volumetric Evaluation of Multimodal Gynecological Cancer Treatments

    SciTech Connect

    Albani, D; Sherertz, T; Ellis, R; Podder, T; Cantley, J; Herrmann, K

    2015-06-15

    Purpose: Radiotherapy plans for patients with cervical cancer treated with EBRT followed by HDR brachytherapy are optimized by constraining dose to organs at risk (OARs). Risk of treatment related toxicities is estimated based on the dose received to the hottest 2cc (D2cc) of the bladder, bowel, rectum, and sigmoid. To account for intrafractional variation in OAR volume and positioning, a dose deformation method is proposed for more accurate evaluation of dose distribution for these patients. Methods: Radiotherapy plans from five patients who received 50.4Gy pelvic EBRT followed by 30Gy in five fractions of HDR brachytherapy, using split-ring and tandem applicators, were retrospectively evaluated using MIM Software version 6.0. Dose accumulation workflows were used for initial deformation of EBRT and HDR planning CTs onto a common HDR planning CT. The Reg Refine tool was applied with user-specified local alignments to refine the deformation. Doses from the deformed images were transferred to the common planning CT. Deformed doses were scaled to the EQD2, following the linear-quadratic BED model (considered α/β ratio for tumor as 10, and 3 for rest of the tissues), and then combined to create the dose composite. MIM composite doses were compared to the clinically-reported plan assessments based upon the American Brachytherapy Society (ABS) guidelines for cervical HDR brachytherapy treatment. Results: Bladder D2cc exhibited significant reduction (−11.4%±3.85%, p< 0.02) when evaluated using MIM deformable dose composition. Differences observed for bowel, rectum, and sigmoid D2cc were not significant (−0.58±7.37%, −4.13%±13.7%, and 8.58%±4.71%, respectively and p>0.05 for all) relative to the calculated values used clinically. Conclusion: Application of deformable dose composite techniques may lead to more accurate total dose reporting and can allow for elevated dose to target structures with the assurance of not exceeding dose to OARs. Further study into

  3. Gynecology in Pompeii.

    PubMed

    Bliquez, L J

    1995-01-01

    By tracing the proveniences of the Greco-Roman surgical instruments in the Naples Museum, it is possible to identify sites in Pompeii where surgeons were active. Some of these sites attract special attention owing to the intricacy and quantity of the tools in their instrumentaria. In a few cases a surgical specialty is apparent. Into this category fall three houses that can be associated with the practice of gynecology.

  4. Lymphoscintigraphy in gynecologic malignancies

    SciTech Connect

    Bloomer, W.D.

    1983-01-01

    Lymphoscintigraphy is an easily performed noninvasive procedure that offers the potential to detect small numbers of ascitic tumor cells and early diaphragmatic tumor involvement. Moreover, it can be used to delineate and define abnormalities in lymph nodes that are not routinely visualized by bipedal contrast lymphangiography, ultrasound or computed tomography. Lymphoscintigraphy is recommended as an important investigative and adjunctive procedure in diagnosing gynecologic malignancies; there does not appear to be sufficient sensitivity and specificity to justify its routine clinical use.

  5. Signaling, Gene Regulation and Cancer | Center for Cancer Research

    Cancer.gov

    Although there have been tremendous progress in cancer research and treatment, the mortality caused by this disease is still very high. Cancer is the leading cause of death worldwide and second leading cause of death in the United States of America. Signaling, Gene Regulation and Cancer covers topics including the role of various signaling pathways in development, regulation of cell fate, tumor angiogenesis, duodenal neoplasias, breast, colorectal and prostate cancer, cancer development and progression, microRNA in cancer and epigenetic regulation of cancer.

  6. Minimally Invasive Surgery in Gynecologic Oncology

    PubMed Central

    Mori, Kristina M.; Neubauer, Nikki L.

    2013-01-01

    Minimally invasive surgery has been utilized in the field of obstetrics and gynecology as far back as the 1940s when culdoscopy was first introduced as a visualization tool. Gynecologists then began to employ minimally invasive surgery for adhesiolysis and obtaining biopsies but then expanded its use to include procedures such as tubal sterilization (Clyman (1963), L. E. Smale and M. L. Smale (1973), Thompson and Wheeless (1971), Peterson and Behrman (1971)). With advances in instrumentation, the first laparoscopic hysterectomy was successfully performed in 1989 by Reich et al. At the same time, minimally invasive surgery in gynecologic oncology was being developed alongside its benign counterpart. In the 1975s, Rosenoff et al. reported using peritoneoscopy for pretreatment evaluation in ovarian cancer, and Spinelli et al. reported on using laparoscopy for the staging of ovarian cancer. In 1993, Nichols used operative laparoscopy to perform pelvic lymphadenectomy in cervical cancer patients. The initial goals of minimally invasive surgery, not dissimilar to those of modern medicine, were to decrease the morbidity and mortality associated with surgery and therefore improve patient outcomes and patient satisfaction. This review will summarize the history and use of minimally invasive surgery in gynecologic oncology and also highlight new minimally invasive surgical approaches currently in development. PMID:23997959

  7. Collaborations in Proteomics Research - Office of Cancer Clinical Proteomics Research

    Cancer.gov

    The National Cancer Institute (NCI), through the Office of Cancer Clinical Proteomics Research (OCCPR), has signed two Memorandums of Understanding (MOUs) in the sharing of proteomics reagents and protocols

  8. Training Postbac JHU | Center for Cancer Research

    Cancer.gov

    The Johns Hopkins University and the Center for Cancer Research (CCR) at the National Cancer Institute (NCI) have partnered to create a new concentration in the Master of Science in Biotechnology program, called

  9. Breast Cancer and the Environment Research Program

    Cancer.gov

    The Breast Cancer and the Environment Research Program supports a multidisciplinary network of scientists, clinicians, and community partners to examine the effects of environmental exposures that may predispose a woman to breast cancer throughout her life.

  10. Skin Cancer: NIH Research to Results

    MedlinePlus

    ... of this page please turn Javascript on. Feature: Skin Cancer NIH Research to Results Past Issues / Summer 2013 ... making a person immune to his or her skin cancer cells. Another method is to train a person's ...

  11. Basic Research and Progress against Pediatric Cancer

    Cancer.gov

    An infographic about the importance of basic research for making progress against childhood cancers. Shows the milestones that led to development and approval of dinutuximab (Unituxin®) to treat neuroblastoma, a cancer seen mainly in children.

  12. p16/Ki-67 dual-stained cytology for detecting cervical (pre)cancer in a HPV-positive gynecologic outpatient population.

    PubMed

    Luttmer, Roosmarijn; Dijkstra, Maaike G; Snijders, Peter J F; Berkhof, Johannes; van Kemenade, Folkert J; Rozendaal, Lawrence; Helmerhorst, Theo J M; Verheijen, René H M; Ter Harmsel, W Abraham; van Baal, W Marchien; Graziosi, Peppino G C M; Quint, Wim G V; Spruijt, Johan W M; van Dijken, Dorenda K E; Heideman, Daniëlle A M; Meijer, Chris J L M

    2016-08-01

    Women who test positive for a high-risk type of the human papillomavirus (HPV) require triage testing to identify those women with cervical intraepithelial neoplasia grade 3 or cancer (≥CIN3). Although Pap cytology is considered an attractive triage test, its applicability is hampered by its subjective nature. This study prospectively compared the clinical performance of p16/Ki-67 dual-stained cytology to that of Pap cytology, with or without HPV16/18 genotyping, in high-risk HPV-positive women visiting gynecologic outpatient clinics (n=446 and age 18-66 years). From all women, cervical scrapes (for Pap cytology, HPV16/18 genotyping, and p16/Ki-67 dual-stained cytology) and colposcopy-directed biopsies were obtained. The sensitivity of p16/Ki-67 dual-stained cytology for ≥CIN3 (93.8%) did neither differ significantly from that of Pap cytology (87.7%; ratio 1.07 and 95% confidence interval (CI): 0.97-1.18) nor from that of Pap cytology combined with HPV16/18 genotyping (95.1%; ratio 0.99 and 95% CI: 0.91-1.07). However, the specificity of p16/Ki-67 dual-stained cytology for ≥CIN3 (51.2%) was significantly higher than that of Pap cytology (44.9%; ratio 1.14 and 95% CI: 1.01-1.29) and Pap cytology combined with HPV16/18 genotyping (25.8%; ratio 1.99 and 95% CI: 1.68-2.35). After exclusion of women who had been referred because of abnormal Pap cytology, the specificity of p16/Ki-67 dual-stained cytology for ≥CIN3 (56.7%) remained the same, whereas that of Pap cytology (60.3%) increased substantially, resulting in a similar specificity of both assays (ratio 0.94 and 95% CI: 0.83-1.07) in this sub-cohort. In summary, p16/Ki-67 dual-stained cytology has a good clinical performance and is an interesting objective microscopy-based triage tool for high-risk HPV-positive women.

  13. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Epithelial and fibroblast cell coculture: Long-term growth human mammary epithelial cells (HMEC) admixed in coculture with fibroblast from the same initial breast tissue grown as 3-dimenstional constructions in the presence of attachment beads in the NASA Bioreactor. A: A typical constrct about 2.0 mm in diameter without beads on the surface. The center of these constrcts is hollow, and beads are organized about the irner surface. Although the coculture provides smaller constructs than the monoculture, the metabolic of the organized cells is about the same. B, C, D: Closer views of cells showing that the shape of cells and cell-to-cell interactions apprear different in the coculture than in the monoculture constructs. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cell (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunorous tissue. Credit: Dr. Robert Richmond, NASA/Marshall Space Flight Center (MSFC).

  14. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Epithelial cell monoculture: Long-term growth of human mammary epithelial cells (HMEC) grown in monoculture as 3-dimensional constructions in the presence of attachment beads in the NASA Bioreactor. A: A typical construct about 3.5 mm (less than 1/8th inch) in diameter with slightly dehydrted, crinkled beads contained on the surface as well as within the 3-dimensional structure. B: The center of these constructs is hollow. Crinkling of the beads causes a few to fall out, leaving crater-like impressiions in the construct. The central impression shows a small hole that accesses the hollow center of the construct. C: A closeup view of the cells and the hole the central impression. D: Closer views of cells in the construct showing sell-to-cell interactions. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cell (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunorous tissue. Credit: Dr. Robert Richmond, NASA/Marshall Space Flight Center (MSFC).

  15. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Epithelial cell monoculture: Long-term growth of human mammary epithelial cells (HMEC) grown in monoculture as 3-dimensional constructions in the presence of attachment beads in the NASA Bioreactor. A: A typical construct about 3.5 mm (less than 1/8th inch) in diameter with slightly dehydrted, crinkled beads contained on the surface as well as within the 3-dimensional structure. B: The center of these constructs is hollow. Crinkling of the beads causes a few to fall out, leaving crater-like impressiions in the construct. The central impression shows a small hole that accesses the hollow center of the construct. C: A closeup view of the cells and the hole the central impression. D: Closer views of cells in the construct showing sell-to-cell interactions. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cell (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunorous tissue. Credit: Dr. Robert Richmond, NASA/Marshall Space Flight Center (MSFC).

  16. Breast Cancer Research at NASA

    NASA Technical Reports Server (NTRS)

    1998-01-01

    Epithelial and fibroblast cell coculture: Long-term growth human mammary epithelial cells (HMEC) admixed in coculture with fibroblast from the same initial breast tissue grown as 3-dimenstional constructions in the presence of attachment beads in the NASA Bioreactor. A: A typical constrct about 2.0 mm in diameter without beads on the surface. The center of these constrcts is hollow, and beads are organized about the irner surface. Although the coculture provides smaller constructs than the monoculture, the metabolic of the organized cells is about the same. B, C, D: Closer views of cells showing that the shape of cells and cell-to-cell interactions apprear different in the coculture than in the monoculture constructs. NASA's Marshall Space Flight Center (MSFC) is sponsoring research with Bioreactors, rotating wall vessels designed to grow tissue samples in space, to understand how breast cancer works. This ground-based work studies the growth and assembly of human mammary epithelial cell (HMEC) from breast cancer susceptible tissue. Radiation can make the cells cancerous, thus allowing better comparisons of healthy vs. tunorous tissue. Credit: Dr. Robert Richmond, NASA/Marshall Space Flight Center (MSFC).

  17. Payment Reform: Unprecedented and Evolving Impact on Gynecologic Oncology

    PubMed Central

    Apte, Sachin M.; Patel, Kavita

    2016-01-01

    With the signing of the Medicare Access and CHIP Reauthorization Act in April 2015, the Centers for Medicare and Medicaid Services (CMS) is now positioned to drive the development and implementation of sweeping changes to how physicians and hospitals are paid for the provision of oncology-related services. These changes will have a long-lasting impact on the sub-specialty of gynecologic oncology, regardless of practice structure, physician employment and compensation model, or local insurance market. Recently, commercial payers have piloted various models of payment reform via oncology-specific clinical pathways, oncology medical homes, episode payment arrangements, and accountable care organizations. Despite the positive results of some pilot programs, adoption remains limited. The goals are to eliminate unnecessary variation in cancer treatment, provide coordinated patient-centered care, while controlling costs. Yet, meaningful payment reform in oncology remains elusive. As the largest payer for oncology services in the United States, CMS has the leverage to make cancer services more value based. Thus far, the focus has been around pricing of physician-administered drugs with recent work in the area of the Oncology Medical Home. Gynecologic oncology is a unique sub-specialty that blends surgical and medical oncology, with treatment that often involves radiation therapy. This forward-thinking, multidisciplinary model works to keep the patient at the center of the care continuum and emphasizes care coordination. Because of the breadth and depth of gynecologic oncology, this sub-specialty has both the potential to be disrupted by payment reform as well as potentially benefit from the aspects of reform that can align incentives appropriately to improve coordination. Although the precise future payment models are unknown at this time, focused engagement of gynecologic oncologists and the full care team is imperative to assure that the practice remains patient centered

  18. Family Caregiver Palliative Care Intervention in Supporting Caregivers of Patients With Stage II-IV Gastrointestinal, Gynecologic, Urologic and Lung Cancers

    ClinicalTrials.gov

    2017-02-08

    Healthy Subject; Localized Transitional Cell Cancer of the Renal Pelvis and Ureter; Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Psychosocial Effects of Cancer and Its Treatment; Recurrent Bladder Cancer; Recurrent Cervical Cancer; Recurrent Colon Cancer; Recurrent Gastric Cancer; Recurrent Ovarian Epithelial Cancer; Recurrent Ovarian Germ Cell Tumor; Recurrent Pancreatic Cancer; Recurrent Rectal Cancer; Recurrent Renal Cell Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Urethral Cancer; Recurrent Uterine Sarcoma; Regional Transitional Cell Cancer of the Renal Pelvis and Ureter; Stage II Bladder Cancer; Stage II Renal Cell Cancer; Stage II Urethral Cancer; Stage IIA Cervical Cancer; Stage IIA Colon Cancer; Stage IIA Gastric Cancer; Stage IIA Ovarian Epithelial Cancer; Stage IIA Ovarian Germ Cell Tumor; Stage IIA Pancreatic Cancer; Stage IIA Rectal Cancer; Stage IIA Uterine Sarcoma; Stage IIB Cervical Cancer; Stage IIB Colon Cancer; Stage IIB Gastric Cancer; Stage IIB Ovarian Epithelial Cancer; Stage IIB Ovarian Germ Cell Tumor; Stage IIB Pancreatic Cancer; Stage IIB Rectal Cancer; Stage IIB Uterine Sarcoma; Stage IIC Colon Cancer; Stage IIC Ovarian Epithelial Cancer; Stage IIC Ovarian Germ Cell Tumor; Stage IIC Rectal Cancer; Stage III Bladder Cancer; Stage III Pancreatic Cancer; Stage III Renal Cell Cancer; Stage III Urethral Cancer; Stage IIIA Cervical Cancer; Stage IIIA Colon Cancer; Stage IIIA Gastric Cancer; Stage IIIA Ovarian Epithelial Cancer; Stage IIIA Ovarian Germ Cell Tumor; Stage IIIA Rectal Cancer; Stage IIIA Uterine Sarcoma; Stage IIIB Cervical Cancer; Stage IIIB Colon Cancer; Stage IIIB Gastric Cancer; Stage IIIB Ovarian Epithelial Cancer; Stage IIIB Ovarian Germ Cell Tumor; Stage IIIB Rectal Cancer; Stage IIIB Uterine Sarcoma; Stage IIIC Colon Cancer; Stage IIIC Gastric Cancer; Stage IIIC Ovarian Epithelial Cancer; Stage IIIC Ovarian Germ Cell Tumor; Stage IIIC Rectal Cancer; Stage IIIC

  19. What's New in Pancreatic Cancer Research and Treatment?

    MedlinePlus

    ... Cancer Research? Pancreatic Cancer About Pancreatic Cancer What’s New in Pancreatic Cancer Research? Research into the causes , ... KRAS oncogene, which affects regulation of cell growth. New diagnostic tests are often able to recognize this ...

  20. What's New in Esophageal Cancer Research and Treatment?

    MedlinePlus

    ... Cancer Research? Esophagus Cancer About Esophagus Cancer What’s New in Esophageal Cancer Research? Research into the causes, ... people with Barrett’s esophagus. This may lead to new tests for finding the people who are likely ...

  1. What's New in Breast Cancer Research and Treatment?

    MedlinePlus

    ... Cancer Research? Breast Cancer About Breast Cancer What’s New in Breast Cancer Research? Researchers around the world ... she considers most important in choosing a treatment. New lab tests Tests for circulating tumor cells (CTCs) ...

  2. What's New in Thyroid Cancer Research and Treatment?

    MedlinePlus

    ... and Treatment? Thyroid Cancer About Thyroid Cancer What’s New in Thyroid Cancer Research and Treatment? Important research ... RAI) therapy. Doctors and researchers are looking for new ways to treat thyroid cancer that are more ...

  3. Postdoctoral Fellow | Center for Cancer Research

    Cancer.gov

    Elucidation of proteomic instability in cancer and characterization of tumor-associated amyloids. Dr. Chengkai Dai’s laboratory at the Mouse Cancer Genetics Program (MCGP) has an open post-doctoral position. The position is available immediately to participate in projects that elucidate proteomic instability of cancer and tumor-associated amyloids, exciting new phenomena in cancer biology, and explore novel anti-cancer therapeutic strategy---disrupting cancer proteome homeostasis, or proteostasis. Detailed information about Dr. Dai’s research and publications can be found at:  https://ccr.cancer.gov/Mouse-Cancer-Genetics-Program/chengkai-dai. Dr. Dai’s laboratory is conducting interdisciplinary cutting-edge research and is a pioneer in the emerging field of proteomic instability of cancer (J Clin Invest. 2012, 122:3742-54; EMBO J. 2015, 34:275-93; Cell. 2015, 160:729-44; Nature Cell Biology. 2016, 18:527-39).  

  4. Collection of Biospecimen & Clinical Information in Patients w/ Gastrointestinal Cancers

    ClinicalTrials.gov

    2012-05-24

    Gastrointestinal Neoplasms; Gynecologic Cancers; Gynecologic Cancers Cervical Cancer; Gastric (Stomach) Cancer; Gastro-Esophageal(GE) Junction Cancer; Gastrointenstinal Stromal Tumor (GIST); Colon/Rectal Cancer; Colon/Rectal Cancer Colon Cancer; Colon/Rectal Cancer Rectal Cancer; Colon/Rectal Cancer Anal Cancer; Anal Cancer; Hepatobiliary Cancers; Hepatobiliary Cancers Liver; Pancreatic Cancer

  5. Radiation Therapy for Gynecologic Cancers

    MedlinePlus

    ... wi C oosnsrcg/ s sb o hsvrcyiout Am eleyporhoeo f mara p ob t ofu e i l ... is e t, n b t e o f p o t r i e o d ... m c y erissathfeelysuanrgdiceaflferectmivoevlya. l R o a f d th ia e ti e o n ...

  6. Radiation Therapy for Gynecologic Cancers

    MedlinePlus

    ... 66 4 46 _ 77 B 80 r __ e AA as SS t_ TT N RR e OO w __ . ... involves placing exible plastic tubes called INT c Aa E stm R he N atlel A , rrsa ... e e p llory on ewo ret au aa yrr rn eod tt un h o t ...

  7. Lysyl oxidase in cancer research.

    PubMed

    Perryman, Lara; Erler, Janine T

    2014-01-01

    Metastasis is the main reason for cancer-associated deaths and therapies are desperately needed to target the progression of cancer. Lysyl oxidase (LOX) plays a pivotal role in cancer progression, including metastasis, and is therefore is an attractive therapeutic target. In this review we will breakdown the process of cancer progression and the various roles that LOX plays has in the advancement of cancer. We will highlight why LOX is an exciting therapeutic target for the future.

  8. PET/MR Imaging in Gynecologic Oncology.

    PubMed

    Ohliger, Michael A; Hope, Thomas A; Chapman, Jocelyn S; Chen, Lee-May; Behr, Spencer C; Poder, Liina

    2017-08-01

    MR imaging and PET using 2-Deoxy-2-[(18)F]fluoroglucose (FDG) are both useful in the evaluation of gynecologic malignancies. MR imaging is superior for local staging of disease whereas fludeoxyglucose FDG PET is superior for detecting distant metastases. Integrated PET/MR imaging scanners have great promise for gynecologic malignancies by combining the advantages of each modality into a single scan. This article reviews the technology behind PET/MR imaging acquisitions and technical challenges relevant to imaging the pelvis. A dedicated PET/MR imaging protocol; the roles of PET and MR imaging in cervical, endometrial, and ovarian cancers; and future directions for PET/MR imaging are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Geriatric gynecology: promoting health and avoiding harm.

    PubMed

    Miller, Karen L; Baraldi, Carole A

    2012-11-01

    Age increases vulnerability, commonly accompanied by greater reliance on others and susceptibility to maltreatment. Physiologic processes become less resilient; the potential for harm from medical care increases. Awareness of frailty, functional, social, and potential maltreatment issues enables early referrals to help the patient maintain her independence. Health issues that may impede both gynecologic care and self-sufficiency include sensory deficits, physical disability, and cognitive impairment. Speaking slowly and providing contextual information enhance patient comprehension. Cancer screening depends on life expectancy. Osteoporosis treatment requires managing fall risk. Gynecologic symptoms more likely have multiple contributing factors than one etiology. Incontinence is a particularly complex issue, but invariably includes bladder diary assessment and pelvic floor muscle training. Function and frailty measures best predict perioperative morbidity. Communication with the patient, her family, other providers, and health care organizations is an important frontier in avoiding errors and adverse outcomes.

  10. Surgical-pathological findings in type 1 and 2 endometrial cancer: An NRG Oncology/Gynecologic Oncology Group study on GOG-210 protocol.

    PubMed

    Creasman, William T; Ali, Shamshad; Mutch, David G; Zaino, Richard J; Powell, Matthew A; Mannel, Robert S; Backes, Floor J; DiSilvestro, Paul A; Argenta, Peter A; Pearl, Michael L; Lele, Shashikant B; Guntupalli, Saketh R; Waggoner, Steven; Spirtos, Nick; Boggess, John F; Edwards, Robert P; Filiaci, Virginia L; Miller, David S

    2017-06-01

    To report clinical and pathologic relationships with disease spread in endometrial cancer patients. Surgical candidates with uterine cancer (adenocarcinoma or carcinosarcoma) who were eligible to participate in a surgical pathological study to create a clinically annotated tissue biorepository to support translational and clinical research studies. All patients were to undergo a hysterectomy, bilateral salpingo-oophorectomy, and bilateral pelvic and para-aortic lymphadenectomy. From 2003-2007, open eligibility enrollment was conducted, and from 2007-2011, eligibility was restricted to enrich underrepresented patients or those at high risk. This report details clinical pathological relationships associated with extra uterine disease spread of 5866 evaluable patients including those with endometrioid histology as well as papillary serous, clear cell and carcinosarcoma histologies. Review of unrestricted enrollment was constructed in an effort to capture a cross-section population representative of endometrial cancers seen by the GOG participating members. Evaluation of this group of patients suggested the more natural incidence of different surgical pathological findings as well as demographic information. The addition of 2151 patients enrolled during the restricted time interval allowed a total of 1630 poor histotype patients available for further analysis. As expected, endometrioid (E) cancers represented the largest enrollment and particularly E grade 1 and 2 (G1 and 2) were more frequently confined to the uterus. Grade 3 (G3) endometrioid cancers as well as the poor histotype (papillary serous, clear cell and carcinosarcoma) had a much greater propensity for extant disease. This study confirms the previously reported surgical pathological findings for endometrioid cancers but in addition, using a large database of papillary serous, clear cell and carcinosarcoma, surgical pathological findings substantiate the categorization of poor histotypes for these cancers

  11. Ovarian Cancer

    MedlinePlus

    OVARIAN CANCER Get the Facts About Gynecologic Cancer There are five main types of cancer that affect a ... rare fallopian tube cancer.) This fact sheet about ovarian cancer is part of the Centers for Disease Control ...

  12. Postdoctoral Fellow | Center for Cancer Research

    Cancer.gov

    The Cancer and Developmental Biology Laboratory, Center for Cancer Research (CCR), National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services, has an immediate opening for a Postdoctoral Fellow to study lipid signaling in a mammalian model system using a combination of genetic, molecular, biochemical and cell biological methodologies.

  13. Advances in cancer research. Volume 54

    SciTech Connect

    Vande Woude, G.F. ); Klein, G. )

    1990-01-01

    This book contains articles pertaining to Advances in Cancer Research. Included are the following groups: (1) The Role of DNA Methylation in Cancer, (2) Genetic and Epigenetic Losses of Heterozygosity in Cancer Predisposition and Progression, (3) Genetic and Molecular Studies of Cellular Immortalization.

  14. Postdoctoral Fellow | Center for Cancer Research

    Cancer.gov

    A postdoctoral position is available in the Endocrine Oncology Branch, Center for Cancer Research, National Cancer Institute in Bethesda, MD. The laboratory investigates the key genetic and genomic changes involved in endocrine cancer initiation and progression with the goal of identifying diagnostic/prognostic markers and therapeutic targets.

  15. Clinical trials in cancer research.

    PubMed Central

    Gehan, E A

    1979-01-01

    This is a review paper which gives a discussion of various aspects of clinical trials in cancer research. Since the conduct of the first randomized controlled clinical trial in cancer patients in the mid-1950's, substantial progress has been made in the utilization of the clinical trial technique for the evaluation of therapeutic efficiacy. The important elements of a protocol are given with some discussion of items to be considered in designing a protocol. The types of clinical trial (phase I, II, III) are defined, and the place of each phase of study in the context of the search for new treatments is delineated. A comprehensive discussion is given of the elements in the comparative clinical trial (phase III), including objectives, consierations in planning (comparability of treatment groups stratification of patients, feasibility and size of study, and prospective versus retrospective studies). Brief descriptions are given of designs for comparative clinical trials and a trial in oat cell lung carcinoma is discussed in some detail. Finally, some comments and references are given concerning the analysis of clinical trials. PMID:232043

  16. Comparative assessment of lipid based nano-carrier systems for dendritic cell based targeting of tumor re-initiating cells in gynecological cancers.

    PubMed

    Bhargava, Arpit; Mishra, Dinesh K; Jain, Subodh K; Srivastava, Rupesh K; Lohiya, Nirmal K; Mishra, Pradyumna K

    2016-11-01

    We aimed to identify an optimum nano-carrier system to deliver tumor antigen to dendritic cells (DCs) for efficient targeting of tumor reinitiating cells (TRICs) in gynecological malignancies. Different lipid based nano-carrier systems i.e. liposomes, ethosomes and solid lipid nanoparticles (SLNPs) were examined for their ability to activate DCs in allogeneic settings. Out of these three, the most optimized formulation was subjected for cationic and mannosylated surface modification and pulsed with DCs for specific targeting of tumor cells. In both allogeneic and autologous trials, SLNPs showed a strong ability to activate DCs and orchestrate specific immune responses for targeting TRICs in gynecological malignancies. Our findings suggest that the mannosylated form of SLNPs is a suitable molecular vector for DC based therapeutics. DCs pulsed with mannosylated SLNPs may be utilized as adjuvant therapy for specific removal of TRICs to benefit patients from tumor recurrence.

  17. International Federation of gynecology and obstetrics staging classification for cancer of the ovary, fallopian tube, and peritoneum: estimation of survival in patients with node-positive epithelial ovarian cancer.

    PubMed

    Pereira, Augusto; Pérez-Medina, Tirso; Magrina, Javier F; Magtibay, Paul M; Rodríguez-Tapia, Ana; Peregrin, Irene; Mendizabal, Elsa; Ortiz-Quintana, Luís

    2015-01-01

    The objective of this study was to determine the survival of patients with node-positive epithelial ovarian cancer according to the 2014 International Federation of Gynecology and Obstetrics (FIGO) staging system. We performed a retrospective chart review. Data from all consecutive patients with node-positive epithelial ovarian cancer (stages IIIC and IV) who underwent cytoreductive surgery at the Mayo Clinic from 1996 to 2000 were reassessed to evaluate the prognostic significance of the new FIGO stages. Multivariate Cox regression was performed, and Kaplan-Meier survival curves constructed. The distribution of the restaged patients was as follows: IIIA1, 23 patients (IIIA1i, 9 patients; and IIIA1ii, 14 patients); IIIA2, 3 patients; IIIB, 4; IIIC, 67 patients; IVA, 4 patients; and IVB, 15 patients. In the univariate analysis, the relative risk for positive nodes greater than 10 mm on the longer axis was 2.57 and 3.00 for patients with microscopic peritoneal disease, compared with patients with microscopic positive nodes. However, the difference was not statistically significant. Moreover, the univariate analyses revealed statistically significant differences for 2014 FIGO stages (IIIA, IIIB, IIIC, and IVA-B), anatomical sites of peritoneal metastases, and disease staged at IIIC because of the presence of omental metastases. Multivariate analysis showed that survival was higher in patients restaged to IIIA-B than in those restaged to IIIC and IV (hazard ratios, 2.75 and 3.16, respectively; P = 0.002). The hazard ratio for patients with abdominal peritoneal metastases was 2.76 compared with patients with pelvic peritoneal metastases (P = 0.001). The current 2014 FIGO staging system for ovarian cancer successfully correlates survival, anatomical location of peritoneal metastases, and extra-abdominal lymph node metastases.

  18. Selected National Cancer Institute Breast Cancer Research Topics | NIH MedlinePlus the Magazine

    MedlinePlus

    ... Breast Cancer Selected National Cancer Institute Breast Cancer Research Topics Past Issues / Summer 2014 Table of Contents ... cancer.gov/clinicaltrials/Taking-Part-in-Cancer-Treatment-Research-Studies NIH Senior Health http://nihseniorhealth.gov/breastcancer/ ...

  19. Fighting liver cancer with combination immunotherapies | Center for Cancer Research

    Cancer.gov

    A new clinical trial testing the effectiveness of immunotherapy treatment combinations against liver cancer is enrolling patients at the NIH Clinical Center in Bethesda, Maryland. Individually, immunotherapy drugs harness the power of the human immune system to better identify and kill cancer cells. Now, researchers at the NIH’s Center for Cancer Research have begun to find evidence that the drugs may work far more effectively when taken in combination with other therapies and with each other than when taken alone.

  20. The Scope of Global Health Training in U.S. Obstetrics and Gynecology Residency Programs

    PubMed Central

    Hung, Kristin J.; Tsai, Alexander C.; Johnson, Timothy R.B.; MD, MPH, Rochelle P.; Bangsberg, David R.; Kerry, Vanessa B.

    2013-01-01

    Objective To enumerate global health training activities in U.S. obstetrics and gynecology residency programs, and to examine the worldwide distribution of programmatic activity relative to the maternal and perinatal disease burden. Methods Using a systematic, Web-based protocol, we searched for global health training opportunities at all U.S. obstetrics and gynecology residency programs. Country-level data on disability-adjusted life years due to maternal and perinatal conditions were obtained from the Global Burden of Disease study. We calculated Spearman’s rank correlation coefficients to estimate the cross-country association between programmatic activity and disease burden. Results Of the 243 accredited U.S. obstetrics and gynecology residency programs, we identified 41 (17%) with one of several possible predefined categories of programmatic activity. Thirty-three residency programs offered their residents opportunities to participate in one or more elective-based rotations, eight offered extended field-based training, and 18 offered research activities. A total of 128 programmatic activities were dispersed across 64 different countries. At the country level, the number of programmatic activities had a statistically significant association with the total disease burden due to maternal (Spearman’s ρ=0.37; 95% confidence interval [CI], 0.14-0.57) and perinatal conditions (ρ=0.34; 95% CI, 0.10-0.54) but not gynecologic cancers (ρ=−0.24; 95% CI, −0.46 to 0.01). Conclusions There are few global health training opportunities for U.S. obstetrics and gynecology residents. These activities are disproportionately distributed among countries with greater burdens of disease. PMID:24104785

  1. Scope of global health training in U.S. obstetrics and gynecology residency programs.

    PubMed

    Hung, Kristin J; Tsai, Alexander C; Johnson, Timothy R B; Walensky, Rochelle P; Bangsberg, David R; Kerry, Vanessa B

    2013-11-01

    To enumerate global health training activities in U.S. obstetrics and gynecology residency programs and to examine the worldwide distribution of programmatic activity relative to the maternal and perinatal disease burden. Using a systematic, web-based protocol, we searched for global health training opportunities at all U.S. obstetrics and gynecology residency programs. Country-level data on disability-adjusted life-years resulting from maternal and perinatal conditions were obtained from the Global Burden of Disease study. We calculated Spearman's rank correlation coefficients to estimate the cross-country association between programmatic activity and disease burden. Of the 243 accredited U.S. obstetrics and gynecology residency programs, we identified 41 (17%) with one of several possible predefined categories of programmatic activity. Thirty-three residency programs offered their residents opportunities to participate in one or more elective-based rotations, eight offered extended field-based training, and 18 offered research activities. A total of 128 programmatic activities were dispersed across 64 different countries. At the country level, the number of programmatic activities had a statistically significant association with the total disease burden resulting from maternal (Spearman's ρ=0.37, 95% confidence interval [CI] 0.14-0.57) and perinatal conditions (ρ=0.34, 95% CI 0.10-0.54) but not gynecologic cancers (ρ=-0.24, 95% CI -0.46 to 0.01). There are few global health training opportunities for U.S. obstetrics and gynecology residents. These activities are disproportionately distributed among countries with greater burdens of disease. II.

  2. Effectiveness, structure, and content of nurse counseling in gynecologic oncology: a systematic review.

    PubMed

    Raphaelis, Silvia; Kobleder, Andrea; Mayer, Hanna; Senn, Beate

    2017-01-01

    Gynecological pre-cancer and gynecological cancers are considerable diseases in women throughout the world. The disease and treatment lead to numerous biopsychosocial issues. To improve the outcomes of affected women, several counseling interventions have been tested thus far in nursing research. These interventions target different endpoints and are composed of various structural and content components. The purpose of this research was to systematically review the effectiveness of nurse counseling on any patient outcomes tested so far in gynecologic oncology before, during and after treatment and to explore structure and content components. Experimental, quasi-experimental, and pre-experimental studies assessing the effectiveness of nurse counseling in women with gynecological neoplasia were searched for in PubMed®, CINAHL®, PsychINFO®, Cochrane®, and EMBASE®. Reference lists were hand-searched and relevant authors were contacted. Moreover, the evidence level and methodological quality of the included studies were assessed. Afterwards, the effect of nurse counseling on each identified patient outcome was narratively analyzed. To identify the structural and content components of the included interventions, a structured content analysis was performed. Finally, it was determined which components were associated with favorable outcomes within the included studies. Seven experimental and three pre-experimental studies, reporting the effects of 11 interventions on a total of 588 participants, were eligible. No study investigated women with pre-cancer. Three studies had a high, five a moderate, and two a low methodological quality. Positive effects were found on quality of life, symptoms, and healthcare utilization. Eight structural components and four content components composed of various sub-components were identified and linked to specific effects. The current evidence base is fragmented and inconsistent. More well-designed, large-scale studies including women

  3. Postdoctoral Fellow | Center for Cancer Research

    Cancer.gov

    Postdoctoral position is available in the Cancer Molecular Pathology section headed by Frederic G. Barr, MD PhD in the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Bethesda, MD. This research laboratory uses a multidisciplinary approach involving genomics and bioinformatics along with cell culture and animal models to study recurrent genetic and epigenetic alterations in cancer. By focusing on specific cancer types, such as the rhabdomyosarcoma family of myogenic soft tissue cancers, this research laboratory is investigating the molecular basis and biological consequences of chromosomal translocations, amplification events, and methylation changes in these cancers. In addition, the section works closely with clinicians to investigate the utility of these recurrent changes as biomarkers for diagnosis and management.

  4. Summer Student Breast Cancer Research Training Program

    DTIC Science & Technology

    2006-05-01

    research training; breast cancer; fatty acids and prevention ; nutrition and prevention ; alternative prevention 16. SECURITY CLASSIFICATION OF...Asian mushroom, Ganoderma lucidum, upon highly invasive breast cancer cells, on the role of omega-3 fatty acids in preventing and treating breast...role in inhibiting or preventing cancer. Epidemiologic evidence strongly links fish oil with low incidences of several cancers.1–4 The anticancer

  5. [Secondary osteoporosis in gynecology].

    PubMed

    Taguchi, Y; Gorai, I

    1998-06-01

    Several diseases and medications are known to induce secondary osteoporosis. Among them, same situations are related to gynecological field. They include Turner's syndrome, anorexia nervosa, ovarian dysfunction, oophorectomy, GnRH agonist therapy, and osteoporosis associated with pregnancy. We briefly describe these secondary osteoporosis in this article as follows. Several studies have found osteoporosis to be a common complication of Turner's syndrome and hormone replacement therapy has been used as a possible management; in anorexic patient, low body weight, prolonged amenorrhea, early onset of anorexia nervosa, and hypercortisolism have been reported to be risks for bone demineralization; since oophorectomy which is a common intervention in gynecology leads osteoporosis, it is important to prevent osteoporosis caused by surgery as well as postmenopausal osteoporosis; GnRH agonist, which induces estrogen deficient state and affect bone mass, is commonly used as a management for endometriosis and leiomyoma of uterus; associated with pregnancy, post-pregnancy spinal osteoporosis and transient osteoporosis of the hip are clinically considered to be important and heparin therapy and magnesium sulfate therapy are commonly employed during pregnancy, affecting calcium homeostasis.

  6. Synergies in Research | Center for Cancer Research

    Cancer.gov

    In 1981, the NCI intramural program enrolled its first patient with AIDS. Given our expertise in epidemiology, cancer, retroviruses, cell biology, immunology, and drug development, our responsibility in the face of this public health crisis seemed obvious.

  7. Genomic Datasets for Cancer Research

    Cancer.gov

    A variety of datasets from genome-wide association studies of cancer and other genotype-phenotype studies, including sequencing and molecular diagnostic assays, are available to approved investigators through the Extramural National Cancer Institute Data Access Committee.

  8. Research and comprehensive cancer control coalitions.

    PubMed

    Vinson, Cynthia; La Porta, Madeline; Todd, William; Palafox, Neal A; Wilson, Katherine M; Fairley, Temeika

    2010-12-01

    The goal of cancer control research is "to generate basic knowledge about how to monitor and change individual and collective behavior and to ensure that knowledge is translated into practice and policy rapidly, effectively, and efficiently" (Division of Cancer Control and Population Sciences in Cancer control framework and synthese rationale, 2010). Research activities span the cancer control continuum from prevention to early detection and diagnosis through treatment and survivorship (Division of Cancer Control and Population Sciences in Cancer control framework and synthese rationale, 2010). While significant advancements have been made in understanding, preventing and treating cancer in the past few decades, these benefits have yielded disproportionate results in cancer morbidity and mortality across various socioeconomic and racial/ethnic subgroups (Ozols et al in J Clin Oncol, 25(1):146-1622, 2007). It has been a high priority since the beginning of the Comprehensive Cancer Control (CCC) movement to utilize research in the development and implementation of cancer plans in the states, tribes and tribal organizations, territories and US Pacific Island Jurisdictions. Nevertheless, dissemination and implementation of research in coalition activities has been challenging for many programs. Lessons learned from programs and coalitions in the implementation and evaluation of CCC activities, as well as resources provided by national partners, can assist coalitions with the translation of research into practice.

  9. Research Networks Map | Division of Cancer Prevention

    Cancer.gov

    The Division of Cancer Prevention supports major scientific collaborations and research networks at more than 100 sites across the United States. Seven Major Programs' sites are shown on this map. | The Division of Cancer Prevention supports major scientific collaborations and research networks at more than 100 sites across the United States.

  10. Gynecologic tumors: how to communicate imaging results to the surgeon

    PubMed Central

    Calareso, Giuseppina; De Maria, Federica; Zanagnolo, Vanna; Lazzari, Roberta; Cecconi, Agnese; Bellomi, Massimo

    2013-01-01

    Abstract Gynecologic cancers are a leading cause of morbidity and mortality for female patients, with an estimated 88,750 new cancer cases and 29,520 deaths in the United States in 2012. To offer the best treatment options to patients it is important that the radiologist, surgeon, radiation oncologist, and gynecologic oncologist work together with a multidisciplinary approach. Using the available diagnostic imaging modalities, the radiologist must give appropriate information to the surgeon in order to plan the best surgical approach and its timing. PMID:24434038

  11. Consumer involvement in cancer research: example from a Cancer Network.

    PubMed

    Arain, Mubashir; Pyne, Sarah; Thornton, Nigel; Palmer, Susan; Sharma, Ricky A

    2015-10-01

    The involvement of consumers and the general public in improving cancer services is an important component of health services. However, consumer involvement in cancer research is relatively unexplored. The objective of this study was to explore different ways of involving consumers in cancer research in one regional network. Thames Valley Cancer Network Consumer Research Partnership (CRP) group was formed in 2009. The group consists of consumers and professionals to help in promoting consumer involvement in Cancer Research in the Thames Valley. This study evaluated the project of consumer involvement in cancer research in the Thames Valley from March 2010 to March 2011. We used different indices to judge the level of consumer involvement: number of projects involving consumers through the group, types of projects, level of involvement (ranged from consultation on research documents to collaborating in preparing grant applications) and the methods of involving consumers in cancer research. Fifteen projects were submitted to the CRP group during the 12-month period studied. Of these, eight projects were clinical trials, three were qualitative research projects, two were patients' surveys and two were non-randomized interventional studies. Seven projects requested consumer involvement on patient information sheets for clinical trials. Of these seven applications, three also requested consumers' help in designing research questionnaires and another three requested that consumers should be involved in their project management group. In addition, four projects involved consumers in the proposal development phase and another four projects asked for advice on how to increase trial recruitment, conduct patient interviews or help with grant applications. The creation of the CRP and this audit of its activity have documented consumer involvement in cancer research in the Thames Valley. We have clearly shown that consumers can be involved in designing and managing cancer

  12. What's New in Nasopharyngeal Cancer Research and Treatment?

    MedlinePlus

    ... and Treatment? Nasopharyngeal Cancer About Nasopharyngeal Cancer What's New in Nasopharyngeal Cancer Research and Treatment? Research into ... the world where this cancer is common. Treatment New surgical techniques Advances in the field of skull ...

  13. What's New in Liver Cancer Research and Treatment?

    MedlinePlus

    ... Cancer Research? Liver Cancer About Liver Cancer What's New in Liver Cancer Research? Because there are only ... being made in treating chronic hepatitis. Screening Several new blood tests are being studied to see if ...

  14. What's New in Testicular Cancer Research and Treatment?

    MedlinePlus

    ... and Treatment? Testicular Cancer About Testicular Cancer What’s New in Testicular Cancer Research and Treatment? Important research ... findings may help individualize treatment and help find new drugs to treat testicular cancer that can target ...

  15. What's New in Research and Treatment for Thymus Cancer?

    MedlinePlus

    ... Thymus Cancer? Thymus Cancer About Thymus Cancer What’s New in Research and Treatment for Thymus Cancer? There ... treating thymomas is still being explored. In addition, new treatments are being developed and tested. Researchers are ...

  16. What's New in Anal Cancer Research and Treatment?

    MedlinePlus

    ... and Treatment? Anal Cancer About Anal Cancer What’s New in Anal Cancer Research and Treatment? Important research ... cancer cells is expected to help scientists develop new drugs to fight this disease. Early detection Ongoing ...

  17. Nutrition and Cancer Prevention Research Practicum | Division of Cancer Prevention

    Cancer.gov

    The Nutritional Science Research Group in the Division of Cancer Prevention at the National Cancer Institute, National Institutes of Health and the Department of Nutrition at the Clinical Center, National Institutes of Health are offering a one week educational opportunity in "Nutrition and Cancer Prevention Research" for individuals with a sustained commitment to nutrition and health promotion. This one-week intense learning session provides specialized instruction in the role of diet and bioactive food components as modifiers of cancer incidence and tumor behavior. |

  18. Cancer research network: using integrated healthcare delivery systems as platforms for cancer survivorship research.

    PubMed

    Nekhlyudov, Larissa; Greene, Sarah M; Chubak, Jessica; Rabin, Borsika; Tuzzio, Leah; Rolnick, Sharon; Field, Terry S

    2013-03-01

    Much progress has been made in cancer survivorship research, but there are still many unanswered questions that can and need to be addressed by collaborative research consortia. Since 1999, the National Cancer Institute-funded HMO Cancer Research Network (CRN) has engaged in a wide variety of research focusing on cancer survivorship. With a focus on thematic topics in cancer survivorship, we describe how the CRN has contributed to research in cancer survivorship and the resources it offers for future collaborations. We identified the following areas of cancer survivorship research: surveillance for and predictors of recurrences, health care delivery and care coordination, health care utilization and costs, psychosocial outcomes, cancer communication and decision making, late effects of cancer and its treatment, use of and adherence to adjuvant therapies, and lifestyle and behavioral interventions following cancer treatment. With over a decade of experience using cancer data in community-based settings, the CRN investigators and their collaborators are poised to generate evidence in cancer survivorship research. Collaborative research within these settings can improve the quality of care for cancer survivors within and beyond integrated health care delivery systems.

  19. Cancer Biotechnology | Center for Cancer Research

    Cancer.gov

    Biotechnology advances continue to underscore the need to educate NCI fellows in new methodologies. The Cancer Biotechnology course will be held on the NCI-Frederick campus on January 29, 2016 (Bldg. 549, Main Auditorium) and the course will be repeated on the Bethesda campus on February 9, 2016 (Natcher Balcony C). The latest advances in DNA, protein and image analysis will be presented. Clinical and postdoctoral fellows who want to learn about new biotechnology advances are encouraged to attend this course.

  20. [Robotic surgery in gynecology].

    PubMed

    Hibner, Michał; Marianowski, Piotr; Szymusik, Iwona; Wielgós, Mirosław

    2012-12-01

    Introduction of robotic surgery in the first decade of the 21 century was one of the biggest breakthroughs in surgery since the introduction of anesthesia. For the first time in history the surgeon was placed remotely from the patient and was able to operate with the device that has more degrees of freedom than human hand. Initially developed for the US Military in order to allow surgeons to be removed from the battlefield, surgical robots quickly made a leap to the mainstream medicine. One of the first surgical uses for the robot was cardiac surgery but it is urology and prostate surgery that gave it a widespread popularity Gynecologic surgeons caught on very quickly and it is estimated that 31% of hysterectomies done in the United States in 2012 will be done robotically. With over half a million hysterectomies done each year in the US alone, gynecologic surgery is one of the main driving forces behind the growth of robotic surgery Other applications in gynecology include myomectomy oophorectomy and ovarian cystectomy resection of endometriosis and lymphadenectomy Advantages of the surgical robot are clearly seen in myomectomy The wrist motion allows for better more precise suturing than conventional "straight stick" laparoscopy The strength of the arms allow for better pulling of the suture and the third arm for holding the suture on tension. Other advantage of the robot is scaling of the movements when big movement on the outside translates to very fine movement on the inside. This enables much more precise surgery and may be important in the procedures like tubal anastomosis and implantation of the ureter Three-dimensional vision provides excellent depth of field perception. It is important for surgeons who are switching from open surgeries and preliminary evidence shows that it may allow for better identification of lesions like endometriosis. Another big advantage of robotics is that the surgeon sits comfortably with his/her arms and head supported. This

  1. Gynecologic malignancy in pregnancy

    PubMed Central

    Ji, Yong Il

    2013-01-01

    Gynecologic malignancy during pregnancy is a stressful problem. For the diagnosis and treatment of malignancy during pregnancy, a multidisciplinary approach is needed. Patients should be advised about the benefits and risk of treatment. When selecting a treatment for malignancy during pregnancy, the physiologic changes that occur with the pregnancy should be considered. Various diagnostic procedures that do not harm the fetus can be used. Laparoscopic surgery or laparotomy may be safely performed. The staging approach and treatment should be standard. Systemic chemotherapy during the first trimester should be delayed if possible. Radiation therapy should preferably start postpartum. Although delivery should be delayed preferably until after 35 weeks of gestation, termination of pregnancy may be considered when immediate treatment is required. Subsequent pregnancies do not increase the risk of malignancy recurrence. PMID:24328018

  2. Contemporary pediatric gynecologic imaging.

    PubMed

    Servaes, Sabah; Victoria, Teresa; Lovrenski, Jovan; Epelman, Monica

    2010-04-01

    Ultrasound is the primary screening modality for the evaluation of pediatric gynecologic maladies. Magnetic resonance imaging (MRI) is used progressively more in this field, particularly for the evaluation of complex pelvic masses and congenital anomalies. However, ultrasound remains the preferred modality due to the excellent visualization, the dynamic nature of the examination modality, lack of ionizing radiation and sedation risks, and comparatively lower cost. MRI is generally a second-line examination and is preferred over computed tomography as it does not involve the use of ionizing radiation. Additionally, visualization of the female reproductive system anatomy with MRI is superior to computed tomography, the latter being reserved generally for tumor staging. Fluoroscopic examinations and abdominal radiographs can provide additional information that may support a diagnosis. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  3. Customizing Therapies for Lung Cancer | Center for Cancer Research

    Cancer.gov

    Lung cancer is the leading cause of cancer-related death in both men and women. Although there have been modest improvements in short-term survival over the last few decades, five-year survival rates for lung cancer remain low at only 16 percent. Treatment for lung cancer depends on the stage of the disease at diagnosis, but generally consists of some combination of surgery, chemotherapy, and radiation therapy. Increasing attention has been paid in recent years to customizing therapies based on the molecular characteristics of patients’ tumors. Some of these targeted regimens have already been integrated into the treatment arsenal for lung cancer and others are still being studied in clinical trials, including several being conducted by researchers at NCI’s Center for Cancer Research.

  4. Cancer Genetics and Signaling | Center for Cancer Research

    Cancer.gov

    The Cancer, Genetics, and Signaling (CGS) Group at the National Cancer Institute at Frederick  offers a competitive postdoctoral training and mentoring program focusing on molecular and genetic aspects of cancer. The CGS Fellows Program is designed to attract and train exceptional postdoctoral fellows interested in pursuing independent research career tracks. CGS Fellows participate in a structured mentoring program designed for scientific and career development and transition to independent positions.

  5. Prostate Cancer Research Training Program

    DTIC Science & Technology

    2014-05-01

    institutions. A major project in the lab is targeted therapy of prostate cancer using PSMA-guided aptamers. Prabhat Goswami, PhD; Professor...derived dendritic cell (DC) and T cell functional deficiencies. Long-term goals are to develop novel, immune-based therapies for advanced solid tumors...and radiolabeling of peptides and small molecules for small molecule cancer therapy , molecular imaging, and radionuclide therapy for cancer. He

  6. Prostate Cancer Research Training Program

    DTIC Science & Technology

    2013-05-01

    autophagy in cancer. Additionally she is interested in investigating novel combined modality therapies that target the EGFR/PI3K/Akt pathway and...how one can predict sensitivity to these therapies in cancer disease sites. Elaine Smith, PhD; Professor, Department of Epidemiology, College of...efficacy of monoclonal antibody therapy of cancer. Preclinical and clinical studies are exploring the relative role of various effector cells in

  7. Proteomics in prostate cancer research.

    PubMed

    Hellström, Magnus; Lexander, Helena; Franzén, Bo; Egevad, Lars

    2007-02-01

    The incidence of early prostate cancer (PCa) among middle-aged men has increased rapidly. For many of these men, curatively intended treatment does more harm than good. Established prognostic factors are tumor stage and grade. As a result of earlier detection a majority of patients now have nonpalpable tumors (T1c) of intermediate grade (Gleason score 6). Prostate specific antigen in serum in such cases is generally at a low level and not a reliable predictor of prognosis. Altogether there is an urgent need for adjunctive prognostic indicators. In the search for relevant tumor markers for improved patient selection an exploration of the proteome (the human proteins) could be fruitful. This paper critically reviews the use of 2-dimensional gel electrophoresis (2-DE) for proteome research. Additional steps such as image analysis and mass spectrometry are described. Techniques based on non-2-DE platforms: surface-enhanced laser desorption/ionization (SELDI), isotope coded affinity tags (ICAT) and array-based technologies are also summarized. Although labor-intensive and time-consuming, 2-DE is presently the most powerful method for analysis of cellular protein phenotype and may potentially reveal gene regulations that cannot be detected on a genetic level.

  8. Researching the experience of kidney cancer patients.

    PubMed

    Taylor, K

    2002-09-01

    The author's personal experience as a kidney cancer patient, researcher and founder of a kidney cancer support group forms the basis for consideration of the challenges involved in researching patients' experiences. The researcher needs to understand the variability of those experiences in both clinical and psychological-emotional terms, and in relation to the personal, familial and social contexts of the patient. It is also essential to define the purpose of the research and to show how an understanding of personal experiences of cancer can be used to enhance the quality of care for cancer patients. The research encounter with a patient is also in some respects a therapeutic encounter requiring a considerable degree of sensitivity on the part of the researcher. The person-centred approach of Carl Rogers is of value in supporting such an encounter.

  9. African Organization for Research and Training in Cancer: position and vision for cancer research on the African Continent.

    PubMed

    Ogunbiyi, J Olufemi; Stefan, D Cristina; Rebbeck, Timothy R

    2016-01-01

    The African Organization for Research and training in Cancer (AORTIC) bases the following position statements on a critical appraisal of the state on cancer research and cancer care in Africa including information on the availability of data on cancer burden, screening and prevention for cancer in Africa, cancer care personnel, treatment modalities, and access to cancer care.

  10. What's New in Gallbladder Cancer Research and Treatment?

    MedlinePlus

    ... and Treatment? Gallbladder Cancer About Gallbladder Cancer What’s New in Gallbladder Cancer Research and Treatment? Research into ... Chemotherapy and radiation therapy Researchers are looking at new ways of increasing the effectiveness of radiation therapy . ...

  11. A phase II study of irinotecan and pegylated liposomal doxorubicin in platinum-resistant recurrent ovarian cancer (Tohoku Gynecologic Cancer Unit 104 study).

    PubMed

    Shoji, Tadahiro; Takatori, Eriko; Omi, Hideo; Kagabu, Masahiro; Honda, Tatsuya; Futagami, Masayuki; Yokoyama, Yoshihito; Kaiho, Michiko; Tokunaga, Hideki; Otsuki, Takeo; Takano, Tadao; Yaegashi, Nobuo; Kojimahara, Takanobu; Ohta, Tsuyoshi; Nagase, Satoru; Soeda, Shu; Watanebe, Takafumi; Nishiyama, Hiroshi; Sugiyama, Toru

    2017-08-01

    We report a phase II clinical study of the combination of irinotecan (CPT-11) and pegylated liposomal doxorubicin (PLD) in platinum- and taxane-resistant recurrent ovarian cancer, based on the recommended doses determined in a phase I trial. PLD was administered intravenously at a dose of 30 mg/m(2) on day 3. CPT-11 was administered intravenously at a dose of 80 mg/m(2) on days 1 and 15, according to the recommendations of the phase I study. A single course of chemotherapy lasted 28 days, and patients underwent at least 2 courses until disease progression. The primary endpoint was antitumor efficacy, and the secondary endpoints were adverse events, progression-free survival (PFS), and overall survival (OS). The response rate was 32.3% and the disease control rate was 64.5%. Grade 3 and 4 neutropenia, anemia, and a decrease in platelet count were observed in 17 (54.9%), 3 (9.7%), and 1 patient (3.2%), respectively. In terms of grade 3 or higher non-hematologic toxicities, grade 3 nausea occurred in 1 patient (3.2%), vomiting in 3 patients (9.7%), and grade 3 diarrhea and fatigue in 1 patient (3.2%). The median PFS and OS rates were 2 months and not reached, respectively. Of the 11 patients with a treatment-free interval (TFI) of ≥3 months, the response rate was 63.3%, and the median PFS was 7 months. The treatment outcomes for the 31 patients enrolled in this study were unsatisfactory. However, sub-analysis suggested that patients with a TFI of ≥3 months had a good response rate and PFS. This suggests that CPT-11/PLD combination therapy may be a chemotherapy option for platinum-resistant recurrent ovarian cancer.

  12. The optimal organization of gynecologic oncology services: a systematic review