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Monday, February 26, 2024
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Targeted Therapy For Ovarian Cancer
Latest Treatment That Damage Cancer Cells

Targeted therapy is a newer type of cancer treatment that uses drugs or other substances to identify and attack cancer cells while doing little damage to normal cells. These therapies attack the cancer cells' inner workings − the programming that makes them different from normal, healthy cells. Each type of targeted therapy works differently, but all alter the way a cancer cell grows, divides, repairs itself, or interacts with other cells.

Bevacizumab (Avastin) belongs to a class of drugs known as angiogenesis inhibitors. In order for cancers to grow and spread, they need new blood vessels to form to nourish the tumors (called angiogenesis). This drug binds to a substance called VEGF that signals new blood vessels to form. This can slow or stop the growth of cancers.

In studies, bevacizumab has been shown to shrink or slow the growth of advanced epithelial ovarian cancers. Trials to see if bevacizumab works even better when given along with chemotherapy have shown good results in terms of shrinking (or stopping the growth of) tumors. But it doesn’t seem to help women live longer.

This drug is given as an infusion into the vein (IV) every 2 to 3 weeks.

Common side effects include high blood pressure, tiredness, bleeding, low white blood cell counts, headaches, mouth sores, loss of appetite, and diarrhea. Rare but possibly serious side effects include blood clots, severe bleeding, slow wound healing, holes forming in the colon (called perforations), and the formation of abnormal connections between the bowel and the skin or bladder (fistulas). If a perforation or fistula occurs it can lead to severe infection and may require surgery to correct.

PARP inhibitors

Olaparib (Lynparza), rucaparib (Rubraca), and niraparib (Zejula) are drugs known as a PARP (poly(ADP)-ribose polymerase) inhibitors. PARP enzymes are normally involved in one pathway to help repair damaged DNA inside cells. The BRCA genes (BRCA1 and BRCA2) are also normally involved in a different pathway of DNA repair, and mutations in those genes can block that pathway. By blocking the PARP pathway, these drugs make it very hard for tumor cells with a mutated BRCA gene to repair damaged DNA, which often leads to the death of these cells.

Olaparib (Lynparza) and rucaparib (Rubraca) are used to treat advanced ovarian cancer, typically after chemotherapy has been tried. These drugs are used mainly in patients who have mutations in one of the BRCA genes. Only a small portion of women with ovarian cancer have mutated BRCA genes. If you are not known to have a BRCA mutation, your doctor will test your blood to be sure you have one before starting treatment with one of these drugs.

Olaparib can also be used to treat patients (with or without a BRCA mutation) with advanced ovarian cancer that has come back after treatment, and then shrank in response to chemotherapy containing cisplatin or carboplatin. Olaparib can help extend the time before the cancer comes back or starts growing again.

In studies, these drugs have been shown to help shrink or slow the growth of some advanced ovarian cancers for a time. So far, though, it's not clear if they can help women live longer.

Niraparib (Zejula) is typically used to treat recurrent ovarian cancer, after chemotherapy has been tried. This drug can be used to treat women with or without a BRCA gene mutation.

All of these drugs are taken daily by mouth, as pills.

Side effects of these drugs can include nausea, vomiting, diarrhea, fatigue, loss of appetite, taste changes, low red blood cell counts (anemia), belly pain, and muscle and joint pain. Rarely, some patients treated with these drugs have developed a blood cancer, such as myelodysplastic syndrome or acute myeloid leukemia.

Other targeted therapy drugs are also being studied.

See Targeted Therapy for more information about these kinds of drugs.
Written by Editorial Team of American Cancer Society
References American Cancer Society at

The American Cancer Society medical and editorial content team

Coding For Proper Modifier Use In Urology
Things You Need to Know in Billing Urology

Live Webinar | Michael Ferragamo


Modifiers have been used in urological coding for many years to obtain correct payments for services provided. Recently the office of the Inspector General, OIG, in its review of the use of modifiers have discovered errors in the use of some of the most commonly used modifiers with the result of overpayments to urologists and other providers. Because of this, CPT and CMS and their medical agencies have increased their surveillance of the use of all modifiers. New modifiers have been installed to clarify the use of certain codes and procedures and to limit the use of some modifiers. Certain modifiers have been identified for special observation and investigation as to their correct usage.

Attendance at this audio-conference will provide the attendees the necessary infōrmation to avoid misuse of specific modifiers and to understand the overall use of modifiers in general. Explanations on how to avoid denials and to ensure proper payments will be máde.

Tips of the Trāde: Tips on coding new and old modifiers will be explained with many clinical examples. When modifiers should be used and when they should not be used will be stressed. Criteria for modifier use will be clearly presented.

Aspects covered in the Session:

The follōwîng will be discussed:

the proper use of modifier-59,
the use of the relatively new modifiers X{ESPU} used in place of modifier -59,
when and how the new modifiers should be used,
the use of modifier-25, a real problem and how to properly use this modifier with E/M services and how to avoid denials when using this modifier,
criteria for use of modifiers 24, 57, 58,
modifier use when sharing patient surgical care, what modifiers should be used.
how to bill for post-surgical care within the global period,
how to bill for surgeries and postoperative care given by different unrelated physicians, and
much more.
For more details Cāll us:- +1-888-800-7608 or Order Through- ORDER FŌRM by emailing us if you want to opt out please email us -

Facts You Need to Know About Podiatry
And Patients Treated by the Medical Specialty


Hugo K. Koch, M.H.A., and Hazel M. Phillips, Division
INTRODUCTION It is based on the findings
of a nationwide survey of podiatrists conducted
by the National Center for Health Statistics
during. The survey
information was collected through a
self-administered questionnaire mailed to all
licensed podiatrists in the United States.

This report on patient characteristics is the
third report to issue from the survey findings.
The first report offered a general demographic
and professional profile ofthe 8,017 podiatrists
in the United States who were active and
inactive in their profession in 197O.r The second
report focused on specific aspects of podiatric
practice reported by the estimated 7,078
podiatrists who were actively engaged in patient
care at the time of the survey.* Highlighting
significant findings from these reports:

‘National Center for Health Statistics: Podiatry manpower:
A general profile, Vital and Health Statistics, Series 14, No. 10,
DHEW Pub. No. (HR4) 74-1805, Health Resources Administration,
Washington, U.S. Government Printing Office.

*National Center for Health Statistics: Podiatry manpower:
Characteristics of clinical practice, United States, Vital
and Health Statistics, Series 14, No. 11, DHEW Pub. go. (HRA)
74-1806, Health Rqsources Administration, Washington, U.S.
Government Printing Office,
of Health Manpower and Facilities Statistics

1. Of the 8,017 podiatrists estimated to be
active and inactive in their profession at
the time of the 1970 survey, 7,113
(about 89 percent) were ,active; and 904
(about 11 percent) were inactive-3 70 by
reason of retirement and 533 for other

2. The national ratio of active podiatrists to’
population was about 3.5 podiatrists per
100,000 population.

3. Podiatrists were unevenly distributed
throughout the Nation. They tended to
concentrate in areas of the greatest
population density. Five States (New
York, California, Pennsylvania, IIhnois,
and Ohio) accounted for more than half
(3,836) of the total number of active
podiatrists. Of the four’ census regions
(Northeast, South, West, and North
Central), the Northeast had the highest
concentration of active podiatrists (6.1
podiatrists per 100,000 population); the
South had the lowest (1.6 per 100,000).

4. About 96 percent of alI active podiatrists
were male. The median age of all active
podiatrists was about 51 years; and the
median number of years active in
podiatry was about 21.

5. About 69 percent held active licenses in
only’ one State.
6. More than 99 percent of all active
podiatrists (7,078) engaged to some
extent in the direct care of podiatric
patients. About 3.5 percent devoted
some time to teaching in colleges of
podiatry; about 7 percent engaged to
some degree in podiatric research; and
about 11 percent were at least partially
active in administrative duties other than
those connected with the care of patients

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