NCCN Guidelines for Patients Ovarian Cancer
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Medical Oncology and Breast Cancer
The Breast Center Smilow Cancer Hospital 20 York Street, North Pavilion New Haven, CT 06510 Phone: (203) 200-2328 Fax: (203) 200-2075 MEDICAL ONCOLOGY Treatment for breast cancer is multidisciplinary. The primary physicians with whom you may meet as part of your care are the medical oncologist, the breast surgeon, and often the radiation oncologist. A list of these specialty physicians will be provided to you. Each provider works with a team of caregivers to ensure that every patient receives high quality, personalized, breast cancer care. The medical oncologist specializes in “systemic therapy”, or medications that treat the whole body. For women with early stage breast cancer, systemic therapy is often recommended to provide the best opportunity to prevent breast cancer from returning. SYSTEMIC THERAPY Depending on the specific characteristics of your cancer, your medical oncologist may prescribe systemic therapy. Systemic therapy can be hormone pills, IV chemotherapy, antibody therapy (also called “immunotherapy”), and oral chemotherapy; sometimes patients receive more than one type of systemic therapy. Systemic therapy can happen before surgery (called “neoadjuvant therapy”) or after surgery (“adjuvant therapy”). If appropriate, your breast surgeon and medical oncologist will discuss the benefits of neoadjuvant and adjuvant therapy with you. As a National Comprehensive Cancer Network (NCCN) Member Institution, we are dedicated to following the treatment guidelines that have been shown to be most effective. We also have a variety of clinical trials that will help us find better ways to treat breast cancer. Your medical oncologist will recommend what treatment types and regimens are best for you. The information used to make these decisions include: the location of the cancer, the size of the cancer, the type of cancer, whether the cancer is invasive, the grade of the cancer (a measure of its aggressiveness), prognostic factors such as hormone receptors and HER2 status, and lymph node involvement. -
Exposure to Carcinogens and Work-Related Cancer: a Review of Assessment Methods
European Agency for Safety and Health at Work ISSN: 1831-9343 Exposure to carcinogens and work-related cancer: A review of assessment methods European Risk Observatory Report Exposure to carcinogens and work-related cancer: A review of assessment measures Authors: Dr Lothar Lißner, Kooperationsstelle Hamburg IFE GmbH Mr Klaus Kuhl (task leader), Kooperationsstelle Hamburg IFE GmbH Dr Timo Kauppinen, Finnish Institute of Occupational Health Ms Sanni Uuksulainen, Finnish Institute of Occupational Health Cross-checker: Professor Ulla B. Vogel from the National Working Environment Research Centre in Denmark Project management: Dr Elke Schneider - European Agency for Safety and Health at Work (EU-OSHA) Europe Direct is a service to help you find answers to your questions about the European Union Freephone number (*): 00 800 6 7 8 9 10 11 (*) Certain mobile telephone operators do not allow access to 00 800 numbers, or these calls may be billed. More information on the European Union is available on the Internet ( 48TU http://europa.euU48T). Cataloguing data can be found on the cover of this publication. Luxembourg: Publications Office of the European Union, 2014 ISBN: 978-92-9240-500-7 doi: 10.2802/33336 Cover pictures: (clockwise): Anthony Jay Villalon (Fotolia); ©Roman Milert (Fotolia); ©Simona Palijanskaite; ©Kari Rissa © European Agency for Safety and Health at Work, 2014 Reproduction is authorised provided the source is acknowledged. European Agency for Safety and Health at Work – EU-OSHA 1 Exposure to carcinogens and work-related cancer: -
Ovarian Cancer and Cervical Cancer
What Every Woman Should Know About Gynecologic Cancer R. Kevin Reynolds, MD The George W. Morley Professor & Chief, Division of Gyn Oncology University of Michigan Ann Arbor, MI What is gynecologic cancer? Cancer is a disease where cells grow and spread without control. Gynecologic cancers begin in the female reproductive organs. The most common gynecologic cancers are endometrial cancer, ovarian cancer and cervical cancer. Less common gynecologic cancers involve vulva, Fallopian tube, uterine wall (sarcoma), vagina, and placenta (pregnancy tissue: molar pregnancy). Ovary Uterus Endometrium Cervix Vagina Vulva What causes endometrial cancer? Endometrial cancer is the most common gynecologic cancer: one out of every 40 women will develop endometrial cancer. It is caused by too much estrogen, a hormone normally present in women. The most common cause of the excess estrogen is being overweight: fat cells actually produce estrogen. Another cause of excess estrogen is medication such as tamoxifen (often prescribed for breast cancer treatment) or some forms of prescribed estrogen hormone therapy (unopposed estrogen). How is endometrial cancer detected? Almost all endometrial cancer is detected when a woman notices vaginal bleeding after her menopause or irregular bleeding before her menopause. If bleeding occurs, a woman should contact her doctor so that appropriate testing can be performed. This usually includes an endometrial biopsy, a brief, slightly crampy test, performed in the office. Fortunately, most endometrial cancers are detected before spread to other parts of the body occurs Is endometrial cancer treatable? Yes! Most women with endometrial cancer will undergo surgery including hysterectomy (removal of the uterus) in addition to removal of ovaries and lymph nodes. -
About Ovarian Cancer Overview and Types
cancer.org | 1.800.227.2345 About Ovarian Cancer Overview and Types If you have been diagnosed with ovarian cancer or are worried about it, you likely have a lot of questions. Learning some basics is a good place to start. ● What Is Ovarian Cancer? Research and Statistics See the latest estimates for new cases of ovarian cancer and deaths in the US and what research is currently being done. ● Key Statistics for Ovarian Cancer ● What's New in Ovarian Cancer Research? What Is Ovarian Cancer? Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer and can spread. To learn more about how cancers start and spread, see What Is Cancer?1 Ovarian cancers were previously believed to begin only in the ovaries, but recent evidence suggests that many ovarian cancers may actually start in the cells in the far (distal) end of the fallopian tubes. 1 ____________________________________________________________________________________American Cancer Society cancer.org | 1.800.227.2345 What are the ovaries? Ovaries are reproductive glands found only in females (women). The ovaries produce eggs (ova) for reproduction. The eggs travel from the ovaries through the fallopian tubes into the uterus where the fertilized egg settles in and develops into a fetus. The ovaries are also the main source of the female hormones estrogen and progesterone. One ovary is on each side of the uterus. The ovaries are mainly made up of 3 kinds of cells. Each type of cell can develop into a different type of tumor: ● Epithelial tumors start from the cells that cover the outer surface of the ovary. -
Reproductive System, Day 2 Grades 4-6, Lesson #12
Family Life and Sexual Health, Grades 4, 5 and 6, Lesson 12 F.L.A.S.H. Reproductive System, day 2 Grades 4-6, Lesson #12 Time Needed 40-50 minutes Student Learning Objectives To be able to... 1. Distinguish reproductive system facts from myths. 2. Distinguish among definitions of: ovulation, ejaculation, intercourse, fertilization, implantation, conception, circumcision, genitals, and semen. 3. Explain the process of the menstrual cycle and sperm production/ejaculation. Agenda 1. Explain lesson’s purpose. 2. Use transparencies or your own drawing skills to explain the processes of the male and female reproductive systems and to answer “Anonymous Question Box” questions. 3. Use Reproductive System Worksheets #3 and/or #4 to reinforce new terminology. 4. Use Reproductive System Worksheet #5 as a large group exercise to reinforce understanding of the reproductive process. 5. Use Reproductive System Worksheet #6 to further reinforce Activity #2, above. This lesson was most recently edited August, 2009. Public Health - Seattle & King County • Family Planning Program • © 1986 • revised 2009 • www.kingcounty.gov/health/flash 12 - 1 Family Life and Sexual Health, Grades 4, 5 and 6, Lesson 12 F.L.A.S.H. Materials Needed Classroom Materials: OPTIONAL: Reproductive System Transparency/Worksheets #1 – 2, as 4 transparencies (if you prefer not to draw) OPTIONAL: Overhead projector Student Materials: (for each student) Reproductive System Worksheets 3-6 (Which to use depends upon your class’ skill level. Each requires slightly higher level thinking.) Public Health - Seattle & King County • Family Planning Program • © 1986 • revised 2009 • www.kingcounty.gov/health/flash 12 - 2 Family Life and Sexual Health, Grades 4, 5 and 6, Lesson 12 F.L.A.S.H. -
"General Pathology"
,, ., 1312.. CALIFORNIA TUMOR TISSUE REGISTRY "GENERAL PATHOLOGY" Study Cases, Subscription B October 1998 California Tumor Tissue Registry c/o: Department of l'nthology and Ruman Anatomy Loma Lindn Universily School'oflV.lcdicine 11021 Campus Avenue, AH 335 Lomn Linda, California 92350 (909) 824-4788 FAX: (909) 478-4188 E-mail: cU [email protected] CONTRIBUTOR: Philip G. R obinson, M.D. CASE NO. 1 - OcrOBER 1998 Boynton Beach, FL TISSUE FROM: Stomach ACCESSION #28434 CLINICAL ABSTRACT: This 67-year-old female was thought to have a pancreatic mass, but at surgery was found to have a nodule within the gastric wall. GROSS PATHOLOGY: The specimen consisted of a 5.0 x 5.5 x 4.5 em fragment of gray tissue. The cut surface was pale tan, coarsely lobular with cystic degeneration. SPECIAL STUDIES: Keratin negative Desmin negative Actin negative S-100 negative CD-34 trace to 1+ positive in stromal cells (background vasculature positive throughout) CONTRIBUTOR: Mar k J anssen, M.D. CASE NO. 2 - ocrOBER 1998 Anaheim, CA TISSUE FROM: Bladder ACCESSION #28350 CLINICAL ABSTRACT: This 54-year-old male was found to have a large rumor in his bladder. GROSS PATHOLOGY: The specimen consisted of a TUR of urinary bladder tissue, forming a 7.5 x 7. 5 x 1.5 em aggregate. SPECIAL STUDfES: C)1okeratin focally positive Vimentin highly positive MSA,Desmin faint positivity CONTRIBUTOR: Howard Otto, M.D. CASE NO.3 - OCTOBER 1998 Cheboygan, Ml TISSUE FROM: Appendix ACCESSION #28447 CLINICAL ABSTRACT: This 73-year-old female presented with acute appendicitis and at surgery was felt to have a periappendiceal abscess. -
FEMALE REPRODUCTIVE SYSTEM Female Reproduc Ve System
Human Anatomy Unit 3 FEMALE REPRODUCTIVE SYSTEM Female Reproducve System • Gonads = ovaries – almond shaped – flank the uterus on either side – aached to the uterus and body wall by ligaments • Gametes = oocytes – released from the ovary during ovulaon – Develop within ovarian follicles Ligaments • Broad ligament – Aaches to walls and floor of pelvic cavity – Connuous with parietal peritoneum • Round ligament – Perpendicular to broad ligament • Ovarian ligament – Lateral surface of uterus ‐ ‐> medial surface of ovary • Suspensory ligament – Lateral surface of ovary ‐ ‐> pelvic wall Ovarian Follicles • Layers of epithelial cells surrounding ova • Primordial follicle – most immature of follicles • Primary follicle – single layer of follicular (granulosa) cells • Secondary – more than one layer and growing cavies • Graafian – Fluid filled antrum – ovum supported by many layers of follicular cells – Ovum surrounded by corona radiata Ovarian Follicles Corpus Luteum • Ovulaon releases the oocyte with the corona radiata • Leaves behind the rest of the Graafian follicle • Follicle becomes corpus luteum • Connues to secrete hormones to support possible pregnancy unl placenta becomes secretory or no implantaon • Becomes corpus albicans when no longer funconal Corpus Luteum and Corpus Albicans Uterine (Fallopian) Tubes • Ciliated tubes – Passage of the ovum to the uterus and – Passage of sperm toward the ovum • Fimbriae – finger like projecons that cover the ovary and sway, drawing the ovum inside aer ovulaon The Uterus • Muscular, hollow organ – supports -
Endometrioid Carcinoma
Ovarian Cancer Endometrioid Carcinoma What is an Ovarian What characterizes Endometrioid Tumor? Ovarian Endometrioid Endometrioid tumors make up Carcinoma? about 2 to 4 percent of all ovar- Ovarian cancer often does not Definition of ian tumors and most of them present clear physical symptoms. Terms (about 80 percent) are malignant, Some signs of ovarian cancer representing 10 to 20 percent of include persistent (more than two Endometrial: all ovarian carcinomas. In some weeks) pelvic or abdominal pain Excessive growth of cases, endometrioid carcinomas of or discomfort; bloatedness, gas, cells in the endome- the ovary appear synchronously nausea and indigestion; vaginal trium, the tissue that with an endometrial carcinoma bleeding; frequent or urgent uri- lines the uterus. (epithelial cancer of the uterus) nation with and/or endometriosis (presence of no infection; Epithelial: Relating endometrial tissue outside unexplained to the epithelium, the uterus). weight gain tissue that lines the Ovarian Endometrioid Carcino- or loss; fa- internal surfaces of mas are the second most common tigue; and body cavities or ex- ternal body surfaces type of epithelial ovarian can- changes in of some organs, cer, which is the most common bowel habits. such as the ovary. ovarian cancer. According to the If you have American Cancer Society, ovar- a known his- ian cancer accounts for 6 percent tory of endo- Ovarian Endometri- Malignant: Cancer- of all cancers among women. The metriosis involving the ovary and oid Carcinoma often ous and capable of fi ve-year survival rate for women there is a change in the intensity does not present spreading. with advanced ovarian cancer is or type of symptoms that you are clear symptoms. -
Primary Screening for Breast Cancer with Conventional Mammography: Clinical Summary
Primary Screening for Breast Cancer With Conventional Mammography: Clinical Summary Population Women aged 40 to 49 y Women aged 50 to 74 y Women aged ≥75 y The decision to start screening should be No recommendation. Recommendation Screen every 2 years. an individual one. Grade: I statement Grade: B Grade: C (insufficient evidence) These recommendations apply to asymptomatic women aged ≥40 y who do not have preexisting breast cancer or a previously diagnosed high-risk breast lesion and who are not at high risk for breast cancer because of a known underlying genetic mutation Risk Assessment (such as a BRCA1 or BRCA2 gene mutation or other familial breast cancer syndrome) or a history of chest radiation at a young age. Increasing age is the most important risk factor for most women. Conventional digital mammography has essentially replaced film mammography as the primary method for breast cancer screening Screening Tests in the United States. Conventional digital screening mammography has about the same diagnostic accuracy as film overall, although digital screening seems to have comparatively higher sensitivity but the same or lower specificity in women age <50 y. For women who are at average risk for breast cancer, most of the benefit of mammography results from biennial screening during Starting and ages 50 to 74 y. While screening mammography in women aged 40 to 49 y may reduce the risk for breast cancer death, the Stopping Ages number of deaths averted is smaller than that in older women and the number of false-positive results and unnecessary biopsies is larger. The balance of benefits and harms is likely to improve as women move from their early to late 40s. -
Photodynamic Therapy for Gynecological Diseases and Breast Cancer
CancCancerer Biol Med 2012;2012 /9: Vol. 9-17 9 /doi: No. 10.3969/j.issn.2095-3941.2012.1 01.002 9 Review Photodynamic Therapy for Gynecological Diseases and Breast Cancer Natashis Shishkova, Olga Kuznetsova, Temirbolat Berezov Department of Biochemistry, School of Medicine, People’s Friendship University of Russia, Moscow 117198, Russia ABSTRACT Photodynamic therapy (PDT) is a minimally invasive and promising new method in cancer treatment. Cytotoxic reactive oxygen species (ROS) are generated by the tissue-localized non-toxic sensitizer upon illumination and in the presence of oxygen. Thus, selective destruction of a targeted tumor may be achieved. Compared with traditional cancer treatment, PDI has advantages including higher selectivity and lower rate of toxicity. The high degree of selectivity of the proposed method was applied to cancer diagnosis using fluorescence. This article reviews previous studies done on PDT treatment and photodetection of cervical intraepithelial neoplasia, vulvar intraepithelial neoplasia, ovarian and breast cancer, and PDT application in treating non-cancer lesions. The article also highlights the clinical responses to PDT, and discusses the possibility of enhancing treatment efficacy by combination with immunotherapy and targeted therapy. KEY WORDS: photodynamic therapy, photosensitizers, cervical/vulvar intraepithelial neoplasia, ovarian neoplasms, breast neoplasms Introduction frequently used drug in PDT is 5-aminolaevulinic acid (ALA). However, 5-ALA is not a photosensitizer, but a precursor of Photodynamic therapy (PDT) is a mode of therapy used in the endogenous photosensitizer protoporphyrin IX, which is cancer treatment where drug activity is locally controlled by a member of the heme synthesis pathway that occurs in the light (Figure 1). -
What Is New on Ovarian Carcinoma
diagnostics Review What Is New on Ovarian Carcinoma: Integrated Morphologic and Molecular Analysis Following the New 2020 World Health Organization Classification of Female Genital Tumors Antonio De Leo 1,2,3,*,† , Donatella Santini 3,4,† , Claudio Ceccarelli 1,3, Giacomo Santandrea 5 , Andrea Palicelli 5 , Giorgia Acquaviva 1,2, Federico Chiarucci 1,2 , Francesca Rosini 4, Gloria Ravegnini 3,6 , Annalisa Pession 2,6, Daniela Turchetti 3,7, Claudio Zamagni 8, Anna Myriam Perrone 3,9 , Pierandrea De Iaco 3,9, Giovanni Tallini 1,2,3,‡ and Dario de Biase 2,3,6,‡ 1 Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum—University of Bologna, Via Massarenti 9, 40138 Bologna, Italy; [email protected] (C.C.); [email protected] (G.A.); [email protected] (F.C.); [email protected] (G.T.) 2 Molecular Pathology Laboratory, IRCCS Azienda Ospedaliero—Universitaria di Bologna/Azienda USL di Bologna, 40138 Bologna, Italy; [email protected] (A.P.); [email protected] (D.d.B.) 3 Centro di Studio e Ricerca delle Neoplasie Ginecologiche, Alma Mater Studiorum—University of Bologna, 40138 Bologna, Italy; [email protected] (D.S.); [email protected] (G.R.); [email protected] (D.T.); [email protected] (A.M.P.); [email protected] (P.D.I.) 4 Pathology Unit, IRCCS Azienda Ospedaliero—Universitaria di Bologna, Via Massarenti 9, 40138 Bologna, Italy; [email protected] 5 Citation: De Leo, A.; Santini, D.; Pathology Unit, AUSL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; Ceccarelli, C.; Santandrea, G.; [email protected] (G.S.); [email protected] (A.P.) 6 Palicelli, A.; Acquaviva, G.; Chiarucci, Department of Pharmacy and Biotechnology, University of Bologna, 40126 Bologna, Italy 7 Unit of Medical Genetics, IRCCS Azienda Ospedaliero—Universitaria di Bologna, Via Massarenti 9, F.; Rosini, F.; Ravegnini, G.; Pession, 40138 Bologna, Italy A.; et al. -
Creating an Artificial 3-Dimensional Ovarian Follicle Culture System
micromachines Article Creating an Artificial 3-Dimensional Ovarian Follicle Culture System Using a Microfluidic System Mae W. Healy 1,2, Shelley N. Dolitsky 1, Maria Villancio-Wolter 3, Meera Raghavan 3, Alexandra R. Tillman 3 , Nicole Y. Morgan 3, Alan H. DeCherney 1, Solji Park 1,*,† and Erin F. Wolff 1,4,† 1 Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA; [email protected] (M.W.H.); [email protected] (S.N.D.); [email protected] (A.H.D.); [email protected] (E.F.W.) 2 Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA 3 Trans-NIH Shared Resource on Biomedical Engineering and Physical Science, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD 20892, USA; [email protected] (M.V.-W.); [email protected] (M.R.); [email protected] (A.R.T.); [email protected] (N.Y.M.) 4 Pelex, Inc., McLean, VA 22101, USA * Correspondence: [email protected] † Solji Park and Erin F. Wolff are co-senior authors. Abstract: We hypothesized that the creation of a 3-dimensional ovarian follicle, with embedded gran- ulosa and theca cells, would better mimic the environment necessary to support early oocytes, both structurally and hormonally. Using a microfluidic system with controlled flow rates, 3-dimensional Citation: Healy, M.W.; Dolitsky, S.N.; two-layer (core and shell) capsules were created. The core consists of murine granulosa cells in Villancio-Wolter, M.; Raghavan, M.; 0.8 mg/mL collagen + 0.05% alginate, while the shell is composed of murine theca cells suspended Tillman, A.R.; Morgan, N.Y.; in 2% alginate.