Fetus can 'catch' mum's cancer

In rare circumstances, it is possible for cancer to be passed in the womb from mother to fetus, according to international researchers. A team of British and Japanese researchers, writing in the journal Proceedings of the National Academy of Sciences, report the case of a Japanese woman who developed acute lymphoblastic leukemia (ALL) shortly after giving birth, and at 11 months, her daughter developed tumors in her cheek and fluid on her lungs.

The researchers examined the DNA of the child's tumors and found that the cells carried the same mutation as the mother's cancer cells, however the child's own DNA did not contain the mutation. Additionally, the child's cancer cells lacked genes related to immune system function which normally block any cancer cells which passes through the placental barrier during pregnancy. 'It appears that in this, and other cases of mother-to-offspring cancer, the maternal cancer cells did cross the placenta into the developing fetus and succeed in implanting because they were invisible to the immune system', said lead researcher Professor Mel Greaves, from the Institute of Cancer Research in the UK.

Genetic analysis showed that there was no DNA from the child's father in her cancer cells, ruling out the possibility that she inherited the disease at conception. Professor Peter Johnson, the chief clinician at charity Cancer Research UK, emphasized that this kind of case is very rare. There are records of only 17 similar cases worldwide, where cancer breaches the placental barrier and is able to grow in the fetus without being attacked by the immune system. 'This is really important research as it adds to the evidence that cancers need to evade the immune system before they can grow, giving hope that by alerting a patient's immune system to a cancer, we can develop new types of treatment', said Professor Johnson.

Assessing Embryo Metabolism May Aid IVF Success

Examining the metabolism of embryos may help determine which ones offer the best chance of success with in vitro fertilization (IVF), a new study finds.

Currently, the process of selecting embryos for implantation in the mother's womb is highly subjective.

"It's a guessing game that can end in IVF failure or multiple pregnancies," Dr. Emre Seli, an associate professor in the obstetrics, gynecology and reproductive sciences department at Yale School of Medicine, said in a school news release. "Our goal is to find a way to pinpoint the embryos with the best chance of success, so that we can transfer fewer embryos and cut down on the possibility of multiple pregnancies without reducing the pregnancy rate."

Seli and colleagues have studied the metabolomic profiles of spent embryo cultures. A metabolomic profile is a unique chemical signature of the activity of embryos in culture.

The Yale team found that a viability score based on a noninvasive metabolomic assessment of embryo culture media affected pregnancy outcomes in women treated at four centers in Europe and Australia. The research, performed in collaboration with Molecular Biometrics Inc., was presented this week at the American Society for Reproductive Medicine annual meeting, in Atlanta.

"These findings have important implications for the more than 125,000 IVF cycles performed yearly in the United States," Seli said. "The high multiple pregnancy rates associated with IVF have significant public health consequences, such as decreased survival and increased risk of lifelong disability associated with severe prematurity."

Cutting Edge in Gynecological Oncology - A MOGS Indo-Israeli Year Event

The MOGS Live Surgical Workshop on the Cutting Edge in Gynecological Oncology was held on 14 November 2009. Cases were performed at the Tata Memorial Hospital, Parel and relayed live to the ITC Grand Grand Central, Parel, Mumbai.

In the morning session, there was a demonstration on Radical hysterectomy for carcinoma cervix by Dr.Rajendra Kerkar.During the course of surgery he especially highlighted the nuances of surgical anatomy with respect to the pelvic vasculature and lymph nodes. This was followed by a demonstration of laparotomy for a large pelvic mass. It turned out to be large degenerating fibroid. This challenging case was skillfully dealt with by the invited Israeli onco-surgeons Dr.Jacob Korach and Prof.Gilad Ben-Baruch.

The next case demonstrated was that of groin node dissection for positive groin nodes in a case of Ca Vulva, which was operated upon by the invited onco-surgeons from Israel. There was healthy interaction between the faculty in the Operation Theatre and the chairpersons and audience at the ITC.

Laparoscopic Radical Hysterectomy-Pune Technique
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In the afternoon session, the Israeli team demonstrated two cases of laparotomy for ovarian masses. In the first case they performed a debulking/cytoreductive surgery for a cystic ovarian tumor. The procedure was carried out very smoothly and it was much appreciated.

This was followed by a secondary cytoreductive procedure. Prof.Jacob Korach and Dr.Gilad Ben-Baruch demonstrated the technique of omentectomy and interacted with the audience about their approach, their surgical technique and their experience in Israel.

The operation theatre at the Tata Memorial Hospital was coordinated by Dr Rajendra Kerkar. The sessions were chaired by Dr GB Belvi, Dr S Sanjanwala and Dr Madhvi Pandya in the morning and Dr Reshma Rao and Dr Aparna Prabhu in the afternoon.

The workshop was attended by over 100 delegates not only form Mumbai but also from all over the country.The organizing secretaries were Dr Sulbha Arora and Dr Parikshit Tank.

The MOGS Conference on the Cutting Edge in Gynecological Oncology was held on the 15th November 2009 at the ITC Grand Central, Parel, Mumbai. There were 127 registrations for this event. There were 35 delegates from outside Mumbai attending the Conference.

Cutting Edge in Gynecological Oncology - Conf Inauguration
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The opening session was an Invited Video Session. The faculty demonstrated a variety of open and laparoscopic techniques for the entire gamut of gynecological cancers. Dr Shailesh Puntambekar, one of the invited faculty from Pune, has been recently awarded the Golden Laparoscope Award from the AAGL. As a last minute request, he shared with the audience his award winning video on laparoscopic posterior exenteration.

Complications of Laparoscopic Surgery-Video album
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The Conference was then officially inaugurated. Appreciation plaques were awarded to Dr Rajendra Badwe, Director, Tata Medical Center and Dr Rajendra Kerkar. The Israeli faculty members, Professor Gillad Ben-Baruch and Dr Jacob Korach were thanked for their efforts at the Workshop yesterday and for their visit to India. Dr Puntambekar was felicitated for his recent achievements.

The next session of invited lectures featured dilemmas in borderline tumors by Dr Anita Borges, a celebrated name in the field of cancer pathology. Dr Jacob Korach from Israel gave a balanced view on treating gynecological cancer in the geriatric patient. The concept of cytoreduction for ovarian cancers was expounded by Dr Hemant Tongaonkar.

Before lunch, Dr Amish Dalal conducted a well-planned and informative panel discussion on controversies in gynecological oncology. The panel comprised of surgeons (Dr Jacob Korach, Dr Amita Maheshwari and Dr Murad Lala), radiation oncologists (Dr V Kannan and Dr U Mahantshetty) and medical oncologists (Dr H Menon and Dr Kumar Prabhas). The discussion was fruitful and had -important take-home messages for the delegates.

After lunch, we opened up the newer vistas of minimal access surgery in gynecological oncology. Dr Neeta Warty dealt with the suspicious adnexal mass. Dr Puntambekar spoke about complications and the videos on the problems one can face were engrossing. Interestingly, most of the complications were treated laparoscopically as well. Dr Rajendra Kerkar gave a detailed account of minimal access surgery and future directions in gynecological cancers.

The next session was a sponsored session on prevention of cervical cancer. Dr Ashwini Bhalerao Gandhi and Dr Bhaskar Pal from Kolkatta spoke on this subject and this was followed by an audience interaction.

The last session was the Indo Israeli Keynote Address. Professor Gilad Ben-Baruch brought with him his immense experience on the subject of his interest, organ preservation and conservatism in gynecological oncology. His talk was peppered with case notes and personal insights which enthralled the audience.

On the whole, the scientific content was of high quality. The program ran on schedule with adequate time for the audience to participate. The venue was well-appointed with a sumptuous lunch buffet. The hotel staff extended a great deal of co-operation to make the program a pleasure to attend and organize.