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Obstetrics and Gynecology Clinics of North America

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https://read.qxmd.com/read/30683270/innovation-and-progress-in-gynecologic-cancer-care-faster-than-ever
#1
EDITORIAL
Carolyn Y Muller
No abstract text is available yet for this article.
March 2019: Obstetrics and Gynecology Clinics of North America
https://read.qxmd.com/read/30683269/gynecologic-cancer-care-innovative-progress
#2
EDITORIAL
William F Rayburn
No abstract text is available yet for this article.
March 2019: Obstetrics and Gynecology Clinics of North America
https://read.qxmd.com/read/30683268/endometrial-cancer-obesity-genetics-and-targeted-agents
#3
REVIEW
Megan E McDonald, David P Bender
It is imperative to understand the underlying mechanisms of both endometrial carcinogenesis and recurrence in order to develop more effective prevention and treatment. This article reviews available molecular data, the interplay between endometrial cancer carcinogenesis with obesity and genetics, as well as current targeted therapies.
March 2019: Obstetrics and Gynecology Clinics of North America
https://read.qxmd.com/read/30683267/ovarian-cancer-clinical-trial-breakthroughs-and-impact-on-management
#4
REVIEW
Rebecca Ann Previs, Angeles Alvarez Secord
Ovarian cancer treatment continues to evolve. Despite aggressive surgery and chemotherapy, most women will ultimately die from disease. Improvement in disease control are due to the incorporation of molecular targeted agents and the adoption of maintenance therapy. Maintenance therapy has been shown to enhance progression-free survival. Recent surgical trials have evaluated the role of neoadjuvant chemotherapy versus primary debulking at the time of diagnosis in advanced stage ovarian cancer. The role of lymph node dissection and secondary cytoreductive surgeries have also been evaluated...
March 2019: Obstetrics and Gynecology Clinics of North America
https://read.qxmd.com/read/30683266/less-is-more-minimally-invasive-and-quality-surgical-management-of-gynecologic-cancer
#5
REVIEW
Evelyn Cantillo, Jenna B Emerson, Cara Mathews
Surgery is a cornerstone of gynecologic oncology. Minimally invasive techniques have been adopted rapidly, in lieu of open approaches, in cervical and endometrial cancer staging. In addition, nodal assessment has undergone significant changes with the introduction of SLN biopsies. The movement toward less is more has also been seen with perioperative and postoperative care and the advent of ERAS protocols, which attempt to maintain normal physiology with the goal of improving functional recovery. It is imperative that new technology be critically evaluated to ensure that oncologic outcomes are not compromised...
March 2019: Obstetrics and Gynecology Clinics of North America
https://read.qxmd.com/read/30683265/germline-and-somatic-tumor-testing-in-gynecologic-cancer-care
#6
REVIEW
Jill Alldredge, Leslie Randall
New technologies have advanced the science of tumor biology and genomics. Commercially available germline and somatic testing modalities have the downstream benefits of enabling prevention strategies in women with hereditary cancers and their family members in addition to identifying women who benefit most from novel targeted therapeutics. The matrix of available testing is complex and evolving. Women's health providers need to be versed in benefits and limitations of available testing. Genetic counselors play a pivotal role in interpretation of relevant mutations, and in avoiding common pitfalls, but their skill set is not sufficient to optimally integrate cancer genomics into clinical practice...
March 2019: Obstetrics and Gynecology Clinics of North America
https://read.qxmd.com/read/30683264/cancer-screening-and-prevention-highlights-in-gynecologic-cancer
#7
REVIEW
Jeanine N Staples, Linda R Duska
This article provides an up-to-date summary of screening approaches and key strategies in prevention of gynecologic malignancies. The Pap smear is the only proven screening intervention in the field of gynecologic oncology. Women should receive treatment for precancerous conditions of the cervix, vulva, vagina, and endometrial lining. Women with inherited conditions should consider having a risk-reducing surgery once they have finished childbearing. The human papilloma virus vaccination should be offered to all girls and boys aged 11 to 12 years, and can also be given as early as age 9 and through 26 years of age...
March 2019: Obstetrics and Gynecology Clinics of North America
https://read.qxmd.com/read/30683263/palliative-care-in-gynecologic-oncology
#8
REVIEW
Mary M Mullen, James C Cripe, Premal H Thaker
The integration of palliative care and hospice into standard gynecologic oncology care is associated with cost-savings, longer survival, lower symptom burden, and better quality of life for patients and caregivers. Consequently, this comprehensive approach is formally recognized and endorsed by the Society of Gynecologic Oncology, the National Comprehensive Cancer Network, and the American Society of Clinical Oncology. This article reviews the background, benefits, barriers, and most practical delivery models of palliative care...
March 2019: Obstetrics and Gynecology Clinics of North America
https://read.qxmd.com/read/30683262/gynecologic-cancer-survivorship
#9
REVIEW
Elizabeth Lokich
Survivorship care includes surveillance and prevention of cancer recurrence, addressing side effects of cancer and cancer treatment and coordination of follow-up care. This article reviews guidelines for surveillance of women with ovarian, endometrial, cervical, and vulvar cancer. It also reviews many of the long-term physical side effects of gynecologic cancer treatment including fatigue, neuropathy, lymphedema, cognitive dysfunction, sexual health concerns, menopausal symptoms, infertility, and economic stressors...
March 2019: Obstetrics and Gynecology Clinics of North America
https://read.qxmd.com/read/30683261/personalized-medicine-in-gynecologic-cancer-fact-or-fiction
#10
REVIEW
Logan Corey, Ana Valente, Katrina Wade
Personalized medicine in gynecologic oncology is an evolving field. In recent years, tumor profiling and large databases such as TCGA and NCI-Match have provided us with enormous amounts of molecular data. Several therapies that capitalize on novel genetic and immune discoveries including VEGF inhibitors, PARP inhibitors, and cancer vaccinations are discussed in this article. Additionally, we have seen direct to consumer marketing play an important role in cancer care and prevention as patients have increased ability to access genetic testing...
March 2019: Obstetrics and Gynecology Clinics of North America
https://read.qxmd.com/read/30683260/chemotherapy-biologic-and-immunotherapy-breakthroughs-in-cancer-care
#11
REVIEW
Christine Rojas, Yovanni Casablanca
As the understanding of cancer biology expands, a wider array of treatment options has become available in the field of gynecologic cancer. Therapies that target specific molecular pathways are now being used. Drugs that target cancer angiogenesis, signal transduction, DNA repair, and immune evasion mechanisms are currently being used, in addition to or in lieu of traditional chemotherapy, to achieve more personalized treatment of each patient and their unique disease. These therapies may lead to improved survival outcomes and quality of life during treatment and during remission...
March 2019: Obstetrics and Gynecology Clinics of North America
https://read.qxmd.com/read/30683259/vulvar-cancer
#12
REVIEW
Daniel Weinberg, Ricardo A Gomez-Martinez
This article reviews the epidemiology, diagnosis, and management of vulvar preinvasive lesions, squamous cell carcinoma, and melanoma. There is an emphasis on sentinel lymph node dissection for early stage disease and advances in chemoradiation for late-stage disease. A brief review of vulvar Paget disease is also included.
March 2019: Obstetrics and Gynecology Clinics of North America
https://read.qxmd.com/read/30683258/-at-least-once-in-her-lifetime-global-cervical-cancer-prevention
#13
REVIEW
Philip E Castle, Amanda Pierz
Cervical cancer disproportionately burdens lower-resourced settings, in which nearly 90% of cervical cancer and cervical cancer-related deaths occur. Targeting human papillomavirus (HPV) by prophylactic HPV vaccination in young adolescent girls and HPV-based screening in mid-adult women offers the most cost-effective strategy to reduce cervical cancer burden worldwide and mitigate the health disparities in cervical cancer burden between low-resourced and high-resourced settings. Political and social will, along with the necessary financial investments, will be necessary to realize the opportunity for significant global reductions in the cervical cancer burden...
March 2019: Obstetrics and Gynecology Clinics of North America
https://read.qxmd.com/read/30683257/current-quality-of-gynecologic-cancer-care-in-north-america
#14
REVIEW
Clare J Reade, Laurie M Elit
Evaluating the quality of care received by gynecologic cancer patients in the real world is essential for excellent outcomes. The recent population-based literature looking at quality of care was reviewed for all gynecologic malignancies. Outcomes are generally highest when care is provided by high-volume providers in high-volume cancer centers. Provision of care according to clinical practice guidelines has also been demonstrated to improve outcomes in many situations. Disparities exist for marginalized groups in terms of the care they receive and subsequent outcomes...
March 2019: Obstetrics and Gynecology Clinics of North America
https://read.qxmd.com/read/30401557/the-disruptive-changes-of-midlife-a-biopsychosocial-adventure
#15
EDITORIAL
Nanette Santoro, Howard M Kravitz
No abstract text is available yet for this article.
December 2018: Obstetrics and Gynecology Clinics of North America
https://read.qxmd.com/read/30401556/a-more-complete-picture-of-reproductive-aging-and-the-menopause-transition
#16
EDITORIAL
William F Rayburn
No abstract text is available yet for this article.
December 2018: Obstetrics and Gynecology Clinics of North America
https://read.qxmd.com/read/30401555/cognitive-changes-with-reproductive-aging-perimenopause-and-menopause
#17
REVIEW
Kelly N Morgan, Carol A Derby, Carey E Gleason
This article reviews the role of endogenous estrogen in neural and cognitive processing, followed by an examination of longitudinal cognitive data captured in various stages of the menopausal transition. The remaining text reviews the contradictory results from major hormone therapy trials to date, evidence for the "timing hypothesis," and closes with recommendations for future research and for practicing clinicians.
December 2018: Obstetrics and Gynecology Clinics of North America
https://read.qxmd.com/read/30401554/genitourinary-changes-with-aging
#18
REVIEW
Caroline M Mitchell, L Elaine Waetjen
Both chronologic aging and menopause affect the physical, physiologic, and microbiological characteristics of the genitourinary tract. The genitourinary syndrome of menopause, characterized by vulvovaginal and lower urinary tract signs and symptoms, is prevalent and has a significant negative impact on women's lives. In this article, the authors detail the genitourinary tract changes associated with menopause and/or aging. They also review the 2014 North American Menopause Society's definition of the genitourinary syndrome of menopause and present the epidemiology and impact of genitourinary aging in midlife and older women, namely, vulvovaginal, urinary, and sexual symptoms...
December 2018: Obstetrics and Gynecology Clinics of North America
https://read.qxmd.com/read/30401553/physical-activity-and-physical-function-moving-and-aging
#19
REVIEW
Sheila A Dugan, Kelley Pettee Gabriel, Brittney S Lange-Maia, Carrie Karvonen-Gutierrez
Evidence supports that the physical disablement process starts earlier than previously thought, in midlife when women still have many years to live. Physical activity participation and interventions have been successful in preventing disability in older adults and may be promising for maintaining function at younger ages. Changing the conversation to more relevant topics in midlife, like positive changes in body composition, sleep, and improved mood, may move the dial on participation, as midlife women do not meet guidelines for physical activity...
December 2018: Obstetrics and Gynecology Clinics of North America
https://read.qxmd.com/read/30401552/female-sexual-function-at-midlife-and-beyond
#20
REVIEW
Holly N Thomas, Genevieve S Neal-Perry, Rachel Hess
Sexual function is an important component of quality of life for women. Midlife poses several challenges to optimal sexual function and intimacy for women. In addition to anatomic factors related to estrogen deficiency, such as genitourinary syndrome of menopause, vulvovaginal atrophy, and pelvic organ prolaps, psychosocial factors, including prior sexual trauma, play an important role in sexual function in women. Several treatments have emerged for female sexual dysfunction; long-term studies and head-to-head comparisons are lacking...
December 2018: Obstetrics and Gynecology Clinics of North America
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