Showing posts with label GTD. Show all posts
Showing posts with label GTD. Show all posts

Sunday, August 13, 2017

#Dazzle4Rare - Rare Disease Campaign 2017




We are pleased to once again support the #Dazzle4Rare Campaign sponsored by @hesaonlineorg. Last year was the first time we partnered with #Dazzle4Rare to raise awareness of rare diseases. You may read least year's blog post here.

A number of gynecologic cancers are considered rare diseases by the NIH. Ovarian, Endometrial/Uterine, Fallopian Tube, Vaginal and Vulvar Cancers are rare as are the two gynecologic cancers we discussed during this month's chat, Primary Peritoneal and Gestational Trophoblastic Disease. 

You may learn more about how you can get involved in this year's #Dazzle4Rare Campaign at  https://www.daycause.com/hesaonlineorg/dazzle4rare-2017

Feel free to share tweets like this one from August 13 to the 20th.

#Dazzle4Rare Learn about PPC & GTD rare gynecologic cancers http://gyncsm.blogspot.com/2017/08/august-92017-chat-you-never-heard-of.html #gyncsm

or

#Dazzle4Rare Vulvar, Vaginal and Fallopian Tube are rare gyn cancers   http://gyncsm.blogspot.com/2016/02/february-chat-rare-gyn-cancers-vuvlar.html #gyncsm

If you would like to share your story with a rare gynecologic disease with the #gyncsm community please e-mail us.


Dee and Christina
Founders, #gyncsm Community

Wednesday, August 9, 2017

August 9,2017 Chat: "You never heard of Primary Peritoneal Cancer or GTDisease?"

This month we were pleased to raise awareness and provide information on two rare gynecologic diseases - primary peritoneal cancer (PPC) and GTD (Gestational trophoblastic disease).

We had 43 people participate in the chat with a total of 1.56 impressions and 370 tweets in the hour. You may find more stats here and the complete transcript here via Symplur. 

Below you may read some of the tweets shared in answer to our topic questions. For complete information please read the transcript or check the Resources at the end of the post. 
 
T1: What is Primary Peritoneal Cancer (PPC)? Why is it treated like ovarian cancer?
  • The peritoneum is a thin membrane that forms the lining of the abdomen. It covers all of the organs within the abdomen.
  • PPC arises is in the peritoneum (lining of the abdomen). It responds to a similar combo of surgery and chemo used for ovar ca
  • PPC is often diagnosed at stage III/IV but can still be completely cleared in the upfront setting
  • The histology (cell type) of PPC is same as #ovariancancer and Fallopian tube
  • And genetically the same as well. Also the same proteins are on the cell surfaces.
  • The most common cell type of PPC, serous carcinoma, is also the most common cell type in #ovariancancer
  • Important fact - a woman can get Primary Peritoneal Cancer even if her ovaries have been removed.
  • PPC most commonly treated like epithelial ovarian cancer w/ surgery and chemo. NCCN guidelines: https://www.nccn.org/patients/guidelines/ovarian/index.html
  • The only way to distinguish PPC vs. #ovariancancer is by path looking at the ovarian surface & stroma to see where cancer arises


T2: Are there risk factors and symptoms of Primary Peritoneal Cancer (PPC)? Is there a known genetic mutation that increases risk?

  • #BRCA mutation can put pts at risk for PPC - even if the ovaries have been removed
  • Primary #peritonealcancer in #BRCA carriers after prophylactic bilateral salpingo-oophorectomy #gyncsm ncbi.nlm.nih.gov/pmc/articles/P…
  • The symptoms & Risk factors are the same for #PrimaryPeritoneal & Ovarian cancer
  • Risk factors for PPC are the same as #ovariancancer - significant exposure to estrogen - early menarche, late menopause
  • The major risk factor for Primary Peritoneal Cancer is advancing age. #gyncsm
  • PPC symptoms are more commonly gastrointestinal - abdominal bloating, changes in bowel habits, and an early feeling of fullness.
  • Like #ovariancancer, no effective screening for PPC
  • Risk of PPC in BRCA positive patients following risk reducing BSO surgery is 1-3% in most studies
  • All women w/ invasive epithelial PPC meet guidelines for genetic counseling & testing, just like ovarian cancer


T3: What is Gestational trophoblastic disease (GTDisease)? What types of GTDisease are there? Are they all malignant? 

  • Normal cells of the placenta, called trophoblast cells,
  • a group of diseases from abnormal proliferation of trophoblasts-- these are cells from the placenta
  • GTDisease is a group of rare diseases in which abnormal trophoblast cells grow inside the uterus after conception. #gyncsm
  • Most GTD is not cancer and does not spread, but some types become cancer and spread to nearby tissues or distant parts of the body
  • GTD buff.ly/2vkVH9e GTD: -Hydatidiform -Invasive Mole -Choriocarcinoma -Placental trophoblastic tumor -Epithelioid
  • Molar pregnancy, persistent mole, invasive mole choriocarcinoma .. most need only a D and C. Some need chemo.…


T4: What are the risk factors and other important things to know for GTDisease? Is there a known genetic mutation that raises risk? 

  • Important to know: About 1/2 from molar pregnancies, 1/4 from miscarriages or ectopic and 1/4 from normal or preterm pregnancies 
  • Invasive GTN characterized into high risk and low risk subgroups which determines adjuvant chemotherapy
  • GTDisease treatments include surgery (removing tumor only or hysterectomy), chemo and radiation
  • Main GTDisease Risk: Age and previous molar pregnancy. Symptoms include abnormal vaginal bleeding and a larger than normal uterus.
  • There's not known genetic mutation related to GTDisease. A family history of molar pregnancy has been found in rare cases.
  • Ethnicity (Asian) also plays a role in GTD
  • Also important to get chest CT. About 40% will have micrometastases to the lungs that were negative on chest x-ray


T5: Are there any special support services for these two rare cancers? Where can people learn more? 


#gyncsm is joining the #Dazzle4Rare campaign August 13-19. Learn more about rare diseases and share your own story (https://www.daycause.com/hesaonlineorg/dazzle4rare-2017 )


We hope you will join us next month on Wednesday, September 13, 2017 at 9pm ET for our chat A balanced life- advocacy, survivorship, new normal. And continue this discussion rare diseases on Smart patients at https://www.smartpatients.com/partners/gyncsm 

Dee
Co-moderator #gyncsm Chat

RESOURCES: 

Primary Peritoneal Cancer

NCCN Guidelines for OC and PPC - https://www.nccn.org/patients/guidelines/ovarian/index.html

Primary Peritoneal Cancer in BRCA carriers after prophylactic bilateral salpingo-oophorectomy
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4922728/

@gyncancer Primary Peritoneal Disease Information : http://www.foundationforwomenscancer.org/types-of-gynecologic-cancers/primary-peritoneal/

PPC from Macmillan UK http://www.macmillan.org.uk/information-and-support/primary-peritoneal-cancer

PPC information Medscape http://emedicine.medscape.com/article/2156469-overview

Peritoneal Cancer Clinical Research Trials @CenterWatch https://www.centerwatch.com/clinical-trials/listings/condition/553/peritoneal-cancer

Goodman :Incidence of Ovarian, Peritoneal, and Fallopian Tube Carcinomas in the United States, 1995–2004 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2706690/)


GTD

Gestational Trophoblastic Disease Treatment (PDQ®)–Patient Version via @theNCI https://www.cancer.gov/types/gestational-trophoblastic/patient/gtd-treatment-pdq#section/all

Patient Information on Gestational Trophoblastic Disease from @gyncancer http://www.foundationforwomenscancer.org/types-of-gynecologic-cancers/gestational-trophoblastic-disease-gdt/

What is GTD American Cancer Society https://www.cancer.org/cancer/gestational-trophoblastic-disease/about/what-is-gtd.html

Gestational Trophoblastic Disease via @CancerDotNet http://www.cancer.net/cancer-types/gestational-trophoblastic-disease

Friday, August 4, 2017

August #gyncsm Chat - "You never heard of Primary Peritoneal Cancer or GTDisease?"

In the past three years we have hosted chats dedicated to a number of the different gynecologic cancers - Cervical, Endometrial/Uterine, Fallopian Tube, Ovarian, Vulvar and Vaginal. This month we are going to discuss two more of the rare gynecologic cancers - primary peritoneal and GTD (Gestational trophoblastic disease).



What are these cancers?

Primary Peritoneal Cancer (PPC) forms in the peritoneum (the tissue that lines the abdominal wall and covers organs in the abdomen), and has not spread there from another part of the body. Primary peritoneal cancer sometimes spreads to the ovary. It is similar to ovarian epithelial cancer and is staged and treated the same way.
-NCI Definition

In data from 1995-2005, Goodman* found that the incidence rate in the U.S. for PPC was 6.78 per million women compared to 119 per million for ovarian cancer. Women with PPC were diagnosed at a later age (mean 67 years) than ovarian cancer (mean 63 years). (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2706690/)

GTD (Gestational trophoblastic disease) is a rare condition in which abnormal cells grow inside the uterus from tissue that forms after conception (the joining of sperm and egg). This tissue is made of trophoblastic cells, which normally surround the fertilized egg in the uterus and help connect the fertilized egg to the wall of the uterus. These cells also form part of the placenta (the organ that passes nutrients from the mother to the fetus). Most GTDs are benign (not cancer) and do not spread, but some types are malignant (cancer) and spread to nearby tissues or other parts of the body. The two main types of GTDs are hydatidiform mole and choriocarcinoma. Also called gestational trophoblastic disease, gestational trophoblastic tumor, and GTT.
-NCI Definition

GTD occurs in 1 out of 1000 pregnancies in the US. It less than 1% of all gynecologic cancers. GTD is more common in Africa and Asia than in North America. (http://www.cancer.net/cancer-types/gestational-trophoblastic-disease/statistics)

You can learn more about GTD or Primary Peritoneal Cancer by joining our chat and reading these pages on the NCI website.

You can also read a GTD survivor story here on our blog:
http://gyncsm.blogspot.com/2015/04/survivors-story-gtd-and-me-story-of.html

Part of #gyncsm's mission is to support those impacted by all gynecologic cancers. One way we can do this is to offer information on rare gynecologic cancers and support survivors of those cancers. #gyncsm will be participating in the #Dazzle4Rare social media campaign during August 13-19. Check out that tag to learn more about rare disease and share your own story.

We hope you will join us as we raise awareness of the risks of these rare gynecologic cancers, support the women impacted by them, and support the clinicians and researchers who focus on treating these rare cancers.

We look forward to chatting with you on Wednesday, August 9th at 9pm EST (8pm CST/ 6pm PST).

Guiding our discussion will be the following topic questions:
T1: What is Primary Peritoneal Cancer (PPC)? Why is it treated like ovarian cancer?

T2: Are there risk factors and symptoms of Primary Peritoneal Cancer (PPC)? Is there a known genetic mutation that increases risk?

T3: What is Gestational trophoblastic disease (GTDisease)? What types of GTDisease are there? Are they all malignant?

T4: What are the risk factors and other important things to know for GTDisease? Is there a known genetic mutation that raises risk?

T5: Are there any special support services for these two rare cancers? Where can people learn more?


Dee
Co-founder #gyncsm

*Goodman Study

Monday, April 13, 2015

Survivor's Story: GTD and Me – A Story of Diligence, Persistence, and Grace

During the recent tweet chat (#CancerFilm) which took place during the viewing of the documentary the Emperor of All Maladies, Christina conversed with Katie Smith, who was diagnosed with GTD (Gestational Trophoblastic Disease). Gestational trophoblastic disease (GTD) is defined by the National Cancer Institute (NCI) as a group of rare diseases in which abnormal trophoblast cells grow inside the uterus after conception. Trophoblast cells help to connect the embryo to the uterine wall and help to form the placenta. GTD, in most cases, is benign but some cases may be malignant and spread to nearby organs. Please see the NCI site for additional information. We are pleased to have Katie share her story with our community. 


GTD and Me
A Story of Diligence, Persistence, and Grace

I was 28 years old in the winter of 2005.  I had a beautiful one year old son that my husband and I had waited on for almost four years, a new job, and was excited about possibly having more children in the future.  Little did I know my world was about to be turned upside down.

After having my son, my monthly menstrual cycles became quite painful.  But, I just attributed it to getting older.  I also began having a thick discharge, but attributed it to post nasal drip (I have horrible allergies and thought that was the culprit).  In February 2005, I went to the doctor about the painful periods and an ultrasound was performed.  The doctor saw something in my uterus, but stated it was a fibroid.  Traditionally, fibroids can cause intense periods so this made sense.  I was sent home.

The next month, I noticed that my “pregnancy nose” had returned.  You know – that ability to smell someone eating a cheeseburger in the neighboring town.  At that point, I got a little scared.  While I wanted more children, I wasn’t prepared to have one now.  When I took a home pregnancy test, it showed faintly positive.  So, off to my OB/GYN doc I went.

The blood pregnancy test indicated that I had been pregnant but had a miscarriage.  This was devastating!  According to the doctor, my HCG levels were low which indicated that there may still be remnants in the fallopian tubes.  I was given a very light dose of Methotrexate to help flush out any remaining items.  I was again sent home, but was asked to come back in a couple of days for another HCG level check.

But, when I came back a couple of days later, my HCG levels were starting to creep up.  I was asked to come back in two more days for another check.  This went on for about 1 ½ months (including a stronger dose of Methotrexate thrown in there).  For some reason, my levels would not go down.  At this point, my OB/GYN doctor became concerned.  She said, “I really don’t think this is cancer, but I want you to go see my doctor.  He is a Gynecological Oncologist who can rule out cancer and figure out what this is.”

Dr. Don Hall, the Gynecological Oncologist, immediately sent me for an ultrasound.  The Ultrasound Tech stated, “I see a fibroid in there.  That’s it.”  But, Dr. Hall had a feeling that this was more than just a fibroid.  After multiple urine and blood tests, along with a PET scan, the diagnosis was found.  While all of this was going on, I became engrossed in finding out what this could be.  I stumbled across a Gynecological Disease website and found something called “Gestational Trophoblastic Disease”.  The symptoms sounded like the ones I had been experiencing.  Could it really be cancer?

It was a Friday afternoon and I was called in for my results.  With my mother on one side of me and my husband on the other, Dr. Hall delivered the news.  I had a Placental Site Trophoblastic Tumor, which is in the GTD family of cancers.  Less than ½ of 1 percent of women have this type of tumor, and it forms where the placenta attaches to the uterus.  He had already scheduled my hysterectomy for the following Wednesday.  I would be in the hospital for 3 days and on leave for 6 weeks minimum.  I would have a long scar starting from my belly button down, and they may have to remove part of my intestine.  The PET scan had indicated the tumor had protruded through the uterus and was wrapped in the intestine.

Part of me was relieved to have a diagnosis but the other part of me was terrified.  In addition, our insurance was completely maxed out (this was in the day of annual maximum amounts and before the ACA).  We would have to pay for the entire surgery and any other treatments that I would have to go through.  Funny enough-I didn’t worry about the money part.  I just wanted to be alive to see my son grow up.

When Dr. Hall went in to do the surgery, he discovered that the tumor had not protruded but was fully contained in the uterus.  It was removed and sent off for growth rate testing.  If the growth rate was low, no further treatment would be necessary.  If the growth rate was high, I would have to take chemotherapy and radiation.  In addition, it was discovered I had really bad endometriosis and one of my ovaries was removed because it was badly damaged. 

The results of the growth rate testing showed that the tumor was growing at a slow rate.  However, I had to come back every month for HCG testing.  Each time I went it, I would get very anxious.  I had ghost symptoms constantly and stayed panicked.  But, the first year went by with no increase in HCG.  In July 2015, I will be 10 years cancer free. 

There is a very slight chance it could recur as lung cancer, with an even slighter chance of breast cancer occurrence.  But, thanks to God, the concern of my OB/GYN doctor Rebecca Walker and the diligence and persistence of Dr. Hall,  I’ve been able to experience 11 years of bliss with my son. 

What can you take from this story:  Listen to your body.  It will tell you when something is wrong.  If something is wrong, don’t blow it off.  Have it checked out – it might just save your life.

- Katie Smith (@katielizsmith)


Thank you so much Katie for sharing your story with us. 

Dee 
#gyncsm co-moderator 


Friday, January 9, 2015

January Chat Topic Questions : Gynecologic Cancer Risk Factors

Happy New Year!

We begin this year's chats on January 14, 2015 at 9 pm EST. We will be discussing the risk factors for gynecologic cancers. "risk factor is anything that increases a person’s chance of developing cancer." - @cancerdotnet.  


Following the questions you will find links to information from Cancer.Net, the Mayo Clinic and the Foundation for Women's Cancer on the risk factors of each gynecologic cancer.


Topic Questions:
T1A: Are you aware of the risk factors for gyn cancers? When did you learn them? How have they influenced your health decisions?
T1B: Providers - Have your patients asked you about risk factors before or after diagnosis?

T2: Viral infections caused by HPV virus raise risk for cervical, vaginal & vulvar cancers. What do women & parents need to know?

T3: What is DES (Diethystibestrol)? How are women exposed to the hormone? What are the risks?

T4: Genetics are thought to account for as much as 25% of GYN cancers. BRCA has received media attn. What are other genetic risks?

T5: Have you tried to reduce your risk for cancer, recurrence or other cancers? What can women do w/ the info about risk factors?



Links for Gyn Cancer Risks:

Risk factors for ovarian cancer  from @cancerdotnet http://www.cancer.net/cancer-types/ovarian-cancer/risk-factors-and-prevention

Risk factors for cervical cancer from @cancerdotnet

Risk factors for uterine cancers from @cancerdotnet

Risk factors for endometrial cancer from @MayoClinic

Risk factors for fallopian tube cancer @cancerdotnet

Risks for vaginal cancer from @cancerdotnet

Risk for vulvar cancer from @MayoClinic

Risks for GTD @GYNcancer

Risks for #primaryperitoneal cancer @GYNcancer

We look forward to having you join us. 

Dee
Co-moderator