What Is Ovarian Cancer? What Causes Ovarian Cancer?

Ovarian cancer is any cancerous growth that may occur in different parts of the ovary. The majority of ovarian cancers arise from the epithelium (outer lining) of the ovary. According to the American Cancer Society it is the 8th most common cancer among women in the USA (excluding non-melanoma skin cancers). In the UK ovarian cancer is the fifth most common cancer among females, after breast cancer, bowel cancer, lung cancer and uterine cancer (cancer of the uterus).


Approximately 5,500 women in the UK and 21,000 women in the USA are diagnosed with ovarian cancer each year. Worldwide, around 140,000 women die of ovarian cancer every year.


Tragically, the overall five year survival rate is only 46 per cent in most developed countries (it is lower for more advanced stages). However, according to the National Cancer Institute, if diagnosis is made early, before the tumor has spread, the five year survival rate is nearer 93 per cent. In 2009 scientists in the US said that current tests for diagnosing ovarian cancer are not good enough .



Visit our specialized news sections


Ovarian Cancer News


Cancer / Oncology News


Women's Health / Gynecology News


Menopause News


Breast Cancer News


Cervical Cancer / HPV Vaccine News


Even modern screening tests for ovarian cancer, which include a blood test for the CA 125 marker, combined with ultrasound, often result in unnecessary surgery and "..are failing to catch early signs of the disease..", a study at the University of Alabama at Birmingham Comprehensive Cancer Center revealed.
What are the ovaries?
The ovary is the female gonad, while the testis is the male gonad. A gonad is a reproductive gland that produces germ cells (gametes). A male sperm is a gamete, and a female egg is also a gamete. Each human gamete has 23 chromosomes, half the number of chromosomes contained in most types of human body cells.















The ovary, also known as the egg sac, is one of a pair of reproductive glands in women. The ovaries are located at either side of the uterus (womb), in the pelvis. Each ovary is about the size and shape of an almond. The ovaries produce ova (eggs) and female hormones, such as estrogen and progesterone. These hormones regulate the menstrual cycle, pregnancy, and control the development of female characteristics, such as body shape, body hair, breasts, etc.


During the female menstrual cycle, which lasts about one month, one egg is released from one of the two ovaries - the egg travels through the fallopian tube and into the uterus. This is known as ovulation.


Cancer of the ovary can spread to other parts of the reproductive system as well as surrounding areas, such as the stomach, vagina and uterus. Ovarian cancer more commonly occurs in women aged 65 or over, but can affect women of any age.
What is cancer?
Cancer is a class of diseases characterized by out-of-control cell growth. There are over 100 different types of cancer that occur in various parts of the body - each is classified by the type of cell that is initially affected.


Usually our cells divide (multiply, form new ones) only when old and dying ones need to be replaced. However, the controls that regulate when a cell divides as well as when a cell should die sometimes become faulty. This may result in cells not dying when they should, while additional cells are still being added - an uncontrolled accumulation of cells. Eventually a mass of cells is formed - a tumor.



Other interesting articles


What is cancer? What causes cancer?


What is chemotherapy? What are the side effects of chemotherapy?


What is breast cancer?


What is function of the lymph nodes?


What is ovulation? What is the ovulation calendar?


What is menopause? What are the symptoms of menopause?


What is pain? What causes pain?


What is endometriosis? What causes endometriosis?

Malignant and benign tumors


Tumors that stay in one place and demonstrate limited growth are usually considered to be benign. Malignant, or more dangerous tumors emerge when two things occur:

Invasion - the cancerous cell manages to move throughout the body using the blood or lymph systems, destroying healthy tissue - this process is called invasion.

Angiogenesis - the cancerous cells manage to divide and grow, making new blood vessels to feed themselves.

Metastasis


When a tumor manages to spread to other parts of the body and grows, invading and destroying other healthy tissues, it is said to have metastasized. This process itself is called metastasis, and the result is a serious condition that is extremely hard to treat.
Three main types of ovarian cancers (tumors)
Epithelial ovarian cancer is by far the most common form of ovarian cancer. Germ cell and stromal ovarian cancers are much less common. Ovarian cancer can also result from a cancer somewhere else in the body that has spread:

Epithelial ovarian cancer (epithelial ovarian tumors) - derived from cells on the surface of the ovary. It occurs mainly in adults.

Germ cell ovarian cancer (germ cell ovarian tumors) - derived from the egg-producing cells within the body of the ovary. This rare type of cancer more commonly affects children and teenage girls.

Stromal ovarian cancer (sex cord stromal tumors) - develops within the cells that hold the ovaries together.

Cancers from other organs in the body can spread to the ovaries - metastatic cancers - a metastatic cancer is one that spreads from where it first arose as a primary tumor to other locations in the body.

What are the symptoms of ovarian cancer?
In the early stages, ovarian cancer usually has vague symptoms which are not easy to recognize. In fact, doctors used to think that ovarian cancer had no symptoms (unfortunately, many still do). Even though healthcare professionals are much better at identifying ovarian cancer symptoms these days, patients often attribute their symptoms to other conditions, such as pre-menstrual syndrome, irritable bowel syndrome, or a temporary bladder problem.


The main difference between ovarian cancer and other possible disorders is the persistence and gradual worsening of symptoms. While most digestive disorders have fluctuating symptoms, those of ovarian cancer are more constant and steadily advancing.


The following are examples of possible early symptoms of ovarian cancer:

Pain in the pelvis
Pain on the lower side of the body
Pain in the lower stomach
Back pain
Indigestion or heartburn
Feeling full rapidly when eating
More frequent and urgent urination
Pain during sexual intercourse
Changes in bowel habits, such as constipation

As ovarian cancer progresses these symptoms are also possible:

Nausea
Weight loss
Breathlessness
Fatigue (tiredness)
Loss of appetite

Ovarian cancer is not a silent killer. A study by the National Breast and Ovarian Cancer Centre, Australia, found that 83% of women experience at least one symptom of ovarian cancer in the year prior to their diagnosis. The researchers also found that 17% of women waited more than three months after the onset of their symptoms before visiting their doctor, with 8% waiting more than six months. The most common symptoms, experienced by half of the study participants, were abdominal symptoms such as fullness and pain. Bloating, bowel or urinary symptoms were reported by approximately one third of participants.


If you experience bloating, pressure or pain in the abdomen or pelvis that persists for more than a few weeks you should see your doctor immediately. If you have already been to the doctor and ovarian cancer was not diagnosed, but treatment is not relieving symptoms, either see your doctor again or get a second opinion. It is important that the evaluation includes a pelvic examination.


People with close family members who have/had ovarian or breast cancer should see a doctor who is trained to detect ovarian cancer.
What are the causes of ovarian cancer?
Although we know that ovarian cancer, like many other cancers, is caused by cells dividing and multiplying in an unordered way, nobody completely understands why cancer of the ovary occurs. We know that the following risk factors are linked to a higher chance of developing the disease:


Family history


Most women who develop ovarian cancer do not have an inherited gene mutation. Women with close relatives who have/had ovarian cancer, as well as breast cancer, have a higher risk of developing ovarian cancer compared to other women. There are two genes - BRCA1 and BRCA2 - which significantly raise the risk. The BRCA1 and BRCA2 genes also raise the risk of breast cancer. Those genes are inherited. The BRCA1 gene is estimated to increase ovarian cancer risk by 35% to 70%, and the BRCA2 by 10% to 30%. People of Ashkenazi Jewish descent are at particularly high risk of carrying these types of gene mutations.


Women with close relatives who have/had colon cancer, prostate cancer or uterine cancer are also at higher risk of ovarian cancer.


Genetic screening can determine whether somebody carries the BRCA1 and/or BRCA2 genes. Although a test for gene mutations known to significantly increase the risk of hereditary breast or ovarian cancer has been available for more than a decade, a study by researchers from Massachusetts General Hospital found that few women with family histories of these cancers are even discussing genetic testing with their physicians or other health care providers.


After eight years of searching, an international team of scientists found that a single nucleotide polymorphisms (SNP) on chromosome 9 that is uniquely linked to ovarian cancer. The scientists estimated that women carrying that particular version of the SNP on both copies of chromosome 9 have a 40 per cent higher lifetime risk of developing ovarian cancer than women who do not carry it on either copy of chromosome 9, while women with only one copy of the variant have a 20 per cent higher lifetime risk of developing ovarian cancer than women who have none.


Age


The majority of ovarian cancers occur in women over 65 years of age. A higher percentage of post-menopausal women develop ovarian cancer compared to pre-menopausal women.


High number of total lifetime ovulations


There is a link between the total number of ovulations during a woman's life and the risk of ovarian cancer. Four principal factors influence the total:

Never having been pregnant - women who have never become pregnant have a higher risk of developing ovarian cancer compared to women who have became pregnant. The more times a woman has become pregnant the lower her risk is.

Never having taken the contraceptive pill - women who have never been on the contraceptive pill have a higher risk of developing ovarian cancer compared to women who have. Taking the Pill for 15 years halves the risk of ovarian cancer, a study by the Collaborative Group on Epidemiological Studies of Ovarian Cancer found.

Early start of menstruation (early menarche) - women who started their periods at an early age have a higher risk of developing ovarian cancer.

Late start of menopause - women whose menopause started at a later age than average have a higher risk of developing ovarian cancer.

Scientists at the Centers for Disease Control and Prevention (CDC) found that survival among women with ovarian cancer is also influenced by age of menarche (when periods start) and total number of lifetime ovulatory cycles.

Some gynecologic surgeries may reduce the risk


Women who have had their fallopian tubes tied (tubal ligation) are estimated to have a 67% lower risk of ovarian cancer. A hysterectomy is said to reduce the risk by about one third.


Infertility or fertility treatment


Some studies have found a link between infertility treatment and a higher risk of ovarian cancer. Nobody is yet sure whether the risk is linked to infertility treatment, just infertility itself, or both. A Danish study published in the peer-reviewed British Medical Journal concluded that the use of fertility drugs does not increase a woman's risk of developing ovarian cancer. The study involved 54,362 women with infertility problems referred to all Danish fertility clinics between 1963 and 1998.


Breast cancer


Women who have been diagnosed with breast cancer have a higher risk of developing ovarian cancer.


HRT (Hormone replacement therapy)


HRT slightly increases a women's risk of developing ovarian cancer. Experts say the risk grows the longer the HRT continues, and returns to normal as soon as treatment stops. Danish scientists reported that compared with women who have never taken hormone therapy, those who currently take it or who have taken it in the past are at increased risk of ovarian cancer, regardless of the duration of use.


A UK study that was published in the peer-reviewed medical journal The Lancet suggested that between 1991 and 2005, an extra 1,000 women in the UK died of ovarian cancer because they were on Hormone Replacement Therapy.


Foods high in acrylamide


A study in the Netherlands found a link between acrylamide, a carcinogenic compound found in cooked, and especially burned, carbohydrate rich foods, and increased risk of endometrial and ovarian cancer in postmenopausal women.


Obesity/overweight


Being obese or overweight increases the risk of developing many cancers. The more overweight you are, the higher the risk. Several studies have also shown that obese cancer patients are more likely to have faster advancing ones compared to cancer patients of normal weight. Obese older women who have never used hormone replacement therapy have nearly twice the risk of their normal weight peers of developing ovarian cancer, according to a study by the researchers at the National Cancer Institute.


Endometriosis


Women who develop endometriosis have an approximately 30% higher risk of developing ovarian cancer compared to other women. Endometriosis is a condition in which cells that are normally found inside the uterus (endometrial cells) are found growing outside of the uterus. Danazol, a medication used to treat endometriosis has been linked to ovarian cancer risk.
Diagnosis of ovarian cancer
There is a tragic myth among many health care professionals and patients in too many countries about early stage ovarian cancer having no symptoms. A UK study, called The Target Ovarian Cancer Pathfinder study which surveyed 400 UK general practitioners and over 1,000 women, including 132 with ovarian cancer, found that 80% of GPs in the UK were wrongly of the view that women have no symptoms in the early stages of ovarian cancer. Studies in countries with top healthcare services have come up with similar findings.


The GP (general practitioner) will carry out a vaginal examination and check for any visible abnormalities in the uterus or ovaries. The doctor will also check the patient's medical history and family history. Further tests will be ordered - these are usually done by a gynecologist - a doctor who specializes in treating diseases of the female reproductive organs.


If the woman is diagnosed with ovarian cancer the doctor will want to identify its stage and grade. The stage of a cancer refers to the cancer's spread while the grade refers to how aggressively it is spreading. By identifying the stage and grade of the cancer the doctor will be able to decide on the best treatment. The stage and grade of ovarian cancer alone cannot predict how it is going to develop.


The following tests are used to diagnose ovarian cancer:

Blood test


There is a cancer marker called CA 125 (cancer antigen 125) which is made by certain cells in the body. A high blood level of CA 125 may indicate the presence of cancer, but could also be due to something else, such as infections of the lining of the abdomen and chest, menstruation, pregnancy, endometriosis, or liver disease. This blood test is just one test among others, designed to help the doctor make a diagnosis. Normal blood levels of CA125 alone do not definitely mean there is no cancer either. They are just indications.

Ultrasound


This is a device that uses high frequency sound waves which create an image on a monitor of the ovaries and their surroundings. A transvaginal ultrasound device may be inserted into the vagina, while an external device may be placed next to the stomach. Ultrasound scans help doctors see the size and texture of the ovaries, as well as any cysts.

Laparoscopy and possibly Endoscopy


A laparoscope - a thin viewing tube with a camera at the end - is inserted into the patient through a small incision in the lower abdomen. The doctor can examine the ovaries in detail, and can also take a biopsy (extract a small sample of tissue for examination). The patient will undergo a general anesthetic for this procedure. The doctor may carry out an endoscopy to determine whether the cancer has spread to the digestive system.

Colonoscopy


If the patient has had bleeding from the rectum, or constipation the doctor may order a colonoscopy to examine the large intestine (colon). The colonoscope - a thin tube with a camera at the end - will be inserted into the rectum.

Abdominal fluid aspiration


If the patient's abdomen is swollen the doctor may decide to carry out this test. A build up of fluid in the abdomen might indicate that the ovarian cancer has spread. A thin needle goes through the skin into the abdomen and a sample of the liquid is extracted. Some of the liquid may be drained into a bag if there is a lot of it (abdominal tap). The fluid is checked in the laboratory for cancer cells.

Chest X-ray


This test will help the doctor see if the cancer has spread to the lungs, or to the pleural space surrounding the lungs.

CT (computerized tomography) scan


X-rays are used to create a 3-dimensional picture of the target area.

MRI (magnetic resonance imaging) scan


Magnets and radio waves produce 2-dimensional and 3-dimensional pictures of the target area.


Combined positron emission tomography (PET) and computed tomography (CT) scanning of patients in the early stages of ovarian cancer can enable physicians to determine whether the cancer has spread to nearby lymph nodes without having to perform surgery, reported scientists at San Gerardo Hospital, Monza, Italy.

The 4 stages of ovarian cancer
Ovarian cancer is classified into four stages, with stage 4 being the most advanced.

Stage 1 - the cancer is confined to one or both ovaries. This is subdivided into three groups:



Stage 1a - the cancer is confined to just one ovary (contained inside it).
Stage 1b - the cancer is confined to both ovaries (contained inside them).
Stage 1c - either 1a or 1b, but there is come cancer on the surface of one or both ovaries, or cancer cells are found in fluid extracted from inside the abdomen during surgery, or the ovary bursts during or before surgery.


Stage 2 - the cancer has spread to the uterus, fallopian tubes or some other areas in the pelvis (tummy area). This is subdivided into 3 groups:



2a - the cancer has spread into the uterus (womb) or the fallopian tubes.
2b - the cancer has spread into other tissues in the pelvis, such as the rectum or bladder.
2c - 2a and 2b, and there is cancer on the surface of one or both ovaries, or cancer cells are identified in fluid extracted from inside the abdomen during surgery, or the ovary bursts during or before surgery.


Stage 3 - the cancer has spread into the peritoneum (the lining of the abdomen), or to the lymph nodes in the upper abdomen, groin or behind the uterus. Most ovarian cancers are diagnosed at this stage. This stage is divided into three subgroups:



3a - an examination with a microscope of tissue taken from the peritoneum (lining of the abdomen) or the omentum (fatty layer over the top of the intestines) detects cancer cells.
3b - tumor growths are identified in the peritoneum 2cm or smaller.
3c - tumor growths larger than 2cm are identified in the peritoneum. Cancer is found in the lymph nodes in the groin, behind the womb or the upper abdomen.


Stage 4 - the cancer has spread beyond the abdomen to other parts of the body, including such organs as the lungs or the liver. If cancer is just found on the surface of the liver, but not inside it, it is still stage 3.

What is the treatment for ovarian cancer?
Treatment for ovarian cancer consists of surgery, chemotherapy, a combination of surgery with chemotherapy, and sometimes radiotherapy. The kind of treatment depends on many factors, including the type of ovarian cancer, its stage and grade, as well as the general health of the patient.


Some studies have indicated that specialized hospitals tend to have better survival rates for ovarian cancer patients, compared to general hospitals. Dutch ovarian cancer patients who were treated at a semispecialized or specialized hospital survived longer than those treated at a general hospital, reported researchers at the University Medical Center Utrecht in The Netherlands.


Surgery


The surgical removal of the cancer is performed in the vast majority of ovarian cancer cases, and is often the first treatment the patient will undergo.


Unless the ovarian cancer is very low grade, the patient will require an extensive operation that includes the removal of both ovaries, the fallopian tubes, the uterus, nearby lymph nodes, and the omentum (a fold of fatty abdominal tissue). Cancer often spreads into the omentum. In most cases the operation will be carried out by a gynecologic oncologist surgeon - a specialist in surgery for women with cancer of the reproductive organs. This operation, sometimes referred to as a total hysterectomy, will mean that the woman will begin her menopause immediately. Recent research by Canadian scientists found that premature removal of the ovaries increases the risk of lung cancer.


If the cancer is confined to just one of the ovaries the surgeon may just remove the affected ovary and the adjoining fallopian tube. The woman will have a chance of being able to conceive. If both ovaries are removed it will not be possible to conceive.


Surgery for ovarian cancer will require a hospital stay of up to two weeks, plus a recovery period of at least six weeks when the patient gets back home.


Chemotherapy


Chemotherapy is the use of chemicals (medication) to treat any disease - more specifically in this text, it refers to the destruction of cancer cells. Cytotoxic medication prevents cancer cells from dividing and growing. When health care professionals talk about chemotherapy today, they generally tend to refer more to cytotoxic medication than others. Chemotherapy for ovarian cancer, as well as most other cancers, is used to target cancer cells that surgery cannot or did not remove.


Patients will typically receive a combination of carboplatin (Paraplatin) and paclitaxel (Taxol) intravenously (injected into the bloodstream). As it is injected into the bloodstream it can target cancer cells in the reproductive system, as well as any cancer cells that may have reached elsewhere in the body.


Treatment usually involves 6 to 12 chemotherapy sessions which will be given three to four weeks apart so that the body has time to recover. One session usually consists of a 3-hour gradual injection of the medicine into the body; sometimes it may be extended to 24 hours. Extended injections require an overnight stay in hospital.


Compounds in cranberries may help improve the effectiveness of platinum drugs that are used in chemotherapy to fight ovarian cancer, scientists at Rutgers University found.



Monitoring response to chemotherapy


Tests will be carried out to determine how well the chemotherapy is working. This will include blood tests to see if levels of CA125 have dropped, and imaging scans to see if tumors have shrunk. Sometimes the surgeon may want to have another look inside.


The patient will be in remission if all tests are clear of cancer. In remission means the cancer is under control.


If cancer is still present after chemotherapy treatment doctors will switch to other treatments. Patients who did not respond well to a specific type of chemotherapy treatment are unlikely to respond well if the same treatment is done again. This may involve another type of chemotherapy, such as intraperitoneal chemotherapy, in which the medication is aimed at the stomach, or radiotherapy.


Researchers in the Duke Comprehensive Cancer Center reported that the addition of a chemotherapeutic drug for leukemia - dasatinib (Sprycel) - to a standard regimen of two other chemotherapy drugs appears to enhance the response of certain ovarian cancers to treatment, according to a pre-clinical study. Study leader, Deanna Teoh, M.D. said "These findings indicate that we may be able to direct the use of a targeted therapy like dasatinib based on gene expression pathways in select ovarian cancers."


Side effects of chemotherapy


Chemotherapy targets rapidly dividing cells. Unfortunately, healthy rapidly dividing cells, such as red and white blood cells and hair follicles may also be affected. The severity and types of side effects depend on the type of medication, number of treatments, and some aspects of the patient and their general health. This may result in the following side effects:

Nausea, vomiting - medication for this may be given intravenously during chemotherapy sessions.
Diarrhea.
Hair loss.
Loss of appetite.
Mouth sores.
Anemia.
Infections because the white blood cell count is low (leucopenia).

In the vast majority of cases the damaged healthy cells repair themselves rapidly after treatment is over and the side-effects will soon disappear.


Radiotherapy


Radiation is not the mainstay of ovarian cancer treatment - it is not generally considered effective for ovarian cancer. It may be used if there are small traces of cancer in the reproductive system, or to treat the symptoms of advanced cancer. External radiotherapy may be used to clear traces of cancer left after chemotherapy, while internal radiotherapy may be used for advanced cancer. Radiotherapy may cause the following symptoms; some symptoms may not appear until a long time after treatment is over:

Bladder infections
Diarrhea
Constipation
Irritation, darkening of your skin that the radiation beams hit
Nausea
Frequent urination
Abdominal pain

Diptheria toxin-enconding DNA


Scientists at Lankenau Institute for Medical Research found that nanoparticle delivery of diphtheria toxin-encoding DNA selectively expressed in ovarian cancer cells reduced the burden of ovarian tumors in mice. Lead researcher, Janet Sawicki, Ph.D said "We now have a potential new therapy for the treatment of advanced ovarian cancer that has promise for targeting tumor cells and leaving healthy cells healthy.".





View drug information on Sprycel; Taxol.

Breast Enlargement Surgery Linked To Boost In Self-Esteem And Sexuality

Women who undergo breast enlargement often see a sizable boost in self-esteem and positive feelings about their sexuality, a University of Florida nurse researcher reports.



Although plastic surgery should not be seen as a panacea for feelings of low self-worth or sexual attractiveness, it is important for health-care practitioners to understand the psychological benefits of these procedures, says Cynthia Figueroa-Haas, a clinical assistant professor at UF's College of Nursing who conducted the study. The findings - which revealed that for many women, going bigger is better - appear in the current issue of Plastic Surgical Nursing.



"Many individuals, including health-care providers, have preconceived negative ideas about those who elect to have plastic surgery, without fully understanding the benefits that may occur from these procedures," said Figueroa-Haas, who conducted the study for her doctoral thesis at Barry University in Miami Shores before joining the UF faculty. "This study provides the impetus for future studies related to self-esteem, human sexuality and cosmetic surgery."



In 2005, 2.1 million cosmetic surgical procedures were performed, according to the American Society for Aesthetic Plastic Surgery. That figure is expected to grow. Consider that the number of breast augmentation procedures alone increased a staggering 476 percent since 2000, according to the American Society of Plastic Surgeons. More than 2 million women in the United States have breast implants, and this year more than 360,000 American women will undergo breast augmentation.



Figueroa-Haas studied 84 women who were 21 to 57 years old, assessing their perceptions of self-esteem and sexuality before and after cosmetic breast augmentation. Study participants had been previously scheduled for breast augmentation and were undergoing the procedure solely for cosmetic purposes. Eligible candidates were mailed a consent form, a demographic questionnaire and pre-tests asking them to rate their self-esteem and sexuality. They were then mailed a similar post-test two to three months after the surgery.



Improvements in the women's self-esteem and sexual satisfaction were directly correlated with having undergone breast augmentation. Figueroa-Haas used two widely accepted scientific scales to measure self-esteem and sexuality, the Rosenberg Self-Esteem Scale and the Female Sexual Function Index, which assesses domains of sexual function, such as sexual arousal, satisfaction, experience and attitudes.



The participants' average self-esteem score increased from 20.7 to 24.9 on the 30-point Rosenberg scale, and their average female sexual function score increased from 27.2 to 31.4 on the 36-point index. Of note, after the procedure, there were substantial increases in ratings of sexual desire (a 78.6 percent increase from initial scores), arousal (81 percent increase) and satisfaction (57 percent increase). Figueroa-Haas did point out that a small number of participants showed no change in their levels of self-esteem or sexuality after surgery.
















With a heightened interest in men's sexuality issues in recent years, the research sheds light on women's sexuality, and how plastic surgery can improve and enhance this important area of life, Figueroa-Haas said.



"So much attention is directed to men's sexuality issues; we have all seen countless commercials on drugs and therapy devoted to improving men's sexuality. Unfortunately, very little is discussed regarding women's sexuality issues," Figueroa-Haas said. "I strongly believe that my research shows that interventions such as cosmetic plastic surgery can address these sorts of issues for some women. For example, those women who may have breast changes due to nursing or from the inevitable natural aging process. These women may not feel as attractive, which could ultimately negatively impact their levels of self-esteem and sexuality."



Figueroa-Haas warned that women should not view plastic surgery as a cure-all for any self-esteem and sexuality woes. In fact, ethical plastic surgeons should screen for this type of behavior and rule out potential patients who may have more serious psychological issues, she said.



"There may be patients who will never be satisfied with their bodies no matter how much surgery they receive or feel that their life will completely change after plastic surgery," Figueroa-Haas said. "These are not ideal candidates for surgery and should seek further counseling to address their underlying psychological issues. But for women who seek improvements in certain physical areas, plastic surgery can be a very positive experience."



Further research should be conducted to assess significant psychosocial issues that may arise after plastic surgery, said Figueroa-Haas, adding that her study helps call attention to the need for health-care providers to be able to predict outcomes in this specialized population.



"Since plastic surgery is increasing dramatically, my intention for researching this topic was to evaluate nurses' attitudes toward cosmetic surgery patients and make recommendations for increasing awareness of the factors surrounding these patients," Figueroa-Haas said. "Nurses should display compassion and understand an individual's reason for seeking cosmetic surgery instead of dismissing or stereotyping these patients. This study shows that there are genuine psychological improvements that follow plastic surgery, and these issues must be understood and respected."







Contact: Tracy Brown


University of Florida

Advaxis Doses First Cervical Dysplasia Clinical Trial Patient

Advaxis, Inc., (OTCBB: ADXS), the live, attenuated Listeria monocytogenes (Lm) biotechnology company, has dosed the first patient in its US Food and Drug Administration (FDA)-approved, phase II clinical trial in cervical intraepithelial neoplasia (CIN), commonly known as cervical dysplasia.


The clinical trial is slated to be a multicenter, randomized, placebo controlled, blinded clinical trial of ADXS11-001 -Advaxis' lead immunotherapeutic candidate. The dosing was administered at the site of Dr. Keith Aqua, M.D. of the Institute for Women's Health & Body.


"Dosing the first patient is a significant milestone for our company," commented Advaxis Chairman/CEO Thomas A. Moore. "It is a highly awaited development amongst all Advaxis and immunotherapy followers, at large; following the recent Dendreon Corporation (Nasdaq: DNDN) FDA approval. We look forward to completing and reporting the first dosing leg over approximately the next fifteen (15) months."


About the Institute for Women's Health & Body


The Institute for Women's Health & Body in Wellington, Florida is Advaxis' first clinical trial site in this multicenter study. The principal investigator at the Institute for the trial is Dr. Keith Aqua, M.D. - an experienced clinical investigator in the development of new therapies for women's health. His center has two (2) Florida sites with 84,000 active patients and conducts over 2,000 Pap smears, per month.


About Advaxis' Cervical Dysplasia (CIN) Trial


Advaxis has initiated the Company's first clinical trial site in its randomized, single blind, placebo-controlled, Phase II clinical trial of ADXS11-001 for the treatment of cervical intraepithelial neoplasia (CIN). The study is designed to assess the safety and efficacy of ADXS11-001 for the treatment of CIN grade 2/3 commonly known as cervical dysplasia.


About Cervical Dysplasia (CIN)


Cervical dysplasia is the precursor condition to cervix cancer, which is diagnosed in 450,000 American women annually. Progressive CIN is currently treated with surgery to prevent cancer from occurring; however, this treatment is associated with a number of problems, which include the development of an "incompetent cervix" i.e., a condition that prevents women from carrying a baby to full term. The typical CIN patient is a woman between 25 and 45 years of age. Although surgery is a viable short-term solution for the condition, it does not address the cause of the disease, which is a human papilloma virus (HPV) infection. Women who require surgery once may need it again. Current HPV vaccination products have not demonstrated effectiveness against active HPV infections.


Source

Advaxis, Inc.

Policy Statement Renews Controversy Over U.S. Efforts To Address Female Genital Mutilation

A recent American Academy of Pediatrics policy statement on female genital mutilation is drawing strong reactions from some human rights advocates and renewing debate over how U.S. physicians should address the issue with immigrant patients who seek genital cutting for their daughters, Time reports.

The policy statement urged physicians to inform parents that genital cutting has no medical purpose and many potential harms. It also changed AAP's language from "female genital mutilation" to "female genital cutting" (Luscombe, Time, 5/11).

AAP said that some doctors who work closely with immigrant populations in which FGM is endemic have noted that U.S. criminalization of FGM has led to adverse effects, including a concern that some families might send their daughters overseas for the ritual (Women's Health Policy Report, 5/7). The statement said, "It might be more effective if federal and state laws enabled pediatricians to reach out to families by offering a ritual nick as a possible compromise to avoid greater harm."

Dena Davis, the lead author of the policy statement and a professor at the Cleveland-Marshall College of Law at Cleveland State University, said, "We knew that it was a controversial idea." She added, "We knew simply making the language more neutral was highly controversial."

AAP acknowledges that it did not consult with communities that practice FGM about whether a ritual nick would be considered acceptable. Davis said that AAP does not have exact figures on "how many families take their daughters overseas" for FGM but that the group "heard anecdotally from doctors who had fears that it had happened."

The policy statement noted that many women from African countries strongly believe that any compromise on the issue "would legitimize even the most minimal procedure." However, the statement added that "in some countries where FGC is common, some progress toward eradication or amelioration has been made by substituting ritual nicks for more severe forms."

Taina Bien-Aime, executive director of the human rights group Equality Now, said, "Encouraging pediatricians to perform FGM under the notion of 'cultural sensitivity' shows a shocking lack of understanding of a girl's fundamental right to bodily integrity and equality." Bien-Aime added, "If foot-binding were still being carried out, would the AAP encourage pediatricians to execute a milder version of this practice?" (Time, 5/11).


Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.


© 2010 The Advisory Board Company. All rights reserved.

Bristol Palin Named Ambassador For Teen Pregnancy Prevention Group

Bristol Palin, the daughter of Alaska Gov. Sarah Palin (R), is promoting teenage pregnancy prevention as a teen ambassador for the Candie's Foundation, an organization that educates teens about the consequences of pregnancy, the AP/Cleveland Plain Dealer reports. Bristol Palin gave birth in December 2008 after an unintended pregnancy. She is scheduled to participate in a town hall meeting on Wednesday to coincide with the National Day To Prevent Teen Pregnancy. Palin said, "I feel that I could be a living example of the consequences of teen pregnancy." Neil Cole, founder of the Candie's Foundation, said, "With Bristol's participation, we hope to reach millions of teens with our message" (AP/Cleveland Plain Dealer, 5/5).


Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.


© 2009 The Advisory Board Company. All rights reserved.

Female Libido Drug, Flibanserin, Discontinued After Regulatory Feedback

Flibanserin, an investigational drug for pre-menopausal women with decreased sexual desire, known as Hypoactive Sexual Desire Disorder or HSDD, has been discontinued by its creator Boehringer Ingelheim following the Food and Drug Administration's (FDA's) safety query - the regulatory agency said that the compound's safety and efficacy were not proven. Hypoactive Sexual Desire Disorder is characterized by an absence or lack of desire for sexual activity as well as sexual fantasies for a prolonged period. It is classed as a disorder when the patient experiences distress and interpersonal difficulties which cannot be accounted for by, for example depression or some other mental disorder, a medical condition, or a substance.


Despite discontinuing flibanserin, Boehringer Ingelheim stresses that the compound would have been of value for pre-menopausal women with HSDD, a condition that affects a considerable number of adult females worldwide, and impacts on their lives.


Professor Andreas Barner, Chairman of the Board of Managing Directors of Boehringer Ingelheim and responsible for the Corporate Board Division Pharma Research, Development and Medicine, said:


The decision was not made lightly, considering the advanced stage of development. We remain convinced of the positive benefit-risk ratio of flibanserin for women suffering with HSDD.


In a communiqu?©, Boehringer Ingelheim explains that responding to the regulatory query and the subsequent complexities of getting the new compound ready for submission for approval contributed to the company's decision to drop flibanserin and focus on other products.


The Reproductive Health Drugs Advisory Committee, USA had met in Washington in June this year to review the NDA (new drug application) for flibanserin for HSDD treatment for pre-menopausal women. The Committee recommended that the FDA gather additional data regarding the compound's safety and efficacy before proceeding. In August the FDA issued is Complete Response Letter to the NDA.


Michael Sand, Director, Clinical Research and Global Strategic Leader of flibanserin, Boehringer Ingelheim, said:


The need for a better understanding of HSDD and its possible treatment continues, and we hope the scientific and medical communities will build on the knowledge that Boehringer Ingelheim's research has provided to find solutions for women who suffer with this disorder.


Boehringer Ingelheim says it now aims to focus on new compounds targeted at such areas as diabetes, oncology and stroke prevention.


Libido drugs, a term sometimes used for medications to treat HSDD, have been the focus of several large drug companies, and without much success. In 2004 Pfizer's attempts to get Viagra to be included as therapy for women was abandoned, Procter & Gamble tried to get a testosterone patch approved, and failed.


Source: Boehringer Ingelheim





View drug information on Viagra.

Search Is On For Genes That Point To Womb Cancer

A Queensland University of Technology study pinpointing the genetic differences between women with and without womb cancer will help in the early diagnosis of the disease.


PhD student Tracy O'Mara, from the School of Life Sciences at QUT, who is working in collaboration with scientists at the Queensland Institute of Medical Research, said there was an acute need for better screening for womb or endometrial cancer, with about 1400 new cases of the disease diagnosed every year.


The disease affects the lining of the uterus, and is the most common form of gynaecological cancer in Australia, and the sixth most common cancer overall.


"Doctors believe early detection can save lives but existing procedures often fail to detect the cancer's early development," Ms O'Mara said.


"I'll be focussing on identifying and understanding the genes that collectively increase the risk of endometrial cancer, particularly the aggressive forms of the disease.


"To do this I'll be looking at the genetic variation in DNA from a large group of women with endometrial cancer, and comparing this to the genetic variation present in a large group of women without cancer.


"The subset of genes containing variants that occur more commonly in endometrial cancer patients are those that are likely to be involved in development of the disease.


"If we can identify these genes we'll not only be able to diagnose earlier, we'll eventually also understand how to develop targeted cancer therapies."


Ms O'Mara said womb cancer was on the increase due to an ageing population and because risk factors like obesity were also on the rise.



"But it is one of the easiest cancers to diagnose and treat if detected early."


Ms O'Mara is the recipient of a $21,000 Smart State PhD Scholarship from the State Government.


The Smart State PhD Scholarships program is part of the Government's $200 million Smart State Innovation Funds, which are designed to help build world-class research facilities, attract top quality scientists and stimulate cutting-edge research projects in Queensland.


Queensland University of Technology