Tuesday, March 26, 2019

Why Targeting Cancer Stem Cells Is So Important

How's this for an interesting fact? It only takes 11 cancer stem-cells to start a tumor. Contrast this with the fact that 50,000 non-stem like cancer cells, if transplanted, won't necessarily cause a tumor.

Considering that chemo generally kills 90-99% of cancer cells, getting at those dormant cancer stem cells is really important.

What causes them to get reactivated? What treatment advances are being made to deal with these residual cells?

An experimental drug used in mouse models of ovarian cancer, 673A, works in combination with standard chemo to target these stem cells and lower the chance of recurrence. To read more about this, follow this link.

Tuesday, March 19, 2019

Stowe Weekend of Hope: May 3-5, 2019

I was thinking about the the first time my partner and I heard about the Stowe Weekend of Hope.

"You mean a whole town puts aside a weekend to host a series of events, workshops and entertainment all devoted to cancer patients and their families? And lodging is free to first time attendees?"

Pretty. Amazing.

Stowe is a wonderful town nestled into the surrounding mountains of Vermont, an area made famous by the Von Trapp family ("Sound of Music" fame) who settled there after escaping Nazi Germany. In fact, we stayed at the Von Trapp Family Lodge, where really, the views are amazing.

If you or someone you know is interested in attending this wonderful weekend of hope,  follow this link to sign up. You'll leave uplifted by the incredible warmth, generosity and camaraderie you'll find after attending this event. But hurry, because spots fill quickly.

NEJM Study Shows No Long-Term Benefit from Removal of Normal Appearing Lymph Nodes

The results of the LION study was released in this month's the New England Journal of Medicine.

In the Lion study (Lymphadenectomy in Ovarian Neoplasms), 647 women with advanced ovarian cancer - as defined by the International Federation of Gynecology and Obstetrics as Stage IIB to IV - were randomly assigned to  either receive or not receive complete pelvic and paraaortic removal of lymph nodes.

What makes this study interesting is the inclusion criteria. All women had to have no residual disease after a complete resection and all women had to have normal appearing lymph nodes. The nodes had to be viewed directly and not simply palpated. In addition, the centers involved in the study had to be evaluated for surgical quality.

Previously normal appearing pelvic and paraaortic lymph nodes have been seen as hiding places for metastatic cancer cells and treatment protocols called for the removal of these lymph nodes. Recurrences showed in second-look surgeries, that these lymph nodes contained cancer cells that had not been successfully treated with initial chemo, prompting some researchers to call these lymph nodes "pharmacological sanctuaries".

However, as many women have attested to, there are complications associated with the removal of these nodes from having to wear thigh-high compression stockings (try wearing those in the summer) to outright lymphedema. Women who had lymph node resection also had higher rates of post-op complications within 60 days of surgery including death.

Ultimately, the median over all survival rate in women without lymph node removal was 69.4 months vs 65.5 months among women with lymph node removal. Median progression-free survival in both groups was the same at 25.5 months.

To read the extract of this study, follow this link.

Tuesday, March 12, 2019

New 'Trojan Horse' Cancer Treatment Shows Early Promise in Multiple Tumor Types

This article was recently published in EurekaAlert. The drug, tisotumab vidotin, TV for short, releases a toxic substance from within the cancer cell to kill it.

It has been shown to be effective in certain drug-resistant tumors.

According to the article,  researchers saw responses "...in 27 per cent of patients with bladder cancer, 26.5 per cent with cervical cancer, 14 per cent ovarian cancer, 13 per cent with oesophageal, 13 per cent with non-small cell lung and 7 per cent with endometrial cancer (although not in any men with prostate cancer). Responses lasted an average of 5.7 months, and up to 9.5 months in some patients."

The article was originally published in Lancet Oncology

Tuesday, March 5, 2019

Revised FIGO Staging for OC & the Role of Imaging

I recently came across this article from the American Journal of Roentgenology and although it was published in 2016, it's still relevant.

If you'd like to read the text, follow this link.