OVARIAN CANCER BREAKTHROUGH
It's called the silent killer. Less than half of women diagnosed with ovarian cancer will live five years. But now, a special kind of chemotherapy lets them live longer.
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Grandmother Mable Parr should be a natural at driving a videogame racecar.
For 21 years, she drove a school bus and a tractor. But last July, she hit a life-changing bump.
Mable Parr
Had ovarian cancer
"Every time I hit a rut, I had pain. So, I went to the doctor, and I had a CatScan, and it was ovarian cancer."
Mable had surgery to remove the tumor and is now getting a special kind of chemotherapy.
Along with standard chemo given through an IV, Mable has chemo delivered directly into her abdominal cavity through a catheter. New research shows women live about 16 months longer with it.
Kristine Zanotti, MD
Gynecologic Oncologist
University Hospitals of Cleveland
Cleveland, OH
"We might see these women actually living through what we would consider a cancer that, that otherwise might have taken their lives."
The method allows doctors to give 20 to 1,000 times the dose of chemo because fewer healthy cells are harmed.
Kristine Zanotti, MD
"With that comes an enhanced killing effect, an enhanced effectiveness."
Mable is one of the lucky ones. She's cancer-free and feeling better each day.
Mable Parr
"I've had more time off from work than I have in 25 years, and I'm getting cabin fever. I want to go back to work."
After all, driving a bus is a little more up her alley.
Mable Parr
"Much easier."
Even with some helping hands.
A side effect unique to this type of chemo is abdominal discomfort and infections from the catheter. But Doctor Zanotti says doctors are working to improve catheters and improve the delivery. The treatment is available at most major medical centers in the country.
SILENT KILLER: They call it the silent killer. Less than half of women diagnosed with ovarian cancer will survive five years after their initial diagnosis. Women with cancers unable to be debulked (reducing tumor size) effectively have an average survival of a little over a year and will have about two years if their cancer can be debulked effectively.
TREATMENT: Women are typically treated first with surgery and then chemotherapy through an IV. However, this method is limiting in terms of the side effects of the chemo on healthy cells. Doctors are limited in how high a dosage they can give because of these effects.
INTRAPERITONEAL METHOD: Through intraperitoneal (IP) chemotherapy delivered into the abdominal, or peritoneal, cavity instead of through a vein, doctors are able to circumvent some of the limitations associated with the IV. The cancer can be exposed to concentrations of chemotherapy that are 20- to 1,000-times higher. "With that comes an enhanced killing effect, enhanced effectiveness, and we see that in the survival rates," explains Kristine Zanotti, M.D., a gynecologic oncology physician at the University Hospitals in Cleveland, Ohio.UNDER STUDY: A multi-center study conducted by the National Cancer Institute, part of the National Institutes of Health, and published in The New England Journal of Medicine, recently revealed the IP method can extend overall survival by an average of 16 months. Even women who didn't complete the full six-course treatment had longer survival rates. For the study, 429 women with state III ovarian cancer were given chemotherapy following the successful surgical removal of tumors -- either just IV chemo or IV with IP chemo. The two chemo drugs studied were paclitaxel and cisplatin. Other research has centered around IP chemo, but this is the first to provide enough evidence for the method to become the new gold standard. It is also one of the first cancer studies to show a particular treatment method can actually extend survival instead of just delaying recurrence or providing better treatment tolerance. Dr. Zanotti says: " I think we may actually get more real cures 20 or 30 years out. We might see these women actually living through what we would consider a cancer that otherwise might have taken their lives."
SIDE EFFECTS: In the study, women who received IP chemo had more side effects than those treated with just IV chemo, but those effects were temporary and easily managed. Dr. Zanotti says having abdominal discomfort is an effect unique to IP chemo because infection rates from the catheter have historically been high. However, Dr. Zanotti adds researchers are working to improve catheters and delivery assistance. She says if that can be improved and an even better, more toxic drug combination -- such as replacing cisplatin with carboplatinum -- is determined, more patients will be able to complete the full chemotherapy course, and there would be even better results.CANDIDACY: IP chemo is best for women with who have had optimal results from tumor removal in surgery, meaning the surgeon reduced the volume of the tumor to what is considered microscopic or less than one centimeter. IP chemo is not intended for women with recurrent cancers or bulky cancers.
Alicia M. Reale
University Hospitals of Cleveland
11100 Euclid Ave.
Cleveland, OH 44106-6031
(216) 844-5158
alicia.reale@uhhs.com
Copyright © 2006 Ivanhoe Broadcast News, Inc.
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