Genetic Testing: Is It Worth It?

The following video is very informational about when genetic testing should be done pertaining to cancer. This question and answer time is with a panel of oncolgists at MD Anderson Cancer Center which is one of the leading cancer centers in the United States. If you have cancer in your family then you must view this video!

Please visit: http://www.mdanderson.org/prevention for more information regarding prevention and screening

How often you should get tested for breast cancer depends on your chances for getting the disease. If you are at increased risk for breast cancer, you may need to start screening exams at an earlier age, get additional tests or be tested more often.

Learn when genetic testing makes sense for you.

Dr. Banu Arun, Professor of Breast Medical Oncology and Co-Director of Clinical Cancer Genetics at The University of Texas MD Anderson Cancer Center and Diana Turco, Certified Genetic Counselor in Clinical Cancer Genetics, answer common questions regarding hereditary risk factors for breast cancer. Dr. Jennifer Litton, Assistant Professor of Breast Medical Oncology, at The University of Texas MD Anderson Cancer Center moderates the discussion.

I hope that this video was very helpful and please share this with others that are concerned about their family history of cancer.

Primitive Neuroectodermal Tumors of the Soft Tissue or Bone

Primitive neuroectodermal tumors or PNET are very rare group of tumors that are highly malignant. In clinical manifestation these tumors exhibit great diversity. They manifest in the bone and soft tissue. Pathologist find them very difficult to distinguish because they have similarities to other small, round tumors.

                                                    PNET tumors under a microscan

PNET tumors are classified into three groups.

I. CNS primitive neuroectodermal tumors (PNETs) - Tumors derived from the central nervous system

II. Neuroblastoma - Tumors derived from the autonomic nervous system

III.Peripheral primitive neuroectodermal tumors (pPNETs) - Tumors derived from tissues outside the central and autonomic nervous system

This cancer is usually seen in children and adolescents and is very fast growing and can quickly metastasize to other organs.

Peripheral primitive neuroectodermal tumors (pPNETs) are also classified as part of the Ewing family of tumors (EFTs); peripheral primitive neuroectodermal tumors (pPNETs) and Ewing family of tumors (EFTs) are often referred to interchangeably in the literature. Generally, Ewing family of tumors (EFTs) and peripheral primitive neuroectodermal tumors (pPNETs) represent different manifestations of the same tumor and have similar genetic alterations. Ewing sarcoma, however, is more common in bone, while peripheral primitive neuroectodermal tumors (pPNETs) are more common in soft tissues. Immunohistochemical and cytogenetic studies suggest that these tumors all have a common origin.

Tissue biopsy with cytogenetic and immunohistochemical studies is paramount in diagnosing peripheral primitive neuroectodermal tumors (pPNETs). Radiologic studies such as CT scans and MRI are essential in determining the limits of tumor involvement and ruling out metastatic disease. On CT scans, peripheral primitive neuroectodermal tumors (pPNETs) appear as heterogeneous masses, often invading surrounding tissues, including bone. MRI reveals a mass isointense to muscle on T1-weighted images, while hyperintense on T2-weighted image 

^{Due to the fact that PNET is metastatic then full body scans need to be performed to see the extent of the tumor growth.} 

^{Treatment Plan}

Chemotherapy and radiation are necessary adjuncts in the treatment of primitive neuroectodermal tumors (PNETs). Chemotherapy regimens have significantly improved outcomes in patients with peripheral primitive neuroectodermal tumors (pPNETs). The treatment paradigms differ based on whether the disease is localized or metastatic. As would be expected, the treatments for peripheral primitive neuroectodermal tumors (pPNETs) and Ewing family of tumors (EFTs) are similar in terms of chemotherapeutic regimens.
Current recommendations advocate complete surgical resection whenever possible, adjuvant versus neoadjuvant chemotherapy, and radiotherapy. Multimodality treatment is advocated to prevent metastatic disease, recurrent disease, and to treat residual tumor after resection. Carvajal and Meyers, in a comprehensive review of the chemotherapeutic regimens in the treatment of PNETs and Ewing family of
 tumors (EFTs), recommend a regimen that includes vincristine, doxorubicin, and cyclophosphamide with ifosfamide and etoposide.
For more specific information:
http://emedicine.medscape.com/article/855644-overview#aw2aab6b8
 

Not All Women are Treated the Same With Ovarian Cancer

Researcher finds problems with the fact that  all women with ovarian cancer do not have access to top quality care to boost survival.
Dr. Robert Bristow believes a decidedly low-tech approach could significantly enhance the survival rate for ovarian cancer, even though it’s the deadliest women’s reproductive cancer, claiming 15,000 lives each year; it has no reliable screening or prevention methods; and its research funding is about one-sixth the amount for breast cancer.
 According to CancerCenter.com recent study and interview there only need to be excellent care for all women concerning ovarian cancer.


“We don’t have to redesign a molecule to improve the outcome for women with ovarian cancer,” says Bristow, the Philip J. DiSaia Chair in Gynecologic Oncology and director of UC Irvine’s Division of Gynecologic Oncology. “Recent research has shown that the most profound impact on survivorship occurs when women get proper care from surgeons trained in the latest techniques for treating ovarian cancer.”


The sad news is that it was discovered that women with low income and black women did not receive the excellent care as white women or affluent women. This study was done in March of 2012. Our health plans have got to change.


“Not all women are benefiting equally from improvements in ovarian cancer care,” Bristow says. “The reasons behind these disparities are not entirely clear, which is why we need additional research.”

For the women who did not receive excellent care due to race and social standing they also extended the research to see if when they were treated for ovarian cancer if the they followed the National Comprehensive Cancer Network treatment guidelines.

Bristow and colleagues found that five-year survival rates varied significantly. (Improvement in ovarian cancer care is measured in length of survival after diagnosis rather than a “cure” rate.)
Among those whose care met NCCN standards, the rate for white women was 41.4 percent, compared with 33.3 percent for African American women. Among those whose care did not meet NCCN standards, the rate for white women was 37.8 percent, compared with 22.5 percent for African American women. Those on Medicaid or without insurance faced a 30 percent increased risk of death. Poor women – defined as having an annual household income of less than $35,000 – had worse survival rates regardless of race.

http://medicalxpress.com/news/2012-05-ovarian-cancer.html