Posts tagged ‘ovarian cancer’
People with a family history of cancer often want, or need, to know whether they have a gene mutation linked to that cancer. For that, they seek genetic testing, involving a blood sample that is analyzed for specific gene abnormalities.
Thomas Slavin, M.D., a geneticist and assistant clinical professor at City of Hope, typically works with patients – primarily breast, ovarian or colorectal cancer patients – who have a hereditary predisposition to cancer. Most are part of City of Hope’s large Hereditary Cancer Registry and are working with a genetic counselor. Slavin, the counselor and the patient use the patient’s history and genetic information to inform testing and make treatment plans.
Here, Slavin explains why he chose such a complex and rapidly involving field.
Why did you choose the field of genetic testing?
It has been an interest of mine since I was very young. When I was in middle school, I wrote to the American Society of Human Genetics requesting information about careers in genetics because I’ve always found it intriguing that one little mutation in a single gene can be life-changing for a family. After pursuing residencies in both pediatrics and medical genetics and completing a board certification in molecular diagnosis, I became particularly interested in the rapid advances in genetics sequencing and the newfound ability to make detailed molecular diagnoses on individuals. » Continue Reading
As genetic testing becomes more sophisticated, doctors and their patients are finding that such tests can lead to the discovery of previously unknown cancer risks. In his practice at City of Hope, Thomas Slavin, M.D., an assistant clinical professor in the Division of Clinical Cancer Genetics, sees the full spectrum of hereditary cancer disorders in adults and children. Here, he discusses the expanded genetic testing options for people at risk for hereditary breast, ovarian and other cancers.
What are some of the latest advancements in genetic testing?
Breast and ovarian cancer patients and family members at risk for hereditary breast and ovarian cancer syndrome are now being offered testing for many more genes outside of the well-known genes BRCA1 and BRCA2. And while there doesn’t appear to be a “BRCA3,” many other genes have been linked to breast and ovarian cancer predisposition. The recent advances in high throughput, cost-effective, next-generation sequencing techniques and the decision by the Supreme Court that genes cannot be patented have combined to form an explosion in hereditary cancer genetics testing. » Continue Reading
Delivering chemotherapy directly to the abdomen in women with advanced ovarian cancer is part of an effective treatment regimen that’s too little used. That’s the conclusion of a new study published in the Journal of Clinical Oncology.
The technique, known as intraperitoneal, or IP, chemotherapy, has been linked to extended survival when delivered with traditional intravenous, or IV, chemotherapy. In fact, the National Cancer Institute in 2006 actively encouraged use of intraperitoneal chemotherapy for ovarian cancer in the wake of a study concluding that women who received the combination approach had a 16-month improvement in median overall survival.
City of Hope experts are well-versed in the regimen and offer IP chemotherapy to appropriate patients. But, says the new study by researchers at City of Hope and elsewhere, fewer than 50 percent of eligible patients in a recent study of select institutions received IP/IV chemotherapy.
“Increasing IP/IV chemotherapy use in clinical practice may be an important and underused strategy to improve ovarian cancer outcomes,” wrote the study authors, which included City of Hope’s Mihaela Cristea, M.D., associate clinical professor of medical oncology, and Joyce C. Niland, the Edward and Estelle Alexander Chair in Information Sciences. » Continue Reading
Upon completing her final round of chemotherapy for ovarian cancer earlier this month, Maria Velazquez-McIntyre, a 51-year-old Antelope Valley resident, celebrated the milestone by giving other patients a symbol of hope – a Survivor Bell.
The bell may look ordinary, but for cancer patients undergoing chemotherapy, ringing it is far from routine. The ringing of the bell signifies the end of active treatment and the beginning of a life free of cancer.
“The bell represents hope and a sense of accomplishment,” said Velazquez-McIntyre, who donated one bell to the Antelope Valley clinic and another to the main City of Hope campus in Duarte. “My goal is to give someone else going through chemotherapy that hope. If I can ring that bell, so can you.” » Continue Reading
In 1975, the median survival for patients with ovarian cancer was about 12 months. Today, the median survival is more than 5 years.
Although researchers and clinicians are far from satisfied, the progress in ovarian cancer treatment is encouraging, said Robert Morgan, M.D., F.A.C.P., professor of medical oncology in the Department of Medical Oncology and Therapeutics Research at City of Hope. Morgan is also chair of the National Comprehensive Cancer Network’s Guidelines Panel for Ovarian Cancer, which recently released its 20th annual edition of the guidelines.
“This is a very treatable illness,” Morgan said. “I’m frustrated that I still hear from women who are diagnosed and told to get their affairs in order. That’s exactly the wrong advice. Much of the time, these patients are curable.”
In fact, ovarian cancer responds to drug treatment as often as 90 percent of the time. While fewer than 40 percent of women are cured, overall survival is improving – and so are treatments. » Continue Reading
Think twice before tossing out those hormone replacement pills. Although a new Lancet study suggests that hormone replacement therapy could increase a woman’s risk of ovarian cancer, a City of Hope expert urges women to keep this news in perspective.
Hormone replacement therapy is prescribed to help alleviate symptoms, such as hot flashes and night sweats, that can damage quality of life in menopausal women. The University of Oxford study found that women who used hormone replacement therapy for less than five years after menopause had a 40 percent higher risk of ovarian cancer than other women.
However, while the statistical finding is an important one, the study was not designed to definitively show that the hormone therapy caused the increased ovarian cancer risk. No mechanism has been identified.
Robert Morgan, M.D., co-director of the gynecological cancers program at City of Hope, said that women do indeed face a slightly increased risk of ovarian cancer when using hormone replacement, but that the overall risk for the general population is very low. Over 21,000 women are expected to be diagnosed with ovarian cancer this year, according to the American Cancer Society, and over 14,000 are expected to die of the disease.
“The fact alone of a slight increased risk of ovarian cancer in women taking hormone therapy won’t, and shouldn’t, impact treatment decisions,” Morgan said in a HealthDay interview. » Continue Reading
Chemotherapy drugs work by either killing cancer cells or by stopping them from multiplying, that is, dividing. Some of the more powerful drugs used to treat cancer do their job by interfering with the cancer cells’ DNA and RNA growth, preventing them from copying themselves and dividing.
Such drugs, however, like Hydroxyurea, do have drawbacks. One is that the body metabolizes them quickly. Patients need frequent doses to achieve the desired effects. Because the side effects of the drugs are already considerable, increased use of them raises the risk of negative reactions. Another drawback is that cancer cells develop rapid resistance to the drugs, reducing their effectiveness.
A team effort
As a physician, molecular pharmacologist Yun Yen, M.D., Ph.D., knows well the limitations of chemotherapy drugs. He partnered with medicinal chemist David Horne, Ph.D., to find — and improve — a molecule, or compound, to overcome these problems.
First, Yen selected a promising anti-cancer compound from the National Cancer Institute’s library of anti-cancer agents. Then, using data obtained with the help of the skilled laboratory scientists in City of Hope’s Core (or “Shared”) Services, Horne began to make structural adjustments to improve the molecule’s effectiveness. Core Services provides researchers, specialized expertise, testing and instrumentation in fields such as molecular modeling, screening, medicinal chemistry and cancer biology. Access to these services enabled Yen and Horne to determine, even before preclinical testing, how the compound worked. » Continue Reading
Ryan Chavira was a senior in high school when she began feeling sluggish, fatigued and, well, “down.” Trips to the doctor ended in “you’re fine” pronouncements; blood tests results showed nothing of real concern.
But Chavira’s grandmother had passed away from ovarian cancer when she was in eighth grade, and the distended stomach and bloated feeling that Chavira was experiencing reminded her of her grandmother’s symptoms.
When the bloating gave way to pain, then excruciating pain, Chavira went to a hospital emergency room. A CT scan revealed a tumor the size of a watermelon engulfing her ovaries. Emergency surgery was the only option.
Chavira, now 22, describes the diagnosis and decision on a course of action in this way: “They come in, say ‘You have cancer and we’ll be right back to operate.’” There was no time for the diagnosis to sink in. » Continue Reading
Immunotherapy — using one’s immune system to treat a disease — has been long lauded as the “magic bullet” of cancer treatments, one that can be more effective than the conventional therapies of surgery, radiation or chemotherapy. One specific type of immunotherapy, called adoptive T cell therapy, is demonstrating promising results for blood cancers and may have potential against other types of cancers, too.
Here, Leslie Popplewell, M.D., associate clinical professor and staff physician in City of Hope’s Department of Hematology & Hematopoietic Cell Transplantation, explains what this treatment entails.
What is adoptive T cell therapy and how does it work to treat cancer?
Every day, our immune system works to recognize and destroy abnormal, mutated cells. But the abnormal cells that eventually become cancer are the ones that slip past this defense system. The idea behind this therapy is to make immune cells (specifically, T lymphocytes) sensitive to cancer-specific abnormalities so that malignant cells can be targeted and attacked throughout the body.
Who would be good candidates for this type of therapy? » Continue Reading
For women with ovarian cancer, the results of recent study could mean new hope for future treatments. The findings, reported at the American Society of Clinical Oncology’s annual meeting, found that a combination of two experimental drugs, olaparib and cediranib, significantly lengthened the duration of progression-free survival compared to olaparib alone and standard chemotherapy.
The phase II trial is the first time that a PARP inhibitor is combined with an anti-angiogenic drug to treat ovarian cancer. PARP inhibitors such as oliparib work by thwarting cancer cells’ ability to repair their own DNA, while anti-angiogenic drugs such as cediranib halts growth of new blood vessels in tumors.
“The significant activity that we saw with the combination suggests that this could potentially be an effective alternative to standard chemotherapy,” said the study’s lead author Joyce Liu, M.D., M.P.H., in a press release.
Liu, an instructor in medical oncology at Dana Farber Cancer Institute, added that these findings showed that the two drugs worked synergistically and bolstered each other’s effectiveness against the cancer.
For this clinical trial, Liu and her colleagues randomized 90 patients with recurrent, platinum-sensitive ovarian cancer into either olaparib-only or olaparib+cediranib groups. In their analysis, they found that progression-free survival was significantly higher in the combination group, over 17 months compared to nine months in oliparib only. Meanwhile, previous trials with standard chemotherapy in this population showed a progression-free survival range from eight to 13 months.