ASCO: Knowledge Part II, Managing OC in Older Women

This early Sunday morning education session presented information on how to manage ovarian cancer in the older women. Many women including myself do get diagnosed at an early age but the median age for diagnosis of ovarian cancer in women is 63 years of age.

Ovarian Cancer Surgery in the Older Woman : Keep It Short and Sweet

Dr Linda Duska

Chronologic age is not the same as physiologic age and age does not define the ability of a woman to undergo surgery or medical treatment. Retrospective studies have showed that women with ovarian cancer who have no gross residual disease after surgery have better outcomes. Older women overall have a worse prognosis stage for stage than younger women. The GOG182 study found that there was a lower chemo completion rate among older women and that toxicity was higher. It has also been found that for women of age 65 and older surgery complications increase and there is higher mortality. It was recommended that an assessment tool like ones for frailty be used before considering surgery in women over 65. It was found that frail women were more likely to be obese and to have post-op complications.

Ovarian Cancer in the Older Women : Less is More

Dr Kathleen Moore

Studies that focus on the older woman are limited. SEER Medicare data shows that the use of chemotherapy in women decreases as age increases. Women > age 70 have higher hematologic toxicity and stop treatment early. A study done in France showed that while in pre-treatment and during treatment the geriatric assessment showed that depression was a poor prognostic factor. A US study, GOG 273 (women age 70 +)  showed that dose modifications , timing changes and variations on chemo schedule may help the older woman complete chemotherapy.

The EWOC ( Elderly Women with OC) studies showed that chemo toxicity could be predicted by 3 factors – depression, dependence and performance status.  The MITO-5 and MITO -6 studies found that weekly carbo taxol was associated with lower toxicity and higher quality-of-life scores.

Clinical Trials in the Older Patient: Who,When and Why?

Dr William Tew

There are not many clinical trials for older patients.

Dr Tew stated that it is important to define who your patient is and what they want. He also recommended assessing functional age not chronologic age. The Cancer and Aging Research Group has developed and assessment tool that can be used before starting chemotherapy. The assessment tool looks at factors that can predict grade 3-5 toxicities in older patients. Some of the tool variables are age, impaired hearing, inability to walk a block, decreased social activity etc.

From this session I learned that:

• better outcomes occur when older women finish chemotherapy- even if that means the dosage/timing needs to  need modified.
• Depression and poor functional ability can impact treatment success
• Age itself does not predict whether or not a woman can undergo surgery or treatment .
• Assessment tools ( fraility / performance status) should be used before surgery

Tomorrow’s post will be on Value Concepts in the Management of Ovarian Cancer

Dee

Every Day is a Blessing!

ASCO 2015 - Connections and Knowledge

Last night I returned home from attending the ASCO Annual Meeting in Chicago. The theme of the 2015 meeting was Illumination and Innovation. As a patient advocate who attended the largest oncology meeting in the world ( 30,000+ people) my theme for the meeting would be Connections and Knowledge.

Over the next week or so I will write a series of posts about my experience and the knowledge I learned. The topics will be:

Connections: 
Patient Advocates and Physicians
Hashtag Communities

Knowledge: 
Genomics
Immunotherapy
Big Data (CancerLINQ)
Value / Cost of treatments
Clinical Trials (Patient Reported Outcomes)
Survivorship

Please be patient as I gather the enormous amount of information I heard and posters I saw over the five days of the meeting and condense it into a reasonable length post. This will not be an easy task but an important one because what I heard gave me hope.

Dee
Every Day is a Blessing!

Chicago, Here I Come!

Tomorrow I will be heading to Chicago for the American Society of Clinical Oncology (ASCO) Annual Meeting "Illumination and Innovation". I will be attending as a patient advocate and representing the #gyncsm( gynecologic cancer social media) Community on Twitter which I co-founded and co-moderate with Christina Lizaso.

I will be tweeting using the #gyncsm hashtag to keep the community up to date on the latest research news for those impacted by gynecologic cancers. Due to my diagnosis I admit in advance they there may be a heavy emphasis on ovarian cancer.

In order to spend my time efficiently,  I spent time the past few days finalizing my schedule. The meeting starts on Friday afternoon and ends on Tuesday afternoon. The  iPlanner on the meeting website made this planning a bit easier. I focused on the Gynecologic Cancer sessions (education and poster sessions) as well as the Patient & Survivor  and Health Services and Quality of Care sessions. There is an app for the meeting for my phone so I can log in at any time and see my schedule, maps of McCormick ( which is huge), places to eat, shuttle locations etc. You might wonder why planning ahead is so important. Well this conference is the largest  oncology conference in the world with well over 30,000 attendees. So with a packed scheduled and long walks between locations and let's not forget the Oncology Professional Hall it sure helps to have it mapped out in advance. There were so many presentations and posters to choose from: BRCA mutations and the genome atlas to managing treatment in older women to  medical diagnostics and immunotherapy just to name a few.

 The other added benefit of planning ahead is that it insures I won't miss the sessions/ posters presented by doctors I have met in the past or followed for years on Twitter. For example, I can't wait to see Dr Matthew Katz's poster on Disease-specific hashtags for online communication about cancer care. Dr Katz has been a supporter of #gyncsm community from its inception in 2013 and helped us with the Tweet Disclaimer on our blog. Another poster I don't want to miss is the one by Roisin O'Cearbhaill on Carboplatin hypersensitivity reactions in carboplatin treatment for recurrent ovarian cancer . I met Roisin a few years ago at a Kaleidoscope of Hope Foundation dinner where she received a grant for her research and having experienced a carboplatin reaction this is of particular interest to me.

I also have set aside time to meet up with other advocates in the Patient Advocate Lounge and look forward to the Tweet-up taking place on Saturday night. Evenings will be busy to with the dinners and receptions and catching up with friends from the Research Advocacy Network.

Be sure to check back frequently for updates from the meeting and if you are on Twitter be sure to follow #gyncsm and #ASCO15 for the latest news.

Lastly, I want to thank the Conquer Cancer Foundation whose support will make this trip and my meeting attendance possible.


Dee
Every Day is a Blessing!