exudates and Ovarian-Neoplasms

This case series describes the survival outcomes of patients who underwent integrative medicine (IM) protocol for ovarian cancer, a treatment protocol, that integrated a carefully selected set of complementary and alternative medicine (CAM) into the conventional treatment for ovarian cancers.. Retrospective review of patients' medical records was conducted at a private medical centre that delivered the IM protocol for patients with advanced and recurrent ovarian cancers. We explored and analysed the overall survival and disease progressions of those who received the IM treatment for at least 2 months.. Forty patients with advanced ovarian cancers fulfilled the inclusion criteria for this case series. An overall of 75% of the cases achieved remission with initial IM treatment, 17.5% had a partial response and 7.5% showed progressive disease. The overall 5-year survival for all 40 cases is 53.1%. When explored further, the 5-year survival for cases who received CAM only is 75%, and cases who received combined limited chemotherapy with CAM had a 5-year survival of 55%. At study endpoint, 11 cases died due to ovarian cancer.. These findings suggest that CAM may be a valuable addition to conventional therapy to treat and improve the survival of patients with ovarian cancers. A formal randomized control trial is required to evaluate the efficacy and long-term outcomes of using IM to treat advanced and recurrent ovarian cancers.

Topics: Adult; Female; Humans; Integrative Medicine; Malaysia; Middle Aged; Ovarian Neoplasms; Retrospective Studies; Survival Rate; Young Adult

Ovarian cancer is particularly lethal due to late stage at presentation. The subtypes behave differently with respect to their biology and response to treatment. Two recent markers reported to be useful in assisting in the diagnosis are WT1 and PAX8. Malaysia, with its multi-ethnic population provides an opportunity to study the expression of these biomarkers in ovarian cancer in the three most populous ethnicities in Asia and ascertain their usefulness in the diagnosis of ovarian carcinoma.. Tissues from ovarian epithelial neoplasms diagnosed between 2004 and 2012 were tested using antibodies to WT1 and PAX8. The slides were assessed to determine levels of marker expression and related to ethnicity, ovarian tumour type, grade and stage.. Serous tumours were the main histological type (n = 44), the remaining being endometrioid (n = 15), mucinous (n = 15) and clear cell tumours (n = 7). Late stage at diagnosis was significantly associated with serous (p < 0.001) and endometrioid (p 0.026) tumours. The vast majority of serous tumours were positive for WT1 (87%, p < 0.001) and PAX8 expression (86%, p < 0.001) whilst 40% of endometrioid tumours were positive for PAX8 and 13% for WT1. Few mucinous carcinomas (n = 1) and clear cell carcinomas (n = 2) expressed PAX8, and none expressed WT1. There was no significant difference in the tumour expression of either WT1 or PAX8 between the three Malaysian ethnicities.. In an Asian setting, PAX8 and WT1 are expressed in the vast majority of serous ovarian cancers and may be useful in distinguishing serous ovarian carcinomas from other poorly differentiated tumours.

Topics: Carcinoma, Ovarian Epithelial; Female; Humans; Malaysia; Middle Aged; Neoplasm Grading; Ovarian Neoplasms; PAX8 Transcription Factor; WT1 Proteins

Ovarian cancer is recognized as the fourth leading cancer in Malaysia. However, women do not always seek help in a timely manner and gaps in awareness may influence screening uptake and presentation. The purpose of this study was to determine levels of awareness of ovarian cancer risk factors in female population in Penang, Malaysia.. A cross-sectional study was conducted in Penang, Malaysia from January until February 2014. Eighty-seven women were selected by convenient sampling. Awareness of risk factors of ovarian cancer was assessed using a self-administered questionnaire. Data were analyzed using statistical package for the social sciences (SPSS) version 20.0 for descriptive statistics and Pearson chi-square test for the association between socio-demographic data and awareness. A p value ≤0.05 was considered statistically significant.. In all, 74.7% of participants answered correctly for the risk factor of increasing age, although 94.3% were unaware of increased risk of tall women. A majority, 71.3%, had a low level of awareness of ovarian cancer risk factors. There was a significant association between age and knowledge (p=0.047). Additionally, there was a significant association between higher education level and level of awareness of ovarian cancer risk factors (p=0.039).. This study revealed that awareness of ovarian cancer risk factors among Malaysian women is low. The results show a need for improved public understanding about ovarian cancer risks and provision of important information for health professionals about initiatives needed for future awareness, prevention and screening programs.

Topics: Adult; Cross-Sectional Studies; Female; Follow-Up Studies; Health Knowledge, Attitudes, Practice; Humans; Malaysia; Middle Aged; Ovarian Neoplasms; Pilot Projects; Prognosis; Risk Factors; Young Adult

Serous epithelial ovarian cancer (SEOC) is a highly metastatic disease and its progression has been implicated with microRNAs. This study aimed to identify the differentially expressed microRNAs in Malaysian patients with SEOC and examine the microRNAs functional roles in SEOC cells.. Twenty-two SEOC and twenty-two normal samples were subjected to miRNA expression profiling using the locked nucleic acid (LNA) quantitative real-time PCR (qPCR). The localization of miR-200c was determined via LNA in situ hybridization (ISH). Functional analysis of miR-200c and miR-31 on cell proliferation, migration and invasion and clonogenic cell survival were assessed in vitro. The putative target genes of the two miRNAs were predicted by miRWalk program and expression of the target genes in SEOC cell lines was validated.. The miRNA expression profiling revealed thirty-eight significantly dysregulated miRNAs in SEOC compared to normal ovarian tissues. Of these, eighteen were up-regulated whilst twenty miRNAs were down-regulated. We observed chromogenic miR-200c-ISH signal predominantly in the cytoplasmic compartment of both epithelial and inflammatory cancer cells. Re-expression of miR-200c significantly increased the cell proliferation and colony formation but reduced the migration and invasion of SEOC cells. In addition, miR-200c expression was inversely proportionate with the expression of deleted in liver cancer-1 (DLC-1) gene. Over-expression of miR-31 in SEOC cells resulted in decreased cell proliferation, clonogenic potential, cell migration and invasion. Meanwhile, miR-31 gain-of-function led to the down-regulation of AF4/FMR2 family member 1 (AFF1) gene.. These data suggested that miR-200c and miR-31 may play roles in the SEOC metastasis biology and could be considered as promising targets for therapeutic purposes.

Topics: Adult; Aged; Carcinoma, Ovarian Epithelial; Cell Line, Tumor; Cell Movement; Cell Proliferation; Epithelial-Mesenchymal Transition; Female; Gene Expression Regulation, Neoplastic; Humans; In Situ Hybridization; Malaysia; MicroRNAs; Middle Aged; Neoplasm Invasiveness; Neoplasm Metastasis; Neoplasms, Glandular and Epithelial; Ovarian Neoplasms; Serous Membrane

Kelantan is one of the states in Malaysia which has a high prevalence of type 2 diabetes (DM2). Other than with endometrial carcinoma, the association of DM2 with particular female cancers is not known.. To determine the proportion of breast, cervical, ovarian and endometrial cancers among females with DM2 diagnosed in Hospital Universiti Sains Malaysia (HUSM) over an 11 year period.. All histologically confirmed cases of breast, endometrial, cervical and ovarian carcinomas admitted to the Hospital were included in the study. The patient diabetic status was traced from the hospital medical records.. There was a total of 860 cases of breast, cervical, ovarian and endometrial carcinomas over this period. Breast carcinoma was the commonest, accounting for 437/860 (50.8%) followed by cervix, 159/860 (18.5%), ovarian, 143/860 (16.6%) and endometrial carcinomas, 121/860 (14.1%). Out of these, 228/860 (26.5%) were confirmed diabetics. Endometrial carcinoma patients showed the highest proportion being diabetics, 42.1% (51/121), followed by ovarian cancer, 25.9% (37/143), breast carcinoma, 23.6% (103/437) and cervical cancer 23.3% (37/159).. There is a significant proportion of DM2 among women with these four cancers, endometrial carcinoma being the highest followed by ovarian, breast and cervical carcinoma. The rising trend of these four cancers is in tandem with an increasing trend of DM2 in the community. In populations where diabetes is prevalent, screening for epithelial cancers should be rigourous. Diabetic clinics should include screening for these cancers among their female patients and gynecology clinics should screen the women they treat for their diabetes status.

Topics: Adult; Aged; Aged, 80 and over; Breast Neoplasms; Diabetes Mellitus, Type 2; Endometrial Neoplasms; Female; Follow-Up Studies; Humans; Incidence; Malaysia; Middle Aged; Neoplasm Staging; Ovarian Neoplasms; Prevalence; Prognosis; Risk Factors; Uterine Cervical Neoplasms; Young Adult

Topics: Anecdotes as Topic; Caregivers; Female; Hospice Care; Humans; Malaysia; Middle Aged; Ovarian Neoplasms; Palliative Care; Stress, Psychological; Terminal Care

The identification of high-risk individuals can help to improve early cancer detection and patient survival. Risk assessment, however, can only be accomplished if the risk factors are known. To date, the genetic risk factors for ovarian cancer, other than mutations in the BRCA1/2 genes, have never been systematically explored in Malaysia. The present study aims to identify from a panel of cancer-associated single-nucleotide polymorphisms (SNPs), those associated with ovarian cancer risk in Malaysia.. A total of 768 SNPs associated with various cancers among Asians were identified through a search of the relevant literature, and these SNPs were then screened for their association with ovarian cancer. A total of 160 Malaysian subjects were recruited for the study, including both ovarian cancer patients and controls. Genotyping was carried out using Illumina BeadArray platform.. A panel of 45 SNPs that are significantly (p<0.05) associated with ovarian cancer risk was identified. These ovarian cancer-associated SNPs were located in genes implicated in various pathways of carcinogenesis. Of these 45 SNPs, 5 have been previously associated with either ovarian cancer risk or survival.. This study has identified a panel of 45 SNPs that are significantly associated with ovarian cancer in a Malaysian population.

Topics: Adult; Female; Genes, BRCA1; Genetic Predisposition to Disease; Genotype; Humans; Malaysia; Middle Aged; Mutation; Ovarian Neoplasms; Polymorphism, Single Nucleotide; Risk Factors

Early studies of genetic predisposition due to the BRCA1 and BRCA2 genes have focused largely on sequence alterations, but it has now emerged that 4-28% of inherited mutations in the BRCA genes may be due to large genomic rearrangements of these genes. However, to date, there have been relatively few studies of large genomic rearrangements in Asian populations. We have conducted a full sequencing and large genomic rearrangement analysis (using Multiplex Ligation-dependent Probe Amplification, MLPA) of 324 breast cancer patients who were selected from a multi-ethnic hospital-based cohort on the basis of age of onset of breast cancer and/or family history. Three unrelated individuals were found to have large genomic rearrangements: 2 in BRCA1 and 1 in BRCA2, which accounts for 2/24 (8%) of the total mutations detected in BRCA1 and 1/23 (4%) of the mutations in BRCA2 detected in this cohort. Notably, the family history of the individuals with these mutations is largely unremarkable suggesting that family history alone is a poor predictor of mutation status in Asian families. In conclusion, this study in a multi-ethnic (Malay, Chinese, Indian) cohort suggests that large genomic rearrangements are present at a low frequency but should nonetheless be included in the routine testing for BRCA1 and BRCA2.

Topics: Adult; Age of Onset; Asian People; BRCA1 Protein; BRCA2 Protein; Breast Neoplasms; Breast Neoplasms, Male; Chromosome Breakpoints; Exons; Female; Gene Rearrangement; Genetic Predisposition to Disease; Humans; Malaysia; Male; Middle Aged; Ovarian Neoplasms; Pedigree; Phenotype; Risk Assessment; Risk Factors; Sequence Deletion

The cost of genetic testing and the limited knowledge about the BRCA1 and BRCA2 genes in different ethnic groups has limited its availability in medium- and low-resource countries, including Malaysia. In addition, the applicability of many risk-assessment tools, such as the Manchester Scoring System and BOADICEA (Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm) which were developed based on mutation rates observed primarily in Caucasian populations using data from multiplex families, and in populations where the rate of breast cancer is higher, has not been widely tested in Asia or in Asians living elsewhere. Here, we report the results of genetic testing for mutations in the BRCA1 or BRCA2 genes in a series of families with breast cancer in the multi-ethnic population (Malay, Chinese and Indian) of Malaysia.. A total of 187 breast cancer patients with either early-onset breast cancer (at age

Topics: Adult; Algorithms; Breast Neoplasms; DNA Mutational Analysis; Female; Gene Deletion; Genes, BRCA1; Genes, BRCA2; Humans; Incidence; Malaysia; Middle Aged; Mutation; Ovarian Neoplasms; Predictive Value of Tests

Topics: Adult; Age of Onset; Breast Neoplasms; Female; Founder Effect; Genes, BRCA1; Genetic Predisposition to Disease; Germ-Line Mutation; Humans; Introns; Malaysia; Middle Aged; Mutation; Mutation, Missense; Ovarian Neoplasms; Polymorphism, Genetic; Singapore

Topics: Breast Neoplasms; Case-Control Studies; Ethnicity; Female; Founder Effect; Genes, BRCA1; Humans; Malaysia; Middle Aged; Mutation; Ovarian Neoplasms; Singapore

The objective of this two year retrospective study is to find out the pattern of ovarian tumours among Malaysian women. A total of 280 cases were reviewed. Of these 193 were benign, 81 were malignant and six cases belonged to borderline malignancy. In the general population, equal distribution of serous and mucinous tumours among the benign (15.4%) and malignant (4.3%) types is quite a striking feature. The teratomas were the commonest benign tumour among the Malays and Chinese. Serous cystadenomas were the commonest among the Indians. The Malays had higher incidence of malignant epithelial tumours whereas the Chinese had a higher incidence of metastatic and germ cell tumours. Endometroid tumours occurred from an earlier age of thirty years. There was a preponderance of mucinous tumours among the borderline variety.

Topics: Adolescent; Adult; Aged; Carcinoma; Child; Child, Preschool; Female; Hospitals, General; Humans; Malaysia; Middle Aged; Neoplasms, Germ Cell and Embryonal; Ovarian Neoplasms; Retrospective Studies; Teratoma

Twenty-three cases of ovarian fibroma, comprising 3% of all benign tumors seen over a 20-year period, were analyzed. It was unilateral in all cases affecting more commonly the left ovary (70%). Whilst a majority of cases (77%) were encountered in the reproductive age group, the tumor was rare before the second decade. Only in 13% of cases was ascitis clinically detectable. This was not influenced by the size and weight (average of 9.3 x 10.8 x 11.1 cm and 959 g, respectively) of the tumors; a smooth-surfaced tumor was, however, associated with a greater amount of peritoneal fluid. Varying degrees of calcification in some tumors are detectable on ultrasonography and occasionally on abdominal radiography. The classical Meig's Syndrome was seldom encountered. The histopathological features, diagnostic problems and management are discussed.

Topics: Adult; Aged; Female; Fibroma; Humans; Incidence; Malaysia; Meigs Syndrome; Middle Aged; Ovarian Neoplasms; Ovary; Retrospective Studies

A ten-year review revealed a similarity in the incidence of teratoma in relation to other childhood tumors in Malaysian as compared with Caucasian children. The most common sites of origin were the sacropcoccygeal, gonadal, and retroperitoneal areas. The reason for the high incidence of retroperitoneal tumor in our series as compared with other countries is not clear. Late presentation and poor followup are associated with poor prognosis.

Topics: Abdominal Neoplasms; Child; Child, Preschool; Epidemiologic Methods; Female; Humans; Infant; Infant, Newborn; Malaysia; Male; Mediastinal Neoplasms; Ovarian Neoplasms; Parotid Neoplasms; Retroperitoneal Neoplasms; Teratoma; Testicular Neoplasms

A study of 207 benign ovarian tumors seen at the University Hospital, Kuala Lumpur between 1968 and 1975 was made to evaluate the clinical features that might be useful in the preoperative differentiation of mucinous cystadenoma, serous cystadenoma, and cystic teratoma of the ovary. This study indicated that the pertinent information included the mean age of the patient, the marital and menstrual status, and the estimated tumor size. The racial background was an additional factor in serous cystadenoma. Features like parity, the location of the tumor, and ABO blood group pattern were of no value in the preoperative differentiation.

Topics: Adult; Age Factors; Cystadenoma; Dermoid Cyst; Diagnosis, Differential; Female; Humans; Malaysia; Marriage; Menopause; Middle Aged; Ovarian Neoplasms; Racial Groups

Topics: Adolescent; Adult; Child; Dermoid Cyst; Female; Humans; Malaysia; Middle Aged; Ovarian Neoplasms; Pregnancy; Torsion Abnormality

The level of serum alpha-fetoprotein (AFP) was estimated by radioimmunoassay in 153 normal healthy Malysians of different ethnic groups. The mean level was 7.5 In1/ml (SD 2.28InU/ml). Among 330 patients with malignant tumors, 11 had increased levels of AFP. The only patient who had hepatoma had a very high level of serum AFP. High levels were also found in three of four patients with dysgerminoma of the ovary, in the only two patients with carcinoma of the testis, and in one patient with secondary carcinoma of the humerus of unknown origin. Lower, but significantly increased levels were observed in one patient (of 48) with breast carcinoma, one patient (of 8) with basal cell carcinoma of the nose, one patient (0f 27) with carcinoma of the lung, and one patient (of 59) with nasopharynegeal carcinoma.

Topics: Adult; alpha-Fetoproteins; Breast Neoplasms; Carcinoma, Hepatocellular; Female; Fetal Proteins; Humans; Liver Diseases; Liver Neoplasms; Malaysia; Male; Neoplasms; Nose Neoplasms; Ovarian Neoplasms; Pregnancy; Racial Groups; Testicular Neoplasms

Topics: Adolescent; Adult; Cystadenoma; Dermoid Cyst; Female; Humans; Malaysia; Ovarian Neoplasms; Pregnancy; Pregnancy Complications

Topics: Adolescent; Adult; Cystadenoma; Dermoid Cyst; Endometriosis; Female; Humans; Lymphangioma; Malaysia; Ovarian Cysts; Ovarian Neoplasms; Pregnancy; Pregnancy Complications; Singapore