July/AuguSt 2012
www.infertilityrepronewS.Com
Vol 4, no 2
The OncOlOgy Issue
ONS ANNUAL CONGRESS
OVARIAN CANCER new Agents prove potent Against Her2-positive Breast Screening for ovarian Cancer Cancer
Researchers seek to resolve outstanding issues regarding testing By Caroline Helwick
By D. “Jeff” Nordquist, RN, MS, CS, FNP, Nurse Practitioner Karin Goodman, RN, CNP, Adult Nurse Practitioner Mayo Clinic, Rochester, Minnesota
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varian cancer is said to “whisper,” because the symptoms are seldom obvious. The most frequent symptoms seen in women diagnosed with ovarian cancer are abdominal bloating, pelvic or abdominal pain, difficulty eating/feeling full fast, or urinary symptoms. These are often passed off as nothing other than symptoms of getting older, gaining weight, or related to menopause. However, this whispering disease is the most lethal of all the breast and gynecologic cancers and accounts for more deaths than any other cancer of the female reproductive system.1
The American Cancer Society estimates that about 22,280 women will be diagnosed with ovarian cancer in 2012, and 15,500 women will die of ovarian cancer.1 Approximately 75% of women will survive 1 year after diagnosis and treatment. The 5-year survival rate is 46%, an increase of less than 10% since 1974, when the survival rate was 37%. Those diagnosed at an early stage (stage I) have a 5-year survival rate of 94%; however, only about 15% of all ovarian cancers are diagnosed at this early stage. One in 71 women will have a diagnosis of ovarian cancer in her lifetime, Continued on page 7
BLADDER CANCER Images representing a HER2 gene amplified specimen to the left and a nonamplified specimen to the right.
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rastuzumab changed the course of HER2-positive breast cancer, and future anti-HER2 therapies may have an even greater impact, said Kristine Abueg, RN, MSN, OCN,
clinical research nurse at Kaiser Permanente in Roseville, California, who discussed “What’s New in HER2?” at the 37th Annual Congress of the Oncology Nursing Society. Continued on page 6
Cultivating personalized medicine Clinical Acumen in the management of Breast Cancer An interview with Edith Perez, MD
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f any cancer can be said to have launched personalized medicine into orbit and establish it as the standard for all cancer therapy to aspire toward, it
is breast cancer. The discovery of the estrogen receptor (ER) and HER2 biomarkers has astonished healthcare professionals and the public alike and raised Continued on page 12
The Publicationof of The Official Offical Publication
We thank Watson Pharmaceuticals, Inc., for their gold level support. ©2012 Novellus Healthcare Communications, LLC
Screening for Bladder Cancer By Gary Shelton, MSN, NP, ANP-BC, AOCNP NYU Cancer Institute, New York, New York
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lthough the increased incidence of bladder cancer (BC) has softened in recent years, proposed to be due in part to smoking cessation strategies, BC remains a significant healthcare problem with high recurrence rates.1,2 Currently, there is inadequate evidence that screening for BC in the asymptomatic population promotes improved overall morbidity or mortality.3 Despite this current state of the science, there is great interest in bettering the gold standard for early diagnosis – cystoscopy, cytology, and imaging – as these are expensive, uncomfortable, and not suggested for low-risk individuals or for those without hematuria.4
Background BC is projected to be the fourth most common cancer diagnosed in American men in 2012, with an expected incidence of over 55,000 cases; for women, the incidence is estimated to be just under 18,000 new cases. More than 10,000 men are expected to die of the disease in 2012, with an estimated 4000 women succumbing as well. BC occurs 4 times more commonly in men than in women and in twice as many white men as African American men.5 Efforts should be made to promote smoking cessation, as smoking is the most well-established risk factor for BC. Other risk factors include workrelated exposures to dyes, rubber, and Continued on page 9
INS IDE MAle FeRTIlITy . . . . . . . . . . . . . . . .
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Age and semen characteristics affect the achievement of pregnancy in in vitro fertilization treatments with donated oocytes
IVF In sAMe-seX cOuPles . . .
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The challenges of IVF are unique for same-sex couples and range from legal and contractual hurdles to treatment coordination