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The Johns Hopkins Hospital Tops U.S. News & World Report's "HONOR ROLL" for the 18th Year in a row!
February 17, 2009


For a detailed list of all rankings, go to the U.S. News and World Report.

The Johns Hopkins Hospital Tops U.S. News & World Report's "HONOR ROLL" for the 17th Year in a row!
February 17, 2009


For a detailed list of all rankings, go to the U.S. News and World Report.

The Johns Hopkins Hospital Tops U.S. News & World Report's "HONOR ROLL" for the 16th Year in a row!
July 26, 2006

The Johns Hopkins Hospital has again earned the top spot as "Best of the Best" in U.S. News &World Report's annual Honor Roll of American hospitals, placing first in five of 16 ranked medical specialties and in the top four in 10 others. Only 14 hospitals nationwide made it to the Honor Roll this year out of 5,189 institutions graded.

This year's annual guide reports results of a survey of a hospital's reputation among a national sample of physicians, along with analysis of objective indicators such as death rates, technology, nurse staffing, service mix and discharge planning.

For a detailed list of all rankings, go to www.hopkinsmedicine.org or to the U.S. News and World Report.

The Johns Hopkins Hospital Tops U.S. News & World Report's "HONOR ROLL" for the 15th Year in a row!
July 11, 2005
For the 15th consecutive year, U.S. News & World Report's annual ranking of American hospitals has placed The Johns Hopkins Hospital at the top of the list.

The magazine's recognition is, as always, a tribute to the Hospital, its dedicated nurses and staff, the School of Medicine's faculty physicians and the community physicians whose contributions are significant.

As we endeavor to rebuild, renew, enrich and expand our services and facilities, and to assure our continued commitment to safety and excellence, such independent evaluations as these rankings are of growing value to patients, the public, referring physicians and insurers.

This year's annual guide ranked American medical centers in 17 specialties to identify hospitals that excel in a variety of difficult areas of care by conducting research, pioneering advanced treatments and bringing the best technology and expertise to bear. Just 176 hospitals scored high enough this year to rank in even a single area out of all 6007 U.S. medical centers, and only 16 accumulated enough points to make it to the Honor Roll reserved for medical centers that ranked at or near the top in at least six specialties. Hopkins placed #3 in Cancer, #1 in Gynecology, # 3 in Digestive Disorders. For a complete list of all rankings, go to www.usnews.com or www.hopkinsmedicine.org .

Current Concepts in the Multidisciplinary Management of Ovarian Cancer (September 10, 2004)
August 24, 2004
Course Objectives
  • Define the current status of ovarian cancer screening and early detection
  • Implement the clinical application of advanced imaging techniques to the diagnosis and management of ovarian cancer
  • Define the role of surgery in the management of primary and recurrent ovarian cancer
  • Interpret results of contemporary clinical trials of chemotherapy and developmental therapeutics for ovarian cancer

  • Program

    Introductory Remarks
    Robert E. Bristow, MD

    Ovarian Cancer Community Education and Outreach
    Ms. Nikki Karl

    Update on Clinical Trials and Novel Treatment Strategies for Ovarian Cancer
    Deborah K. Armstrong, MD

    Clinical Applications of Proteomics in Ovarian Cancer
    Daniel W. Chan, PhD

    Molecular Pathways of Ovarian Cancer
    Ie Ming Shih, MD, PhD

    Current Status of Ovarian Cancer Screening
    Ginger Gardner, MD

    Advanced Imaging Techniques for Ovarian Cancer
    Elliot K. Fishman, MD

    Complementary and Alternative Medicine Applications for Ovarian Cancer
    Adrian, s. Dobs, MD

    Primary Surgical Management of Ovarian Cancer
    Robert L. Giuntoli, II, MD

    A Target-based Approach to the Treatment of Recurrent Ovarian Cancer
    Robert E. Bristow, MD

    Sidney Kimmel Comprehensive Cancer at Johns Hopkins
    The Harry and Jeanette Weinberg Building
    401 North Broadway
    Baltimore, Maryland

    For Further Information
    Registration/Confirmation/Certificates (410)955-3169 / (410)955-2959
    To Fax Your Registration (410)955-0807
    Other Course Information cmenet@jhmi.edu / www.hopkinscme.net
    Click here to register online

    Hopkins Scientists Use Blood Proteins To Detect Ovarian Cancer
    August 18, 2004
    Johns Hopkins Kimmel Cancer Center researchers have designed a blood test to detect ovarian cancer using three proteins found in common in the blood of women with the disease. Their preliminary studies with the new test suggest a molecular signature exclusive to this deadly cancer, known for its ability to remain undetected and spread quickly.

    The Hopkins test, described in the August 15 issue of Cancer Research, identifies the proteins as a truncated form of transthyretin, a fragment of ITIH4 and apolipoprotein A1, teased out with a rigorous evaluation of protein patterns present in blood samples from ovarian cancer patients at several U.S. and international hospitals. Other research groups are evaluating ovarian cancer blood tests that use protein profiles consisting of tens of thousands of unidentified molecules.

    "By identifying a select group of biomarkers specific to ovarian cancer, we not only know the proteins we are dealing with, but we can trace them back to alterations in the genetic code of ovarian cancer cells," says Daniel W. Chan, Ph.D., professor and director of the Biomarker Discovery Center at Johns Hopkins. "We are focusing on the markers for which we have good biological reasoning behind their selection, and hope to expand the panel of markers to catch as many variations in ovarian cancer proteins as possible."

    This research was funded by the National Cancer Institute and Ciphergen Biosystems, which has licensed the test.

    Chan and his co-workers emphasize that the test will not be commercially available for screening the population at large until completion of further validation studies in larger groups of patients. And even then, Chan notes, it is never going to be possible for a blood test to correctly diagnose 100 percent of cancerous tumors 100 percent of the time. "The goal is to come as close as possible to that by using this test in combination with other available diagnostic tools." They believe, however, that with some refinements it may already have use for helping determine whether a pelvic mass is ovarian cancer.

    In a systematic search to find the most promising blood proteins for their test, the Hopkins scientists conducted a multicenter study and used protein chip technology to screen a total of 195 blood samples from two groups of ovarian cancer patients, healthy people, and patients with benign ovarian tumors. A sophisticated bioinformatics program was used to select proteins present at unusually high or low levels in ovarian cancer samples as compared with normal or benign. Samples in the two groups were analyzed separately to account for differences in patient populations and sample collection techniques. Then, researchers compared protein profile results in these two groups and ultimately narrowed the search for potential marker candidates to the three proteins, one of which (ITIH4) is commonly found at high levels in ovarian cancer and the other two at lower levels.

    "Typically, only half of early-stage ovarian cancer patients have elevated blood levels of a standard marker called CA125," says Zhen Zhang, Ph.D., associate professor and associate director of the Biomarker Discovery Center at Johns Hopkins. "But combining CA125 with our new markers may improve early detection capabilities."

    The new proteins were screened against a separate collection of blood samples from patients with normal and cancerous tissues. Of 23 patients with early-stage ovarian cancer, the three protein markers plus CA125 correctly identified cancer 74 percent of the time (17 of 23) as compared to 65 percent (15 of 23) with CA125 alone. Although the sample size was too small for this difference to be statistically significant, the scientists conducted further studies lowering the cutoff value for CA125 to below current standards. The new test plus CA125 as well as CA125 alone detected 83 percent (19 of 23) of the cancers. In addition, the new test plus CA125 correctly identified healthy samples 94 percent of the time (59 of 63) as compared to 52 percent (33 of 63) for CA125 alone.

    To verify that the candidate markers were specific to ovarian cancer, the scientists also compared results of the protein profiles with a separate group of blood samples from 142 Johns Hopkins ovarian, breast, colon, prostate cancer patients and healthy people. Protein markers from Hopkins' ovarian cancer samples matched those from the other two groups of blood samples. Breast, colon and prostate cancer samples exhibited levels of the three proteins closer to those of normal patients, indicating that the markers may be exclusive to ovarian cancer.

    The scientists will conduct further studies to map all three proteins to the genetic pathways linked to ovarian cancer development and combine the blood test with radiologic tools such as ultrasound. They also will search for more proteins to add to the current panel of markers.

    Additional research participants included Robert Bast Jr. and Yinhua Yu from the M.D. Anderson Cancer Center; Jinong Li, Lori Sokoll, Alex Rai, Jason Rosenzweig, Bonnie Cameron, and Young Wang from Johns Hopkins; Andrew Berchuck from Duke University Medical Center; Carolien van Haaften-Day and Neville Hacker from The Royal Hospital for Women, Australia; Henk de Bruij and Ate van der Zee from University Hospital Groningen, the Netherlands; Ian Jacobs from Bart's and The London, Queen Mary's School of Medicine, United Kingdom, and Eric Fung from Ciphergen Biosystems.

    Zhang, Z. et al, "Three Biomarkers Identified from Serum Proteomic Analysis for the Detection of Early Stage Ovarian Cancer," Cancer Research 2004; 64.

    Under a licensing agreement between Ciphergen Biosystems, Inc. and the Johns Hopkins University, Chan is entitled to a share of royalty received by the University on sales of products described in this article. Chan is entitled to Ciphergen Biosystems, Inc. stock options, which is subject to certain restrictions under University policy. Chan also is a consultant to Ciphergen Biosystems, Inc. and a member of the company's scientific advisory board. The terms of this arrangement are being managed by the Johns Hopkins University in accordance with its conflict of interest policies.

    Discovery Health Channel to Rebroadcast "Hopkins 24/7"
    July 23, 2004
    The Discovery Health Channel plans to rebroadcast the first four episodes of Hopkins 24/7, with updated information on patients featured in the series.

    The Emmy-winning documentary, first aired in 2000 is a powerful, six-part documentary series that gives viewers a candid look inside Johns Hopkins Medicine and its patient care. Hopkins allowed ABCNEWS to spend three months inside its walls documenting the work of the medical staff and students.

    The following is a schedule of the Hopkins 24/7 re-broadcasts. All programs will air at 10-11 p.m. ET on Discovery Health Channel.
    Ep. 1 = July 4, 2004 Discovery Health, Sunday, 10 p.m.
    Ep. 2 = July 11, 2004 Discovery Health, Sunday 10 p.m.
    Ep. 3 = July 18, 2004 Discovery Health, Sunday 10 p.m.
    Ep. 4 = July 25, 2004 Discovery Health, Sunday 10 p.m.
    This episode features Dr. Rick Montz.

    Dr. Montz passed away on Nov. 21, 2004
    More information on the ABC News Site

    3rd Annual HERA Climb for Life
    July 20, 2004
    Join us for the 3rd Annual Ovarian Cancer Climb for Life!
    Salt Lake City, Utah
    September 16-19, 2004

    New this year - Learn to Climb with Exum.

    Don't know how to climb but want to participate? - here is your chance! Exum Utah will be providing 2 days of instruction to Novices. Space is limited for this special clinic so register early.

    Learn more about this important event on the Climb for Life Website.

    2nd Annual HERA Swing for Life
    July 20, 2004
    The second annual HERA Foundation Golf Scramble, 'Swing for Life', was held May 17, 2004 at the Tulsa Country Club under blue skies and perfect green conditions. The format for this years tournament was a four-person scramble with each team having at least one female participant. The field consisted of 19 teams vying for the top two places from two blind flights as well as individual prizes for longest drive and closest to the pin for both male and female golfers. Each golfer also had a chance to win the hole-in-one prize of a free two-year lease on a Porsche Cayenne donated by Jackie Cooper Imports of Tulsa. As last year, no one was skillful (or lucky) enough to win the Porsche this year but it was sure fun trying!

    Several door prizes donated by Tulsa area businesses were handed out to well over 50% of all participants and all were appreciative of the donated beverages from Anheuser-Busch and Crisscross Vending at the end of the day.

    In addition to the tournament, a silent auction was held for donated items. Some of the items auctioned off included the John Q. Hammons Hotel Classic LPGA Pro-Am spot ($1,300) that will be held in Tulsa in September, a Stan Musial autographed baseball bat ($400), and a beautiful seedling tree from the Elm 'survivor tree' located at the Oklahoma City Memorial ($40).

    Any way you measure it, the 2004 Swing for Life event was a great success and raised over $10,000.00 that will benefit ovarian cancer research and help Oklahoma women battling the disease. The HERA Foundation golf committee would like to give special thanks to our platinum sponsors Halliburton and Samson for sponsoring the embroidered Cutter & Buck golf shirts, the Tulsa Country Club for price breaks on green fees and donating a round of golf for four as a silent auction item, and the John Q. Hammons Hotel Classic organization for donating the LPGA Pro-Am spot. A special thanks also goes to all of our volunteers, sponsors, and supporters. Without their help, the tournament would not have been possible.

    2004 HERA Foundation Golf Committee:

    Bank of Oklahoma - Randy Wheatley
    Charles and Lynn Schusterman Family Foundation - Alana Hughes
    City of Tulsa - Laureen Gibson Gilroy
    Dominion - Wendy Straatmann
    ONEOK - Kathy Bradley

    Samson - Mona Ables, Jane Baranowski, David Fenton and Trish Wilson Framel

    How Does Epithelial Ovarian Cancer Develop?
    October 27, 2003
    Three recently published papers from our group indicate that there are two main pathways in the development of ovarian serous carcinomas and that the two different types of tumors, designated conventional (high-grade) serous carcinoma and micropapillary (low-grade) serous carcinoma have different molecular genetic alterations and specific gene expression profiles.

    The 'Low-grade pathway' illustrates the development from the normal ovarian surface epithelium to a low-grade serous carcinoma through multiple stages. The 'High-grade pathway' depicts the development of a high-grade serous carcinoma from the ovarian surface epithelium without recognizable intermediate lesions. Although clinically less aggressive than high-grade carcinomas, low-grade carcinomas are deadly as patients almost inevitably experience recurrence after initial tumor resection and eventually succumb to the disease after a protracted clinical course. Unlike high-grade carcinomas, low-grade serous carcinomas do not respond well to chemotherapy. Many distinctive molecular changes are associated with different types of ovarian serous carcinoma.

    [abstract] Mutations in BRAF and KRAS characterize the development of low-grade ovarian serous carcinoma. Singer G, Oldt R 3rd, Cohen Y, Wang BG, Sidransky D, Kurman RJ, Shih IeM. J Natl Cancer Inst. 2003 Mar 19;95(6):484-6

    [abstract] Mutational analysis of K-ras segregates ovarian serous carcinomas into two types: invasive MPSC (low-grade tumor) and conventional serous carcinoma (high-grade tumor). Singer G, Shih IeM, Truskinovsky A, Umudum H, Kurman RJ. Int J Gynecol Pathol. 2003 Jan;22(1):37-41.

    [abstract] Noninvasive and invasive micropapillary (low-grade) serous carcinoma of the ovary: a clinicopathologic analysis of 135 cases. Smith Sehdev AE, Sehdev PS, Kurman RJ. Am J Surg Pathol. 2003 Jun;27(6):725-36.

    ACOG Issues Opinion that Referral to a Gynecologic Oncologist Is Recommended for All Women Suspected of Having Ovarian Cancer
    October 27, 2003
    Sean Patrick , OvCA Survivor and Advocate
    The American College of Obstetricians and Gynecologists (ACOG) recently published a committee opinion recommending referral to a gynecologic oncologist for women suspected of having ovarian cancer. Recent studies have shown that when surgery is performed by a gynecologic oncologist, survival rates improve.

    This opinion follows the large study completed by Dr. Bristow et al at Hopkins that demonstrates that surgery has a greater impact on length of survival than chemotherapy. So where you have your surgery and who does your surgery are the two most important things to consider when facing a possible diagnosis of ovarian cancer.

    The complete opinion appears in the January 2003 issue of Gynecologic Oncology.

    Better Scanning for Metastases
    October 27, 2003
    Richard Roden, Ph.D.
    Dr. Pannu of our Radiology Department has not only written a primer on Radiology for our website, but also published two recent manuscripts describing advances in the radiographic detection of metastases.

    [abstract] Thin section dual-phase multidetector-row computed tomography detection of peritoneal metastases in gynecologic cancers. Pannu HK, Horton KM, Fishman EK. J Comput Assist Tomogr. 2003 May-Jun;27(3):333-40.

    [abstract] Multidetector CT of peritoneal carcinomatosis from ovarian cancer. Pannu HK, Bristow RE, Montz FJ, Fishman EK. Radiographics. 2003 May-Jun;23(3):687-701

    Ovarian cancer is usually in an advanced stage at diagnosis due to the presence of cancerous cells throughout the peritoneum (the tissue that lines the abdominal cavity and most of the organs within it), which develop as a result of peritoneal fluid circulation. Metastases of varying size can occur anywhere from the diaphragm through the pelvis. Computed tomography (CT) can be used to detect these metastatic lesions, which can be small and seed-like or large and appear as soft-tissue or low-attenuation masses. Recent advances in CT technology have improved the flexibility of acquiring CT images, thereby allowing the use of thin sections and multiplanar reformatting. With multidetector CT, thin-section images of the abdomen and pelvis can be obtained to assess for subcentimeter metastases and to create high-quality three-dimensional images. Multiplanar reformatting can be used to confirm the presence of metastases. Structures such as the diaphragm, paracolic gutters (around the colon), bowel, and cul-de-sac can be evaluated from many angles for surface nodules and small metastases. Interactive multiplanar review of the abdomen and pelvis has the potential to improve detection of peritoneal metastases at CT, that will help in treatment decisions.

    Simple Blood Test to Detect Cancer
    October 27, 2003
    [abstract] Increased plasma DNA integrity in cancer patients. Wang BG, Huang H-Y, Chen Y-C, Bristow RE, Kassauei K, Roden R, Sokoll LJ, Chan DW, Shih I-M. Cancer Res. 2003; 63:3966-3968

    Increased plasma DNA strand length appears to be associated with cancer according to a study in July 15 issue of Cancer Research.

    Cancer becomes a devastating disease because most cancers are diagnosed late when tumor cells may spread beyond the original tumor to other parts of the body. Therefore, detection of cancer at earlier stages has paramount importance in curing this disease. In an effort to develop molecular cancer diagnostic tests, Dr. Shih’s team, at Johns Hopkins has developed a relatively simple and inexpensive technology to detect cancer using blood samples. The technique is based on the fact that tumor cell death (necrosis) releases DNA of varying sizes from the tumor, which contrasts with cell death in normal tissue (apoptosis) that releases smaller and more uniform DNA fragments. Accordingly, increased DNA integrity, i.e., a longer DNA strand, could be a tumor-associated marker in blood. Brant Wang, MD, PhD and Ie-Ming Shih, MD, PhD and their colleagues at Johns Hopkins measured DNA length in 61 patients with female reproductive cancers including ovarian cancer and 65 female patients without neoplastic diseases (tumors). The authors found that given 100% specificity, the highest sensitivity achieved in detecting the cancer group was 62% at the index cutoff of 0.59. Fifty percent of stage I cancers had a DNA integrity index above this cutoff. All 11 patients with benign adnexal masses that clinically can be confused with malignant ovarian tumors had DNA integrity index below 0.59. Their findings suggest that increased DNA length or integrity in plasma DNA is associated with cancer and measurement of DNA integrity may provide a simple and inexpensive measure for cancer detection. This study is supported in part by the HERA ovarian cancer research award.

    Ovarian Cancer Can Show Up as Molecular Abnormalities in Peritoneal Fluid
    October 27, 2003
    [abstract] Molecular analysis of peritoneal fluid in ovarian cancer patients. Parrella P, Zangen R, Sidransky D, Nicol T.

    Dr Nicol's group is interested in improving diagnosis and detecting cancer cells in peritoneal fluids by screening for signature genetic changes. Her findings indicate that molecular abnormalities can be detected in peritoneal fluid from patients with ovarian cancer and may be used to complement current conventional diagnostic procedures for detection of primary ovarian cancer.

    Mucinous Carcinoma
    October 27, 2003
    One of Dr. Ronnett's main interests is peritoneal mucinous tumors, and the origin of pseudomyxoma peritonei. Her recent studies indicate the appendix rather than the ovaries as the origin for most, but not all cases of pseudomyxoma peritonei.

    [abstract] Mucinous tumors arising in ovarian mature cystic teratomas: relationship to the clinical syndrome of pseudomyxoma peritonei. Ronnett BM, Seidman JD. Am J Surg Pathol. 2003 May;27(5):650-7.

    The distinction of metastatic mucinous carcinomas in the ovary from primary ovarian mucinous tumors (atypical proliferative/borderline and carcinoma) and metastatic pancreatic cancers can be difficult because of similarities in morphology (the cells appearance). Drs. Ji, Ronnett and collaborators describe markers useful in distinguishing these tumors and which help in treatment decisions.

    [abstract] Cytokeratins 7 and 20, Dpc4, and MUC5AC in the distinction of metastatic mucinous carcinomas in the ovary from primary ovarian mucinous tumors: Dpc4 assists in identifying metastatic pancreatic carcinomas. Ji H, Isacson C, Seidman JD, Kurman RJ, Ronnett BM. Int J Gynecol Pathol. 2002 Oct;21(4):391-400.

    Improving Diagnosis by Detection of Signature Genetic Changes
    October 27, 2003
    [abstract] Identifying Tumor Origin Using a Gene Expression-based Classification Map Phillip Buckhaults, Zhen Zhang, Yu-Chi Chen, Tian-Li Wang, Brad St. Croix, Saurabh Saha, Alberto Bardelli, Patrice J. Morin, Kornelia Polyak, Ralph H. Hruban, Victor E. Velculescu and Ie-Ming Shih.

    Identifying the primary site in cases of metastatic carcinoma of unknown origin has profound clinical importance in managing cancer patients. Although transcriptional profiling promises molecular solutions to this clinical challenge, simpler and more reliable methods for this purpose are needed. A combination of supervised and unsupervised computational methods were used to select a small group of candidate genes with maximal power to discriminate carcinomas of different tissue origins. The diagnostic power of this set of genes was evaluated using unsupervised cluster analysis methods. Eighty-one percent (50 of 62) of the carcinomas were correctly allocated in their corresponding diagnostic regions. Metastases clustered tightly with their corresponding primary tumors. A classification map diagnostic of tumor types was generated based on expression patterns of five genes. This expression map analysis (see journal cover) may provide a reliable and practical approach to determining tumor type in cases of metastatic carcinoma of clinically unknown origin.

    Common Mutations Prevalent in Low-Grade Ovarian Cancers
    March 20, 2003

    Press Release from the Journal of the National Cancer Institute:
    Wang et al. JNCI 95(6):417, 2003

    Linda Wang, Assistant News Editor, Katherine Arnold, News Editor

    Mutations in the growth regulatory genes BRAF and KRAS appear to be associated with the development of low-grade ovarian cancer but not of aggressive high-grade ovarian cancer, according to a study in the March 19 issue of the Journal of the National Cancer Institute.

    Mutations in BRAF and KRAS are present in a variety of human cancers, and mutations in BRAF are especially prevalent in cutaneous melanoma.

    To determine the role of these mutations in ovarian cancer, which is one of the most lethal cancers in women, Gad Singer, M.D., Ie-Ming Shih, M.D., Ph.D., and their colleagues from the Johns Hopkins University School of Medicine examined 182 ovarian tumor samples of different types for the presence of three common mutations in BRAF or KRAS.

    They examined serous ovarian cancers, which are the most common type of ovarian cancer and include both high-grade tumors and low-grade tumors, and non-serous ovarian cancers, which are less common and include endometrioid carcinomas and clear-cell carcinomas. The authors also looked for BRAF and KRAS mutations in benign precancerous lesions, which are known precursors to low-grade ovarian tumors.

    The authors found one of the three mutations in BRAF and KRAS in 15 of 22 (68%) of the invasive low-grade tumors and in 31 of 51 (61%) of the precancerous lesions. None of the tumors contained a mutation in both genes. In contrast, none of the aggressive high-grade ovarian cancers contained a mutation in either gene. Further, the authors detected BRAF mutations in 24% of endometrioid cancers. They point out that no other gene, except for PTEN, has had such a high mutation rate in ovarian endometrioid cancers.

    "The apparent restriction of these BRAF and KRAS mutations to low-grade serous ovarian carcinoma and its precursors suggest that low-grade and high-grade ovarian serous carcinomas develop through independent pathways," the authors say.

    Blocking KRAS-BRAF signaling may provide more effective therapy for low-grade serous carcinomas, which generally do not respond well to conventional chemotherapy, the authors conclude.

    Contact: Vanessa Wasta, Johns Hopkins Kimmel Cancer Center, 410-955-1287; fax: 410-614-2611, wastava@jhmi.edu

    Singer G, Oldt R 3rd, Cohen Y, Wang BG, Sidransky D, Kurman RJ, et al. Mutations in BRAF and KRAS characterize the development of low-grade ovarian serous carcinoma. J Natl Cancer Inst 2003;95:484–6.

    Note: The Journal of the National Cancer Institute is published by Oxford University Press and is not affiliated with the National Cancer Institute. Attribution to the Journal of the National Cancer Institute is requested in all news coverage.

    Recurrent Micropapillary Serous Ovarian Carcinoma
    March 10, 2003
    Richard Roden, Ph.D. , Assistant Professor of Pathology
    (Cancer 2002 Aug 15;95(4):791-800).
    In a recent study, Dr. Bristow et al sought to characterize the clinical outcome of patients with recurrent micropapillary serous ovarian carcinoma (MPSC) and evaluate the survival impact of secondary cytoreductive surgery and other prognostic variables. They noted that optimal secondary cytoreductive surgery is feasible in the majority of patients with recurrent MPSC and is a predictor of subsequent survival. Surgical intervention should be considered for those patients with recurrent MPSC but the administration of chemotherapy prior to surgical intervention was associated with a trend toward worse survival and a lower likelihood of optimal secondary cytoreduction.

    Micropapillary Serous Ovarian Carcinoma: Surgical Management and Clinical Outcome (Gynecol Oncol 2002 Aug;86(2):163-70).
    In a second study, Bristow et al sought to characterize the prognostic features of micropapillary serous ovarian carcinoma (MPSC), examine the clinical impact of surgical staging, and define the role of cytoreductive surgery for patients with advanced disease. They found that MPSC carries a significant risk of extraovarian spread. However, adequately sampled Stage I/II disease is associated with a favorable prognosis. Optimal cytoreduction is associated with improved survival and should be the primary therapeutic objective for patients with advanced-stage MPSC.

    Proteomic Approaches to Tumor Marker Discovery
    March 10, 2003
    Richard Roden, Ph.D. , Assistant Professor of Pathology
    (Arch Pathol Lab Med 2002 Dec;126(12):1518-26).
    Mass spectrometry is the foundation of many proteomic (protein-level) approaches to discover blood markers of ovarian cancer, and is a focus of Dr. Chan's group. Current tumor markers for ovarian cancer still lack adequate sensitivity and specificity to be applicable in large populations. High-throughput proteomic profiling and bioinformatics tools allow for the rapid screening of a large number of potential biomarkers in serum, plasma, or other body fluids. Therefore, Dr. Chan's group sought to determine whether protein profiles of plasma can be used to identify potential biomarkers that improve the detection of ovarian cancer. They analyzed plasma samples from patients with sporadic ovarian serous neoplasms and from women without cancer using proteomic profiling and bioinformatics. They compared results between the patients with and without cancer and evaluated their discriminatory performance against that of the cancer antigen 125 (CA125) tumor marker. They selected several candidate biomarkers. Individually, the biomarkers did not perform better than CA125. However, a combination of 4 of the biomarkers significantly improved performance and were complementary to CA125. Thus the combined use of bioinformatics tools and proteomic profiling provides an effective approach to screen for potential tumor markers.

    Long-term Management of Women with Ovarian Cancer: Shifting Directions
    March 10, 2003
    Richard Roden, Ph.D. , Assistant Professor of Pathology
    (Oncologist 2002;7 Suppl 5:20-8)
    Advances in the treatment and early detection of ovarian cancer have led to gains in 5-year survival rates, with 52% of women diagnosed between 1992 and 1997 surviving 5 years or longer, compared with 41% of women diagnosed between 1983 and 1985. Although approximately 10%-15% of patients achieve and maintain complete responses to therapy, the remaining patients have persistent disease or eventually relapse. These patients will generally undergo a series of treatments, each associated with progressively shorter treatment-free intervals. Nevertheless, median survival of patients with recurrent ovarian cancer ranges from 12-24 months, demonstrating the chronic natural history of the disease. Advances in the treatment of ovarian cancer over the past decade have led to these improvements and have prompted oncologists to now view the management of patients with ovarian cancer as an ongoing, long-term challenge. This shift in approach has raised important new questions regarding patient management, including the need to define trigger points for initiating or changing treatment (e.g., sequential increases in serum cancer antigen 125 (CA125) levels, appearance of symptoms, or cumulative toxicities), anticipation of impending treatment decision points, recognition that the overtreatment of patients early in the disease process may adversely affect future treatment opportunities, and a renewed emphasis on patient education and participation in decision-making. Dr. Deborah Armstrong reviews these important patient management issues and provides case studies illustrating two distinct treatment strategies (planning and sequencing) for the long-term management of patients with ovarian cancer.

    In 1994, the National Institutes of Health convened a 14-member panel of experts in the management of ovarian cancer to generate a consensus statement of recommendations. The panel concluded that: "Adequate and complete surgical intervention is mandatory primary therapy for ovarian cancer, permitting precise staging, accurate diagnosis, and optimal cytoreduction. The procedure is best conducted by a qualified gynecologic oncologist when there is a high probability of ovarian cancer... all women with a suspected ovarian cancer should be offered a preoperative consultation with a gynecologic oncologist." The Society of Surgical Oncology has also offered the following guidelines for ovarian cancer surgery: "Surgeons undertaking operations for possible ovarian cancer should have both the necessary technical expertise and a thorough understanding of the management of the disease itself...optimal treatment of this disease requires the skillful and appropriate integration of cancer surgery and chemotherapy, and is best carried out in centers in which an experienced and coordinated multidisciplinary team is available".

    Since the establishment of gynecologic oncology as a recognized division of the American Board of Obstetrics and Gynecology in 1972, accessibility to these surgical sub-specialists has gradually increased for women with suspected ovarian cancer. Currently, however, the proportion of ovarian cancer patients initially operated on by gynecologic oncologists remains below 50%. It has therefore been asserted that American women are not receiving the standard of care for ovarian cancer, primarily due to incomplete surgical staging and/or cytoreduction performed by surgeons without advanced training in gynecologic oncology. While specialty training is critically important to quality cancer care, recent attention has focused on the positive relationship between surgeon and hospital case volume and clinical outcome for malignancies treated with technically complex surgical procedures. Patterns of care studies have been slow to address the issue of volume-based access to care for United States women with ovarian cancer.

    New Surgical Technique Can Significantly Improve Chance for Optimal Debulking
    March 10, 2003
    Richard Roden, Ph.D. , Assistant Professor of Pathology
    (Gynecol Oncol 2001 Oct;83(1):39-48).
    Given the importance of surgery to outcome of treatment, Bristow et al evaluated the utility of the argon beam coagulator (ABC) in achieving the conversion of visible disease to microscopic residual disease (complete cytoreduction) among patients with advanced ovarian carcinoma. They found that the ABC is a useful adjunct to conventional tumor reductive techniques and appears to significantly increase the feasibility of achieving both optimal disease status and complete cytoreduction of all visible tumor in patients with visible metastatic ovarian carcinoma.

    Argon Beam Coagulator Follow-Up Study (Gynecol Oncol 2001 Oct;83(1):49-55).
    In a follow-up study, Bristow et al found that the destruction of ovarian carcinoma tumor tissue produced by the ABC is dependent upon both power setting and tissue interaction time. They demonstrate that increasing depth of destruction is due predominantly to a deeper level of tissue vaporization and provide a means of estimating the true depth of tumor destruction produced by the ABC that may contribute to increased safety and efficacy of electrosurgical cytoreduction using this technique.

    Plasma DNA Levels, Allelic Imbalance, and CA 125 as Diagnostic Tests for Cancer
    March 10, 2003
    Richard Roden, Ph.D. , Assistant Professor
    (J Natl Cancer Inst 2002 Nov 20;94(22):1697-703).
    A second seminal study by Dr. Shih's group employed digital PCR to detect DNA released by tumor cells into the bloodstream. Allelic imbalance (AI) is the loss or gain of chromosomal regions, and occurs in many cancers. AI can be detected in genomic tumor DNA released into the blood. Dr. Shih's group evaluated plasma DNA concentration, allelic status in plasma DNA, and serum CA125 level as screening tests for ovarian and other cancers. They found that while the elevation of plasma DNA concentration may not be sensitive or specific enough for cancer screening or diagnosis, even when combined with CA125, AI was detected with high specificity in plasma DNA from patients with ovarian cancer and should be studied further as a screening tool. More details can be found in this article.

    Treatment of LMP Tumors: A More Conservative Approach
    March 10, 2003
    Richard Roden, Ph.D. , Assistant Professor of Pathology
    (Gynecol Oncol 2002 Jul;86(1):34-7).
    Dr. Trimble et al performed a statistical study of the long-term survival and patterns of care in women with ovarian tumors of low malignant potential. They confirmed that the diagnosis of an ovarian tumor of LMP conveys a relatively benign prognosis. They further conclude that conservative surgery should be considered in younger women with early-stage disease. They found insufficient data to support a role for adjuvant chemotherapy for women with advanced disease.

    Knowing Your Family History Can Decrease Mortality from Cancer
    March 10, 2003
    Richard Roden, Ph.D. , Assistant Professor of Pathology
    (J Obstet Gynecol Neonatal Nurs 2002 Mar-Apr;31(2):208-16).
    It is now known that all cancer originates from changes in the cellular DNA (the genome). Although most cancer occurs by chance, approximately 5% of individuals inherit specific genetic mutations that predispose them to cancer. The genetic characteristics of some cancers are known. Such information can be useful to health care providers in the clinical setting for treatment, early detection, and prevention. Zawacki and Phillips review basic carcinogenesis (cancer development) as well as genetic syndromes that predispose women to ovarian, breast, colorectal, and endometrial cancer. Knowledge of hereditary cancer syndromes and familiarity with them will assist in the management of patients who are at risk. Cancer continues to contribute substantially to the mortality of women in all age groups. Knowledge of these syndromes provides an excellent opportunity to decrease mortality by early detection and prevention.

    Obstacles to Genetic Testing Lead to Tests Being Under-Utilized
    March 10, 2003
    Richard Roden, Ph.D. , Assistant Professor of Pathology
    (Cancer 2002 Mar 15;94(6):1876-85).
    Clinical testing for BRCA1/2 has been available since 1996. Interest in testing in research and hypothetical situations has been consistently high, but there have been limited reports on its clinical utilization. Lee et al report a retrospective study of BRCA1/2 test utilization by high-risk patients who were seen at the Johns Hopkins Breast and Ovarian Surveillance Service (www.hopkinsmedicine.org/breastcenter/care/boss/index.htm). Between February 1996 and December 1999, 258 families who had at least a 10% chance of carrying a BRCA1/2 mutation were offered genetic testing. Overall, 26% underwent genetic testing. Eligibility for free testing, prior history of breast or ovarian carcinoma, Ashkenazi Jewish versus non-Ashkenazi Jewish heritage, genetic risk category, and age category were associated with test utilization, and in multivariate analysis, the first three remained statistically significant factors associated with genetic testing. Only a quarter of the patients who did not have access to free testing sought insurance reimbursement, of which more than half had a prior diagnosis of breast or ovarian carcinoma. In conclusion, Lee et al observed that the actual utilization of BRCA1/2 genetic testing in a clinical setting is lower than in the research and hypothetical settings. Potential obstacles include cost, fear of insurance discrimination, and a need to involve an affected family member in the testing process.

    Accurate Diagnosis Critical to Selection of Treatment
    March 10, 2003
    Richard Roden, Ph.D. , Assistant Professor of Pathology
    (Cancer 2002 Jun 25;96(3):135-9).
    Accurate diagnosis is critical to the selection of the appropriate therapy. Drs. Alli and Ali have examined whether MPSC is associated with specific cytomorphologic (cell structure) features in peritoneal/ pelvic washings. They observed that although MPSC shares cytomorphologic similarities with papillary serous carcinoma of the ovary, it can be diagnosed adequately in peritoneal/ pelvic washings. Careful interpretation of the subtle cytologic differences seen in the two tumor types may facilitate the differentiation of these neoplasms for a more appropriate management of the patient.

    Surgery: Who and Where are Two Most Important Decisions You Will Make When Facing a Possible Ovarian Cancer Diagnosis
    March 10, 2003
    Richard Roden, Ph.D. , Assistant Professor of Pathology
    (J Clin Oncol 2002 Mar 1;20(5):1248-59).
    Dr. Robert Bristow and colleagues highlight the importance of referring patients with suspected ovarian cancer to expert centers for their first surgery. By combining multiple studies of patients with stage III or IV ovarian carcinoma (6,885 patients) Bristow et al showed that consistent referral of patients with apparent advanced ovarian cancer to expert centers for primary surgery may be the best means currently available for improving overall survival. Even with the use of platinum based chemotherapy, maximal cytoreduction was one of the most powerful determinants of cohort survival among patients with stage III or IV ovarian carcinoma. While the influence of platinum dose-intensity upon survival was not statistically significant, maximal cytoreduction was associated with a 50% increase of actuarial survival.

    New Markers May Provide Test for Sex-cord Stromal Ovarian Neoplasms
    March 10, 2003
    Richard Roden, Ph.D. , Assistant Professor of Pathology
    (Am J Surg Pathol 2002 Nov;26(11):1477-83).
    Over a hundred different ovarian tumors have been described and their accurate diagnosis and classification is the realm of the pathologist. Sometimes microscopic examination is insufficient for a confident diagnosis and special staining studies are performed to identify particular proteins that are characteristic of a tumor type. Drs. Movahedi-Lankarani and Kurman sought to improve the diagnosis by testing a new marker for sex cord-stromal neoplasms. They showed that both calretinin and inhibin are useful in the diagnosis of ovarian sex cord-stromal and fibrous neoplasms. Calretinin is particularly useful in the diagnosis of sex cord-stromal and fibrous neoplasms that are inhibin-negative. The high frequency of calretinin in fibrous neoplasms suggests that a subgroup of these neoplasms may be derived from specialized gonadal stromal cells, perhaps thecal cells.

    Cataloguing Chromosomal Imbalances in Benign and Malignant Ovarian Tumors
    March 10, 2003
    Richard Roden, Ph.D. , Assistant Professor of Pathology
    (Hum Pathol 2002 Jan;33(1):47-59).
    Cancer is a genetic disease and a recent study by Dr. Annette Staebler et al begins to catalogue the different patterns of chromosomal imbalance in benign and malignant ovarian cancer. Such studies are critical to understand the changes in the DNA of cancer cells that are responsible for their behavior and to identify new targets for therapy. The precursor lesions of ovarian cancer have not been defined. Some chromosomal changes in MPSC are shared with serous carcinoma and APST and others with serous carcinoma only, suggesting that a subset of MPSC may represent a stage in progression from APST to serous carcinoma. Other cases of MPSC with independent genetic alterations may represent another subset of tumors that are a distinct entity from APST and SC.

    Hopkins Study Finds Combined PET-CT Better At Detecting Ovarian Cancer Spread
    December 04, 2002
    Hopkins radiologists have found that a combination of positron emission tomography (PET) and computed tomography (CT) detects cancer spread better than PET alone. In a study to be presented at the Radiological Society of North America, researchers reported that overall, PET-CT improves the ability to distinguish cancerous from normal tissue and locate metastases, where they have spread.
    Read more …

    Hopkins Researchers Detect Ovarian Cancer in Blood Samples
    November 25, 2002
    HealthWorld Online
    Scientists at Johns Hopkins have successfully detected ovarian cancer using a blood test for DNA shed by tumors. The test is based on digital analysis of single nucleotide polymorphisms (SNP, or "snips"), in which investigators separate the two strands of code found in every gene to search for imbalances that are a hallmark of cancer cell DNA.

    With 54 blood samples from late- and early-stage ovarian cancer patients, the Hopkins team used digital SNP analysis to find so-called "allelic imbalance" in 87 percent (13 out of 15) of early-stage ovarian cancers and 95 percent (37 out of 39) with late-stage disease. No allelic imbalance was detected in 31 blood samples from healthy individuals. The researchers also compared the type of allelic imbalance found in 17 of the samples with the corresponding tumor tissue and found that 15 of these had matching allelic imbalance patterns.

    Details of the initial studies of the test are published in the November 20, 2002 issue of the Journal of the National Cancer Institute. "Digital SNP appears to detect ovarian cancers very well and is far more precise than other available tests," says Ie-Ming Shih, M.D., Ph.D., pathologist and director of this study for the Kimmel Cancer Center at Johns Hopkins. But, Shih cautioned, digital SNP is too costly and labor intensive at present to serve as a general screening test. "Currently there still is no way to usefully screen all women for ovarian cancer," Shih says, although it might be useful for women at high risk.

    The Johns Hopkins group also is investigating ways of achieving the same accurate detection rate with a less costly, more efficient test that could be used on a broader scale for ovarian and a variety of other cancers, Shih says.

    DNA released from dying cells has long been detectable in blood samples, using sensitive molecular technology. But to distinguish normal from cancerous DNA, Kimmel Cancer Center scientists analyzed both sets of genetic code in DNA sequences. The individual sets of code are called alleles. In normal cells, DNA's two alleles -- one derived from the maternal copy of the gene and the other from the paternal copy -- are balanced in their basic building blocks. Tumor cells, on the other hand, have an unequal ratio of maternal and paternal alleles. Digital SNP analysis counts the alleles present in each blood sample.

    In the Johns Hopkins study, investigators first measured the total amount of DNA in blood samples taken from 44 healthy individuals; 122 patients with a variety of cancers ranging from head and neck cancers to brain cancer, as well as the 54 ovarian cancer patients; and 164 patients with non-cancerous diseases such as diabetes and hypertension. They found that, compared with blood samples of healthy individuals, average amounts of total DNA more than doubled for those with non-cancerous disease (7 ng/mL) but were eight times greater in samples from all cancer patients (59 ng/mL).

    "The problem with using the total amount of DNA in the blood without performing digital SNP is that they are not specific for cancer, as elevated DNA levels can be found in blood samples from patients without cancer," says Shih.

    Next, singling out the ovarian cancer samples, Shih and his team found high total amounts of DNA in only 47 percent (7 of 15) early-stage ovarian cancers and 56 percent (22 of 39) with late-stage disease. Adding another test, employing a standard ovarian cancer protein marker (CA125) currently used to monitor disease, added little improvement in detection rates, Shih reported.

    "A test based on digital SNP holds promise for improved detection in a wide range of cancers, as well as ovarian cancer, which is currently detected almost always when it is in late stages and difficult to treat," says Shih.

    Ovarian cancer will strike an estimated 23,000 U.S. women and cause approximately 14,000 deaths this year. It ranks fifth in cancer deaths among women. Generally, ovarian cancer is "silent" until the cancer has spread. Women should consult their physicians if they experience pressure or fullness in the pelvis, abdominal bloating, or changes in bowel and bladder patterns that continue and/or worsen.

    Funding for this research was provided by the National Cancer Institute and the Richard TeLinde Research Fund.

    In addition to Shih, other Johns Hopkins participants in this research include Hsueh-Wei Chang, Shing M. Lee, Steven N. Goodman, Gad Singer, Sarah K. R. Cho, Lori J. Sokoll, Fredrick J. Montz, Richard Roden, Zhen Zhang, Daniel W. Chan, and Robert J. Kurman.

    Chang, Hsueh-Wei et al, "Assessment of Plasma DNA Levels, Allelic Imbalance, and CA125 as Diagnostic Tests for Cancer," Journal of the National Cancer Institute, Nov. 20, 2002, Vol. 94, No. 22. (abstract)

    Catching Ovarian Cancer with Time to Spare
    July 25, 2002
    William Check, PhD , Medical Writer
    Richard Roden, Johns Hopkins researcher and author of this Website, is featured in this article from CAP, the College of American Pathologists. Dr. Roden and other scientists discuss their research and the great need for a screening tool for ovarian cancer. Read entire article.

    Refined Diagnosis of Serous Tumors of the Ovary
    June 10, 2002
    Richard Roden, Ph.D.
    Consistent, accurate diagnosis of invasive peritoneal implants from patients with noninvasive serous ovarian tumors has important prognostic and treatment implications, but the criteria for distinguishing invasive and noninvasive implants vary among investigators and can be difficult to apply. In a recent article (Am J Surg Pathol 2001 Apr;25(4):419-32), Dr Karen Bell and co-workers decribe more refined diagnostic criteria for implants associated with ovarian atypical proliferative serous tumors (borderline) and micropapillary serous carcinomas.

    New Findings Suggest Serous Carcinoma Is Comprised of at Least Two Distinctive Types of Tumors Instead of One
    June 10, 2002
    Richard Roden, Ph.D.
    Although ovarian cancer is often viewed as a single disease, it is considerably more complex and represents a family of related but distinct tumors. However, serous carcinoma is responsible for the large majority of "ovarian cancer"-related deaths and therefore is the focus of our research program at Hopkins. At present, serous carcinoma is considered by most investigators to be a single entity. However we believe that 'serous carcinoma' comprises at least two distinctive types of tumors: the conventional type of serous carcinoma (CSC) grows rapidly and kills patients within 5 years despite aggressive treatment and the second type designated "micropapillary serous carcinoma (MPSC)"is low grade and indolent but fails to respond to conventional chemotherapy. Based on our files and a population-based study, MPSC represent 35% of all serous carcinomas. Understanding the molecular basis that distinguishes CSC and MPSC is important to rational development of early diagnostic tests and effective, specific therapy.

    Distinct Chromosomal Imbalances in Different Serous Tumors
    June 10, 2002
    Richard Roden, Ph.D.
    Recent studies have subdivided serous borderline tumors into 2 categories: atypical proliferative serous tumors (APSTs), which have a relatively benign course, and micropapillary serous carcinomas (MPSCs), which behave like low-grade carcinoma. Dr Annette Staebler and co-workers show that Micropapillary serous carcinoma of the ovary has distinct patterns of chromosomal imbalances by comparative genomic hybridization compared with atypical proliferative serous tumors and serous carcinomas (Hum Pathol 2002 Jan;33(1):47-59). These molecular data support the subdivision of noninvasive serous tumors of the ovary into these two categories: APST and MPSC.

    On the Origin of Germ Cell Tumors
    June 10, 2002
    Richard Roden, Ph.D.
    While less common than epithelial ovarian cancer, the germ cell type of ovarian cancer tends to strike at a much earlier age. Pediatric germ cell tumors (GCTs) commonly arise at extragonadal sites (outside the ovaries). It has been proposed that GCTs which are not derived from the ovaries arise from early germ cells that have migrated to an abnormal part of the body during the formation of the embryo. Schneider and co-workers, in their recent article (Cancer Res 2001 Oct 1;61(19):7268-76), use multipoint imprinting analysis to show a common precursor cell for gonadal and nongonadal pediatric germ cell tumors.

    Hopkins Recipient of Ovarian Cancer Program Grant
    June 10, 2002
    Richard Roden, Ph.D.
    We are excited to announce the recent funding of an ovarian cancer research program grant by a Department of Defense Congressionally Directed Medical Research Program for the next 3 years. This project entitled "Pathogenesis of Ovarian Serous Carcinoma as the Basis for Immunologic Directed Diagnosis and Treatment" and is led by Robert J. Kurman, M.D. Ovarian cancer is the most lethal gynecologic malignancy. Approximately, 23,000 women are diagnosed with ovarian cancer each year in the United States and 14,000 women succumb to this disease annually. Several factors account for the high mortality of ovarian cancer. These include inadequate techniques to detect the disease at an early stage, lack of truly effective chemotherapeutic agents (chemotherapy drugs), and lack of understanding of the etiology (origin) of ovarian cancer. The latter is particularly important because without a clear understanding of the etiology/pathogenesis of serous carcinoma of the ovary, research remains empiric and progress slow. This program aims to identify biomarkers that define the critical molecular events in the development of ovarian cancer, and thus provide the foundation for rational development of an early detection test and a cancer vaccine for this dreaded disease.

    HOXA7 Protein May Be Useful In Diagnosis
    June 10, 2002
    Richard Roden, Ph.D.
    Ovarian cancers are classified for treatment and prognosis by their microscopic appearance and similarities to different cell types (histotype). However, the genes responsible for these characteristics are not known. In a recent article, (Proc Natl Acad Sci USA 2001 Dec 18;98(26):15209-14) Dr Honami Naora and co-workers show that aberrant expression of homeobox gene HOXA7 is associated with mullerian-like histotype of epithelial ovarian tumors. Interestingly, the aberrant expression of HOXA7 is also associated with the generation of a specific antibody response that may have diagnostic utility.

    Special Benefit for OvCA Research at Johns Hopkins
    April 19, 2002
    Tabitha LaRue , WFLS News Reporter
    93 WFLS and the Riverside Dinner Theater are teaming up to fight Ovarian Cancer Friday evening, June 14th. Plan now to join us for this special benefit performance of Guys and Dolls. Proceeds will benefit Johns Hopkins' Ovarian Cancer research projects. Tickets are priced at just $50 per person. Join our honorary chairpersons Virginia State Delegate Bobby Orrock and WFLS News Reporter Tabitha Larue and make your reservations now by calling the Riverside Box Office at 540-370-4300. Join the team to fight Ovarian Cancer with 93 WFLS.

    News Release About Event

    New Research Shows Different Pathways in the Development of Ovarian Cancer
    February 09, 2002
    Gad Singer M.D.,Robert J.Kurman M.D., Hsueh-Wei Chang Ph.D., Sarah K.R. Cho B.S., and Ie-Ming Shih M.D., Ph.D. recently completed a study entitled: "Diverse Tumorigenic Pathways in Ovarian Serous Carcinoma". The hypothesis of the research was that there is a molecular-genetic relationship between atypical proliferative serous tumors (APST) (also known as serous borderline tumors/LMPs), noninvasive and invasive micropapillary serous carcinoma (MPSCs), and that invasive MPSCs differ molecularly from the conventional (usual) high-grade ovarian serous carcinomas. (Serous carcinomas are the most common type of ovarian cancer).

    Over 100 ovarian serous tumors were studied. Novel techniques called Digital SNP analysis and Digital PCR were used to identify mutations on the oncogene K-ras and losses of chromosomal arms (which is typical for cancer) on 6 chromosomes.

    APST, noninvasive and invasive MPSCs show gradually increasing chromosomal losses from APST to noninvasive and then invasive MPSCs and a high rate of K-ras mutations. In contrast, conventional serous carcinomas show a high level of chromosomal losses even in very small tumors and no K-ras mutations. The study concluded that ovarian serous tumor development occurs along two independent main pathways: 1)In the slower pathway APST develops from the ovarian surface epithelium (thin superficial "coat" of the ovaries) and can progress to noninvasive MPSC. Noninvasive MPSC then can progress to invasive MPSC. 2)In the faster pathway conventional serous carcinoma develops directly from the ovarian surface epithelium without recognizable intermediate steps.

    Hopkins has been on the forefront of research into borderline tumors. The first clinicopathologic research on MPSCs was conducted in the Division of Gynecologic Pathology under Dr. Robert J. Kurman and suggested that MPSCs are a distinct tumor different from APSTs. This study builds on that early morphologic work and concludes that MPSC is indeed a molecularly different neoplasm.

    These are important findings for women with the hard to treat slow growing MPSC, as this study leads the way to being able to identify genes that could result in a test to detect early disease and more effective treatment options.

    This study was supported by the Richard TeLinde Research Endowment at Johns Hopkins and the Swiss National Science Foundation for Dr. Gad Singer.

    Singer G, Kurman RJ, Chang HW, Cho SK, Shih IeM. Diverse tumorigenic pathways in ovarian serous carcinoma. Am J Pathol. 2002 Apr;160(4):1223-8.

    Ovarian Cancer Website Receives Two Prestigious Awards
    January 28, 2002

    Johns Hopkins Ovarian Cancer website has been selected as a recipient of the highly regarded "Editor's Choice Award" from HealingWell.com.

    This award is reserved for select health web sites that exhibit 1) exceptional web design, 2) reliable and quality health information on disease and disorder topics, and 3) patient accessibility and support.

    The Golden Web Awards is presented to those sites whose web design, originality and content have achieved levels of excellence deserving of recognition.

    Survival Impact of Maximum Cytoreductive Surgery for Advanced Ovarian Cancer Topic of Talk by Hopkins doctor at ASCO
    September 18, 2001
    Sean Patrick , OvCa Survivor
    Dr. FJ Montz delivered the findings of a meta-analysis of 6,885 patients with stage III/IV ovarian cancer treated with platinum at the American Society of Clinical Oncologists, May 13, 2001 in San Francisco.

    Drs. Bristow, Tomacruz, Armstrong, E. Trimble and Montz set out to study the effect of maximum cytoreductive surgery for advanced ovarian cancer during the platinum era. They wanted to see, as it had long been contended, if the use of platinum based chemotherapies had a much stronger effect than surgery on length of survival.

    This study found that there was a statistically significant correlation between percent maximum cytoreduction and log median survival time that remained significant after controlling for all other variables. Women with stage III/IV disease who achieved maximum surgical cytoreduction had a 50% longer survival time than those who did not achieve maximum cytoreduction.

    For patients this means where they have their surgery and who performs that surgery are important. The more experience the hospital and doctors have with ovarian cancer the more likely there will be a better outcome. "We hope these findings improve surgical patterns of care and referral patterns so patients get to the right people to do their surgery," Dr. Bristow commented.


    Survival Impact of Maximum Cytoreductive Surgery for Advanced Ovarian Carcinoma During the Platinum-Era: A Meta-Analysis of 6,885 Patients
    RE Bristow, RS Tomacruz, DK Armstrong, EL Trimble, FJ Montz

    Questions persist regarding the survival benefit associated with aggressive surgical cytoreduction for advanced ovarian carcinoma, particularly in light of the effectiveness of platinum-based chemotherapy. This study was undertaken to evaluate the relative effect on survival of percent maximum cytoreduction, and other prognostic variables, among cohorts of patients with advanced-stage ovarian carcinoma treated during the platinum-era.

    Study Design: Eighty-one cohorts from 53 studies (6,885 patients) of Stages III/IV ovarian carcinoma treated with platinum-based chemotherapy were identified from a Medline search from 1989 through 1998. Simple and multiple linear regression models, with weighted correlation calculations, were used to assess the effects on log median survival time of: the proportion of each cohort undergoing maximum cytoreduction, dose intensity of platinum compound administered, proportion of Stage IV patients, median age, and year of publication.

    Results: There was a statistically significant positive correlation between percent maximum cytoreduction and log median survival time that remained significant after controlling for all other variables (p<0.001). Each 10% increase in maximal cytoreduction was associated with a 6.3% increase in medial survival time. When measured as estimated actuarial survival, cohorts with ?25% maximum cytoreduction had a mean weighted median survival time of 22.7 months, while cohorts with >75% maximum cytoreduction had a mean weighted median survival time of 34 months, an increase of 50%. Platinum dose-intensity was not statistically significantly related to log median survival time; each 10% increase in dose-intensity was associated with a 0.9% increase in median survival time.

    Conclusions: Within the platinum-era, the proportion of patients with Stages III/IV ovarian carcinoma undergoing maximal cytoreduction is one of the most powerful determinants of cohort survival. Consistent referral of patients with apparent advanced ovarian cancer to expert centers for primary surgery may have an immediate and significant impact on the overall survival of women with this disease.

    Hopkins Researcher Named America's Best In Oncology
    August 22, 2001
    Alice Park

    August 20, 2001

    Cancer Spotter

    In cancer, early detection is key. David Sidransky is giving doctors the tools to catch tumors long before symptoms appear

    By Alice Park

    (TIME) -- To most of us, blood, urine and saliva are just unsightly bodily fluids to be disposed of as quickly as possible. But to David Sidransky, they are valuable sources of biological information that can be mined for nuggets of potentially life-saving data.
    Sidransky, a cancer specialist at Johns Hopkins Hospital, is particularly interested in what these fluids reveal about a patient's risk of developing cancer. The best-known of today's cancer-screening tests, the PSA for prostate cancer, is at most 70 percent accurate in picking up tumors. Sidransky is pioneering a new generation of tests that can detect cancer more accurately and at a much earlier stage in the progress of the disease.

    It's not an easy task, especially since doctors still don't fully understand how a normal cell becomes cancerous. But the challenge of stripping cancer down to its essential operations was what originally attracted Sidransky to the field when he was a medical resident at Baylor College of Medicine in Houston. "Of all the diseases confronting us in the early 1980s, cancer seemed the most interesting from an intellectual point of view," he says. "It seemed like something had to change."

    What that "something" was became clear in the past decade as scientists began to see at the molecular level precisely what pushes a normal cell to become malignant. As more and more genetic mutations were linked to various types of cancers, researchers could see patterns of genetic changes that permit cells to grow into tumors. If doctors could identify the steps that a cell has to go through to become cancerous, Sidransky reasoned, they might be able to pick up a budding tumor's malignant imprints along the way — tracking cancer as it develops, from start to finish.

    Rather than rely on indirect cancer markers like PSA, which have an unacceptably high rate of false positives, Sidransky zeroed in on DNA shed directly from tumors. Many solid tumors, it turns out, result from mutations in stretches of DNA that are repeated several times. Finding these abnormal DNA snippets in urine or saliva could mean a cancer is just beginning to take root. In a small pilot study of bladder-cancer patients, one screen that Sidransky developed picked up more than 90 percent of tumors — a hit rate that could revolutionize the early detection and treatment of bladder cancer.

    It won't always be so simple, however. For one thing, some cancers leave bigger footprints than others. In the urine of a patient with bladder cancer, for example, more than half the genetic material could derive from the tumor, making detection relatively straightforward. The sputum of a lung-cancer patient, on the other hand, is much more diverse; less than 1 percent of its DNA is traceable to cancer. Clearly, other genetic clues will have to be developed, and Sidransky is already tracking down several of them.

    Copyright © 2001 Time, Inc and © 2001 Cable News Network

    Find article online: http://www.cnn.com/SPECIALS/2001/americasbest/science.medicine/pro.dsidransky.html.

    Promoting Quality of Life in Chronic and Terminal Illness
    August 15, 2001
    Fourth Annual Palliative Care Lecture Series
    October 8 - November 19, 2001
    Schedule of Speakers and Titles


    October 8, 2001 Palliative Care at Johns Hopkins: Updates from Medicine and Pediatrics Nancy Hutton, MD
    Sydney Dy, MD
    5-6 pm

    October 11, 2001 Implementation of the JCAHO Pain Management Standards at Hopkins Michael Carducci, MD 5-6 pm

    October 15, 2001 Simultaneous Care James Zabora, ScD 5-6 pm

    October 18, 2001 Artificial Nutrition and Hydration as Palliative Measures Thomas Finucane, MD 5-6 pm

    October 22, 2001 "Why are we doing this?" Ethical Issues at the End of Life Cynda Rushton, DNSc, RN 5-6 pm

    October 25, 2001 Opportunities and Obligations in End of Life Care Janet Abrahm, MD 5-6 pm

    October 29, 2001 Physicians' Emotional Reactions to their Patients' Deaths Susan Block, MD 5-6 pm

    November 1, 2001 Understanding Quality Qualitatively Kenneth Rosenfeld, MD 5-6 pm

    November 5, 2001 How long do I have to live? Why prognostic questions trouble doctors Nicholas Christakis, MD, PhD 5-6 pm

    November 8, 2001 Healing Children's Grief Grace Christ, DSW 5-6 pm

    November 12, 2001 Depression and Chronic Pain Michael Clark, MD 5-6 pm

    November 15, 2001 Family Conferencing: Communication in Palliative Care Oncology Social Work 5-6 pm

    November 19, 2001 Care You Could Count On — Making the End of Life Meaningful and Comfortable Joanne Lynn, MD, MA 5-6 pm

    Speaker Information:
    October 8, 2001 Nancy Hutton, MD
    Sydney Dy, MD
    Johns Hopkins University, School of Medicine
    October 11, 2001 Michael Carducci, MD
    Johns Hopkins University, School of Medicine
    Johns Hopkins Oncology Center
    October 15, 2001 James Zabora, ScD
    Johns Hopkins University, School of Medicine
    Johns Hopkins Oncology Center
    October 18, 2001 Thomas Finucane, MD
    Johns Hopkins Health System
    Bayview Medical Center
    October 22, 2001 Cynda Hylton Rushton, DNSc, RN, FAAN
    Johns Hopkins University, School of Nursing
    October 25, 2001 Janet Abrahm, MD
    Dana-Farber Cancer Institute
    October 29, 2001 Susan Block, MD
    Dana-Farber Cancer Institute
    November 1, 2001 Kenneth Rosenfeld, MD
    Greater Los Angeles Healthcare System
    November 5, 2001 Nicholas Christakis, MD, PhD, MPH
    Harvard Medical School
    November 8, 2001 Grace Christ, DSW
    Columbia University
    November 12, 2001 Michael Clark, MD, MPH
    Johns Hopkins University, School of Medicine
    Department of Psychiatry
    November 15, 2001 Oncology Social Workers
    Johns Hopkins Oncology Center
    November 19, 2001 Joanne Lynn, MD, MA
    RAND Center to Improve Care of the Dying
    The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 13 hours in category 1 credit toward the AMA Physician's Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the activity.

    All lectures will be held in Hurd Hall with the exception of November 12, 2001 which will be held in the Weinberg Auditorium.

    Chairpersons: Dr. Michael Carducci, Dr. Nancy Hutton, Dr. Sydney Dy, Ms. Susan Blacker

    This activity is sponsored by the Johns Hopkins University School of Medicine, The Johns Hopkins Oncology Center/Continuing Education Program in Psychosocial Cancer Care, and Harriet Lane Compassionate Care/The Johns Hopkins Children's Center.
    Co-sponsored by The Institute for Johns Hopkins Nursing

    Lecture — Clinical Trials: Risks and Benefits, September 24, 2001
    August 11, 2001
    Lecture: "Clinical Trials: Risks and Benefits"

    What: The Brigid G. Leventhal, M.D. Memorial Lectureship: "Clinical Trials: Risks and Benefits."
    Sponsor: The Johns Hopkins Comprehensive Cancer Center
    Guest Speaker: Sharon B. Murphy, M.D.
    Chief, Division of Hematology/Oncology
    Children's Memorial Hospital
    When: Monday, September 24, 4:30 p.m. - 5:30 p.m.
    Where: Johns Hopkins Hospital, Harry and Jeanette Weinberg Auditorium, Baltimore, Maryland
    Info: Gail Voelker at (410) 955-8823

    Background: Sharon B. Murphy, M.D., is chief of the division of Hematology/Oncology at Children's Memorial Hospital and professor of pediatrics at Northwestern University Medical School in Chicago. Dr. Murphy is an oncologist and clinical investigator who is recognized as an international authority on the diagnosis, staging, and treatment of non-Hodgkin's lymphomas. She is a former chair of the Pediatric Oncology Group, an NCI-sponsored clinical trials cooperative group, and a founding director of the Coalition of National Cancer Cooperative Groups Inc. Dr. Murphy, a graduate of Harvard University School of Medicine, received her postgraduate training in pediatrics at the University of Colorado and in hematology and oncology at the University of Pennsylvania, Children's Hospital of Philadelphia. Before assuming her positions in Chicago, she was on the faculty at St. Jude Children's Research Hospital in Tennessee for many years.

    Florida Newspaper Puts a Face on Ovarian Cancer and Features Hopkins Ovarian Cancer Web Site
    May 31, 2001
    Sherry Anderson , Journalist

    Living Day to Day
    With Love and Faith

    Reprinted with permission from the Southwest Orlando Bulletin.

    On a quiet street in Southwest Orlando live two women whose lives have followed similar paths in more ways than they ever expected. They each have two daughters, and over the years, they have had their fair share of homework, trips to malls, and carpooling to friends' houses and after-school activities. They also have had their own work and volunteer commitments. The similarities in their lives are noticeable, but what most people do not realize is that these women share a bond that goes beyond any neighborhood, school group, or car pool. They know and understand what it is like to face life-threatening illnesses and meet them head-on with unwavering strength and determination.

    Pam's Story

    Pam Fogle is well-known to many families in the Southwest community. Wherever her daughters, Jennifer and Heather, went to school, Pam also was there. She served as ADDitions coordinator at Dr. Phillips Elementary School; president of the PTA at Bay Meadows Elementary School for the first two years the school was open; treasurer and president of the PTSA at Southwest Middle School; and vice president and president of the PTSA at Dr. Phillips High School. Today, students still remember her as "Mrs. Wishy-Washy" the storyteller, as the queen of England at BMES's World Bazaar, or as a familiar face at ballgames and school events.

    "Children are my life," Pam once said, and her volunteer efforts have been recognized with several awards, including Orange County Council PTA Volunteer of the Year and a regional award for the Kraft/Walt Disney World Volunteer of the Year. In her honor, Bay Meadows PTA annually presents the Pam Fogle Volunteer Award to one parental volunteer and one fifth-grade student who show service to the community through volunteerism.

    In the fall of 1994, Pam and her family were looking forward to a relaxing trip to the Florida Keys before another busy school year got under way. Heather was 13 and in the eighth grade at SWMS, and Jennifer was a 16-year-old junior at DPHS.

    "We were on our vacation in the Keys when I had a severe ulcer attack," Pam said. "I had been on medication for ulcers in my stomach and esophagus for several years, but I had been eating all the wrong things - like fried foods and margaritas. Usually within 10 to 12 hours, the pain would subside. This time it lasted for three days, and I finally told my husband, Bill, that I needed to go to the emergency room."

    At Fisherman's Hospital in Marathon, Fla., Pam was given medication and told that if it was an ulcer attack, she would feel better within a few minutes. The pain continued, and doctors ordered a series of X-rays and a sonogram. The tests indicated that Pam had gallstones, and the doctor wanted her to have emergency gallbladder surgery. But Pam wanted her family members to enjoy their vacation, and she wanted to consult with her own doctor in Orlando before having surgery. She was given some medication to ease her symptoms and agreed to see a surgeon the next day, just in case her symptoms worsened and emergency surgery was needed.

    "He was the one who told me that they also had seen a small mass in the pelvic area, and he felt like I needed to see my gynecologist," Pam said. "I went right to the phone and made an appointment with my primary-care physician to see me when we got back home."

    Pam's primary-care physician agreed with the surgeon in Marathon that Pam should have her gallbladder removed and consult with a gynecologist, even though she had been unable to detect anything out of the ordinary during Pam's pelvic exam.

    "When I saw the gynecologist, he said the same thing," Pam said. "He said there might have been something wrong with the X-ray film. I thought, Well, that's what it was. After all, I had had two pelvic exams."

    Pam did not know it at the time, but Bill was not reassured and asked the surgeon performing the gallbladder surgery to look at her other organs while he had the laparoscope inserted.

    "The surgeon noticed a large mass about the size of a saucer on my right ovary," Pam said. "He contacted my gynecologist, who asked for a Ca125 blood test immediately. I went home to wait."

    Pam waited for five long days before hearing the news that her blood count from the Ca125 test was almost 400. A normal range is 0 to 30. Pam was referred to Dr. Neil Finkler of the Walt Disney Memorial Cancer Center at Florida Hospital and was told that she would have to wait another week to see the doctor.

    "My mother said, 'No way are we going to wait,'" Pam said. "So she got on the phone, and I got in to see him in two days. My mother was very strong through all of this."

    Before Pam saw Dr. Finkler, a friend gave her some valuable advice.

    "She said, 'Pam, when you go, you make sure you feel comfortable in this place, because you are probably going to spend the rest of your life going there for checkups. You need to be comfortable with everything, not just the doctor.'

    "At the time, Dr. Finkler was in a little office across the street from the hospital, and it was packed," Pam continued. "I walked in, and it felt like I had an immediate bonding with everyone in the waiting room. [The staff was] so sweet and so loving, and the doctor came in and was like a knight in shining armor. I knew I was in the right place."

    Dr. Finkler's exam detected a large mass on Pam's left ovary.

    "I knew the surgeon said that he saw something on the right ovary, so I knew I was in big trouble," Pam said. "At times, I felt like I was watching a bad movie. The actors were great, but the story line wasn't."

    It had been only six days since Pam's gallbladder surgery, and her body still needed to heal. She would have to wait two weeks before having a complete hysterectomy and almost another week to get the pathologist's report, which confirmed that she had Stage III ovarian cancer.

    "Dr. Finkler did not feel that I needed chemotherapy right then," Pam said. "He felt very positive [that all the cancer had been removed]. I remember I asked him if I was his wife, would he recommend chemotherapy at this time, and he said definitely not, because he did not like the idea of putting toxins in the body if we didn't have to."

    Pam saw Dr. Finkler every month and regularly had Ca125 blood tests. Her count stayed around 17 to 23 for approximately six months, and then it began to slowly rise. By October 1995, one year after her hysterectomy, her count was up to 78, and laparoscopic surgery revealed the same cancer cells in her stomach. Chemotherapy could no longer be avoided. In January 1996, Pam began a series of six chemotherapy treatments, one every three weeks.

    "I really didn't get that sick," she said. "I thought I was prepared to lose my hair, but I absolutely lost it. I can't describe the feeling. I thought I was ready, but I wasn't. Heather had the hardest time with me losing my hair. She hated it. She didn't even want to look at me at first if I didn't have on a wig, hat or turban. She was only 14, and Mom was not supposed to get sick."

    Pam finished her last treatment right before Jennifer's high-school graduation.

    "It probably helped me a lot that I kept myself busy with her activities and getting her ready to go to school," Pam said. "The house was constantly busy with the girls' friends. There were times I wish I had stayed in bed, but I didn't want to disrupt their lives."

    Sometimes in the early morning hours when the girls were still asleep and the house was quiet, Pam would lie awake, and fear and doubt would creep into her thoughts.

    "I would think, What are my children going to do? and How can I ever miss all of this?" Pam said. "I wanted to see my girls graduate from high school and college and get married and have my grandchildren. Then I'd kick myself, or if I was still down later, then maybe a friend would do it for me, and I would get over it. I never really dwelled on the thought that I wouldn't get well. I truly felt like I would."

    Pam said she attributes her positive attitude to her faith.

    "I turned it all over [to God]," she said. "From the day I found out I had cancer, I put myself in a constant state of prayer and thanksgiving. I believe that this is the only way I could have survived physically and emotionally. I think that had a lot to do with my attitude - and the fact that my family and friends always seemed to be there whenever I might be hitting a low point. I couldn't have asked for them to be any stronger."

    Pam said she even received cards and letters from friends of friends.

    "It really lifts you up to think someone has thought about you," she said.

    Now when she hears about someone who has cancer, she always tries to write the person a note of encouragement.

    Pam has continued to depend on the love and support of her family, including her parents, Art and Martha Beach of Winter Garden, who have been by her side for every procedure and treatment.

    Last year, Pam's Ca125 count began to rise again, and a computerized-tomography, or CT, scan revealed a small spot on the outside of her left lung. A needle biopsy determined that it was the same cell as the ovarian cancer. In April 2000, Pam began another round of six chemotherapy treatments. Her daughter, Heather, now a college student at Santa Fe Community College in Gainesville, came home last summer to care for her mother.

    "I felt like I'd lost my best friend when she went back to school," Pam said.

    Jennifer, who is in a management-training program with Macaroni Grill, is living at home again and keeping an eye on Mom.

    Jennifer Fogle keeps an eye on her mother, Pam, while her sister,
    Heather, attends Sante Fe Community College in Gainesville.

    Pam is in remission and is going every three months for her blood tests.

    "I'll go through chemotherapy as many times as I have to, if that's what it takes," she said. "You do what you have to do. You pick yourself up and dust yourself off."

    Recently, Pam had a positron-emission tomography, or PET, scan, which is similar to a CT scan. Glucose is injected into the body, and if there is any cancer present, it will show up like a hot spot. Pam feels that insurance companies are hesitant to authorize its use because it is an expensive test. Its real value to her came in the form of peace of mind.

    She tries not to think about what might have happened if she had not had the gallbladder attack that prompted the X-rays. She always kept up with her annual visits to the gynecologist, and she never had any discriminating pain. In her early 40s, she was under the typical age for the onset of ovarian cancer.

    "Ovarian cancer is so hard to diagnose because the symptoms are what every woman goes through at one time or another," Pam said.

    Throughout her ups and downs with cancer, Pam has remained an active mother and volunteer. Four years ago, she also became a school employee as an office clerk at Bay Meadows.

    "The Bay Meadows family has been so good to me," Pam said. "The teachers and the staff were there for me every day. They helped look after my family with food after each treatment. The children and their parents have been so supportive. I was concerned with how the children would react to seeing me with a hat on. They still came in and hugged me as if everything was the way it should be.

    "God said that he will help those who help themselves, so I made it my challenge to try and keep a positive outlook. I guess that old saying 'When life gives you lemons, make lemonade' is true. Faith has been a constant with me. I have learned a lot from this whole experience. Life is so very precious. We should embrace every moment and learn to be more tolerant and understanding of people. We really shouldn't sweat the small stuff. I value life, family and my friends more every day."

    Nina's Story

    Just down the street from the Fogles' home is the house where Nina Bamberger lives with her husband, Andy, and their daughters, Lauren and Diana. Nina's story begins in a similar way - with another medical problem leading to the diagnosis of Stage IV ovarian cancer.

    Nina describes herself as a full-time mother and full-time producer. She has worked for more than 20 years for Sesame Workshop, the producers of Sesame Street, and currently is the executive producer of Dragon Tales, a preschool series co-produced by Sesame Workshop and Sony Columbia Tristar Television. Dragon Tales is nominated for a Daytime Emmy as Outstanding Animated Children's Series, and when the awards ceremony is held in New York on May 18, Nina will be there as a winner, regardless of whether she comes home with the award.

    Dragon Tales premiered on PBS in June 1999 and quickly became one of the top-rated preschool series on television. Traveling between Orlando, New York, Los Angeles and London would be exhausting for most people, but Nina has always thrived on her work. When the year ended, she felt like she was on top of the world.

    "I was at a point that I would consider to be one of my happiest and, I thought, healthiest times of my life," Nina said. "When I'm in Orlando, I work at home, and I think I've always been able to balance my two wonderful daughters' lives. I also was exercising and thought I was at a weight I should be. I had a ton of energy. I thought everyone was thriving. This was all a big surprise."

    In remission from Stage IV ovarian cancer, Nina Bamberger relishes
    spending time with her daughters, Lauren (left), and Diana. Nina said,
    "Being a mother fills me with an indescribable fullness and joy."

    A routine mammogram revealed a small cyst, and Nina was sent to a surgeon to have a sonogram and a closer look. She was not concerned, and the doctor confirmed that it was a benign cyst like others she had before. But the surgeon was concerned about her swollen lymph nodes, and he immediately did a needle biopsy. Again, Nina was not concerned. She assumed her lymph nodes were swollen from a recent bout of the flu. She was stunned when the doctor called her four days later with the pathology report.

    "I thought he would call and say it was nothing, but he said he thought it was papillary thyroid cancer," Nina said. "He thought I had cancer in my thyroid and that it had spread to my lymph nodes."

    Nina had her thyroid and lymph nodes removed, and she was surprised to learn when the pathology report came back that there was no evidence of cancer. The surgeon's theory was that, since only a small section of the thyroid was sent to pathology for a biopsy, it was possible that this section did not have any cancer cells, and the cancer probably would have been found somewhere else in the thyroid. At this point, Nina accepted his explanation and was optimistic, because thyroid cancer has a 95 percent survival rate and is one of cancer's most curable forms.

    Prior to her thyroid surgery, Nina asked the doctor numerous times if she should have a CT scan to rule out cancer in other areas of her body.

    "I must have asked a million times, and so did my husband and my mother, and [the surgeon] said, 'No, if any scans are needed, they will be done after your surgery.' And that is too bad, because if I had a full-body scan before my thyroid surgery, they would have found the ovarian cancer."

    About three weeks after the surgery, when she began to feel better, Nina developed a new problem. She began to feel pressure in her abdominal area and was having difficulty urinating. It was on a Sunday, so she called her friend, Dr. Franz Ritucci, who practices at Florida Hospital Centra Care, an urgent-care center in Lake Buena Vista. He ran a test to see if she had a urinary-tract infection, and it came back negative. Suspecting that something more serious was wrong, he urged her to go to the emergency room for a CT scan.

    The scan showed that she had ovarian cancer that had spread throughout her abdominal area and was in an advanced stage. Within the next two days, Nina was seen by her gynecologist and also a surgeon who specializes in women's cancers.

    "Within 48 hours, I went from being this person who had always been so healthy to being someone who maybe had only 12 months to live," Nina said. "I was in complete shock. I don't think my husband and I fully understood what had happened to us."

    This was on a Tuesday morning, and Nina was scheduled for surgery on Thursday. Top on her priority list was to spend time with her daughters. She was worried about Diana finding a dress for a dance, and so the night before surgery, she went on an outing to the mall with her girls.

    On Thursday morning, Dr. Richard Boothby operated on Nina at the Orlando Regional Medical Center. Nina had a partial hysterectomy almost two years previously to remove a benign cyst, but her ovaries were healthy at the time and had been left behind. In this surgery, her ovaries and fallopian tubes were removed, as well as portions of her small intestine and bowel. Cancerous lymph nodes were wrapped around an artery, and after attempts to remove them from the left side of her pelvic area resulted in a nick in her artery, vascular surgery was needed. Dr. Boothby decided to leave some cancerous lymph nodes in her right pelvic area rather than risk further injury to her artery. He felt confident that all the tumors had been removed and that the cancer had not spread to any other vital organs.

    The surgical procedure that is done before chemotherapy begins is called debulking, and Nina said, "Dr. Boothby did an aggressive debulking, which is exactly what a patient would want and is one of the reasons that I think he is a wonderful doctor. The second is his compassion. He visited me every day in the hospital and was available whenever I needed to talk to him. He believed in me and my power to try and heal myself and supported and encouraged me throughout my ordeal."

    Nina's advice to other persons just learning they have cancer is to look at the physician's education, his prognosis, and his ability to listen to the patient.

    "Make sure, in your gut, that you trust him and feel that he is listening to you," she said. "You must take control of your treatment from the very beginning. I have always been a fighter, and I knew I was going to fight this. I believed in my heart that I wasn't going to die, but I just didn't know what to do."

    A friend gave Nina a book that provided her with hope and her first sense of direction. Love, Medicine and Miracles by Bernie Siegel, M.D., who practices surgery in New Haven, Conn., and teaches at Yale University, looks at the forces beyond conventional medicine that can heal a patient.

    "Dr. Siegel believes that love is the most powerful stimulant of the immune system and that love heals," Nina said. "He believes that miracles happen to exceptional patients every day and that exceptional patients are those who have the courage to love and those who have the courage to work with their doctors to participate and influence their own recovery. He teaches you how to heal your life and fight for it."

    Nina said that the book included three principles that she followed: to have a positive, optimistic attitude; to take charge of her own body and treatment; and to have a strong spiritual belief and trust in God.

    "I knew I believed in God, but I had never realized how I needed to turn myself over fully to him," she said. "For example, being that compulsive, anal-retentive, type-A+ personality that I've always been, I got out my calendar and marked off all the chemotherapy treatments. I planned my entire life around this schedule.

    "After my first treatment, my white cell count was too low to be able to have the second treatment. It was at that moment - I had written it all in pen - at that moment, I thought, Well, I either have to be depressed, or I can say that God knows when it's best for me to have this treatment, and this is not the right time. I went home and erased my appointments, and from that day on I turned it over to him. I had bad days, but I always felt God was watching over me and would take care of my family and me. I felt very loved and very calm, and this gave me strength to concentrate on other things."

    To take charge of her own body and treatment, Nina wrote down in a notebook each medication, blood count, and doctor recommendation. She read with interest the information her husband found on the Internet. She talked with friends about treatments and lifestyle changes that had worked for others.

    One of the first things Nina did was visit a nutritionist at the M.D. Anderson Cancer Center, where she was having her chemotherapy treatments. The strict diet she followed included low-fat foods, protein shakes, plenty of cooked vegetables, whole grains, vitamin supplements, limited sugar, no caffeine, and no alcohol.

    "I used to begin every day with a Starbucks coffee and a bagel," Nina said. "Now I was drinking herb tea and eating oat bran. But for me, the diet was another way I could control my health, and that was very empowering."

    Andy prepared daily protein shakes for her and also took over some of the cooking for the family. Friends frequently brought food, including a good friend who is still bringing homemade vegetable soup each week. Nina's mother, Maria Elias, lives in Winter Park and devoted much of her time to caring for Nina and her family.

    Nina encourages others who are ill to ask for help and to accept it.

    "You have to keep your strength, and this is something that those who love you can do for you," she said. "It makes everyone feel good."

    Nina said her friends and family were phenomenal, but she struggled to find words adequate to describe how supportive, strong and loving Andy was and continues to be.

    "The hardest part was watching our children trying to cope with a mother who could no longer drive the car pool, who lost 20 percent of her body weight and all of her hair, and who was someone who was often bedridden, tired and sick," Nina said. "The thing I tried to do most often was to talk to them about everything. I didn't want them to think that we were keeping something terrible from them. Since I always believed that I was not going to die, I wanted our children to believe it."

    On good days, Nina enjoyed time with her family and continued working and traveling. She also returned to the gym to work out.

    "It was not the same intensity, but it made me feel like I was doing something to get my strength back," she said.

    She also tried alternative therapies, including weekly acupuncture sessions. Some of the treatments were designed to help toxins pass through the liver more quickly, and other needles induced relaxation. Her oncologists at M.D. Anderson were open to her combining traditional chemotherapy with alternative medicine, and one of the doctors often passed along personal remedies that other patients had found.

    "The important thing is to share everything with your doctor so that you don't do anything that would hinder your treatment," Nina said. "Make a list of your vitamins, minerals and anything else you are doing."

    She learned about clinical trials from her oncologists, and her case was discussed during a routine conference between physicians at the Orlando clinic and doctors at the M.D. Anderson Cancer Center in Houston. She sought additional opinions from oncologists at Sloan-Kettering and Mt. Sinai hospitals in New York and the Moffit Cancer Center in Tampa. Nina discovered that Dr. Carmel Cohen at Mt. Sinai had more positive results with two additional treatments beyond the six normally prescribed chemotherapy treatments. After sharing this information, she was able to have the treatments at M.D. Anderson.

    Throughout her months of chemotherapy, Nina continued to work and travel, but she did so with a different attitude.

    "I've always loved my work," she said. "It has always been part of who I am. Before, work demanded a lot from me and took a lot from me, but after becoming sick, I started to use work rather than work using me. I used it as a divergence, but if I didn't feel like working, I didn't. And now I can put my work down at the drop of a hat. When 6 p.m. comes, I put it away and don't think about it. I find I enjoy it much more, and I'm as successful as I was before but much happier. The cancer was a wake-up call to me to the importance of family and friends and, as much of a cliché as it is, to live every moment."

    It has been more than a year since Nina's surgery and more than six months since her last chemotherapy session. She's in remission and back to balancing life as a full-time mother and full-time producer. In addition to Dragon Tales, she is the executive producer of a new computer-generated preschool series called Tiny Planets, which is being co-produced by Sesame Workshop and PeppersGhost in London. Her daughters remain her No. 1 priority, and she is overjoyed to be involved with their activities. Lauren is graduating this month from Dr. Phillips High School, and Diana is completing eighth grade at Holy Family Catholic School.

    With regular checkups and blood tests, cancer will always be part of her life, but Nina plans to turn her experience into something positive.

    "I have met women who are battling cancer, and I am trying to be a supportive voice," she said. "I tell them 'No matter what the statistics say, somebody has to be in that small percentage, and why couldn't that be you?' Miracles happen everyday — things we can't explain — and you have to believe that it can happen, take charge, and have faith."

    Nina and Pam wanted to share their stories for several important reasons: to educate women about the symptoms of ovarian cancer and the need to listen to their bodies and to insist on medical tests when things "don't feel right"; to emphasize the importance of obtaining research dollars that have been key to breakthroughs in other forms of cancer; and to inspire cancer patients and their families by showing what love and faith can accomplish.

    What Every Woman Should Know:

    The following information from Johns Hopkins Hospital in Baltimore may be found at http://ovariancancer.jhmi.edu/ on the World Wide Web:

    Ovarian cancer is a serious and under-recognized threat to women's health:

    • Ovarian cancer kills more women than all other gynecological cancers combined.
    • Ovarian cancer is the fifth-leading cause of cancer death among women in the United States.
    • Ovarian cancer occurs in one in 57 women, up from one in 70 several years ago.
    • This year, 14,500 women will die from ovarian cancer and more than 25,500 will be diagnosed.

    Ovarian cancer is treatable when caught early; however, the vast majority of cases are not diagnosed until too late:

    • When ovarian cancer is caught before it has spread outside the ovaries, more than 90 percent of the women will survive five years.
    • Only 24 percent of ovarian cancer is caught early.
    • When diagnosed after ovarian cancer has spread, the chance of a five-year survival drops to less than 25 percent.
    Ovarian cancer is difficult to diagnose:
    • There is no reliable screening test for the early detection of ovarian cancer. Pap smears only check for cervical cancer.
    • The symptoms of ovarian cancer often are vague and easily confused with other diseases.

    Early recognition of ovarian cancer symptoms is the best way to save women’s lives:

    Early symptoms include:
    • Bloating, a feeling of fullness, gas
    • Frequent or urgent urination
    • Nausea, indigestion, constipation, diarrhea
    • Menstrual disorders, pain during intercourse
    • Fatigue, backaches

      Women should take action if any symptoms last more than two to three weeks.

    These important tests help to rule out ovarian cancer:
    • Bimanual pelvic exam
    • Ca125 blood test
    • Transvaginal ultrasound

    Who is at the greatest risk of having ovarian cancer?
    • Women who have two or more relatives who have had ovarian cancer
    • Women with a family history of multiple cancers
    • Women who were diagnosed with breast cancer under the age of 50
    • Women who have a personal history of multiple exposures to fertility drugs
    • Women of Ashkenazi Jewish descent
    • Women who have had uninterrupted ovulation (never used birth control pills and no pregnancies)
    • Women who have the BRCA1 or BRCA2 gene mutation
    • Women over the age of 50

    Hopkins Doctors Present New Techniques for Ovarian Cancer Surgery at SGO Meeting
    April 27, 2001
    Sean Patrick , Ovca Survivor
    Dr. Robert Bristow, Associate Professor, The Kelly Gynecologic Oncology Service of the Johns Hopkins Hospital and Medical Institutions, presented his and Dr.FJ Montz's study at the 32nd Annual Meeting of the Society of Gynecological Oncologists, on the use of the Argon Beam Coagulator (ABC) to achieve optimal tumor debulking.

    They found the Argon Beam Coagulator is an effective cytoreductive tool and is associated with a statistically significantly higher rate of cytoreduction to microscopic residual disease than conventional surgical debulking. Women whose ovarian cancer was debulked using the ABC achieved optimal disease status more frequently - 93.6% compared to only 64.3% for non-ABC cases.

    While it has long been known that optimal debulking improves the chance of survival for women with ovarian cancer, the addition of the ABC, in the hands of an experienced surgeon, can help increase a woman's chances of being optimally debulked.

    Argon beam coagulator ablation

    "While we are excited about the use of the Argon Beam Coagulator at Hopkins, it is important to remember, it is a very useful tool. It is not a magic wand." Dr. Bristow commented. Full Abstract

    Dr. Montz and Dr. Bristow continue to advance the knowledge of the important role surgery plays in survival outcome for women with ovarian cancer and will present their latest findings on this topic at the American Society of Clinical Oncologists Annual Meeting next month in San Francisco. A full abstract will be available on this web site after the meeting.

    Amplistar Licenses Ovarian Cancer Genes from Johns Hopkins University
    April 03, 2001
    Press Release


    Amplistar Licenses Ovarian Cancer Genes from Johns Hopkins University

    Breakthrough In The Development Of The First Ovarian Cancer Screening Test Announced

    Winston-Salem, North Carolina, March 29, 2001 -- Amplistar, Inc., announced today the signing of an exclusive worldwide license agreement with Johns Hopkins University, to commercialize immunogenic ovarian cancer gene products for both diagnostic and therapeutic purposes.

    As presented in the latest issue (March 27, 2001) of the Proceedings of the National Academy of Sciences (PNAS), Drs. Honami Naora and Richard Roden, scientists in the Department of Pathology at Johns Hopkins University, recently identified cancer antigens that produce an antibody immune response in ovarian cancer patients. These antibodies were then used to develop a blood test for ovarian cancer. Preliminary clinical results suggest that this blood test is highly specific for ovarian cancer.

    Ovarian carcinoma is the most deadly cancer in women. Over 14,000 women will die from ovarian cancer this year, in the U.S. alone. The high mortality rate is primarily due to the silent nature of this disease, which is often not symptomatic until the cancer is widespread. The survival rate for ovarian cancer is 28% when distant metastasis are present at the time of diagnosis, but jumps dramatically to 95% when diagnosed with only local spread present. Amplistar's screening test will offer a significant improvement in future survival rates by helping to "catch" ovarian cancer in it's early and most curable stages.

    Commenting on the agreement, Eric Button, CEO of Amplistar, said, "The addition of these gene products to our portfolio will greatly enhance our ability to fast-track development of an effective screening test for ovarian cancer. We believe that the measurement of circulating antibodies to cancer represents an exciting and entirely novel scientific approach to the development of highly accurate blood tests, for the early detection of a wide variety of cancers. In addition to our ovarian test development program, we possess an extensive collection of high-potential cancer antibody targets for several primary cancers including colon, lung, prostate, and breast." Exploiting their unique technology, Amplistar has begun development of routine blood tests for the early detection of these and other cancers.

    "We are pleased to enter into this agreement with Amplistar," said Dr. Richard Roden, of Johns Hopkins University. "They have the scientific expertise and vision to take this exciting discovery through to the development of a clinically significant, routine screening test for ovarian cancer. Their unique technologies and novel strategy to the development of highly specific blood tests for the early detection of a variety of cancers hold great promise for the future."

    Amplistar, Inc. is a post-genomics company focused on the identification of antibody targets for the early detection and treatment of cancer. The company utilizes both genomic and functional genomic information to identify and validate unique antibody targets - a radically different discovery approach to the development of screening tests for cancer.

    This press release contains forward-looking statements about Amplistar's future. No assurance express or implied.

    Contact: Eric Button, CEO, Amplistar, Inc. 336.777.0425 or ebutton@amplistar.com

    Lecture in Surgical Pathology focuses on Tumors of the Ovary, May 18, 2001
    February 08, 2001
    Dr Brigitte M. Ronnett will present a lecture entitled "Distinguishing Primary from Metastatic Mucinous Tumors in the Ovary" as a part of a course in Surgical Pathology for Continuing Medical Education. This course for pathologists is a didactic presentation of practical and critical issues in surgical pathology, presented by the Johns Hopkins School of Medicine. The goal of the course is to help pathologists acquire the diagnostic approaches to surgical specimens of senior consultants, to select and interpret special procedures, i.e. immunochemistry, to recognize new tumor entities and recognize non-neoplastic lesions that masquerade as neoplasms. Contact cmenet@jhmi.edu for more information.

    Or visit the Hopkins CME Website.

    Johns Hopkins Nurses Featured in Discovery Television Show
    February 08, 2001
    Whether responding to save a patient in sudden respiratory arrest, counseling those just diagnosed with cancer, or running a neighborhood medical center for young women, Nurses features inspiring real-life stories from Johns Hopkins.


    HOX proteins A7 and B7: Immunogenic Antigens Associated with Differentiation and Development of Ovarian Tumors
    October 10, 2000
    Dr. Honami Naora
    Honami Naora,1 YanQin Yang,1 Fredrick J. Montz,2, Chee-Yin Chai,1 Robert J. Kurman1,2 and Richard B.S. Roden1. Departments of Pathology1 and Obstetrics and Gynecology2, Johns Hopkins Medical Institutions, Baltimore, MD

    The majority of women diagnosed with ovarian cancer present with disseminated disease. Most ovarian tumors arise from the epithelial surface of the ovary. These are classified by their predominant pattern of histologic differentiation, with serous carcinomas being the most common and aggressive type. Little is known of the molecular mechanisms underlying the histogenesis and development of the disease. We have found that antibodies are present in sera of patients with serous ovarian carcinomas which recognize specific proteins expressed in serous carcinomas and not, or at significantly lower levels, by normal ovarian surface epithelium. To identify ovarian tumor antigens, serum antibodies of a patient with serous ovarian carcinoma were used to immuno-screen a lZAP ovarian carcinoma cDNA expression library. After immuno-screening 800,000 recombinant phage plaques, thirty-one positive clones were isolated. Twenty-one of these clones encoded HOXA7, while another seven encoded HOXB7. HOXA7 and HOXB7 are highly homologous members of the HOX family of homeobox genes whose products act as transcription factors and play important roles in regulating normal cellular differentiation and development. HOXA7 reacted with sera from 80% of patients with serous ovarian carcinomas, but not with sera from healthy women. HOXA7 antibodies were also detected in sera from 75% of patients with benign ovarian serous cystadenomas, but in less than 25% of sera from patients with poorly differentiated ovarian carcinomas. An identical profile of reactivity was observed against HOXB7 among the over-80 serum samples tested. The profile of serum reactivity against HOXA7 strongly correlated with the expression of HOXA7 in the majority of serous carcinomas and cystadenomas, as detected by RT-PCR and immunohistochemical analyses, and the absence of, or very low, HOXA7 expression in normal ovarian surface epithelium and poorly differentiated carcinomas. In contrast, HOXB7 was found to be constitutively expressed in all carcinomas and cystadenomas examined, irrespective of their differentiation patterns, and also in normal ovarian surface epithelium. This indicates that patients with differentiated ovarian carcinomas and cystadenomas generate humoral responses against up-regulated HOXA7, and that such antibodies can cross-react with HOXB7. More importantly, these results reveal HOXA7 as a novel immunogenic antigen with etiologic relevance to the complex histogenesis of ovarian tumors.

    Hopkins Researchers Develop New Class of Anti-Cancer Drug
    August 14, 2000
    Researchers Ellen Pizer and Frank Kuhajda in the Department of Pathology, JHU are developing a novel class of anti-cancer drugs that target the enzyme fatty acid synthesase(FAS). Ovarian cancer cells produce large quantities of FAS. Hopkins researchers developed a new drug called C-75 to inhibit FAS. Ovarian cancer cells grown in the laboratory are killed by C-75. C-75 treatment of mice harboring ovarian cancer cells stopped the growth of the tumor. For more information see:

    Archived News on Research Elsewhere

    Lysophosphatidic Acid May Point to Early Ovarian Cancer (Reuters Report)
    July 22, 2004
    See this important report from Reuter's

    Biomarker May Point to Early Ovarian Cancer
    Tue Jul 13, 2004 04:43 PM ET

    Impact of Individual Physicians on Enrollment of Patients into Clinical Trials
    October 27, 2003
    Mannel RS, Walker JL, Gould N, Scribner DR Jr, Kamelle S, Tillmanns T, McMeekin DS, Gold MA. Am J Clin Oncol. 2003 Apr;26(2):171-3. Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73190, U.S.A.
    Entry into clinical trials may be the best approach for treatment of many ovarian cancer patients. The factors that influence enrollment of cancer patients in clinical treatment trials are poorly understood. This study analyzes the role of individual physicians in recruitment of patients in clinical trials. There was a significant difference between medical faculty members in offering protocol therapy and likelihood of successfully enrolling patients. Successful enrollment was associated with faculty experience and principal investigator status. This study shows that availability of patients, patient variances, support staff, and institutional commitment are secondary to individual physician factors in determining successful enrollment of patients.

    Adjuvant ChemoTherapy in Ovarian Neoplasm Trial: Two Parallel Randomized Phase III Trials of Adjuvant Chemotherapy in Patients with Early-Stage Ovarian Carcinoma
    October 27, 2003
    International Collaborative Ovarian Neoplasm trial 1 and Trimbos JB, Parmar M, Vergote I, Guthrie D, Bolis G, Colombo N, Vermorken JB, Torri V, Mangioni C, Pecorelli S, Lissoni A, Swart AM; International Collaborative Ovarian Neoplasm 1; European Organisation for Research and Treatment of Cancer Collaborators-Adjuvant ChemoTherapy un Ovarian Neoplasm. Department of Gynecology, Leiden University Medical Center, The Netherlands. J Natl Cancer Inst. 2003 Jan 15;95(2):105-12.
    Adjuvant chemotherapy has been suggested as a possible strategy to improve survival in women with early-stage ovarian cancer; however, all randomized studies to date have been too small to answer this question reliably. Overall survival at 5 years was 82% in the chemotherapy arm and 74% in the observation arm. Recurrence-free survival at 5 years was also better in the adjuvant chemotherapy arm than it was in the observation arm. The investigators conclude that Platinum-based adjuvant chemotherapy improved overall survival and recurrence-free survival at 5 years in a combined group of patients with early-stage ovarian cancer defined by the inclusion criteria of the ICON1 and ACTION trials.

    OPCML at 11q25 Is Epigenetically Inactivated and Has Tumor-Suppressor Function in Epithelial Ovarian Cancer
    October 27, 2003
    Sellar GC, Watt KP, Rabiasz GJ, Stronach EA, Li L, Miller EP, Massie CE, Miller J, Contreras-Moreira B, Scott D, Brown I, Williams AR, Bates PA, Smyth JF, Gabra H. Nat Genet. 2003 Jul;34(3):337-43. Cancer Research UK Edinburgh Oncology Unit, University of Edinburgh Cancer Research Centre, Crewe Road South, Edinburgh EH4 2XR, UK.
    Epithelial ovarian cancer (EOC) arises as a result of genetic alterations sustained by the ovarian surface epithelium. The causes of these changes are unknown but are manifest by activation of oncogenes and inactivation of tumor-suppressor genes (TSGs). Our analysis of loss of heterozygosity at 11q25 identified OPCML as a candidate TSG in EOC. OPCML is frequently somatically inactivated in EOC by allele loss and by CpG island methylation. OPCML has functional characteristics consistent with TSG properties both in vitro and in vivo. A somatic missense mutation from an individual with EOC shows clear evidence of loss of function. These findings suggest that OPCML is an excellent candidate for the 11q25 ovarian cancer TSG.

    Yondelis Enters Phase II Trial
    October 27, 2003
    This sea squirt toxin stops cancer cells from making proteins involved in cancer growth and also helps to sensitize resistant cells to chemotherapy. Breast, Ovarian and Endometrial cancers. www.pharmamar.com

    Two New Agents Enter Phase III Clinical Trials
    October 27, 2003
    OvaRex® and Telcyta are two therapies that recently entered large, randomized Phase III trials.

    These agents operate in novel ways, and could provide new treatment options for women with this disease.

    • Telcyta Phase III Trial Information:
      A large, randomized Phase III registration trial is underway, comparing Telcyta treatment in women with advanced ovarian cancer to the FDA approved second-line drug treatments (Doxil® and Hycamtin®).

      Telcyta is being developed by Telik, Inc. of Palo Alto, CA.

      For more information, go to www.telik.com Or visit www.clinicaltrials.gov and search for TLK286

    • OvaRex Phase III Trial Information
      United Therapeutics recently announced the initiation of two identical Phase III clinical trials called IMPACT I and II are being conducted at centers throughout the United States.

      A current list of participating sites in the IMPACT I and II trials may be obtained by accessing www.clinicaltrials.gov and entering the keyword: OvaRex.

    Progress and Results from Selected Recent Clinical Trials Worldwide
    March 10, 2003
    Richard Roden, Ph.D. , Assistant Professor, Ph.D.

    Phase II Trial of Irinotecan in Patients with Metastatic Epithelial Ovarian Cancer or Peritoneal Cancer (J Clin Oncol 2003 Jan 15;21(2):291-7). Purpose: To evaluate the efficacy and toxicity of irinotecan in patients with metastatic platinum-resistant or platinum-refractory epithelial ovarian cancer or primary peritoneal cancer.
    Conclusion: Irinotecan has moderate efficacy and substantial toxicity in patients with metastatic platinum-resistant or platinum-refractory epithelial ovarian or primary peritoneal cancer.

    Evaluation of Monoclonal Humanized Anti-HER2 Antibody, Trastuzumab, in Patients with Recurrent or Refractory Ovarian or Primary Peritoneal Carcinoma with Overexpression of HER2 (J Clin Oncol 2003 Jan 15;21(2):283-90). Purpose: To evaluate the feasibility, toxicity, and efficacy of single-agent monoclonal antibody therapy targeting the human epidermal growth factor receptor 2 (HER2)/neu receptor in ovarian and primary peritoneal carcinoma.
    Conclusion: The clinical value of single-agent trastuzumab in recurrent ovarian cancer is limited by the low frequency of HER2 overexpression and low rate of objective response among patients with HER2 overexpression.

    Phase II Trial of Gemcitabine Plus Cisplatin Repeating Doublet Therapy in Previously Treated, Relapsed Ovarian Cancer Patients (Gynecol Oncol 2003 Jan;88(1):35-9). Purpose: The aim was to determine the safety and efficacy of gemcitabine plus cisplatin for patients with relapsed ovarian carcinoma and to compare ex vivo drug sensitivity profiles with clinical outcomes.
    Conclusion: Cisplatin plus gemcitabine is active for patients with relapsed ovarian cancer. Toxicities, primarily hematologic, are manageable with dose modifications. Responses observed in heavily pretreated and platin-resistant patients indicate activity in drug-refractory patients. The results of the ex vivo analyses correlate with clinical outcomes.

    Phase I Study of Intraperitoneal Recombinant Human Interleukin 12 in Patients with Mullerian Carcinoma, Gastrointestinal Primary Malignancies, and Mesothelioma (Clin Cancer Res 2002 Dec;8(12):3686-95). Purpose: The purpose is to determine dose-limiting toxicity, pharmacokinetics, pharmacodynamics, and immunobiology after intraperitoneal (i.p.) injections of recombinant human IL-12 (rhIL-12).
    Conclusion:rhIL-12 at 300 ng/kg by weekly i.p. injection is biologically active and adequately tolerated for Phase II studies.

    A Phase II Trial of ZD0473 in Platinum-Pretreated Ovarian Cancer (Eur J Cancer 2002 Dec;38(18):2416-20). Purpose: The primary aim of this phase II trial was to assess the antitumor activity of ZD0473 in ovarian cancer patients who had failed initial platinum-based therapy.
    Conclusion:ZD0473 has a manageable toxicity profile and encouraging activity in platinum-sensitive ovarian cancer patients.

    Thiotepa in Combination with Cisplatin for Primary Epithelial Ovarian Cancer: A Phase II Study (Int J Gynecol Cancer 2002 Nov-Dec;12(6):710-4). Purpose: The objectives of this phase II protocol were: 1) to determine the clinical activity of thiotepa combined with cisplatin in suboptimally debulked advanced epithelial ovarian carcinoma as first-line chemotherapy, 2) to determine by surgery the response after 6 courses of chemotherapy, and 3) to identify the regimen's qualitative and quantitative toxicities.
    Conclusion:This study indicates that first-line treatment with thiotepa and cisplatin produces significant long-term responses when tumors are sensitive. Such treatment is a reasonable option when paclitaxel is not available.

    Phase I Safety, Pharmacokinetic, and Pharmacodynamic Trial of ZD1839, a Selective Oral Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor, in Patients with Five Selected Solid Tumor Types (J Clin Oncol 2002 Nov 1;20(21):4292-302). Purpose: To establish the safety and tolerability of ZD1839 (Iressa), a selective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, and to explore its pharmacokinetic and pharmacodynamic effects in patients with selected solid tumor types.
    Conclusion: ZD1839 was generally well tolerated, with manageable and reversible AEs at doses up to 600 mg/d and dose-limiting toxicity observed at 1,000 mg/d. ZD1839 treatment resulted in clinically meaningful disease stabilization across a range of tumor types and doses. Pharmacodynamic changes in skin confirmed inhibition of EGFR signaling, which was predicted from the mode of action of ZD1839.

    Dose-Dense Cisplatin/Paclitaxel. A Well-Tolerated and Highly Effective Chemotherapeutic Regimen in Patients with Advanced Ovarian Cancer (Eur J Cancer 2002 Oct;38(15):2005-13). A randomized phase I/II trial with weekly cisplatin 70 mg/m(2) (days 1, 8, 15, 29, 36, 43) in combination with escalating doses of paclitaxel either 4-weekly or weekly was conducted in 49 patients with ovarian cancer; patients were chemotherapy-naive or had a first relapse after platinum-based chemotherapy. Both cisplatin/paclitaxel regimens showed excellent activity with manageable toxicity in patients with advanced ovarian cancer.

    A Phase I Study of Combined Modality (90)Yttrium-CC49 Intraperitoneal Radioimmunotherapy for Ovarian Cancer (Clin Cancer Res 2002 Sep;8(9):2806-11). Purpose: The purpose of this study was to determine the feasibility and maximum tolerated dose of (90)Yttrium-CC49 ((90)Y-CC49) as the radioimmunotherapy (RIT) component of an i.p. combined modality treatment for recurrent ovarian cancer.
    Experimental Design: A Phase I trial of (90)Y-CC49 RIT was conducted in ovarian cancer patients who had persistent or recurrent intra-abdominal disease, had failed one or two prior chemotherapy regimens, and demonstrated TAG-72 expression. Patients were treated with a previously established combined modality treatment protocol of s.c. IFN alpha2b, i.p. paclitaxel, and increasing dosages of i.p. (90)Y-CC49.
    Conclusion:(90)Yttrium-CC49-based RIT in combination with IFN alpha2b and i.p. paclitaxel is feasible and well tolerated at a dose of < or =24.2 mCi/m(2).

    CA125 Response Is Associated with Estrogen Receptor Expression in a Phase II Trial of Letrozole in Ovarian Cancer: Identification of an Endocrine-Sensitive Subgroup (Clin Cancer Res 2002 Jul;8(7):2233-9). Purpose: This study was an open-label Phase II trial of the aromatase inhibitor letrozole (Femara) in patients with relapsed ovarian cancer with evaluation of possible biological markers for response.
    Conclusion: These results imply that letrozole treatment can produce disease stabilization and CA125 responses that in turn are linked to higher levels of ER expression. These data suggest the presence of an endocrine-sensitive group that could be targeted in future studies.

    Ovarian Cancer in the Spotlight at Winter Outdoor Retail Show
    February 04, 2003
    The Outdoor Industry Women's Council (OIWC) featured the HERA Foundation and the Ovarian Cancer Climb for Life at their Pioneering Women Reception 2/2/03 in Salt Lake City,Utah. Sean Patrick, HERA founder and JH Ovarian Cancer web site co creator spoke about the climb and the need to raise awareness for this under-recognized threat to women's health.

    The main focus of the evening was the 2nd annual Pioneering Woman Award which was awarded to Rachel Ligtenberg, general manager of the REI Seattle Flagship Store. OIWC's mission is to promote the advancement and participation of women in the outdoor community and this award recognizes distinguished women in the outdoor industry who have demonstrated a positive impact on women's careers.

    For more information on the HERA Ovarian Cancer Climb for Life http://ovariancancer.jhmi.edu/climb

    Or the OIWC www.oiwc.org

    Weekly Cisplatin and Daily Oral Etoposide Is Highly Effective in Platinum Pretreated Ovarian Cancer Patients
    June 10, 2002
    Dr ME van der Burg and co-workers investigated the potential of weekly cisplatin and daily oral etoposide followed by oral etoposide maintenance therapy in patients with platinum-refractory ovarian cancer. They conclude that this intensive regimen of weekly cisplatin plus daily etoposide is highly effective and well tolerated in patients with ovarian cancer relapsing after conventional platinum-based combination chemotherapy, including patients who have progressed during or within 4 months after platinum treatment.

    PI3k Inhibitor and Taxol in Combination
    June 10, 2002
    Richard Roden, Ph.D.
    Recent research by RB Jaffe et al. from the University of San Francisco California Center for Reproductive Sciences and the Department of Molecular Oncology at M.D, Anderson, Houston,Texas suggests that a combination of a PI3k inhibitor and conventional chemotherapy provide an effective approach to inhibiting tumor growth and ascites production in ovarian cancer. Look for clinical trials to start sometime in the future.

    Fenretinide (4-HPR) in Phase II Trial
    June 10, 2002
    Richard Roden, Ph.D.
    This synthetic form of Vitamin A has been found to cause cancer cell death. In phase I trials, patients were given Fenretinide in pill form 2 times a day for one week followed by a two week cycle of rest. The side effects were all mild.

    A phase II trial for recurrent ovarian cancer or primary peritoneal cancer is underway in California using Fenretinide as a single agent. Contact the Clinical Trials Office 323-865-0451.

    Gleevec™ (STI 571) in Phase II Trials
    June 10, 2002
    Richard Roden, Ph.D.
    The FDA approved Gleevec™ (imatinib mesylate) for the treatment of chronic myeloid leukemia this past year. Due to the overwhelming success of the first clinical trials, Gleevec™ was approved in record time.

    As part of a new class of drugs called tyrosine kinase (TK) inhibitors, Gleevec™ can shut down cancer cell growth without affecting normal cells. Phase II clinical trials are getting underway for ovarian cancer at M.D. Anderson Cancer Center in Houston and at the National Cancer Institute (NCI) in Bethesda.

    Researchers believe ovarian cancer is a good candidate for the use of Gleevec™ as a high percentage of ovarian cancer cells in the lab have at least one of the three target kinases (pdgfr, c-kit or bcr-abl).

    For more information:
    Novartis: www.gleevec.com
    M.D. Anderson: www.mdanderson.org or 800-392-1611
    NCI: cancer.gov or 888-624-1937.

    Study Shows There May Be a New Blood Test for Ovarian Cancer (08-Feb-02)
    February 09, 2002
    A recent clinical study by EF Petricoin et al. showed that a new marker for ovarian cancer may be found through a simple blood test. Full story

    Lancet 2002 Feb 16;359(9306):572-7

    New Research Presented at 32nd Annual SGO Meeting
    April 25, 2001
    Sean Patrick , Ovca Survivor
    The Society of Gynecological Oncologists held their 32nd Annual Meeting, March 3-7, 2001 in Nashville, Tennessee. Scientists, advocates and health professionals came from all over the country to attend the conference. We have recapped three hot topics below with links to the full abstracts and provided a link to all the abstracts on ovarian cancer presented at the meeting at the end of this article.

    Can New Ultrasound Technology Improve Ovarian Cancer Detection?

    A new study compared three-dimensional power Doppler ultrasound with the more often used two-dimensional ultrasound. While both the 3-D and 2-D correctly identified all malignancies, specificity was significantly improved with the newer 3-D imaging. This allows for optimized patient management and appropriate referral.  Full Abstract

    Aspirin Could Reduce the Risk of Ovarian Cancer

    Long-term use of aspirin appears to reduce one's chances of developing ovarian cancer. Used 3 or more times a week for at least 6 months could be associated with a 40% reduction of epithelial ovarian cancer.  Full Abstract

    Progestin and Ovarian Cancer

    Oral contraceptives that are progestin potent may confer greater protection against ovarian cancer. This study presents further evidence in support of the theory that progestin may be a mechanism underlying the protective effect of oral contraceptives.  Full Abstract

    To read more on the latest from SGO's 32nd Annual Meeting:  All Ovca Abstracts

    Early Ovarian Cancer Does Have Symptoms
    February 08, 2001
    Seventy-eight percent of the women with early stage ovarian cancer and borderline ovarian tumors had presenting symptoms, the most common of which were abdominal or pelvic pain (34. 7%), bloatedness (31.9%), and abnormal vaginal bleeding (19.4%). Symptoms were similar among women with borderline ovarian tumors and those with ovarian cancer, but a higher proportion of borderline ovarian tumor patients reported no symptoms (31.8% versus 18. 0% in early stage ovarian cancer patients). Abdominal and/or pelvic masses were palpable in 72.2% of the patients and ascites (fluid accumulation) was present in 12.5%. The average time interval between onset of symptoms and diagnosis was 4.6 months. Reduce this time by making an appointment with your doctor when these symptoms occur.

    Protect yourself, know the symptoms.

    From "Clinical picture of women with early stage ovarian cancer." By Eltabbakh et al. Gynecol Oncol 1999 Dec;75(3):476-9. Abstract

    Predicting Outcome in Stage I Ovarian Cancer
    February 08, 2001
    Richard Roden, Ph.D.
    Degree of differentiation, the most powerful prognostic indicator in stage I ovarian cancer, should be used in decisions on therapy in clinical practice and in the FIGO classification of stage I ovarian cancer. Rupture should be avoided during primary surgery of malignant ovarian tumors confined to the ovaries. Vergote et al undertook a retrospective study of patients with invasive epithelial ovarian cancer stage I to identify the most important prognostic variables. The analyses identified degree of differentiation as the most powerful prognostic indicator of disease-free survival. Patients with well differentiated tumors were 3-fold less likely to survive disease-free for 5 years than those with moderately differentiated tumors, those with poorly differentiated tumors were 9-fold less likely to survive 5 years disease free than patients with well differentiated tumor. Patients whose tumor had ruptured either before surgery or during surgery were 2.7 or l.6-fold respectively less likely to survive 5 years disease free than those whose tumors were removed without rupture. FIGO 1973 stage Ib were 1.7-fold less likely to survive 5 years disease free than FIGO 1973 stage Ia. Risk also increased with age (per year 1.02-fold). When the effects of these factors were accounted for, none of the following were of prognostic value: histological type, dense adhesions, extracapsular growth, ascites, FIGO stage 1988, and size of tumor.

    In LANCET 2001, Vol 357, Iss 9251, pp 176-182 and article entitled "Prognostic importance of degree of differentiation and cyst rupture in stage I invasive epithelial ovarian carcinoma" by Vergote I et al.

    The Efficacy of Transvaginal Sonographic Screening in Asymptomatic Women at Risk for Ovarian Cancer
    August 14, 2000
    van Nagell et al. examined the efficacy of transvaginal sonographic screening (TVS) in asymptomatic women at risk for ovarian cancer. Annual TVS screening was performed on 14,469 asymptomatic women of greater than or equal to 50 years of age or women greater than or equal to 25 years of age with a family history of ovarian cancer. In screening this population they concluded: (1) TVS screening, when performed annually, is associated with a decrease in stage at detection and a decrease in case-specific ovarian cancer mortality. (2) TVS screening does not appear to be effective in detecting ovarian cancer in which ovarian volume is normal.


    News You Can Use — Archives

    A Woman's Journey: Johns Hopkins Premier Woman's Health Conference
    November 09, 2004
    The 10th Annual Johns Hopkins Women's Health Conference, A Woman's Journey, will be held on Saturday, November 20, 2004 at the Baltimore Marriott Waterfront.

    The event's 32-seminars will be presented by Johns Hopkins faculty including Gynecological Oncologist, Terri Cornelison, M.D., and Medical Oncologist,Deborah Armstrong, M.D., the guest speakers focusing on gynecological cancers.

    A woman’s risk for developing gynecologic cancer increases with menopause. Dr. Cornelison explains the need for early detection, and the latest treatments for uterine, ovarian and cervical cancers.

    Deborah Armstrong, M.D.,[ Bio ] a medical oncologist specializing in gynecologic cancers will also be speaking. Join Dr. Armstrong for a discussion about the causes of cancer, and how this information helps doctors detect, treat and ultimately prevent cancer.

    Topics of other speakers include, Women and Heart Disease, Overcoming Barriers to Sexual Fulfillment, Fitness Fundamentals, Taking Control: Hypertension and High Cholesterol, Treating Menopausal Symptoms, Mood Changes As We Age, and more.

    For more information and to register, click here.

    HERA Foundation Receives IZZE Beverage 2004 Q Award
    November 04, 2004
    Seven Summits Circle: Black Diamond, Climbing Magazine, Fox River, Izze Beverages, Jenny Q Herbals, NIKE ACG, Patagonia, PowerBar, REI & Timberland

    (Aspen, CO) - The HERA (health, empowerment, research and advocacy) Women's Cancer Foundation recently received the IZZE Beverage Company's IZZE Q Award, an honor recognizing the quality and achievement of non-profit and charitable organizations that inspire through commitment and passion. In addition to a cash grant, the HERA Foundation and their Climb for Life events will have a limited edition printed profile on IZZE four-pack cartons for six consecutive months on IZZE's Blackberry all natural sparkling juice, beginning in 2005. This award will allow HERA to raise awareness of ovarian cancer through IZZE retailers in the U.S., Caribbean and South Pacific markets that include Starbucks, Target stores, Harry & David, Whole Foods, Wild Oats, fine dining and casual delis as well as grocery stores.

    "This is a tremendous honor that enables HERA to reach our goal of raising awareness of ovarian cancer among healthy women," says ovarian cancer survivor and director of the HERA Foundation, Sean Patrick, who three years ago, when given four - six weeks to live, started the HERA Foundation and Climb for Life event series. "Ovarian cancer caught in its early stages has a 90% survival rate, yet only 24% of cases are caught early. If caught late the chance of five-year survival drops to less than 25%."

    IZZE Beverage has been a loyal supporter of HERA's Climb for Life events that include Salt Lake City, Las Vegas as well as eight cities on the 2005 R.E.I. Road Tour that include Washington, DC, Boston, Seattle, Denver and Portland.

    The HERA Foundation is a registered 501 (c) 3, whose mission is to stop the loss of mothers, daughters, wives, sisters and girlfriends from ovarian cancer by empowering women to take control of their health, empowering the medical community to find new directions in ovarian cancer research and empowering communities to provide support. For more information call 970.948.7360 or visit http://ovariancancer.jhmi.edu/climb.

    Canadian Survivor Awarded “Pulitzer Prize” of Ovarian Cancer Advocacy
    November 01, 2004
    Washington, DC– Canadian ovarian cancer advocate Sandi Pniauskas received the “Spirit of Survivorship” award at the Ovarian Cancer National Alliance’s seventh annual conference. Pniauskas received the top advocacy honor because of her consistent efforts to help the lives of others who are battling this often fatal disease.

    OCNA Board member Deborah Bell presented the award and described how Pniauskas chose to radically change her life after her diagnosis. Bell said, “Sandi gave up a successful career and has devoted her time, as well as considerable resources, to learning about this disease that suddenly was changing her life. She now spends her time raising public awareness of ovarian cancer to help others who are diagnosed with cancer.”

    Pniauskas exceeded the awards criteria, “particularly as a person who has demonstrated the ability to direct positive energy, as a model for others, towards overcoming the disease and through her optimistic approach to inspire and teach community members.”

    Pniauskas advocacy efforts include:
    • Coordination of “Dare to Dream for Ovarian Cancer,” a nationwide Canadian ovarian cancer awareness event in 2003.
    • Membership on the Breast/Gynecologic Cancer major fundraising committee and participation on the Community Advisory Committee at Princess Margaret Hospital at the University of Toronto, devoted exclusively to cancer research, treatment and education.
    • Numerous presentations including one she made at the 2003 Canadian Cochrane Collaboration Third Annual Conference: “Patient and Practitioner Partnership – A Practically Perfect Combination”
    • Submission in 2002 of an ovarian cancer paper for the Commission on the Future of Health Care in Canada. Out of tens of thousands of papers hers was the only one on ovarian cancer.

      The “Spirit of Survivorship” award was named in honor of Cindy Melancon, a founder of the Ovarian Cancer National Alliance who passed away in 2003. When diagnosed with ovarian cancer in 1993, Melancon discovered there were no support groups for survivors. She founded “Conversations” an international newsletter which helped build the ovarian cancer community and the advocacy movement. Her spirit created a community of hope among cancer survivors. The award is the highest honor in the ovarian cancer community. During Pniauskas’ address to the audience, she emphasized the recognition and importance of the ‘Spirit of Survivorship’ award describing it as the ‘Pulitzer Prize of Ovarian Cancer’.

    Climb for Life on NBC
    August 27, 2004
    Monday August 30th on NBC on the new Jane Pauley show there will be climbing clips from the Climb for Life Grand Teton 04. Airtimes are different in each market. Sean Patrick is on the show and provides a teaser for the upcoming hour long show that is set to air in September.

    Jane Pauley show is scheduled to be on air in Baltimore on WMAR (ABC) 2/52 (HDTV) at 10 a.m.

    Check out www.janepauley.com and click the VIEW PROMO for this week.

    September Issue of Prevention Magazine Highlights Ovarian Cancer
    August 24, 2004
    Sean Patrick makes an "appearance" in Prevention Magazine to spread the word about Ovarian Cancer. The article, "4 Must-Know Ovarian Cancer Facts" appears on page 54 of the September 2004 issue.

    Read the Online version:

    7th Annual OCNA Advocacy Conference
    July 21, 2004
    Ovarian Cancer National Alliance
    September 30-October 2, 2004
    Washington, DC

    For more information see:
    Conference Website

    September is National Ovarian Cancer Awareness Month
    July 20, 2004
    In 1998 and 1999, President Clinton issued proclamations proclaiming one week in September, Ovarian Cancer Awareness Week. Since then support has grown nationally and the week of awareness has turned into the entire month of September being declared Ovarian Cancer Awareness Month. Governors in many states including Florida and Illinois have issued their own proclamations to help raise awareness for this dreaded disease.

    Until there is a test, hope lies in raising awareness, among woman and their healthcare providers, for the subtle symptoms of ovarian cancer so action may be taken earlier before the disease has spread, when the chance for survival is high.

    Help us raise awareness by sending the Ovarian Cancer Alert (below) to every woman you know. Until there is a test, Awareness is best!!!

    Send an alert to every woman you know!

    Medical Update on Recurrent Ovarian Cancer
    March 11, 2004
    Tuesday April 27,2004
    1:30 - 2:30 PM EST

    A free Telephone Education Workshop for women living with ovariancancer, their families, friends, and health professionals.

    Presented by CancerCare and The National Ovarian Cancer National Alliance

    To register see:: http://www.cancercare.org

    HERA E Newsletter Winter Issue now Available!
    November 10, 2003
    The second HERA E-newsletter is up. Chock full of fun information and news. Click here to get your copy.

    HERA E Newsletter Makes Debut
    July 01, 2003
    Sean Patrick , Advocate
    The first HERA E newsletter is up. Chock full of fun information and news. Click here to get your copy.

    Events Related to Ovarian Cancer
    February 25, 2003
    Sean Patrick , Ovca Survivor

    Winter 2003/2004

    Winter Climb for Life Events
    In the first 4 months of 2004, REI and Black Diamond are teaming up with the HERA Foundation to take the Climb for Life to six geographic regions that include 28 stores and local rock gyms.

    The event is a month-long personal challenge that will allow individual climbers to test their climbing skills on specially designated Climb for Life routes and earn points towards prizes. Climbers will also be able to challenge their friends to support them by pledging dollars for research and awareness of ovarian cancer. Climbers raising the most money will also get special prizes.

    Each city event starts with a kick-off party that includes an inspirational talk by HERA founder, ovarian cancer survivor and climber Sean Patrick, refreshments, goodie bags for registered participants and a Peloton Productions Climb for Life documentary.

    A mid-month event will feature a climbing clinic by a nationally-known climber and a slide show. A wrap-up party will celebrate climbers' accomplishments and will include an awards ceremony.

    Other sponsors include Climbing Magazine, Beal Ropes and Franklin Climbing Equipment.

    For more information go to www.rei.com/climbforlife or contact customer service at participating stores for more information and a schedule of local events and participating gyms.

    May 2003

    HERA "Swing for Life"
    Tulsa, Oklahoma
    May 19, 2003

    The 2003 HERA Foundation Golf Scramble "Swing for Life" will take place to benefit ovarian cancer research and to help Tulsa women and their families battling the disease.

    The 2003 HERA Foundation Golf Scramble will be held on Monday, May 19, 2003, at The Tulsa Country Club located at 701 N. Union in Tulsa, OK. The format will be a four-person scramble limited to 112 entrants. Check-in will begin at 11:30, followed by lunch and use of the driving range. There will be one shotgun start at 1:00 p.m. Prizes will be awarded to at least the top two places from two blind flights.

    The Tulsa Country Club plays host to the top women golfers during the LPGA Williams Golf Championship. Last year¹s winner Annika Sorenstam will be back this year in September along with other well-known women golfers.

    Sponsors to date of the HERA Swing for Life include Civil Design Engineers, Dominion, Jackie Cooper Imports, Samson Energy and the Tulsa country Club. For more information please see their web page or contact Wendy Straatman at wstraatm@samson.com

    September 2003

    HERA "Climb for Life"
    Salt Lake City, Utah
    September 11 - 14, 2003

    The HERA Ovarian Cancer Climb for Life dates have been set 9/11 -9/14, 2003 in Salt Lake City. Black Diamond will once again be our host. Lisa Gnade and Nancy Feagin have committed to being there. As more "Rockstars" sign on we will keep you updated. A schedule will be posted soon. To register go to http://ovariancancer.jhmi.edu/climb. Or call 970 948 7360 for more information.

    Past Events

    The President of the United States of America proclaims September 2002 as National Ovarian Cancer Awareness Month
    September 10, 2002
    Click to view the press release. http://www.whitehouse.gov/news/releases/2002/08/20020830-4.htm

    Patient Treatment Survey
    July 25, 2002
    Researchers from the NCI and FDA are interested in studying women in treatment for ovarian cancer in an effort to understand the experience and provide guidance for other women. Read about the study and possibly participate.

    One Canadian Advocate Speaks Out
    June 18, 2002
    Sandi Pniauskas , Ovarian Cancer Patient and Advocate

    Submission to the Health Care Commission of Canada

    Sandi Pniauskas* Pamela J. West Ovarian Cancer RN, M.Sc., CON(C) Patient and Advocate Acute Care Nurse Practitioner Oncology May 30, 2002

    Introduction. Thank you for allowing me this opportunity to present my views regarding the ongoing debates concerning our Health Care system in Canada. The issues are overwhelming. There are many needs and enormous disparities. I will tell you that I have reviewed all the Submissions on your website that directly and indirectly affect Ovarian Cancer women. I have also communicated with Ovarian Cancer women across the Nation - from coast to coast. I consider it a privilege and an honour to be the voice of many of these women and to be able to express their views. I will tell you about dignity and care and respect and the human side of this woman's cancer. But, I also want to highlight about other realities as well. This is not for the faint of heart. I need to preface my remarks by saying that Ovarian Cancer women in this province, and in this country, value and appreciate the dedication and commitment of medical professionals who go above and beyond their duties in practicing quality patient care: not only quality care, but outstanding support of ovarian cancer women and their families as they face and endure daily obstacles. I witnessed this only this past Tuesday when visiting the Kingston Cancer Centre. Pam West, who is with me here today, exemplifies a real life example of true progression between patient and nursing. The support which Pam has provided to me and in turn our Ovarian Cancer community is not to be found elsewhere in the whole of this country. She recognized the need to educate and communicate. She allowed me the opportunity to teach nurses about ovarian cancer. We just decided - okay - let's do it and we did and we continue to do so. It has progressed from there. It does not have to be complicated. No budget, no meetings, no bureaucracy Please keep this in mind as you hear what I am about to say, as I do have some criticisms. Let me present a patient's perspective on what is not working and propose some solutions that can be put in place today, without draining our existing limited resources.

    Background. In order to understand what I am about to discuss, it is important that you appreciate the significance of a cancer women fear the most - Ovarian Cancer. Being diagnosed with ovarian cancer gives the connotation that this is a disease which comes with an automatic death sentence. This misconception permeates the minds of both only the public and health professionals. It does not have to be that way. In Canada in 2002, ovarian cancer has the highest mortality rate of all gynecologic cancers with an estimated annual mortality rate of 62% of all diagnosed cases. (1) To contrast this and to use the same criteria, the annual mortality rate of women's breast cancer is 26%. Colorectal cancer (a disease of both men and women) has a 37% annual death rate among its diagnosed. There are no screening tests, such as a PSA test in prostate cancer, colonoscopy in colorectal cancer or mammography in breast cancer. Seventy-five per cent of ovarian cancers are diagnosed in advanced stages resulting in a 5-year survival rate of approximately 25%. Approximately 78% of ovarian cancer women live at least one (1) year post diagnosis and the majority will die within two and a half (2*) years.(3) There have been no significant improved survival rates in years and decades.(14) The fact remains that ovarian cancer has a high rate of recurrence after surgery and other treatment modalities. There is no known cause of 90% of ovarian cancers. Five to ten per cent of women are pre-disposed due to genetic/familial links between ovarian/breast and ovarian/colorectal cancers. Ovarian cancer does not necessarily exist in isolation.

    As an example, if a woman is predisposed by carrying the HNPCC gene, her lifetime risk of colorectal cancer is 80%. A secondary cancer is also of grave concern in that it relates to the treatment of a first cancer (ie: leukemia as a direct result of chemotherapy and/or radiation therapy). There is also no established relationship between diet and smoking and ovarian cancers.(2) Often considered an "older" woman's disease, sadly (and fortunately uncommon), this disease may strike your young daughters. We, ovarian cancer patients, do not fit the mold of today's mantra of Healthy Lifestyle and Prevention. Sadly, these lifestyle and health issues have no relationship with Ovarian Cancer issues. In Canada, there is simply not enough attention paid to Ovarian Cancer. Barriers 1) Access to Specialized Care Ovarian Cancer women in this country deserve equal and fair access to services. Many women across this country use the term "luck" when speaking about their care. This "luck" refers to waiting times for surgery, waiting times in emergency care, waiting times for treatments and waiting times for doctors' appointments. All Canadian women must have access to gynecologic oncologists.

    International clinical evidence supports specialist care right from the onset of a suspicion of ovarian cancer. (4,5,6) Specific guidelines regarding the proper surgical procedures exist and need to be followed. In this country these guidelines are not being met (7,8,9) Surgery is one of the most important keys to ovarian cancer survival. In Canada, we are ignoring this evidenced-based research. The practical implementation is not happening. In fact, gynecologist/obstetricians still practice ovarian cancer surgery, when it should be left to gynecologic oncologists only. In doing this, I am reminded of the medical profession's code of ethics of "Do the least harm". Inadequate resources(10),including human resources, outdated diagnostic equipment, lack of knowledge and education: these key issues have been ignored. Allow me to share several experiences of ovarian cancer women, told to me over the past week. One woman stated that it would always be a thought in her mind that if she had proper surgical staging, maybe her tumour would not have ruptured. In another incident, a gynecologist's secretary told a woman that a specific doctor would "take very good care of her," meaning she did not need to see a gynecologic oncologist. It seemed like they were "selling/advertising" their services, which is impossible to understand. In addition, in both of these cases, gynecologic oncologists were available nearby, and waiting times were not an issue.

    In a third case, a woman recently went out of the country for a second opinion because in her province, there is no one to provide a second opinion. Last year, an ovarian cancer patient saw a general oncologist (not a gynecologic oncologist) because she was having significant symptoms of recurrence. This doctor performed an inappropriate physical exam and told her to come back in six months for a Catscan.

    So, here we stand. Ignorance of the disease and ignorance of adequate health care interventions.

    Treatment. Ovarian Cancer does not care where you live, and yet, from province to province there are gross disparities in the delivery of care and in the availability of chemotherapy drugs. Drug formularies or drug coverage (or lack of) prescription medication varies from province to province. A case in point relates to Gleevec™ (STI 571). While Gleevec™ clinical trials are accruing patients in Ontario, British Columbia has lifted Gleevec™ (STI 571) from it drug formulary.

    Another example would be Taxol in the recent past. Should patients diagnosed with ovarian cancer move to a province that will care for them in the fairest way? Community-based cancer centres are popping up all over Ontario without the foresight and/or ability to include/hire the appropriate staffing.

    Canadians have expressed their desire to receive access to care closer to home but at what expense? If the ovarian cancer patient fully understood that traveling to see a specialist could impact on her survival, there would be no decision. This should be obvious from recent examples of patients willing to travel outside of the country for treatment. In remote communities, this may be understandable. However, are we at the point in our Health Care system where any care is deemed better than no care? Women are sent home from hospital to die without the proper support mechanisms. Ovarian cancer women suffer excruciating pain because health care workers are not available. Women experience nausea because they have no private health care plan and cannot afford the costly anti-nausea medications. There is financial distress but families are too proud to talk about it; preferring to suffer in silence. I could tell you of a 'middle-class' family who could not afford the bus fare to send their children to the hospital to visit their dying Mom. Have we considered single Moms and elderly women who live on their own? Cancer pain at the close of life should not be a medical issue in 2002, but it exists because of an ineffective system that does not recognize the wider problem. We have choices and we need to make them right. 3) Quality of Care Quality of care not only surrounds the previously alluded to 'specialist' care but also includes diagnosis, treatment, counseling and follow-up care for a cancer which never goes away. Palliative care is a reality in ovarian cancer. We have leapt into a home care system with little resources and poor planning. We need to pay more attention to these realities. 4) Respect of Patient - Education - Awareness - Patients' Bill of Rights/Dispute Mechanism It is time for a new patient bill of rights, but not in the prevailing or traditional manner. I have had personal experience with a "Patient Advocate" and realized later that in fact this 'Patient Advocate' was more of a Hospital or Doctor Advocate. A Patients' Bill of Rights means one thing to an institution but something entirely different to a patient. There needs to be a forum or individual ombudsman for support when things go wrong and a protective mechanism in place without having to revert to legal counsel. Communication is key and, in fact, solves most issues. Who speaks for the patient? Patients are afraid to contact doctors because of physicians' time limitations and a fear that this may jeopardize future care. Sometimes, this is too late. It is incumbent upon Canadians, as a compassionate Nation, to stand by those who are in need and who are unable to advocate for themselves. Although this may represent a minority of cases, one case is one too many. Specifically ovarian cancer patients need education and resources from diagnosis to death, including not only the physical but the emotional support. Today when patients are diagnosed with ovarian cancer, many leave their doctor's office without any resources. They go home stunned, shocked and in fact totally emotionally isolated. We need to provide both the public and medical personnel with accurate information about ovarian cancer. Awareness will achieve many things. Most importantly, it will result in the detection of ovarian cancer in earlier stages when survival is much improved and women can return to their place in society as healthy and fully contributing members. No one wants this more than the patient herself. Ovarian Cancer patients are not abusers of our health care system: they just want their fair share of resources and supports. Overall, I am advocating that: 1) All women suspected of ovarian cancer will be referred to a gynecologic oncologist at onset of a suspicion of malignancy (exception noted - see #4) 2) All women will have initial surgery performed by a gynecologic oncologist (exception noted - see #4) 3) All women will be educated in an unbiased manner as to the survival advantages of specialized care; 4) In remote communities where a gynecologic oncologist is not available (and the patient does not wish to commute outside her community), a consultation between all affected parties will take place 5) All women at the time of initial will be given appropriate and timely educational material covering the basic facts of ovarian cancer; 6) A nationwide Ovarian Cancer education programme will be established in all communities - for both the public and health care professionals 7) A nationwide Ovarian Cancer Survivor panel will be established to ensure that a patient's opinion/participation is sought in any discussion or proposal (research or community/hospital based program).(12)

    Implementation. We acknowledge with evidenced-based medicine that ovarian cancer surgery and specialized care is required. The allocation of resources stretches far beyond me. However, if you educate family doctors regarding ovarian cancer then the mechanism for direct referral is already in place. You can circumvent the "middle man" in this case, gynecologic obstetricians, thereby relieving their workload. Time is money. Time is savings.

    There need not be more studies. There needs to be action. Education can start today. It can be done across this country with little cost. Seminars, community activities, communication through nursing associations and designated awareness campaigns: all are easy ways to share the message.

    Conclusions. Our universal health care philosophy is sound but needs to be updated to reflect the diversity of current needs and today's environment. We have to stop thinking about why things can't be done but rather what can be done. We need to honour the intellectual capabilities of patients and we need to operate in a manner of mutual respect and in a time frame conducive to doing so. We have internationally recognized researchers whose talents are wasted.(11,13) We need to find solutions to ovarian cancer mortality rates and we have people with a great desire and ability to do so. We need to scrap the politics because this truly is THE very one thing that stands in the way of progress. Lastly, we need to put a human face to our health care system.

    We need to find the will to do this. I truly believe the will exists on an individual basis but, collectively, we are in a mess. Communication + Will = Success + Benefits

    Thank you on behalf of Ovarian Cancer women in Canada

    Sandi Pniauskas
    117 Glen Hill Drive
    Whitby, Ontario, Canada L1N 6Z8

    (1) NCI Canadian Cancer Statistics 2002 Current Incidence and Mortality Estimated New Cases and Deaths for Cancer Sites by Gender, Canada, 2002

    (2) American Cancer Society 2001 e.5 Cancer Medicine

    (3) Excerpts: Management of Advanced-Stage Ovarian Cancer; Prescrire Int Feb 2002, Survival in familial, BRCA 1-associated, and BRCA-2-associated epithelial ovarian cancer; United Kingdom Coordinating Committee for Cancer Research, Familial Ovarian Cancer Study Group Cancer Res Feb 1999, Prognostic factors of stage IV epithelial ovarian cancer: a multicenter retrospective study; Gynecol Oncol 2001, Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai, Japan, Long-term follow-up of the Stockholm screening study on ovarian cancer; Gynecology Oncol Dec 2000; Gynecological Department, Radiumhemmet, Stockholm, Sweden

    (4) The Benefits of comprehensive surgical staging in the management of early-stage epithelial ovarian carcinoma, Gynecol Oncol May 2002 Le T, Adolph A; Krepart GV; Lotocki R; Heywood MS, Division of Gynecologic Oncology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada

    (5) Why American Women are not receiving state-of-the-art gynecologic cancer care Gershenson DM, Department of Gynecologic Oncology, The University of Texas, M.D. Anderson Cancer Center, Houston, Texas, USA Nov-Dec 2001

    (6) Surgical Management of Ovarian Cancer, Mutch DG, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Washington University School of Medicine, St Louis, MO, USA Feb 2002 (excerpt)

    (7) Surgical standards in the management of ovarian cancer, Robert E. Bristow, MD Johns Hopkins Hospital and Medical Institutions, Baltimore, Maryland, USA

    (8) Surgical Management of Ovarian Cancer David G. Mutch Seminars in Oncology Feb 2002

    (9) Implementation of Ovarian Cancer Surgery Guidelines Elit,L, Rosen,B, Anderson G, Thircuchelvan D, Department of Obstetrics and Gynaecology, McMaster University, Department of Obstetrics and gyneaecology, University of Toronto, Health Administration, Faculty of medicine, University of Toronto, Toronto, Research Services Unit, Public Health Science, University of Toronto, Toronto

    (10) A Shortage of Medical Oncologists at the McGill University Health Centre Prompts an Aggressive Recruitment Campaign March 2002 McGill University health Centre, Montreal, Quebec

    (11) First line chemotherapy in advanced ovarian cancer, Dan Grisaru Oncology Rounds from Princess Margaret Hospital, Toronto, Ontario February 2002

    (12) Cancer Survivor Involvement: California Cancer Research Program, Sacramento California, USA 2002

    (13) Canadian Institute for Health Research, Ottawa, Ontario - database search Funding years 1999-2003 - All Provinces/All Institutions - All Themes/All Classes/All Areas - Ovarian Cancer - total dollar amount for specified search criteria - $1,956,205

    (14) Distinguished Professor Series: Is There any Progress in the Outcome of Patients Suffering from Ovarian Cancer? Treatment Strategies

    Calendar of Events, Past Events
    June 05, 2002
    2002 Events, Past

    January 2002

    Special Wine tasting featuring women winemakers
    Toronto, Canada
    January 30, 2002

    Crowne Plaza Hotel, 6:30-9:30 pm. A preview tasting of the winter edition of the Classics tasting featuring 10 French women winemakers and their wines. All wines featured are available for front-of-the-line purchase at the Vintages order desk. Limited to 400 tickets. Price:$95.00 per ticket. A portion of the proceeds from ticket sales will be donated to the National Ovarian Cancer Association.

    February 2002

    Fourth Annual Ted Couch Cancer Research Lectureship & Reception: " Opening the Black Box of Cancer"
    Tampa, Florida
    February 4, 2002

    Moffitt Research Center presents a lecture for the general public featuring J. Michael Bishop, M.D., Chancellor, University of California, San Francisco, internationally recognized author on the molecular mechanisms of cancer and co-recipient of the 1989 Noble Prize in Medicine. The lecture will be held at 4 p.m. in the Moffitt Research Center Auditorium, 13131 Magnolia Drive, Tampa, on the University of South Florida campus. Please RSVP by January 30 to 1-888-MOFFITT (888-663-3488). Reception will follow presentation.

    Dancin' Through the Decades III
    Philadelphia, PA
    February 8, 2002

    Location: Knowlton Mansion, Fox Chase Cancer Center, $35 per person. Event is sponsored by Institutional Advancement. For additional information contact Kim Wagner at 215-728-3163, K_Wagner@fccc.edu or visit their website www.fccc.edu

    For A Woman in Your Life!
    Toronto, Canada- The Royal York Hotel
    February 14, 2002

    A downtown breakfast fundraiser will be held at the Royal York Hotel, 7am-9:30am. Guest speakers and door prizes-an uplifting way to begin Valentine's Day. For more information call 416-217-1266. Sponsored by NOCA

    March 2002

    Daffodil Days
    Gambrills, MD
    March 11-17, 2002

    Celebrate spring and the lives your donation will help save. Fresh cut daffodils and potted mini daffodils are offered to the public for a donation to the American Cancer Society. For more information or registration procedures, contact Peggy Morgan at 410-721-4304, email: pmorgan@cancer.org, or visit their website www.cancer.org

    Annual Daffodil Days Tee-Shirt Sale
    Baltimore, MD
    March 14-15, 2002

    Johns Hopkins Hopsital area. The Harry & Jeanette Weinberg Building Jefferson Street Lobby, 9am-3pm, Thursday, and Friday. All tee-shirts will be sold for $10.00. All proceeds from the sale of tee-shirts go directly to support the patient and family care programs of the ACS.

    Promotional Tour Bus Stop
    Baltimore, MD
    March 15, 2002

    Johns Hopkins Hopsital area. On Friday, March 15th from 9am-11am, the American Cancer Society will be making a stop at Hopkins during their national bus tour to raise awareness around the needs of cancer patients and families across the country. Please stop by to sign the tour bus to show your support. Refreshments will be served. The bus will be located on Jefferson Street, in front of the CRB.

    SGO 33rd Annual Meeting
    Miami Beach, FL
    March 16-20, 2002

    The Fontainebleau Hilton, Miami Beach, FL. For more information, visit their website www.sgo.org/meetings

    April 2002

    NOCC National sponsored "Walk/Run for the Whisper
    Tradewinds Park in Coconut Creek, Florida
    April 13, 2002

    A fun way for our members and friends alike to come together to raise awareness about this devastating disease. For additonal information visit http://www.ovarian.org/

    6th Annual Cancer Survivors Conference
    Philadelphia, PA
    April 13, 2002

    8:30AM- 4:00PM Holiday Inn, Presidential Blvd & City Avenue. For registration and other information contact Sonja Ogden-Clark at (215) 985-5330 or email sogdencl@cancer.org. Sponsored by the American Cancer Society

    May 2002

    5th Annual Sprint for Life 5K Run/Walk & Sprint for Sprouts Children's Run/Walk
    Houston, TX
    Saturday, May 4, 2002

    Begins at 7:30 am at 1400 Holcombe Blvd. Register online today at Sprint for life, or call (713) 792-2765 for information.

    New York City Revlon Walk/Run
    Times Square, New York City, finishing in East Meadow, Central Park
    Saturday, May 4th, 2002

    Join 40,000 participants in Times Square to kick off the fifth annual Revlon Run/Walk For Women. Men, women and children are invited to share in the excitement as we come together in a united effort to help eradicate women's cancers. Your participation in raising critical funds will work toward ensuring this bright future. Join the Fight! To register online http://www.revlonrunwalk.com

    9th Annual Revlon Run/Walk For Women
    Los Angeles, Ca.- Los Angeles Memorial Coliseum
    May 11, 2002 - Mother's Day Weekend

    Join the Fight Against Breast and Ovarian Cancer May 11th!
    Proceeds from the Revlon Run/Walk For Women are distributed to a variety of charitable organizations leading the fight against breast and ovarian cancer. For additional information, visit Revlon Run/Walk For Women

    Nutrition After Cancer
    Chicago, Illinois
    May 8, 2002

    The American Institute for Cancer Research presents a Conference on the Role of Diet and Cancer Survivorship. Location: Chicago Marriott Downtown at 9:45 AM - 3:30 P.M. For More information visit http://www.aicr.org/chiseminar.html

    Cancer, Culture and Literacy: Developing Effective Communication Strategies to Reduce Health Disparities
    Clearwater, Florida
    May 16-18, 2002

    The H. Lee Moffitt Cancer Center and Research Institute at the University of South Florida is sponsoring its third biennial conference, Cancer, Culture and Literacy: Developing Effective Communication Strategies to Reduce Health Disparities*, May 16-18, 2002, at the Sheraton Sand Key Resort in Clearwater, Florida. For more information about the conference, contact Ann Gordon at (813) 903-4975 or gordonac@moffitt.usf.edu.

    Sandi Childers Ovarian Cancer Awareness Benefit
    Merritt Island, FL
    May 18, 2002

    This annual event is being held in order to increase awareness of ovarian cancer on the Space Coast, as well as raise funds to help with awareness, support, and research into this most deadly disease. Included in the day's activities are a Co-Ed Softball Tournament, 5K-run/3K-walk, Craft Show, Live Music, Catered Seafood Lunch, Door Prizes & 50-50 Drawing, and a Candlelight Memorial. The National Ovarian Cancer Coalition (NOCC) is the official sponsor for the event, with a portion of the proceeds raised going to the Ovarian Cancer Research Fund (OCRF). For more information, please visit the event website at http://home.cfl.rr.com/ovarianbenefit

    June 2002

    National Cancer Survivors Day
    Sunday, June 2, 2002
    To organize or find a celebration in your area, call 615-794-3006 or e-mail: ncsd@aol.com .

    Celebrity Stroll
    Orlando, FL
    Sunday, June 2, 2002

    Includes a Fashion Show by Nordstrom's, featuring celebrities and well known business leaders. Sponsored by Florida Hospital Foundation to benefit Central Florida Women and Girls with Cancer. Bonnie Donihi of FL, an ovca survivor, will be honored with the May Brogan Celebration of Life Award at this event. Contact Florida Hospital Foundation at 407-303-2781.

    Healing and Renewal Retreat
    Derby, New York
    Saturday, June 8, 2002

    For Woman Cancer Patients and Survivors. Companions, friends and spouse may also attend. Sponsored they the National Cancer Coalition, NY Division.
    Location: St. Columban Center- 6892 Lake Shore Road. For more information call: Marcia VanDewark, President, NOCC - NY Division 716-207-8946

    Silent Auction and Theater production of "Guys and Dolls"
    Fredericksburg, VA
    Friday, June 14, 2002

    Sponsored by 93 WFLS and the Riverside Dinner Theater. Half of the $50 ticket price is tax deductible and donated to John Hopkins OvCa Research. Call Riverside Box Office at 540-370-4300.

    2nd Annual Joyce Kozloski Memorial 5K Run
    Brocton, NY
    Saturday, June 15th , 2002

    To benefit Ovarian Cancer Research at Roswell Park Cancer Institute.
    9:30 (walkers) - 10:30 (runners) T-shirts to all preregistered participants.
    Entry Fee: $10.00 by May 1st, $12.00 after (must preregister by May 24th for a T-shirt)
    For more information: Contact Amy Miller (716) 792-4578 Or www.joycekozrun.org

    River's Edge 2002 Women's Triathlon
    Naperville, IL
    Sunday, June 23, 2002

    Benefit to raise money for ovarian cancer research. Sponsored by The Ovarian Cancer Research Fund, Inc. Contact OCRF at 212-268-1002 or 800-873-9569 visit River's Edge website or http://www.ocrf.org .

    Super Saturday 5
    Water Mill, NY
    June 27, 2002

    Benefit to raise money for ovarian cancer research. Sponsored by The Ovarian Cancer Research Fund, Inc. Contact OCRF at 212-268-1002 or 800-873-9569 or e-mail: info@ocrf.org web: http://www.ocrf.org.

    8th Annual Swedish SummeRun Walk/Run
    Seattle, WA
    Sunday, June 28, 2002
    Begins at 7 am at corner of Madison and Minor. Benefits the Marsha Rivkin Center for Ovarian Cancer Research. Pre-registration $20, but $25 on race day. Call 206-386-2738 or e-mail ed.boyle@swedish.org .

    Bicycle Ride for Roswell
    Roswell, NY
    June 29, 2002

    From 9 to 100 miles at the University of Buffalo to raise funds for research and patient care at Roswell Park Cancer Institute in Buffalo, NY. Contact Roswell at http://www.ride4roswell.org or phone 716-845-8788 or Dorothy roybob5360@yahoo.com or phone at 716-285-2906.

    July 2002

    Philadelphia, PA
    July 14, 2002

    7:00 am - Philadelphia start. 8:00 am Voorhees start. 9:00 am Hammonton start. 9:30 am-3:30 pm riders arrive at endpoint in Lenape Park. 11:00 am BBQ lunch available at Lenape. 1:30 pm Survivor Ceremony.
    Foe additional information contact Gladys Handal at (215) 985-5400,e mail ghandal@cancer.org

    Golf Event
    Upper Marlboro, Maryland
    July 15, 2002

    Golfing event to benefit the American Cancer Society.
    Location: Marlborough Golf Club, 4720 John Rogers Blvd.
    Start time: 8:00AM - 12:00AM
    For additional information cocntact Marian Swift at (410) 721-4304, email marian.swift@cancer.org

    NIH State-of-the-Science Conference on Symptom Management in Cancer: Pain, Depression and Fatigue
    Bethesda, Maryland
    July 15 -17, 2002

    The conference will be held at Natcher Conference Center National Institutes of Health. For registration and additional information visit NIH

    8th Annual Swedish Summer Run/Walk
    Seattle, WA
    July 28, 2002

    Location: corner of Madison and Minor at 7 am. Benefits the Marsha Rivkin Center for Ovarian Cancer Research. Pre-registration $20, but $25 on race day. Call 206-386-2738 or e-mail ed.boyle@swedish.org

    August 2002

    Relay For Life of Prince William/Woodbridge
    Dumfries, VA
    August 2, 2002

    A fun-filled overnight activity that mobilizes communities across the country to celebrate survivorship, remember those who lost their lives to cancer, and raise money for the fight against cancer. This is an American Cancer Society signature activity. For additional general program information contact Ann M. Welch at (703) 938-5550, Email ann.welch@cancer.org

    Tennis Clinics
    Newport, RI
    August 24, 2002

    Tennis Clinics with tennis legends at the International Tennis Hall of Fame. Sponsored by Health Magazine’s Destination Health for the Ovarian Cancer National Alliance. Contact OCNA at 202-331-1332 or e-mail ocna@ovariancancer.org

    Shoot-Out Benefit Golf Tournament
    Stillwater, MN
    August 29, 2002

    Location: Oak Glen Country Club sponsored by Minnesota Ovarian Cancer Alliance. Prizes, dinner, auction. To play or sponsor a team, call 952-890-8775, 877-569-7612 or e-mail: kgavin@mnovarian.org.


    Kaleidoscope of Hope Walkathon
    Morristown, NJ
    September 7, 2002

    Kaleidoscope of Hope Walkathon to raise money for ovarian cancer research. Sponsored by The Ovarian Cancer Research Fund, Inc.
    Contact OCRF at 212-268-1002 or 800-873-9569 or e-mail: info@ocrf.org, web: http://www.ocrf.org

    Camp Mak-A-Dream
    Gold Creek, MT
    September 11-15, 2002

    Camp Mak-A-Dream is a camp for women who are fighting ovca. Campers limited to 56. Registration is on a first-come first-serve basis. Scholarships are available. Medical care is available. Contact Women’s OvCA Retreat, Camp Mak-A-Dream, PO Box 1450, Missoula, MT, 406-549-5987 or fax 406-549-5933 or e-mail camp@montana.com .

    Las Vegas to Join the HERA Ovarian Cancer Climb for Life
    Las Vegas, Nevada
    September 14,2002

    The Red Rocks Challenge will take place at the Powerhouse Climbing Center and Desert Rock Sports September 14th from 10am-6pm. Open to everyone - even non-climbers. Money raised will be presented at the national event in Salt Lake City September 19-22. The Ovarian Cancer Alliance of Nevada will be there to hand out materials and answer any questions about ovarian cancer. Sponsors to date include Red Rocks Community Bank, GC Wallace Engineering, Climbing Magazine, Powerbar, prAna and Nevada Woman. For more information call event organizer Stephanie Forte: 702 804 4799 or email climbforlifelv@msn.com

    Golf Event
    Crofton, MD
    September 16, 2002

    Golfing event to benefit the American Cancer Society. Contact Marian Swift at (410) 721-4304, email marian.swift@cancer.org

    Johns Hopkins Kelly Gynecologic Oncology Service Kicks Off Awareness
    Baltimore, MD
    September 17, 2002
    10 a.m. - 12 noon

    The Gynecologic Oncology Service hosts this commemorative event in the Outpatient Center Lobby at Johns Hopkins to support gynecologic cancer research, and remember and honor patients who have battled this disease.

    Celebration on the Hill
    Washington, DC
    September 18 - 20, 2002

    A national event designed to establish the American Cancer Society as the political force in the fight against cancer, both in Washington, DC and in communities across the country.
    For registration and additional information contact Carol White at (512) 919-1889, or email carol.white@cancer.org

    Ovarian Cancer National Alliance Conference
    Washington, DC
    September 19-21, 2002

    The Alliance will host its Fifth Anniversary Advocacy Conference at the Hyatt Regency on Capitol Hill in Washington, D.C.

    For the fifth year, the Alliance will bring together ovarian cancer survivors, caregivers, healthcare professionals, advocates and policymakers from across the nation to learn the latest developments in ovarian cancer research and treatments, survivorship issues, public policy and educational efforts, and organizational development tools.

    In addition to an Alliance birthday celebration, agenda highlights include sessions on emerging therapies, cutting-edge research, speaker and media training, and public policy.

    For more information: www.ovariancancer.org

    The HERA Ovarian Cancer Climb for Life
    Salt Lake City Utah
    September 19-22,2002

    This national event hosted by Black Diamond and the HERA Foundation brings together celebrated climbers Bobbi Bensman, Kitty Calhoun, Tiffany Campbell, Nancy Feagin, Stephanie Forte, Lisa Gnade, Anna Keeling, Mindy Shulak and many others for a weekend of climbing, slide shows, survivor events and raffles. For more information go to http://ovariancancer.jhmi.edu/climb To celebrate the life of a loved one, climbers will carry names for a tax deductible donation of $50 or more. See Giving on climb Website. The Climb for Life will benefit the Johns Hopkins Ovarian Cancer Initiative.

    Bay Area Weighs in with Climb for Life
    San Rafael, California
    September 20 and 22,2002

    Organized by Kristin Nute, Class 5 Climbing and Fitness in San Rafael, California will be helping to raise money and awareness for the HERA Ovarian Cancer Climb for Life. Details are still being finalized. For more information contact Kristin at 415 485 6931.

    Third Annual International Conference on Ovarian Cancer
    MD Anderson, Houston Texas
    September 20-22, 2001

    The goal of this conference is to bring together oncologists, scientists, gynecologists and general and/or family practitioners to discuss and present the most current information on ovarian cancer with the hope of finding a cure for this disease.

    A wide range of topics will be covered including histogenesis, imaging, prevention, early detection and treatment.

    While the conference is designed for doctors and scientists, patient advocates interested in attending should contact Valerie James 713 792 2765.

    Cincinnati to Hold Day of Climbing to Raise Awareness for Ovarian Cancer
    Cincinnati, OH
    September 21,2002

    As part of the HERA Ovarian Cancer Climb for Life, the Rockquest Climbing Center is holding a special day of climbing fun open to everyone. You do not have to be a climber to participate. The event happens Saturday 9/21 from 10 am to 4 pm at the Rockquest Climbing Center 3475 E Kemper in Cincinnati, OH. Claudia York, an ovarian cancer survivor and head of the local NOCC, will be on hand to answer questions and hand out materials on the disease. For more information contact: Chris Woods at info@rockquest.com

    Candlelight Vigil to increase Awareness of Women's Cancers
    Monument Circle, (Downtown) Indianapolis, IN
    September 21, 2001

    Sponsored by Ovar'coming Together, Indiana's group to increase awareness of and education about ovarian cancer in Indiana. No cost to participate.

    Call (317)-250-6827 or email sherrrid@scican.net

    Dinner and Dance
    Kingston, NY
    September 22,2001

    A dinner and dance starting at 6:30 PM at the Hillside Manor in Kingston. Live music by the Harvey Citron Band. Sponsored by the Linda Young Ovarian Cancer Support Program at Benedictine Hospital and Caring Together, The Northeastern New York Ovarian Cancer Support Network.

    For an invitation, call 845-334-3171 or e-mail surech@benedictine.org

    Ovarian Cancer 5K Run/Walk
    Indianapolis, Indiana
    September 22,2001

    We are pleased to announce a run/walk partnership between Ovar'coming Together and The Indianapolis Star newspaper! (www.indystar.com/community) Our two organizations are holding a joint run/walk event on Saturday morning September 22, that will benefit Ovar'coming Together and the cause of ovarian cancer.

    The StarStrides to Fight Ovarian Cancer Run/Walk is being held in conjunction with The Star's Women's Expo also held on Saturday. The run/walk event is being organized by Ken Long and Associates.

    Contact Ovar'coming Together at (317)-250-6827 or register on-line at www.kenlongassoc.com

    Walk for the Whisper
    Grapevine, TX and New York City
    Sept 22, 2001

    Sponsored by the Dallas/Fort Worth Chapter of NOCC. For more information fax 817-868-6610 or email nanperry@aol.com or rrossi@onramp.net

    Sponsored by the New York Chapter of NOCC. Call 888-ovarian.

    Delores Sawan 5k Memorial Run
    Akron, Ohio
    September 23,2001

    This first ever run is sponsored by the Delores Sawan Ovarian Cancer Fund through the Akron General Hospital. It will be held at Cuyahoga Valley National Park.

    For more information contact: Carolyn Sentelik 330 344 6437.

    Pathways to Healing Survivor Activity
    Philadelphia, PA
    September 25, 2002

    Seminar with speaker Deforia Lane, breakouts and panel discussion for cancer survivors, family members, or friends. Sponsored by the American Cancer Society.
    Contact Susan Kramer at (717) 231-5780, or email skramer@cancer.org

    Crusaders Ball
    Philadelphia, PA
    September 28, 2002

    This Black-Tie event provides an evening of dinner, dancing and a raffle drawing. There is also a Silent and Live Auctions, along with a “Champagne & Diamonds” chance and a “Heart of Roses” tribute. To raise funds which will be used by the American Cancer Society in the fight against cancer through research, education and community programs of prevention, detection and services to the patients and their families.

    Cost/registration fee contact Kathy Plaugher at (215) 985-5367, or email plaugher@cancer.org

    Ovarian Cancer Awareness Program for Women and Doctors
    Albany, NY
    Sept 28, 2001

    Free. Sponsored by Albany-Saratoga Dutch Apple Cruises and Caring Together, The Northeaster New York Ovarian Cancer Support Network. Wines and a selection of hot and cold hor d'oeuvres available during the cruise. At Dutch Apple Cruise Pier, 139 Broadway in Albany. Reservations required.

    Call Lorraine at 518-381-1178 or Linda at 518-783-9032 by Sept 23, 2001.

    Third Annual Carolyn A. Marks Walk for the Whisper
    Philadelphia, PA
    Sept 30, 2001

    Sunday at 1 PM on Kelly Drive. Sponsored by the Pennsylvania Chapter of NOCC. Call 610-346-9523 or e-mail jldonahue@enter.net

    Golf Event
    Phoenix, MD
    September 30, 2002

    Golfing event to benefit the American Cancer Society. Contact Jennifer McGreevy at(410) 781-4316.

    October 2002

    Tour de Triompe: The Joann Gaddy Grimes Bike Ride To Fight Cancer
    Greensboro, North Carolina
    October 7, 2001

    The seventh annual Joann Gaddy Grimes Bike Ride to Fight Cancer (Tour de Triomphe) Sunday, October 7, 2001 at 8:30 am. A group of people will ride 25, 50 or 100 miles to raise money for the Duke Comprehensive Cancer Center. The ride will begin and end at Hagan-Stone Park in Greensboro, North Carolina.

    For more information contact Jennifer Steinl at (336) 282-1700, email:jsteinl@triad.rr.com . Registration and other information can be found at bike2duke.org

    "Women’s Cancer Conference: Merging Science and Care"
    Rochester, MN
    October 11-12, 2002

    Conference sponsored by Mayo Women’s Cancer Program. To register call 507-266-4886 or e-mail:kgavin@mnovarian.org.

    Ovarian Awareness of Kentucky (O.A.K.)'s Informational / Outreach Seminar, "Fear of Recurrence"
    Louisville, Kentucky
    October 22, 2001

    St. Matthews/Eline Library, 2nd floor, 7pm. Cost: TBA.
    For more information call 502-721-8311 or 502-241-5499, email: ovarianawareness@yahoo.com, www.ovarian.homestead.com

    UJA/Federation of NY Task Force on Breast and Ovarian Cancer
    New York, NY
    October 31, 2001

    Starts 12:00 pm - 2:00 pm. The agenda for this meeting will include a legislative update; information on newly funded programs; and a discussion about future directions of the Task Force. Please call Mamie Banks at (212) 836-1698 for further information.

    November 2002

    Christmas Show at Rockefeller Center
    New York, New York
    Sunday, November 17, 2002

    2375 Woodward Avenue at 9 a.m. Contact: Jeanne DeVirgiliis, 215-728-2441 J_DeVirgiliis@fccc.edu
    *Sponsored by Fox Chase Cancer Center; Marlyn Fein Chapter, Board of Associates

    The Sister Run
    Melbourne,FL at Wickham Park
    November 23-24, 2001

    Sponsored by the Space Coast Ovarian Cancer Advocacy Group. Run starts at 8am on 24th. Pre-registration deadline postmarked November 16.
    Write P.O. box 360-357, Melbourne, FL 32936.

    Cancer Survivor Conference
    Bethlehem, PA
    November 17, 2002

    Activity for cancer survivors, family members, or friends. Lunch, keynote speaker and 2 workshop sessions. Sponsored by the American Cancer Society.
    Contact Marcie Grello at (888) 227-5445, or email mgrello@cancer.org

    December 2002

    Sweet Honey In The Rock
    Indianapolis, Indiana - Murat Theatre
    December 1, 2001

    Sponsored by Ovar'coming Together. The Grammy Award-winning female a cappella ensemble with musical talents that span hymns, gospel, jazz,will sings songs that relate to justice, activism, and the praises of love.

    Individual ticket sales, and VIP ticket packages are available. Contact Ovar'coming Together at 317.250.6827 for more information on this event.

    "Deep Fun: Serious and Silly Get Well"
    West Los Angeles, CA
    December 1

    Join us for a joyful workshop presented by Bernie DeKoven, the originator of the "play community" concept and author of numerous books. Cancer patients and their loved ones are invited to explore ways to integrate the silly and serious sides of themselves to support their fight for recovery. 11:00 a.m. - 1:00 p.m.

    The Wellness Community-West Los Angeles 2716 Ocean Park Blvd., Suite 1040 Santa Monica, CA 90405
    For more information, please call 310-314-2555.

    Return to Current Calendar of Events

    Ovarian Cancer and High-Risk Women: Implications of Prevention, Screening and Early Detection (May 6-7, 2002)
    November 26, 2001
    University of Pittsburgh Cancer Institute presents a program on ovarian cancer May 6-7, 2002. For more information, please see UPCI's Website

    Free Ovarian Cancer National Alliance Teleconference Features Hopkins Doctor
    October 19, 2001
    Sean Patrick , Ovca Survivor and Patient Advocate
    Update June 26, 2002: Conference now available online on CancerCare's Website: Conference

    Dr. Deborah K Armstrong will present a free workshop titled "Recurrent Ovarian Cancer: State of the Art Treatments", 1-2 pm ET on October 30, 2001.

    These popular Alliance teleconferences are presented in conjunction with Cancer Care, Inc.

    Do You Have Questions About Coping With Cancer?
    June 15, 2001
    Staying Active with Cancer
    When: June 20, 10 a.m.-12 noon
    Speakers: Cindy Masom, PT and Aline Hauber, OT
    Where: Johns Hopkins Medical Institutions, Weinberg Building, 1st Floor
    Baltimore, Maryland USA

    Each expert will be available to answer questions and provide handouts in the 1st floor lobby of the Weinberg building, by the Outpatient Waiting Area and elevators.

    Click here for information on exercise and energy during chemotherapy treatment.

    New Study Demonstrates Ovarian Cancer Has Recognizable Symptoms.
    April 16, 2001
    Sean Patrick , ovca survivor
    Sixty percent of women ages 35 -44 fear ovarian cancer, yet almost 80% do not know the warning signs or what they can do to reduce their risk, according to a new survey of 3200 women conducted by Harris Interactive.

    Until recently, the prevailing thinking was that early stage disease was asymptomatic (without symptoms). Talk to any ovca survivor and you will be told that yes she had symptoms, vague symptoms, that were usually diagnosed as something else.

    In an attempt to validate what ovca survivors were saying, a large study by Goff et al (full abstract: Cancer 89:2068-75, 2000) was completed of 1725 women with ovarian cancer representing 46 states. When asked about symptoms prior to the diagnosis of ovarian cancer, 95% reported symptoms, which were characterized as abdominal(77%), GI(70%), pain(58%), constitutional(50%), urinary(34%), and pelvic (26%). Only 11% of women with Stage I/II and 3% with Stage III/IV reported no symptoms prior to their diagnosis. Women who ignored their symptoms were more likely to be diagnosed with advanced stage disease than those who did not.

    This large national survey confirmed that the majority of women have symptoms and frequently have delays in diagnosis. Earlier detection may be possible if women and their doctors carefully evaluate abdominal and pelvic symptoms and avoid misdiagnosis.

    Raise the Awareness of Every Woman You Know
    Click on the OVCA Alert Button below to send important information on ovarian cancer.
    When ovarian cancer is caught early, before it has spread beyond the ovaries, 90% of the women will survive longer than five years. Awareness can save lives.

    Send an alert to every woman you know!

    Dr. Deb Armstrong Discusses Emerging Therapies in the Treatment of Recurrent Ovarian Cancer
    December 11, 2000
    This Question and Answer discusses angiogenesis inhibitors and targeted biologic therapies with Deborah Armstrong, MD, Medical Oncologist.

    Hopkins Researcher Presented New Findings at the International Symposium "Cancer Vaccines 2000" (Oct. 2-4)
    September 27, 2000
    Sean Patrick , OvCa Survivor
    Dr. Honami Naora was a a featured speaker during the October 2-4, 2000 international symposium in New York City sponsored by the Cancer Research Institute.

    Dr. Naora talked about new proteins identified by Hopkins researchers associated with the differentiation and development of ovarian tumors.

    The implications for patients in the long-term are that the proteins might represent biomarkers which could be used in early detection and could also have relevance as immunotherapeutic targets. " We believe these proteins could play a key role in the transformation of normal cells to tumor cells," Dr. Naora said. " Our initial findings are very exciting, but more work needs to be done."

    An abstract of Dr. Naora's research has been posted on this website.

    Hopkins Doctor was a Featured Speaker at the Ovarian Cancer National Alliance Conference in Washington DC (Sept. 20-23)
    September 04, 2000
    Sean Patrick , OvCa Survivor
    Dr. Deborah Kay Armstrong, Assistant Professor of Oncology, and Gynecology and Obstetrics at Johns Hopkins was a featured speaker at the National Ovarian Cancer Alliance's third annual conference: Ovarian Cancer, Silent No More. She spoke on "Emerging Treatments for the Treatment of Ovarian Cancer." The conference was September 20 -23, 2000 in Washington DC.

    Designed for ovarian cancer survivors, family and friends, healthcare providers, women's health advocates and public policy makers, the conference provides up-to-date information in a supportive atmosphere. Other topics at the 2000 Conference included: Ovarian Cancer Diagnosis: Results of a National Survey, Fertility Drugs, Hormone Replacement Therapy, Improving Tools for Early Detection and Diagnosis and Clinical Trials.

    September Is National Ovarian Cancer Awareness Month
    September 01, 2000
    In 1998 and 1999, President Clinton issued proclamations proclaiming one week in September, Ovarian Cancer Awareness Week. Since then support has grown nationally and the week of awareness has turned into the entire month of September being declared Ovarian Cancer Awareness Month. Governors in many states including Florida and Illinois have issued their own proclamations to help raise awareness for this dreaded disease.

    Until there is a test, hope lies in raising awareness, among woman and their healthcare providers, for the subtle symptoms of ovarian cancer so action may be taken earlier before the disease has spread, when the chance for survival is high.

    Help us raise awareness by sending the Ovarian Cancer Alert (below) to every woman you know. Until there is a test, Awareness is best!!!

    Send an alert to every woman you know!

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