Category Archives: Ovarian Cancer

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U.S. cancer deaths continue long-term decline

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By Bill Robinson
NCI Cancer Bulletin

According to the latest national data, overall death rates from cancer declined from 2000 through 2009 in the United States, maintaining a trend seen since the early 1990s.

SR-inside

Mortality fell for most cancer types, including the four most common types of cancer in the United States (lungcolon and rectumbreast, and prostate), although the trend varied by cancer type and across racial and ethnic groups.

The complete “Annual Report to the Nation on the Status of Cancer, 1975–2009″ appeared January 7 in the Journal of the National Cancer Institute.

The report also includes a special section on cancers associated with the human papillomavirus (HPV) that shows that, from 2008 through 2010, incidence rates rose for HPV-associated oropharyngealanal, and vulvar cancers.

HPV vaccination rates in 2010 remained low among the target population of adolescent girls in the United States.

As in past years, NCI, the American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), and the North American Association of Central Cancer Registries (NAACCR) collaborated on the annual report.

Cancer incidence data came from NCI’s Surveillance, Epidemiology, and End Results (SEER) database and the CDC, with analyses of pooled data by NAACCR. Mortality data came from the CDC’s National Center for Health Statistics.

Incidence Rates Vary, Death Rates Continue to Drop

Among men, the overall rate of cancer incidence fell by an average of 0.6 percent annually from 2000 through 2009. Cancer incidence rates were stable among women during the same time period and rose by 0.6 percent per year among children. (See the table.)

“The continuing drop in cancer mortality over the past two decades is reason to cheer . . . The challenge we now face is how to continue those gains in the face of new obstacles, like obesity and HPV infections.”

The declines in cancer mortality averaged 1.8 percent per year for men, 1.4 percent per year for women, and 1.8 percent for children (ages 0 to 14 years) from 2000 through 2009.

During the same period, death rates among men fell for 10 of the 17 most common cancers and rose for three types of cancer. Death rates among women fell for 15 of the 18 most common cancers and also rose for three types of cancer.

“The continuing drop in cancer mortality over the past two decades is reason to cheer,” said ACS Chief Executive Officer Dr. John R. Seffrin in a statement. “The challenge we now face is how to continue those gains in the face of new obstacles, like obesity and HPV infections. We must face these hurdles head on, without distraction, and without delay, by expanding access to proven strategies to prevent and control cancer.”

HPV Vaccination Rates Low

The special section on HPV-related cancers showed that from 2000 through 2009, incidence rates for HPV-associated oropharyngeal cancer increased among white men and women, as did rates for anal cancer among white and black men and women. Incidence rates for cancer of the vulva also increased among white and black women.

However, cervical cancer rates declined among all women except American Indian/Alaska Natives. In addition, cervical cancer incidence rates were higher among women living in lower-income areas.

The annual report also showed that, in 2010, fewer than half (48.7 percent) of girls ages 13 through 17 had received at least one dose of the HPV vaccine, and only 32 percent had received all three recommended doses, a rate that fell well short of the Department of Health and Human Services’ Healthy People 2020 target of 80 percent.

The rate is also much lower than vaccination rates reported in Canada (50 to 85 percent) and the United Kingdom and Australia (both higher than 70 percent).

Vaccination series completion rates were generally lower among certain populations, including girls living in the South, those living below the poverty level, and Hispanics.

“The influence that certain viral infections can have on cancer rates is significant and continued attention to the effect[s] of HPV infection, in particular, on cervical cancer rates is critical,” said NCI Director Dr. Harold Varmus in a statement. “It is important, however, to note that the investments we have made in HPV research can only have the tremendous payoff of which they are capable if vaccination rates … increase.”

Cancer Incidence and Mortality Rates, 2000–2009

Men Women
Incidence Increase

  • kidney
  • pancreas
  • liver
  • thyroid
  • melanoma
  • myeloma

Decrease

  • prostate
  • lung
  • colorectal
  • stomach
  • larynx
Increase

  • thyroid
  • melanoma
  • kidney
  • pancreas
  • leukemia
  • liver
  • corpus and uterus

Decrease

  • lung
  • colorectal
  • bladder
  • cervix
  • oral cavity and pharynx
  • ovary
  • stomach
Mortality Increase

  • melanoma
  • liver
  • pancreas

Decrease

  • lung
  • prostate
  • colon and rectum
  • non-Hodgkin lymphoma
  • kidney
  • stomach
  • myeloma
  • oral cavity and pharynx
  • larynx
  • leukemia
Increase

  • pancreas
  • liver
  • corpus and uterus

Decrease

  • lung
  • breast
  • colon and rectum
  • leukemia
  • non-Hodgkin lymphoma
  • brain and other nervous system
  • myeloma
  • kidney
  • stomach
  • cervix
  • bladder
  • esophagus
  • oral cavity and pharynx
  • ovary
  • gallbladder

The NCI Cancer Bulletin is an award-winning biweekly online newsletter designed to provide useful, timely information about cancer research to the cancer community. The newsletter is published approximately 24 times per year by the National Cancer Institute (NCI), with day-to-day operational oversight conducted by federal and contract staff in the NCI Office of Communications and Education. The material is entirely in the public domain and can be repurposed or reproduced without permission. Citation of the source is appreciated.

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Lung Cancer

A glimpse into future of cancer screening

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Lung Cancer

X-ray showing lung cancer – Photo/NCI

By Elia Ben-Ari
NCI Cancer Bulletin

Ask experts to predict the future of cancer screening, and you’ll get a range of answers.

But all would agree that we need better ways to detect cancers early in the course of disease, and these new tools should improve on the benefits of screening while limiting the harms.

“There have been some improvements in triaging patients with new molecular approaches, but with the possible exception of spiral CT screening for lung cancer, we haven’t had any major breakthroughs in early detection” for more than two decades, noted Dr. David Sidransky, director of head and neck cancer research at the Johns Hopkins University School of Medicine.

The dearth of such advances is not for lack of trying. Developing new screening approaches and rigorously establishing their validity is challenging, however, and there are many potential stumbling blocks along the way.

“The bar for ‘proof’ that a particular screening strategy is clinically effective is very high,” noted Dr. Mark Greene, chief of the Clinical Genetics Branch in NCI’s Division of Cancer Epidemiology and Genetics (DCEG). “A screening test must be shown to reduce the death rate from the disease for which screening is being done.”

Much of the search for new screening tests focuses on biomarkers—proteins, DNA, RNA, or other molecules that can signal the presence of cancer and be detected noninvasively in blood, urine, or other readily obtained patient samples or tissues.

Researchers are also developing new imaging methods that could be used for early detection, either alone or in concert with biomarkers.

Whatever the approach, “screening is moving away from detecting an advanced consequence of cancer, which is the formation of a mass [or tumor], toward detecting the very earliest changes in the cancer process,” said Dr. Larry Norton, deputy physician-in-chief for breast cancer programs at Memorial Sloan-Kettering Cancer Center.

Dr. Norton chairs the external consulting team for the Early Detection Research Network (EDRN), an initiative of NCI’s Division of Cancer Prevention that supports efforts to discover and validate new cancer biomarkers and technologies.

“Molecular detection of cancer is possible only through evidence-based strategies and implementation,” commented Dr. Sudhir Srivastava, who directs the EDRN. “It takes a village to meet the challenges of early-detection research.”

The Post-PSA Era

Microscopic view of prostate cancer

Prostate Cancer

In the case of some cancers, researchers are developing new screening tests because the value of existing tests for those cancers has been called into question, perhaps most notably in the case of prostate specific antigen (PSA) testing for prostate cancer.

“The idea that one biomarker such as PSA is going to be useful for all settings has evolved. We now believe that we’ll need panels of biomarkers,” said Dr. Mark Rubin, a professor of pathology at Weill Cornell Medical College.

To identify those biomarkers, researchers are using methods such as microarrays and whole-genome sequencing, which rapidly yield a wealth of information, to profile changes that occur in cancer.

Using such an approach, Dr. Rubin, Dr. Arul Chinnaiyan of the University of Michigan, and their colleagues discovered the fusion gene TMPRSS2-ERG, which is found in about half of all prostate cancers.

“That fusion gene is seen only in cancer, and, in particular, only in prostate cancer,” said Dr. Rubin, whose team has developed a test to assess the levels of this fusion gene in urine samples. “Our approach now is to try to explain the other 50 percent of prostate cancers with other cancer-specific molecular events” that could eventually form a screening test based on a panel of genetic markers.

For example, Dr. Rubin co-led a recent study that identified a gene called SPOP that is mutated in about 10 percent of prostate cancers.

“We can add that gene mutation to the gene fusion to improve on the test,” he explained. “This is the sort of approach we think will be useful for prostate cancer, as well as other cancers in the future.”

Applying Lessons Learned

To avoid unnecessary biopsies or treatment of prostate and other screen-detected cancers, researchers are trying to find biomarkers that better identify which cancers are likely to progress, noted Dr. Joshua LaBaer, director of the Center for Personalized Diagnostics at the Biodesign Institute at Arizona State University and co-chair of EDRN’s steering committee.

“What we’ve learned from PSA is that if we’re going to come up with new screening tools, we also have to develop tools that give us a better idea of disease prognosis.”

Whereas some cancers detected by screening will progress and metastasize, others may never cause illness during a person’s lifetime.

“What we’ve learned from PSA is that if we’re going to come up with new screening tools, we also have to develop tools that give us a better idea of disease prognosis,” said Dr. James Brooks, a professor of urology at Stanford University.

Dr. Brooks and Dr. Sanjiv Gambhir, chair of the department of radiology at Stanford, lead a project to deploy new technologies that could form the basis for the next generation of prostate cancer screening tests.

To pave the way for tests that rely on panels of blood-based diagnostic or prognostic protein biomarkers, they are starting to test the performance of a magneto-nanosensor chip technology developed at Stanford.

The sensor, which detects proteins tagged with magnetic particles, can measure the levels of up to 64 different proteins simultaneously, in very small sample volumes.

The Stanford team also hopes to adapt an imaging technology being studied in Dr. Gambhir’s lab to improve the accuracy of prostate cancer detection by transrectal ultrasound.

The method uses gas “microbubbles” that are encased in a lipid shell to which specific antibodies are attached as a contrast material for ultrasound imaging.

The antibodies target a receptor for vascular endothelial growth factor, which is a protein found in newly formed tumor blood vessels. The patented antibody-labeled microbubbles are awaiting Food and Drug Administration approval for human testing.

The Stanford team’s long-term goal is to combine their blood-based biomarker and imaging methods to improve early detection and prognostic assessment of prostate cancer and eventually other cancers.

Combining molecular biomarkers and imaging for cancer screening “is a very powerful approach,” commented Dr. Sidransky. “We used to believe in the power of a marker to do everything,” he added. “We now know that’s not true.”

A Sense of Urgency

Researchers have long sought an effective screening strategy for ovarian cancer, and numerous candidate biomarkers for the disease have fallen short of expectations.

“Ovarian cancer is the paradigm for why we need early detection,” said Dr. Michael Birrer, a professor of medicine at Harvard Medical School. The disease can be cured by surgery if discovered early. But “75 percent of tumors are detected at the advanced stage, and those patients are hard to cure,” said Dr. Birrer.

Dr. Birrer and Dr. Steven Skates, an associate professor of medicine at Harvard, are leading a two-pronged effort to discover new biomarker candidates that may ultimately lead to a blood test for the early detection of ovarian cancer.

We used to believe in the power of a marker to do everything. We now know that’s not true.—Dr. David Sidransky

The first strategy will use extensive proteomic profiling of fluids from benign and malignant tissues, such as ovarian cysts, “to find candidate biomarkers that are systematically different between the two,” Dr. Skates explained.

The second strategy involves genomic analyses to identify genes that are expressed differently in ovarian cancer tissue samples than they are in normal tissues that may give rise to ovarian cancer, and then bioinformatic analyses to look for genes whose protein products are also likely to be secreted into the bloodstream.

Using either the proteomic or genomic approach, or a combination of both, the researchers hope to come up with a short list of candidate biomarkers for further testing and refinement.

“We may be lucky to find that some of those candidates are actually early-detection biomarkers that can be measured in blood,” Dr. Skates said.

Those biomarkers could form the basis of a blood test to screen postmenopausal women, and other women at increased risk of ovarian cancer, at regular intervals.

For women who test positive on the blood test, a follow-up test, such as transvaginal ultrasound or newer imaging methods, might be used as part of an overall screening approach in the future, Drs. Birrer and Skates suggested.

Gazing into the Crystal Ball

3d Chromosome with DNA visible insideNo one can predict with certainty which types of tests will be most effective for screening for particular cancers. However, “if you want to prognosticate the future of cancer screening, my guess is that nucleotide [RNA or DNA]-based tests are going to be the most promising, at least in the short term,” Dr. Brooks said. “The power of nucleic acids is that you can amplify them to an extraordinary degree, which you can’t do with proteins,” Dr. LaBaer added.

Future DNA-based screening tests might detect methylation or other epigenetic modifications of DNA that occur specifically in cancer. “For example, we published a paper last year showing widespread and reproducible changes in DNA methylation in prostate cancer,” Dr. Brooks said.

And future screening tests may detect biomarkers in patient samples other than blood or urine. “One area where I think you’re going to see a change is in…tumors that affect the gastrointestinal tract” or other parts of the digestive system, Dr. LaBaer predicted. “You can look in stool for aberrant nucleic acids [from cells shed by tumors].” Researchers are also investigating sputum-based tests to detect lung cancer early.

“A possibility for the future is that we may stop thinking about cancers in terms of organ sites and may think more in terms of disrupted pathways or molecular variants of cancer,” Dr. LaBaer continued. In that case, “the biomarker people are going to have to work closely with the imaging people to very quickly turn a biomarker discovery into identifying where the tumor is.”

“We’re rapidly changing our concept of what cancer is,” noted Dr. Norton. “You can’t separate screening from understanding biology, from therapy, from prevention. The biggest challenge is weaving it all together [into] the big picture.”

Furthermore, he added, “we may find out that early detection is not helpful in certain situations, and that’s also important. We may not want to screen for certain cancers if we find out that prevention may be a better place to put our resources.”

“Mortality rates for some cancers have remained constant for the past 40 years, and in some of these cancers, new therapies have extended life for a few years but are not increasing the cure rates,” Dr. Skates noted. “Improved early detection for these cancers could shift that number so that more people are cured…. The payoff could be so big.”

The NCI Cancer Bulletin is an award-winning biweekly online newsletter designed to provide useful, timely information about cancer research to the cancer community. The newsletter is published approximately 24 times per year by the National Cancer Institute (NCI), with day-to-day operational oversight conducted by federal and contract staff in the NCI Office of Communications and Education. The material is entirely in the public domain and can be repurposed or reproduced without permission. Citation of the source is appreciated.

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5K SummerRun to benefit ovarian-cancer research – Sunday

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18th-Annual Swedish SummeRun Benefiting Ovarian-Cancer Research Set for this Sunday Morning, July 22

WHAT

More than 3,000 people are expected to take part in the 18th-annual Swedish SummeRun on Sunday, July 22 at 8:15 a.m. on Seattle’s First Hill. Proceeds from the 5k (3.1-mile) run and walk will benefit the Marsha Rivkin Center for Ovarian Cancer Research (MRCOCR; www.marsharivkin.org).

Swedish Cancer Institute Medical Oncologist Saul Rivkin, M.D., founded the MRCOCR in honor of his late wife, Marsha, who died of the disease in 1993.

Through SummeRun proceeds, the Center helps fund promising studies that may lead to breakthroughs in new early diagnostic tests and treatments. Last year’s event raised more than $600,000.

Over the last 17 years, Swedish SummeRun has raised nearly $5 million for the MRCOCR. Although ovarian cancer is relatively rare compared to breast cancer, it’s usually not detected until it has reached the more advanced stages when it’s often too late to cure.

The American Cancer Society estimates that 22,280 new cases of ovarian cancer will be diagnosed in the United States this year, and that 15,500 women will die of the disease in 2012.

WHEN

Sunday morning, July 22, 2012

The 5k run and walk will get under way at 8:15 a.m. Participants can take part in an aerobics warm-up session starting at 7:45 a.m. Afterward (around 9:30 a.m.), runners, walkers, volunteers and other supporters will be treated to a post-event celebration featuring a tribute to ovarian-cancer survivors, complimentary refreshments and other freebies, music, a random prize drawing, and distribution of the overall race awards.

WHERE

The run and walk start at the corner of Madison St. and Minor Ave. and head north through Seattle’s scenic Capitol Hill neighborhood before finishing back on Swedish’s First Hill campus.

HOW

Day-of-event registration and pre-registered packet pick up will open at 6:30 a.m. at the corner of Marion St. and Minor Ave. Day-of-event registration, which includes a T-shirt, is $35 per person. Cash, check and credit cards accepted.

MORE INFORMATION

For more information, visit www.summerun.org or call 206-215-6200.

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Gilda's Club Seattle Logo

You’ve been treated for cancer — now what?

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Treatment Summaries and Surviorship Care Planning

What do you do when you’ve finished treatment?

How do you coordinate your ongoing care with your Primary Care doc?

How do you keep track of your medical records and get the right information to the right people about what you’ve been through?

Now we have some answers.

  • Debra Loacker, RN, will provide an overview of the valuable information provided in cancer treatment summary and the survivorship care plan. You will learn where to obtain a copy of your own treatment summary, and how your doctor can use it.
  • Patricia Read-Williams, MD, will share her perspective as a Primary Care Provider on the importance of these documents in the care provided to cancer survivors.

When:

6/21/12 , 6:45-8:30 p.m.

Where:

Gilda’s Club Seattle • 1400 Broadway, Seattle, WA 98122

Phone: 206.709.1400 • info@gildasclubseattle.org • www.gildasclubseattle.org


Gilda’s Club Seattle

Gilda’s Club is a non-profit group that provides meeting places where men, women and children living with cancer and their families and friends join with others to build emotional, social and educational support as a supplement to medical care.

The club’s services are free and include support and networking groups, lectures, workshops and social events in a nonresidential, homelike setting.

The club is named in honor of Gilda Susan Radner was an American comedienne and actress, best known for her years as a cast member of Saturday Night Live.

Radner, who died at 42 of ovarian cancer, helped raise the public’s awareness of the disease and the need for improved detection and treatment.

Lectures are held on Thursday evenings at Gilda’s Club, 1400 Broadway, Seattle.

Please RSVP to attend.

Refreshments served 6:45-7:00 pm

Lecture begins 7:00-8:30 pm

All lectures are open to the public. There is no cost to attend our lectures.

Please RSVP 24+ hours in advance to attend and pre-register for Noogieland childcare a minimum of 72 hours in advance.

When:

6/21/12 , 6:45-8:30 p.m.

Where:

Gilda’s Club Seattle • 1400 Broadway, Seattle, WA 98122

Phone: 206.709.1400 • info@gildasclubseattle.org • www.gildasclubseattle.org

 

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Swedish to open new Women’s Cancer Center

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Seattle’s Swedish Medical Center will open a new cancer center that will provide services tailored specifically for women — next Tuesday, June 5th.

The 23,600-square-foot True Family Women’s Cancer Center will occupy the fifth and sixth floor of the medical center’s Arnold Pavilion at 1221 Madison on Swedish’s First Hill campus.

The goal is to bring the Swedish physicians specializing in treating cancer in women into a single location to better coordinate care and to provide women cancer patients with a place where they can find all the services they need under one roof, said Dr. Patricia Dawson, the medical director of the new center and a breast surgeon with the Swedish Cancer Institute.

Although women and men have many of the same kinds of cancer, these cancers often have a different course in women and respond differently to treatment, said Dr. Dawson.

Women with cancer also often seek the kind of community and support services the new center hopes to offer, she said.

In addition to exam rooms, imaging services and procedure rooms, the new center will have support-group meeting rooms, counseling services and an educational resource center.

The facility’s decor and layout was designed to be both practical and “calming and restful” with the aim of enhancing both the quality of care and the quality of the patients’ experience, Dr. Dawson said.

The new center brings together a variety of clinicians and services that in the past have been scattered across the Swedish Medical Center’s main campuses.

Alexis Vanden Bos, a patient of Dr. Dawson who has been treated for two breast cancers, remembers having to shuttle between campuses during her treatments, often carrying her radiology films under her arm.

Alexis Vanden Bos

“It wasn’t bad, but how much easier this will be,” Vanden Bos said. “Now, I’ll be able to talk to both my surgeon and my oncologist in one place. I’ll love having all my people together.”

Construction of the $11 million facility was funded entirely from philanthropic gifts. The families of Patricia True, Doug and Janet True, and Bill and Ruth True began the fund-raising effort with $2 million donation.

Other major contributors include Eve and Chap Alvord, Robin Knepper, the Norcliffe Foundation, Bruce and Jeannie Nordstrom, Seattle Radiology, and Sellen Construction.

Additional support came from more that 2,500 individual donors.

The center’s staff will include oncologists, surgeons, onsite radiologists, psychological and genetic counselors, physical therapists, social workers and patient education specialists.

The center will provide resources for women with most cancers, including bladder, brain, breast, cervical, colorectal, esophageal, head and neck, leukemia, liver, lung, lymphoma, multiple myeloma, ovarian, pancreatic, renal/kidney, skin, thyroid and uterine.

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U.S. cancer deaths continue steady decline

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By Sharon Reynolds
NCI Cancer Bulletin Staff Writer 

According to the latest data on nationwide death rates from cancer, overall mortality from cancer declined from 1999 to 2008, maintaining a trend seen since the early 1990s.

Mortality fell for most cancer types, including the four most common types of cancer in the United States (lungcolorectalbreast, and prostate), although the rate of decline varied by cancer type and across racial and ethnic groups.

The complete Annual Report to the Nation on the Status of Cancer, 1975–2008 appeared March 28 in Cancer.

The declines in cancer death rates (mortality) averaged 1.7 percent per year for men and 1.3 percent per year for women from 1999 through 2008.

Among men, the overall rate of new cancer cases (incidence) fell by an average of 0.6 percent annually from 1999 to 2008.

Among women, incidence dropped by an average of 0.5 percent annually from 1999 to 2006 but held steady from 2006 to 2008.

Cancer incidence in children ages 0 to 14 rose from 1999 to 2008 (by 0.5 percent a year), continuing a trend seen in previous Annual Reports to the Nation.

However, advances in treatment contributed to a steady decline in mortality rates for children with cancer in the last 5 years (an average of 2.8 percent per year).

“Steady progress, as measured by declines in cancer death rates for many cancers, is good because we have an aging, growing population,” said Dr. Brenda K. Edwards, NCI’s senior advisor for surveillance.

“While the number of people diagnosed with cancer or who die of the disease may be increasing, the decline in cancer death rates for more than a decade is the best indicator of progress due to prevention, screening, diagnosis, and treatment,” she added.

NCI, the American Cancer Society, the Centers for Disease Control and Prevention (CDC), and the North American Association of Central Cancer Registries (NAACCR) collaborated on the report. Cancer incidence data came from NCI’s Surveillance, Epidemiology, and End Results (SEER) database and from the CDC, with analyses of pooled data by NAACCR. Mortality data came from the CDC’s National Center for Health Statistics.

Not All Good News

There were some notable exceptions to the overall decreases in incidence and mortality. From 1999 to 2008, death rates rose for pancreatic cancer in men and women, for liver cancer and melanoma in men, and for endometrial cancer in women.

The cervical cancer death rate, which had been falling for decades, showed no further decrease over the last 5 years.

And, although incidence rates fell overall for men and women from 1999 to 2008, the decline was not distributed evenly across racial and ethnic groups.

Cancer incidence rates did not decrease significantly among American Indian/Alaska Native men and women combined or among black, Asian and Pacific Islander, and American Indian/Alaska Native women.

Although incidence rates in black men did decline, this group still had the highest cancer incidence rate of any racial and ethnic group, 15 percent higher than that of white men and nearly double that of Asian and Pacific Islander men.

Major Modifiable Risk Factors

Each Annual Report to the Nation includes a special feature that focuses on a topic of importance to the cancer research community and the public.

This year’s report featured an analysis on the contribution of excess weight (overweight and obesity) and insufficient physical activity to the nation’s cancer burden.

More than 60 percent of the U.S. adult population is estimated to be overweight or obese, and a similar percentage of adults do not get the recommended amount of physical activity.

The rates of insufficient physical activity are even worse for children; for example, up to 90 percent of high school girls do not engage in recommended levels of physical activity.

Excess weight “is a major modifiable risk factor for cancer and other diseases—probably second only to tobacco use in terms of its impact on cancer incidence and mortality,” said Dr. Edwards. “The risk may be modest but it’s so pervasive that we felt this was the time to look at [cancer] incidence in this context.” Physical inactivity not only contributes to excess weight but is itself a risk factor for several cancer types.

The report was not designed to quantitatively link the trends in excess weight and lack of physical activity to the national trends for cancer, explained Dr. Rachel Ballard-Barbash, associate director of the Applied Research Program in NCI’s Division of Cancer Control and Population Sciences.

Many other studies have shown convincing links between excess weight and several cancer types, including endometrial, postmenopausal breast, colorectal, kidneyesophageal, and pancreatic cancer.

The point of the special feature, she noted, “is to highlight specific types of cancer that are related to [excess weight and lack of sufficient physical activity], show how these behaviors relate to these cancers in terms of their relative risks, and briefly describe some of the mechanisms by which they relate.”

The special feature also highlights national- and state-level prevention strategies in policy and environmental change that are intended to help people achieve recommended changes in their diets and physical activity levels.

As the nation’s weight has risen, so has the incidence of some, although not all, types of cancer related to excess weight and lack of sufficient physical activity. From 1999 to 2008, incidence rates of kidney cancer and of adenocarcinoma of the esophagus each rose about 3 percent per year for men and women, while incidence of pancreatic cancer rose 1.2 percent per year among men and women.

In addition, incidence rates of endometrial cancer rose significantly among black, Asian and Pacific Islander, and Hispanic women. Incidence of postmenopausal breast cancer stabilized from 2005 to 2008, after a period of decline.

“Although all of these cancers are influenced by multiple factors, the high prevalence of excess weight and insufficient physical activity likely contributed to these observed increases and to the lack of decline in breast cancer,” the authors wrote. “Continued progress in reducing cancer incidence and mortality rates will be difficult without success in promoting healthy weight and physical activity, particularly among youth.”

Excess weight and lack of physical activity also influence cancer survivorship, explained Dr. Ballard-Barbash, as both can negatively affect outcomes after a cancer diagnosis, further increasing the need for these risk factors to be addressed on a personal and societal level.

The NCI Cancer Bulletin is an award-winning biweekly online newsletter designed to provide useful, timely information about cancer research to the cancer community. The newsletter is published approximately 24 times per year by the National Cancer Institute (NCI), with day-to-day operational oversight conducted by federal and contract staff in the NCI Office of Communications and Education. The material is entirely in the public domain and can be repurposed or reproduced without permission. Citation of the source is appreciated.

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Bowtell

Seattle’s Rivkin Center awards over $1.2 million to ovarian cancer researchers

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Seattle’s Marsha Rivikin Center will award over $1.2 million in grants this year to researchers studying ovarian cancer.

Prof. Bowtell

The largest grant will go to David Bowtell, PhD of the Peter MacCallum Cancer Center in Melbourne, Australia, who won the Center’s first Scientific Challenge Grant, a new award that seeks to encourage research into the origins of ovarian cancer with the goal of developing ways to diagnose the cancer early, when it is more treatable.

The two-year, $150,000 grant will fund Professor Bowtell’s to research to see whether ovarian cancers release enough of a form of DNA into the bloodstream that it might be possible to detect the cancer early with a simple blood test.

The Center also awarded one-year $75,000 Pilot Study Awards to 13 researchers conducting innovative research and three $60,000, one-year Scientific Scholar grants for promising young laboratory and clinical scientists pursuing careers in ovarian cancer research.

Dr. Salazar

Among the recipients of the Pilot Study Awards is Lupe Salazar, MD of the University of Washington’s Tumor Vaccine Group, who studies how the immune system’s white cells can be induced to attack cancer cells. For a summary of her grant click here.

Dr. Liao

Among the three Scientific Scholar grantees is John Liao, MD, PhD, assistant professor of the UW Obstetrics & Gynecology Department, who is working on developing vaccines against ovarian cancer. For a summary of his grant click here.

Ovarian cancer is the ninth most common cancer among women, excluding non-melanoma skin cancers, according the American Cancer Society.

Each year in the U.S., about 21,990 women are diagnosed with ovarian cancer and about 15,460 die from the diseases.

Only about half of women diagnosed with ovarian cancer will be alive in five years, but if the cancer is found and treated before it has spread outside of the ovary, the five-year survival rate is 94 percent.

Early diagnosis is difficult, however, because early ovarian cancers often produce no or only subtle symptoms and no screening test has yet been proven to be effective, according to American Cancer Society.

As a result, only about one in five cases of ovarian cancer are diagnosed early.

To learn more:

  • Visit the Marsha Rivkin Center’s webpage.
  • Visit the American Cancer Society’s webpage on Ovarian Cancer.

Pilot Study Awardees for 2011:

Karen Abbott, PhD
University of Georgia

Targeting Tumor-Specific Glycosylation: Discovery of Novel Membrane Receptors

Dr. Abbott’s work is focused on discovering new tumor-specific targets on the surface of cancer cells. Tumor-targeted therapy regimens will have less toxic side effects to normal tissues, and lead to a better quality of life for patients. This project is based on a recent discovery of a unique type of carbohydrate (glycan) found on proteins that cover the surface of ovarian tumor cells and not normal ovarian cells. The membrane receptors that help this glycan stick to the surface of tumor cells will be identified and subsequently used for the development of tumor-targeted therapeutics in the future.

Karen Cowden Dahl, PhD
Indiana University

The role of ARID3B isoforms in ovarian cancer and chemoresistance

Around 70% of women diagnosed with ovarian cancer have advanced disease and the prognosis is very poor. Treatment for ovarian cancer consists of surgery followed by chemotherapy. One of the contributing factors to the poor prognosis for advanced ovarian cancer is due to tumor cells becoming resistant to chemotherapy. This project aims to understand how a new overexpressed gene (ARID3B) is regulated in ovarian cancer and how different forms of this gene contribute to chemoresistance. These studies will further the understanding of genes that are involved in ovarian cancer and chemoresistance in order to better treat ovarian cancer patients.

Daniela Dinulescu, PhD
Brigham and Women’s Hospital

Experimental Models to Validate a Tubal Cell of Origin for Serous Ovarian Cancer

Too little is known about the genetic lesions responsible for ovarian cancer tumor initiation, and uncertainty remains over the specific cell or cells of origin. Data emerging from The Cancer Genome Atlas (TCGA) on the many genomic alterations in serous ovarian carcinoma has delivered a treasure trove of new candidates for investigation, but discerning which gene alterations are critical early events in cancer pathogenesis, how tumors evolve to their highly aggressive state, and which pathways represent the best therapeutic targets will require a large scale collaborative research effort. Animal models developed in Dr. Dinulescu’s lab, which accurately recapitulate the human disease, constitute great tools for defining the key roles that ovarian cancer cells in the ovarian surface epithelium and distal fallopian tube play in tumor initiation and resistance to chemotherapy. Furthermore, they provide us with unique, relevant in vivo systems in which to screen novel molecularly targeted therapies as they become available.

Thuy-Vy Do, PhD
University of Kansas Medical Center

Preclinical Evaluation of Aurora A Kinase and PARP Inhibitor Combination Therapy

Women carrying mutations in the breast-cancer associated 1 or 2 (BRCA1/2) genes are at higher risk for developing epithelial ovarian cancer. BRCA1/2 play critical roles in repairing DNA and helping genes avoid mutation. Interestingly, BRCA1/2 is not functioning optimally in cases of sporadic epithelial ovarian cancer, and BRCA2 and Aurora A interact in cells to regulate genomic stability. Dr. Do will test the hypothesis that Aurora A and BRCA1/2 interact to mediate DNA repair and cell growth. An Aurora A kinase inhibitor and a PARP inhibitor will be tested as therapies for ovarian cancer.

Alexander Nikitin, MD, PhD
Cornell University

Role of Stem Cells in Ovarian Cancer

Understanding of epithelial ovarian cancer development is critical for designing effective diagnostic and therapeutic approaches. During recent years it has become increasingly clear that cancers may arise from stem and progenitor cells. However, the location of the stem cell compartment of the ovarian surface epithelium that give rise to cancer cells remains unknown. Dr. Nikitin will explore a newly identified stem cell compartment in the ovary and determine properties of these stem cells and their contributions to epithelial ovarian cancer.

Daniel Powell, PhD
University of Pennsylvania

Preclinical Evaluation of Costimulated CIR Therapy for Ovarian Cancer

Adoptive immunotherapy is extremely effective for triggering tumor regression in patients with malignant melanoma. To develop adoptive T-cell therapy for epithelial ovarian cancer, we have created a chimeric immune receptor (CIR) that redirects the immune system against alpha-folate receptor, a protein on the surface of 90% of epithelial ovarian cancer cells. In designing this therapy, other strategies that will be taken into account including promoting growth and survival of the body’s own immune cells to fight ovarian cancer. The results of Dr. Powell’s work will provide preclinical data essential for clinical development.

Carrie Rinker-Schaeffer, PhD
University of Chicago

Milky Spot Macrophages: Co-Conspirators in Omental Metastasis Formation

No one knows what microenvironmental interactions control ovarian cancer metastasis. Getting this crucial information requires a fresh look from a new perspective. Recently Dr. Rinker-Schaeffer’s lab made a novel connection between ovarian cancer metastatic colonization and structures on the omentum (tissues in the abdomen) that contain immune cells and are called milky spots. It is suspected that cancer cells take advantage of milky spots to promote their own survival and growth. This project will identify interactions between omental immune cells and cancer cells that can be targeted in combination with current therapies in order to suppress metastatic growth, improve quality of life, and extend disease-free survival.

Lupe Salazar, MD
University of Washington

Adoptive transfer of tumor specific Th1 cells derived from vaccine-primed patients achieved clinical benefits

Adoptive immunotherapy can induce cancer regression but rarely results in cure. We have infused HER2-specific Th1 cells in breast cancer patients, and 50% of patients had a partial or complete response to the treatment. Dr. Salazar hypothesizes that Th1/Th17 immune cells that can recognize tumor cells can have enhanced therapeutic efficacy. This project will determine the optimal conditions to grow these multifunctional immune cells in the lab in order to enhance their ability to identify and target cancer cells using IGFBP2. Results from this project will lead to a phase I study of adoptive immunotherapy in ovarian cancer after priming with an IGFBP2 vaccine.

Janet Sawicki, PhD
Lankenau Institute for Medical Research

Utilizing HuR to Combat Chemotherapeutic Resistance in Ovarian Cancer

The molecular basis underlying the range of ovarian cancer patient responses to chemotherapeutic agents is poorly understood. This project will address the urgent need to stratify ovarian cancer patients for therapy and enhance currently available treatment strategies. Recently, Dr. Sawicki’s lab discovered that the stress response protein, HuR, can mediate therapeutic efficacy of gemcitabine and a PARP inhibitor, two drugs currently used to treat ovarian cancer, by rapidly binding and regulating cancer-associated mRNA transcripts. Therefore, HuR may serve as both a potential predictive marker for drug efficacy and a promising target for therapeutic manipulation for the treatment of epithelial ovarian cancer.

Kavita Shah, PhD
Purdue University

Chemical genetic dissection of Aurora A Kinase in ovarian cancer

The function of kinases is to turn proteins on and off in cells. Aurora A kinase is one such kinase whose levels increase early in ovarian cancer and are associated with poor prognosis. By identifying the proteins that Aurora A kinase turns on and off in ovarian cancer cells that are not affected in normal cells, Dr. Shah can design drugs to inhibit Aurora A kinase from doing its job and reverse the cascade of proteins that are involved in progression of ovarian cancer. Safer drugs can be developed which target only ovarian cancer cells while avoiding normal cells.

Barbara Vanderhyden, PhD
Ottawa Hospital Research Institute

Role of PAX2 in the etiology of ovarian and fallopian tube cancers

The origins of ovarian cancer are poorly understood but most cancers seem to arise from the surface layer of cells on the ovary or the fallopian tube. Ovarian surface epithelial cells have the ability to develop into ovarian cancer subtypes that fall into two broad categories: low-grade and high-grade. Previous work shows that changes in a protein, PAX2, occur in the earliest cancerous structures in both ovaries and fallopian tubes. Dr. Vanderhyden’s lab has developed methods to isolate both ovarian and fallopian tube cells from mice and will determine how changes in PAX2 contribute to the early stages of ovarian cancer.

 Christine Walsh, MD
Cedars-Sinai Medical Center

Genetic Modifiers of BRCA1-Associated Gynecologic Cancer Penetrance

Women who inherit a mutation in the BRCA1 gene have a 40% risk of developing ovarian, tubal, or peritoneal cancer. Dr. Walsh is seeking to shed light on genetic and molecular events that lead to tumor development in some women in this high-risk population but not in others. A significant difference in the genetic sequence of the PARK2 gene distinguishes BRCA1 mutation carriers that do develop cancer from those who do not develop cancer. This project will further investigate PARK2, which is mutated in other cancers and has a tumor suppressor function, by looking at its role in the biology of BRCA1-associated gynecologic cancer development.

Jian-Jun Wei, MD
Northwestern University

MiR-182 overexpression in early tumorigenesis of high grade serous carcinoma

High grade papillary serous carcinoma may arise from serous tubal intraepithelial carcinoma in the fallopian tube. MiR-182 is a small RNA molecule that is significantly overexpressed in both types of carcinomas. Dr. Wei hypothesizes that miR-182 overexpression is a critical and early molecular change in papillary serous carcinoma. He will use normal fallopian tube secretory epithelial (FTSE) cell lines to investigate whether adding miR-182 in large amounts will result in tumors and whether miR-182 causes tumors via target genes BNC2 and MTSS1 known to be involved in papillary serous carcinoma. The results will provide a new marker in early detection and a potential therapeutic target for PSC.

 

Scientific Scholar Awardees: 

Young Min Chung, PhD
Stanford University School of Medicine

Targeting Ovarian Cancer with Combination of Olaparib and Trifluoperazine

Dr. Chung is developing innovative therapeutic strategies by combining a clinically used small-molecule drug called trifluoperazine (TFP) and a chemical compound named Olaparib, which is an inhibitor of an enzyme called PARP, to suppress advanced ovarian cancer and to overcome PARP inhibitor-unresponsive ovarian cancer. In addition, novel biomarkers will be identified for monitoring therapeutic sensitivities in ovarian cancer. Ultimately, the results of this project will be used to design a clinical trial to treat patients with advanced ovarian cancer.

John Liao, MD, PhD
University of Washington

Development of a polyepitope DNA vaccine for ovarian cancer immunotherapy

While ovarian cancer patients can respond to chemotherapy and achieve remission, the majority of advanced stage patients succumb to recurrent disease. Strategies harnessing the immune system have the potential to augment available therapies, prolong remissions, and prevent relapses. Vaccines generating immune responses against proteins in ovarian cancer cells could offer a possibility of selectively killing those cells. Dr. Liao has identified 6 proteins associated with poor prognosis. Vaccines targeting fragments of these 6 proteins will then be tested in a mouse model for ovarian cancer to evaluate safety and effectiveness in preparation for clinical trials.

Fiona Simpkins, MD
University of Miami

Characterization of subpopulations capable of self-renewal in ovarian cancers

Most ovarian cancer patients suffer disease recurrence, and most available chemotherapies are toxic and stop working. Cancer stem cells comprise a subpopulation of cells capable of self-renewal and are resistant to chemotherapy. By characterizing such subpopulations and determining which signaling pathways drive their growth, Dr. Simpkins would like to develop better strategies to target these subpopulations and overcome drug resistance. This project will characterize the self-renewal potential of cell populations expressing different surface markers suggestive of “stemness” in ovarian cancer, determine developmental and mitogenic signaling pathways unique to these populations, and determine how targeted treatments effect these subpopulations.

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January Gilda’s Club talks cover breast cancer screening, gynecologic cancers and cancer risk

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Gilda’s Club is a non-profit group that provides meeting places where men, women and children living with cancer and their families and friends join with others to build emotional, social and educational support as a supplement to medical care.

The club’s services are free and include support and networking groups, lectures, workshops and social events in a nonresidential, homelike setting.

The club is named in honor of Gilda Susan Radner was an American comedienne and actress, best known for her years as a cast member of Saturday Night Live.

Radner, who died at 42 of ovarian cancer, helped raise the public’s awareness of the disease and the need for improved detection and treatment.

Lectures are held on Thursday evenings at Gilda’s Club, 1400 Broadway, Seattle.

All lectures are open to the public. There is no cost to attend the lectures.

Refreshments served 6:45-7:00 pm

Lecture begins 7:00-8:30 pm

Please RSVP to attend.

(Please RSVP 24+ hours in advance to attend and pre-register for Noogieland childcare a minimum of 72 hours in advance.)

1/13/2011

Reduce your cancer risk — Dr. Julie Gralow, member of Gilda’s Club Medical Board, will review steps YOU can take in 2011 to reduce your cancer risk.  Learn about important cancer risk reduction strategies – including reducing risk of cancer returning after cancer treatment.  Find out about community resources to motivate you to action on your 2011 resolutions.

1/20/2011

ASK THE DOCTORGynecologic Cancer – Come hear from Dr. Kathryn McGonigle, named Top Doc by Seattle and Seattle Metropolitan Magazines. Learn about the HPV vaccine and how it prevents cervical cancer.  Learn what type of symptoms women should be aware of that might be associated with uterine, cervical or ovarian cancer.  When should you alert your physician about a symptom? Get a general overview on management of gynecological cancers.

1/27/2011

NOTE: THIS LECTURE IS NOT AT GILDA’S CLUB – TO BE HELD AT SCCA HOUSE at 207 Pontius Ave N 2nd Floor

Breast Cancer Screening – Why One Size Doesn’t Fit All

This presentation is part of Seattle Cancer Care Alliance’s series Discovering Hope: A Decade of Cancer Advances—celebrating SCCA’s 10th anniversary

What’s the most effective way to screen for breast cancer? And how should screening guidelines impact women in our community? Should women wait until 50 to start mammography, or start earlier? Does it make a difference if you are high-risk or have already had a diagnosis? Join Dr. Connie Lehman, an expert in the field of breast imaging and intervention, as she explains her research in the area of early detection.

CLICK HERE TO REGISTER FOR LECTURES

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Learn about cancer vaccines at UW open house — Oct. 14

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UW Medicine Tumor Vaccine Group hosts open house

The UW Tumor Vaccine Group will hold an open house in the afternoon and evening of October 14, a Thursday.

There will be two sets of lab tours: one, at 5:30 p.m. and, the second, at 8 p.m.

UW Medicine scientists will discuss the latest research on cancer vaccines and provide updates on breast and ovarian cancer research projects taking place right here in Seattle.

In addition, there will be a change with cancer advocacy group representatives from the Puget Sound area.

Logo for the UW Tumor Vaccine Group

Click on image to learn more.

Learn what it takes to make clinical trials happen—from the patient and research perspective.

The event is open to the public and refreshments will be provided.

Free parking is available on site and the UW Medicine research complex is close to several bus lines.

Who:

  • Dr. Mary “Nora” Disis, Tumor Vaccine Group founder
  • Researchers Dr. Lupe Salazar and Dr. Hailing Lu
  • Staff, patients, cancer advocacy group members

What:

  • Two sets of lab tours at 5:30 and 8 p.m., presentations and a chance to talk with patients and researchers.

When:

  • Thursday, October 14, 2010 –  5 to 9 p.m.

Where:

  • UW Medicine Research facility, 815 Mercer Street, Seattle, 98109

To learn more:

  • Questions? Call 206.543.8557.

PHOTO CREDIT: Thumbnail is a scanning electron micrograph of a breast cancer cell courtesy of the National Cancer Institute.

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Ovarian Cancer Research Symposium

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The Marsha Rivkin Center for Ovarian Cancer Research at Swedish Medical Center is hosting its 2010 Ovarian Cancer Research Symposium in Seattle, October 28-29.

Topics:

  • Origins of Ovarian Cancer
  • Developing Therapeutics
  • Biomarkers for Ovarian Cancer Diagnosis, Prognosis and Treatment
  • Novel Therapeutics in Ovarian Cancer

Keynote Speakers:

To learn more:

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Symptoms may be of little help in the early detection of ovarian cancer

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Symptoms like nausea, abdominal bloating, and pelvic pain may be of little help in detecting ovarian cancer early, when the chances of cure are best, according to a new study by researchers at Seattle’s Fred Hutchinson Cancer Research Institute.

Ovarian cancer is the ninth most common cancer among women (not counting skin cancers), according to the American Cancer Society.

Because ovarian cancer is usually detected late, it is often lethal, killing about 14,600 women in the U.S. each year.

Guidelines adopted by a number of organizations, including the American Cancer Society, recommend that such symptoms be used to identify women who should undergo medical evaluation with ultrasound and other testing in the hope of detecting ovarian cancer early while it is still curable.

But in the Seattle researchers found that while the majority of women who have the cancer do indeed commonly experience those symptoms before they are diagnosed, the symptoms appear for a relatively short time before diagnosis, whether or not they had early- or late-stage disease.

Moreover, because these symptoms are so common and ovarian cancer relatively rare, the Seattle team calculate it would be necessary to evaluate 100 women to find one ovarian cancer and around 200 women to detect an early stage cancer.

In the study, the researchers interviewed 812 women in Western Washington who had ovarian cancer and 1313 similar women who did not, asking them whether they had these symptoms and for how long.

Mary Anne Rossing, Ph.D., of the Program in Epidemiology at the Fred Hutchinson Cancer Research Center was the lead author of the study. Dr. Noel Weiss, M.D., Ph.D., also of the Hutchinson Center, was the senior author.

The paper was published Thursday online by the Journal of the National Cancer Institute.

In a phone interview, Dr. Weiss said that whether doctors should conduct the often costly medical evaluations of women with these symptoms when so many must be evaluated to find just one case is a value and economic judgement.

But even if this approach does identify women with ovarian cancer, it is still not clear that it will reduce their mortality, Dr. Weiss said. “It may not be early enough to make a difference.”

Advocates of the approach, he said, are “basically taking on faith that there is some benefit for the women with ovarian cancer who are identified by these means—that’s unproven.”

In an accompanying editorial, Dr. Llana Cass and Dr. Beth Y. Karlan, of the Division of Gynecologic Oncology at Cedars-Sinai Medical Center in Los Angeles write that the Seattle group’s findings suggest that it is not likely that evaluating women on the basis of symptoms alone will improve survival rates from ovarian cancer and “highlight the urgent need to develop better molecular markers and improved imaging modalities for ovarian cancer screening.”

ILLUSTRATION: Courtesy of the National Cancer Insitute – Alan Hoofring and Don Bliss

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The

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