Showing posts with label screening. Show all posts
Showing posts with label screening. Show all posts

Tuesday, May 28, 2019

2019 Annual Retreat On Cancer Research in New Jersey


This year's retreat was as informative and interesting as in years past.

The morning began with the Public Forum on ScreenNJ - Cancer Prevention , Education and Detection. Dr A Stroup started off the session talking about cancer burden in NJ. 
NJ Cancer Burden

Cancer Disparaties

Dr M Steinberg talked about Lung Cancer screening and treatment. Lung cancer is the leading cause of cancer death in women. He also made note of the fact that smoking affects nearly every organ of the smokers body. If a smoker stops smoking,  over time the risk of heart attack and stroke will drop. If you have 30 pack years of smoking ( smoke one pack a day for 30 years) then  Low Dose CT screening is available to you as a screening tool.


Screening option

Dr Natalie Pereira discussed Colorectal Screening and noted that it takes about 10 years for a abnormal polyp to become malignant cancer. The risks for colorectal cancer are age, family history, polyps, Lynch Syndrome and eating high quantities of fat or red meat.

Symptoms of colorectal cancer

Screening Recommendations

Dr Kinney shared information on the ScreenNJ Statewide program. Less than 60% of the eligible population in NJ has been screened for colorectal cancer and 10% of the eligible population in NJ has had lung cancer screening. We need to educate residents of NJ that these screening tests are available to them.


The Keynote speech was by Dr Steve Rosenberg, Chief of Surgery at the NCI. He presented an overview of the development of cell transfer therapy. There are a number of Immunotherapies using immune cells to recognize and kill cancer cells . He then focused on using those therapies to treat epithelial cancers. Epithelial cells are found in the linings of most organs - ovaries are one of those organs. Cell transfer therapy has had durable regressions in melanoma and in recent research in other epithelial cancers.


After lunch I listened to a short talk on Nanotechnology Approach for Precision Targeted Therapy for Ovarian Cancer by J Sapiezynski, a student at the Earnest Mario School of Pharmacy, Rutgers. He used liposomes as a dose delivery system for cisplatin and SiRNA.

During the poster session I was able to chat with researchers who presented the results of the  Gynecologic Cancer Patients' and Supporters' Reports of Sharing (and Holding Back)Cancer-Related information during Onoclogy Visits Study. Eighteen patients ( during cycles 2 and 5 of their treatment)  and sixteen caregivers took part in the study. The theme that "Everything is easy to share" showed that patients found it easiest to discuss side effects with their oncology team. Yet there was also a theme of "Nothing held back...except" when patients or caregivers felt uncomfortable sharing some information - such as embarrassing information or prognosis.

I am so pleased to see that important research is taking place right here in my home state.

Dee
Every Day is a Blessing! 

Wednesday, April 24, 2019

Upcoming Public Forum on ScreenNJ - May 2019

For the past few years I have attended a number of public forums as part of the Annual Retreat on Cancer Research in NJ. You may read about the one I attended in 2018 on HPV cancers here  and  the one I attended in 2017 about precision medicine here

If you are an cancer advocate or just a resident interested in learning more about screening I invite you to register for this year's Public Forum about ScreenNJ - Cancer Prevention Education and Detection. Presentations this year include Cancer Burden in NJ, Colorectal Prevention and Detection, Lung Cancer Screening , and information on the ScreenNJ State Program. This year's forum is on May 23, 2019 from 8:30 am - 10:00 am at the Rutgers Student Center in New Brunswick, NJ.



Registration is free and may be found at:
www.mpi-evv.com/2017NJCR/2017PFReg.asp

I hope to see you there!

Dee
Every Day is a Blessing! 

Monday, June 5, 2017

#ASCO17 Twitter Highlights

I was not able to attend this year's ASCO Annual Meeting in Chicago so instead I followed the latest oncology news from the meeting via Twitter (#ASCO17).  I appreciate all the attendees who used the #gyncsm hashtag too.

Below find the tweets I found most interesting in the areas of gynecologic cancers, social media and survivorship.

Let's start first with how to read cancer related news:
Patient Reported Outcomes Leads to Improved survival
Impact of HPV vaccinations:

PD-1 Pathways in Gynecologic Cancers: 


Progress in High Grade Serous Ovarian Cancer:

Liquid Biopsy

Parp Inhibitors in Ovarian Cancer:

Resection of Recurrent OC:

ICON6:
"ICON6 is designed to evaluate the safety and efficacy of platinum-based chemotherapy in combination with cediranib in women with platinum-sensitive relapsed ovarian cancer . Cediranib is an oral targeted small molecule inhibitor of a key signalling molecule Vascular Endothelial Growth Factor (VEGF) which is an oral inhibitor of tyrosine kinase (TK) activity and acts through blockade of the TK receptor. Cediranib (AZD2171)" source :http://www.icon6.org/


OC risk reduction w/ BRCA mutation:


BRCA testing - ovarian cancer:


Endometrial Cancer and Genetic Testing:
Homologous Recombination Deficiency:

Germline Testing:

Abstract 1524 http://abstracts.asco.org/199/AbstView_199_187114.html

from this study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048908/

Immunotherapy:

Screening for OC:


Fallopian Tube /Ovarian Cancer:

Based on this study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048908/

Social Media:

session description- https://iplanner.asco.org/am2017/#/session/12030
 
Li-Fraumeni Syndrome:

Cost of Care:


I hope I'll get the opportunity to report live from ASCO 2018.

Dee
Every Day is a Blessing!

Sunday, December 20, 2015

Part 1: Using the Risk of Ovarian Cancer Algorithm for Screening - US launch

Last June, when I attended the ASCO annual meeting I was fascinated by a presentation by Dr Usha Menon on the UK Collaborative Trial of Ovarian Cancer Study (UKCTOCS) using the ROCA (Risk of Ovarian Cancer Algorithm) test. I wrote about it here.

Results reported in this JCO article,
Risk Algorithm Using Serial Biomarker Measurements Doubles the Number of Screen-Detected Cancers Compared With a Single-Threshold Rule in the United Kingdom Collaborative Trial of Ovarian Cancer Screening
found that using the risk algorithm detected double the amount of invasive epithelial ovarian cancers, before the CA-125 alone, at a fixed, 35u/ml cutoff. .

Earlier this month I was contacted by a representative of the PR firm that is representing Abcodia, a company that develops early detection tests for cancer. On December 2, 2015  Abcodia launched the ROCA (Risk of Ovarian Cancer Algorithm) test here in the US. After finding and reading my blog, the  firm contacted me to share that the test was now available. Of course I was interested in learning more about this test that was now available in 5 states - Texas, Massachusetts, Illinois, Arizona and my home state of New Jersey. You can find the press release at http://www.abcodia.com/news_021215.php.

We conversed via e-mail and then I had a teleconference with the PR firm's representative as well as the representatives from Abcodia.  Abcodia's  responses to my questions are shown below in quotes and italics. I have permission from Abcodia to share the information provided.

  • What is the difference between the ROCA test and the CA-125, which is one component of the ROCA test? "The ROCA Test does not use CA-125 with a fixed cutoff, instead, ROCA establishes a patient’s baseline, and then evaluates her CA-125 pattern over time."  (CA-125 uses a fixed cut-off of either 35 u/ml or 20 u/ml depending on which test protocol is followed. "ROCA incorporates the CA-125 result (and all the following CA-125), and, factors in age,
    menopausal status and high risk factors, which affect CA-125 levels. ROCA takes all of this data on one patient and creates a unique profile for her.  ROCA then compares her profile to known profiles in a database of thousands of women to see if her profile more closely resembles that of  women who have cancer or women who do not have cancer.  The ROCA Test reports a
    numerical score which represents a woman’s risk of having ovarian cancer (e.g. 1 in 5,000) now. The risk score is categorized as Normal, Intermediate or Elevated as a guide for clinical decisions by your doctor."
  • Who is the ROCA test meant for and when should they have it? The ROCA test is meant for women in the general population who are "Between 50 and 85 years and have been through menopause; or"  high risk women "Between 35 and 85 years with a family history of ovarian and/or breast cancer, are of Ashkenazi Jewish descent with a known family history of ovarian or breast cancer, or have tested positively for BRCA1, BRCA2 or Lynch syndrome gene mutations." The CA-125 may be used for high risk women only. The test would be similar to "Routine testing, just like you would a physical or mammogram." Currently the CA-125 with a fixed cutoff is sometimes used for high risk women only when advised by their physicians. As many of my readers know, the CA-125 is used by gynecologic oncologists to manage the care of women who have been diagnosed with ovarian cancer. 
  • How does the ROCA test compare to the CA-125 in terms of how well it detects ovarian cancer?"When combined with appropriate clinical follow-up, the ROCA Test has been shown to detect more than twice as many ovarian cancers before the current CA-125 35U/ml fixed cutoff. As a screening tool by itself, CA-125 is not reliable and has not been shown to improve outcomes for women with ovarian cancer."
  • How does a woman go about getting the test?  She fills out a form online to see if she is eligible and orders the kit. Then she finds a referring physician (OB-GYN or primary care physician) to sign the request for the test and the blood work. "Abcodia is proactively educating OBGYNs, has a dedicated phone line and online materials specifically for healthcare professionals."
  • What is the cost of the test and is it covered by Medicare, other insurances? "The cost of each ROCA Test is $295. This includes the cost for the Iggbo blood draw service, who will have a trained phlebotomist come to a doctor’s office, a patient’s home or other location of the patient’s choice to draw blood.  Iggbo will then ship the blood sample via FedEx to Abcodia’s laboratory." Abcodia's lab is a CLIA, registered lab. Currently the test is not covered by Medicare or other insurances. "Abcodia does plan to seek regulatory and reimbursement approvals"
  • Can a woman get the CA-125 drawn at a different lab and then submit it to Abcodia? It is recommeded that the blood draw be through Abcodia's blood draw partner, Iggbo. A patient can have her blood drawn at her physician's office or a hospital if a phlebotomist is available. All samples do need to be tested at the Abcodia lab to insure there is no lab to lab variability. CA-125 test results from other labs (Quest, Labcorp) for use with the test are not accepted.
  • What happens after the initial result? "The frequency of the ROCA test will be determined by the woman's doctor based on her risk factors for ovarian cancer and the ROCA test result. Post menopausal women with no additional risk factors will likely have one test per year. Women at high risk for ovarian cancer , will complete the test more frequently, at a minimum three times per year and may include a Transvaginal Ultrasound (TVU). If the result falls outside of the normal range(intermediate or elevated) a doctor may recommend a repeat ROCA test within the next six weeks to three months. Patients may also be referred for a transvaginal ultrasound scan of the ovaries or other possible clinical assessments. "                                
  •  Does the women pay $295 each time she has a follow-up test?"After a patient takes her first test, Abcodia offers the patient several options: 1. The patient can pay per test ($295) for each test. 2.  The ROCA Test Subscription: one for high risk patients and one for the general population.  Abcodia will offer patients a 2 year subscription that includes the Iggbo blood draw, repeat ROCA tests and TVU (Transvagina Ultrasound) as a result of intermediate, elevated or severe ROCA result. 3. Interest free payment plans."
  • Why is the test available in only five states ? Starting in five states will allow the test process to be optimized. The delay with other states is due to each individual state's permit application period and process. Some are longer than others.


This video is an overview of how the ROCA test works.



I have charted my CA-125 results since my initial diagnosis. So monitoring the trends in CA-125 makes sense to me. But there is one caveat, there is a small percentage of women, like myself, who have a CA-125 result that is normal and disease may be still present. My CA-125 was normal at 17 u/ml,  when I learned via CT scan that I had recurred on my liver and spleen. So woman whose CA-125 does not rise may not benefit from this type of screening.

I still had a few questions about applying this test to the general public. I wondered if the ROCA test would find the disease at an earlier stage and if the survival would be longer for women whose disease was detected by this test.   I did not have to wait too long for some of the answers because on December 17th the results were published in the Lancet journal.

Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial 

My next post will discuss what was reported in this article as well as responses from various ovarian cancer organizations and oncologists.  

 Dee  

Every Day is a blessing!

Updated 12/21/15



Friday, April 27, 2012

It's the little things HAWMC 27


5  Challenges  &  5  Small  Victories.  Make  a  list  of  the  5  most  difficult  parts  of  your   health  focus.  Make  another  top  5  list  for  the  little,  good  things  (small  victories)  that   keep  you  going. 


5 Challlenges 
  1. Make women aware that there are symptoms of Ovarian Cancer ( Bloating, frequent urination, abdominal pain, difficulty eating)
  2. Make women aware that all women are a risk for ovarian cancer .(Even if you had a hysterectomy you are at risk.)
  3. Make women aware that the Pap Test does not screen for Ovarian Cancer. (There is NO screening test for ovarian cancer. )
  4. Change people's reaction when I tell them " I am an  ovarian cancer survivor." ( It is not a death sentence.  At least right now for me it is not.) 
  5. Have more doctors and researchers choose to focus their research on ovarian cancer


5 Victories 
  1. Be able to share my story online through this blog and other sites
  2. Wake up some mornings and cancer is not the first thing I think of ( like this morning) 
  3. Be treated by wonderful gynecologic oncologists and nurses 
  4. Have the opportunity to meet so many wonderful women 
  5. Have the opportunity to interact with researchers at ASCO 

This was an interesting prompt. When I first started writing I wasn't sure I could find 5 good things but look at that I did. 


Dee
Every Day is a Blessing!