THE QUESTIONS TO ASK & OTHER THINGS TO KNOW

             Linda visits a modest cottage along the Thames

I have written several times over the years that the main value of this endless series of blogs is to equip you to ask the right questions if, God forbid, you receive a diagnosis of ovarian cancer.  Well, US News and World Report has just published an article that does a commendable job of addressing just that question.  Every woman should read it, now.  Hell, every man lucky enough to have a woman in his life should read it, too.  Here it is:

https://health.usnews.com/health-care/patient-advice/articles/questions-to-ask-when-youre-diagnosed-with-ovarian-cancer 

If your computer is like mine you will have to copy this link to the appropriate line; you know what I mean.  Simply clicking on it won’t work, for reasons that escape me.  Anyway – just do it.

Oh, by the way the ten best cancer centers are listed,  Fred Hutch is one of them/.

 

UNIVERSAL GENETIC TESTING

                        Linda in Quito, central square

                 At the time known as pick-pocket central

In this blog series I have written several times about the benefit of universal genetic testing of women for susceptibility to ovarian and breast cancer.  If I had my way, every little girl baby  at birth would have her foot pricked, yielding a precious little drop of blood, which immediately would go into a machine that would test for mutations in the BRCA genes and others known trouble makers.  Surprisingly, NIH has failed to adopt my scheme, citing its rather immense cost.  Well, now a bunch of medical economist types in Germany purport to have shown that some sort of scheme like this is cost effective!  And that’s as much as I can tell you.  Here, puzzle through it yourself:

https://www.journalofclinicalpathways.com/news/targeted-genetic-testing-cost-effective-breast-and-ovarian-cancer 

The analysis summarized above involves  measures like ICER (incremental cost effectiveness ratio) and QALY (quality-adjusted life years).  I googled these objects and – Stanford economics grad though I am – understood them not at all. Maybe you will do better.  Anyway, good news, I guess.

  If we can’t trust German medico-statisticians  we are in big trouble!

OVARIAN CANCER AWARENESS MONTH, 2021

                              Linda visits Mt. St. Helens

Lest you forgot, February is ovarian cancer awareness month.  Read this rather quaint blurb out of Australia:

https://www.miragenews.com/february-is-ovarian-cancer-awareness-507692/  

and wear your teal ribbon.  Also, use some of that money that has been accumulating in your bank account because you can’t travel or eat out to support OVCA research.  Donate to:

https://secure.fredhutch.org/site/TR/PersonalFundraisingPages/FredHutchinsonCancerResearchCenter?px=1148821&pg=personal&fr_id=1573&fb_comment_id=1379501758839112_1582806938508592

 I don't understand why neither of the URLs above show up an inviting blue.  You'll just have to cut and paste.

MORE RECENT ITEMS

                                                   In much happier times

COVID seems to have crowded out news of other medical matters.  I tell you that because I haven’t been posting OVCA news as frequently lately as before.  What news I do run across usually concerns details of one clinical trial or another, concerns some drug whose name ends in “ab” and whose purpose is to extend life for a few months.  Not your cup of tea, I suspect.  However, you may find something new and/or interesting in this compendium published by Cure Today.  In the meantime, I will keep looking.

https://www.curetoday.com/view/7-ovarian-cancer-news-and-updates-that-patients-may-have-missed-in-2020 

WHEN MITOCHONDRIA GO TO THE DARK SIDE

          LINDA HER BIG BROTHER RICHARD

Maybe I’m just stupid, but I simply don’t understand how this particular natural process can have come about.  In my naïve way I always have thought that biological traits survived and prospered only when they offered some procreative advantage.  The operative word here is “procreative”; only things that procreate are able to pass on favorable modifications; if the modification isn’t useful it gets erased.  Now, individual tumors cannot in any sense be regarded as reproducing; they come into being, perhaps prosper – and kill their host.  No babies, no evolution.

So, then, how did the OVCA tumor develop the ability to manipulate the cell – specifically its mitochondria – to defend itself against a “hostile environment”?  That’s exactly what it does, according to new research at Virginia Tech.  See below:

https://www.eurekalert.org/pub_releases/2021-01/f-occ010521.php. 

New avenues of therapy opened up by this research are hinted at, albeit somewhat indistinctly.  Let us hope.

In passing, British tabloids are all agog over the news that NICE (their FDA) has approved niraparib for general maintenance purposes - that is, prolonging the period of wellness between episodes of tumor growth, thereby prolonging life and enhancing its quality.  For once we Yanks are ahead of them; under the trade name Zejula, niraparib has been available here for some time.  See below:

https://ljb-quiltcutie.blogspot.com/2019/11/exciting-adventures-in-parp-inhibition.html  

Apparently the problem has been that niraparib was thought to be effective only against tumors caused by a BRCA mutation.  Thankfully, this  isn’t so.

MORE ON BREASTFEEDING - THE LAST WORD

                  Kristen and Linda prepare to tackle the                                                    canyon

As if it were needed, JAMA (Journal of the American Medical Association – the last word in health) has come out with another reason to breastfeed: it helps prevent ovarian cancer,  I have blogged about this previously, I think, but apparently there remained some doubt – which now is officially eliminated.  Even a few months of breastfeeding reduces OVCA risk to a statistically important degree.  As to why….?  Part of the reason lies in the reduction in lifetime ovulation: ovulation involves rapid cell division, which increases the probability of mistakes that could result in cancer.  Also, breastfeeding may trigger long-term modifications of the immune system – although that appears to be less certain.  Also, it was noted that nearly all women in the various statistical experiments were white, leaving unresolved the efficacy of breastfeeding in non-white women.

https://www4.curetoday.com/view/breastfeeding-lowers-the-risk-of-ovarian-cancer 

 

NCI SUMMARIZES THE YEAR

                                Linda and Carolyn, in happier times

NCI has published its list of most viewed stories for 2020.  Some I have blogged about; others I haven’t.  It is worth devoting a few minutes of your COVID-lengthened day to giving it a glance.  There are several very useful explanations of how things work – especially, our old friend CRISPR.  Just go to the NCI web site and poke around.

One thing that struck me during my own “poking around”:  there is a dangerous lack of people trained to properly administer these new therapies.  All the more reason to seek help from the major league institutions: Fred Hutch, Sloan Kettering, Fox Chase, MD Anderson, etc.  And all the more reason for smart and ambitious young people to train for these fields.

 And, of course – geez, these new wrinkles sound incredibly expensive!