Regular screening provides ovarian cancer protection for high-risk women with hereditary colon cancer

Women with mutated genes for hereditary non-polyposis colon cancer (Lynch Syndrome) are at increased risk for both endometrial and ovarian cancer, as well as colon cancer.  A hysterectomy to remove uterus and ovaries is sometimes recommended to reduce the risk.

Researchers at the University of California at San Francisco and Stanford University considered the benefits of three different strategies to prevent endometrial and ovarian cancer in women with Lynch Syndrome.

• Annual gynecologic exams
• Annual screening with gynecological exams, transvaginal ultrasound, endometrial biopsy, and measurement of CA 125 in the blood beginning at age 30
• Prophylactic surgery to remove ovaries, fallopian tubes, and uterus (Hysterectomy with Bilateral Salpingo-oophorectomy)

Using Surveillance, Epidemiology and End Results (SEER) data from 1988 to 2001, they found that surgery was most effective in preventing both ovarian and endometrial cancer, following by screening,

• Ovarian cancer would be diagnosed in .0056 percent of women who had surgery, endometrial cancer in .0060 percent.
• 3.7 percent of those who had annual screenings would get ovarian cancer during their lives, 18.4 percent would get endometrial cancer.
• With annual gyn exams 8.3 percent would get ovarian cancer and 48.7 percent would be diagnosed with endometrial cancer during their lifetimes.

Writing for the research team, Lee-may Chen, MD, pointed out,

When comparing prophylactic surgery with the screening option, one would need to perform 75 surgeries to save one woman’s entire life. For cancer prevention, however, only 28 and 6 prophylactic surgeries would need to be performed to prevent one case of ovarian and endometrial cancer, respectively.

She concluded,

Risk-reducing hysterectomy and bilateral salpingo-oophorectomy may be considered in women with Lynch/HNPCC to prevent gynecologic cancers and their associated morbidities.

SOURCE:  Chen et. al. Obstetrics and Gynecology, Volume 110, Issue 1, July 1, 2007.

WHAT THIS MEANS FOR PATIENTS

Women who carry a gene for Lynch Syndrome hereditary non-polyposis colon cancer may want to consider surgery to reduce their risk of ovarian or endometrial cancer.  An alternative to surgery is annual screening with with transvaginal ultrasound, uterine biopsy, and measurement of CA-125.   

Although removal of the ovaries and fallopian tubes greatly reduces risk of ovarian cancer, it does not prevent it entirely.  Ovarian cancer can develop within the peritoneal cavity even when there are no ovaries.

Posted by Kate Murphy on July 3rd, 2007
Posted in: Research & Treatment News | 1 Comment »

Use the August Recess to tell Congress to Properly Fund Cancer Research

Your Representative and Senators will be working in their district offices during the upcoming August Congressional Recess (August 6-31) and we need you to reach out to them while they’re home. House and Senate leaders have requested far less than the amount needed to advance crucial cancer research.

WE NEED YOU!! Tell Congress to keep their promise and properly fund cancer research.

Here are some ideas on how to get the message out about proposed funding levels for cancer research to your Representative and Senators while they are home in the district.

1. Option 1: CALL your Representatives and Senators at their district office today and tell them that the current funding level for the NIH, which includes the NCI, won’t work and needs to be fixed. Click here for their phone numbers

2. Option 2: Attend a public meeting or event where your Representative and Senators may be at.

3. Option 3: Drop by their district office. You may not be able to sit down with your Member of Congress, but you should be able to at least speak with a staff member.

4. Option 4: If time is short, send an E-MAIL to your Representative and Senators today.

Materials:

Click here for talking points developed by C3: Colorectal Cancer Coalition.

SPEAK OUT TODAY!!

For more information please contact Joe Arite, Policy and Grassroots Manager at Joe.Arite@FightColorectalCancer.org

Don’t forget to visit C3: Colorectal Cancer Coalition’s Advocacy Blog

Posted by Joe Arite on July 2nd, 2007
Posted in: Policy & Advocacy News | No Comments »

Good Morning America film critic Joel Siegel dies of colon cancer

Joel Siegel, entertainment editor and film critic for ABC News, died of colon cancer last Friday, June 29, 2007.  He was 63.

In 1997, the same year he learned he had colon cancer, he also found out that he was to become a father for the first time.  Fearing that his son might have to grow up not knowing his father, Siegel wrote Lessons for Dylan to share those things he wanted his son to know. 

DEAR DYLAN:
They are words you don’t easily forget, “I don’t have good news.” Especially when they’re said by a doctor who’s just finished giving you a colonoscopy.

Talking about dealing with staying “positive and serene through days of discomfort” during radiation treatments and chemotherapy, Siegel wrote,

I pictured my grandmother. I’d see her face, I’d try to feel her hands, her long fingers, wrinkled as if she’d spent too much time in the pool. She, too, had colon cancer. She was diagnosed at 80 and lived till 90 and died of something else.

Chemotherapy ended at the same time Dylan was born, and Siegel had several good months,

I had about three great months. My hair came back. Darker. My colostomy was reversed. That was nice. It took major surgery and I had to figure out a new diet and relearn muscle control and Easter Sunday at friends I ran out of my diapers and had to borrow one of Dylan’s, but life was getting better. My CT-scans were clean, I was getting better.

But then the cancer returned.  He wrote in Lessons for Dylan,

Dylan was happy and gurgling. Ena was painting. I was feeling good. Things were going well.

And the witch came back.

In 1991 Siegel and actor Gene Wilder founded Gilda’s Club to support people living with cancer in honor of Wilder’s wife Gilda Radner who died of ovarian cancer.

He is survived by his wife Eva Swansea and son Dylan.

Posted by Kate Murphy on July 2nd, 2007
Posted in: Research & Treatment News | No Comments »

Phase III trial underway to study Sutent for metastatic colorectal cancer

Pfizer has announced the opening of a multinational Phase III clinical trial to study the safety and effectiveness Sutent (sunitinib malate) combined with FOLFIRI chemotherapy as first-line treatment for colorectal cancer that has spread to organs beyond the colon or rectum.  The trial is designed to be first-line treatment for metastatic cancer.

Seven hundred patients will be recruited internationally and randomized to receive either:

• FOLFIRI — Irinotecan, leucovorin, and continuous infusion 5FU – plus a placebo
• FOLFIRI plus sunitinib

The clinical trial is open and recruiting patients in Europe, Canada, Asia, and South America.

Who is eligible?

• Patients with confirmed colorectal cancer that has spread to organs beyond the colon (metastatic disease).
• Patients who have received no other treatment for metastatic colorectal cancer.
• Patients for whom treatment with FOLFIRI is indicated.
• Patients whose overall organ functioning is adequate based on blood tests.

Who is not eligible?

• Patients who have had different primary cancer within the past three years.
• Patients who have had full field radiotherapy within 4 weeks of enrollment, who have received partial field radiotherapy within 2 weeks, or who have had radiation treatment to more than 30% of their bone marrow.
• Patients whose cancer has spread to their brain or who have compression of their spinal cord.

For more information about the trial, call 1-877-369-9753.

Posted by Kate Murphy on June 30th, 2007
Posted in: Research & Treatment News | 2 Comments »

Phase I data shows safety and activity for FOLFIRI plus Sutent in patients with metastatic colorectal cancer

NEWS FROM 2007 WORLD CONGRESS ON GASTROINTESTINAL CANCER

Sutent® (sunitinib maleate) combined with FOLFIRI chemotherapy was active and generally well-tolerated in previously untreated patients with colorectal cancer that had spread according to a Phase I study presented at the World Congress on Gastrointestinal Cancer in Barcelona.

Ten patients received Sutent daily for four weeks, followed by two weeks of rest.  They were also getting FOLFIRI chemo treatments.  FOLFIRI is a combination of intravenous irinotecan, leuvocorin, and 5FU.  The 5FU is given as continuous infusion.

Of the 10 patients in the trial, 4 had a partial response and 6 have had stable disease.  Serious side effects included one respiratory infection and two cases of low white cell counts (neutropenia) with fever.

Alfredo Carrato, MD, who will lead a multinational randomized Phase III study of FOLFIRI plus Sutent, said,

Despite progress in recent years, colorectal cancer remains a hard-to-treat cancer for which new options are sorely needed. These data support further research of sunitinib malate in metastatic colorectal cancer, in an effort to potentially expand the range of therapies available to physicians and patients.

Sutent is currently indicated for patients with advanced renal cell carcinoma or gastrointestinal stromal tumor (GIST).

WHAT THIS MEANS FOR PATIENTS

These are results of a small Phase I study whose goal was to find a dose of Sutent that is safe and has tolerable side effects.  Effectiveness is not an objective of Phase I clinical trials.

The trial was designed for patients who had not been previously treated for metastatic colorectal cancer, so it is not reasonable to conclude that it might have similar activity in patients who had already had other treatments.

It is too soon to assume that Sutent and FOLFIRI  might be a better treatment than FOLFIRI alone.  A randomized Phase III trial is planned to answer that question.

Posted by Kate Murphy on June 30th, 2007
Posted in: Research & Treatment News | No Comments »