Ovarian Cancer Symptoms Speak Out-But What Are They Really Saying?

Journal of the National Cancer Institute (Impact Factor: 12.58). 02/2010; 102(4):211-2. DOI: 10.1093/jnci/djp525
Source: PubMed

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    ABSTRACT: Epithelial ovarian cancer is the leading cause of death from gynecologic malignancies in the United States. Although the prevalence of ovarian cancer when compared with other neoplasms is low, with an estimated 21,550 new cases in 2009, the majority of patients are diagnosed at an advanced stage of disease, with projected 5-year relative survival rates of 31%. Early detection is a clinically relevant goal for the optimal management of patients with ovarian cancer. Attempts to develop valuable screening strategies and incorporate preventive measures are ongoing. Frontline management of ovarian cancer involves primary cytoreductive surgery followed by platinum-based combination chemotherapy and up to 80% of women with advanced disease achieve an objective response and 10%-20% are cured with this regimen; nevertheless, disease recurrence is inevitable in most patients. Multiple strategies including the inclusion of effective targeted therapies upfront and the incorporation of maintenance regimens are being investigated to improve frontline response rates. Currently, the choice of treatment in recurrent ovarian cancer is based on the disease-free interval from completion of first-line platinum-based therapy; several platinum and non-platinum agents are used in the recurrent setting with equivalent efficacy outcomes. The roles of targeted therapies, secondary cytoreductive surgery, and rising cancer antigen 125 levels in the treatment of recurrent disease are being delineated. Clearly, there is a need to identify novel agents and personalized strategies that will improve clinical outcomes in this disease. It is likely that a better understanding of the molecular changes in the pathogenesis of ovarian cancer will pave the way for more effective therapeutic options. This summary highlights current challenges in the management of ovarian cancer and outlines expert perspectives, key questions, and future directions.
    No preview · Article · Nov 2010 · Clinical Ovarian Cancer
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    ABSTRACT: Ovarian cancer is the most lethal form of gynaecological cancer. It can be difficult to diagnose, with the majority of diagnoses made at a late stage of disease. An integrative literature review was conducted to explore the ovarian cancer diagnostic journey of women and to examine the potential contribution of using a person-centred approach. Factors associated with ovarian cancer diagnostic delay were described in terms of two phases. The principles of person-centred health care (PCHC) were identified. This paper proposes utilising the principles of PCHC to improve women's experience of the diagnostic journey. Specific strategies are suggested for each delay phase to enhance the experience for women. Whilst the challenges in diagnosing the disease are likely to remain until a screening test is available, it is hoped that by implementing strategies based upon PCHC, nurses may facilitate the ovarian cancer diagnostic process and improve the diagnostic experience for women.
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    ABSTRACT: Most of the research on tumor cell metabolism has focused on glucose utilization. However, when glucose is limited, solid tumors are forced to catabolize alternative substrates such as fatty acids and amino acids as an energy source. Measuring these alternations in tumor cell metabolism enables us to track neoplastic changes in the tissue to lead towards a more reliable diagnostic outcome. Although a very small number of elements are used in biochemistry, the metabolome is structurally diverse for the production of simple compounds such as phosphate and amino acids as well as more structurally complex compounds such as nucleotides, oligosaccharides, and complex lipids. Characterization of the metabolome, therefore, requires analytical methods that can handle a wide range of molecular structures and physicochemical properties, including solubility, polarity, and molecular weight. A further factor for consideration in the selection of technology for metabolomics is the wide range of concentrations of biochemical typically present in biological systems. MS has established itself as the high-throughput, information-rich, industrially stable approach to assess both the composition of diverse sample types as well as changes to that composition following perturbation.
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