Ovarian Cancer

Each year close to 600,000 women undergo a hysterectomy in the United States.[1] Although the number of these

The borderline category of ovarian tumors is one of the most controversial topics in gynecologic oncology and pathology, and is confusing to both clinicians and patients. Although numerous reviews have appeared in the literature, most of them rehash the prevailing views on borderline tumors without critically evaluating the published data that allegedly validate some rather puzzling and perplexing notions. For example, although these tumors are considered to be a subset of carcinoma, most patients are cured even when they have “metastatic” disease that has been inadequately treated. In addition, reports cite recurrence and death as late as 39 years after the diagnosis of tumors that appear histologically bland and noninvasive.

Ovarian tumors of low malignant potential (LMP) would benefit from a new name, not to mention a deeper understanding of their biology, effective treatment, and a framework within which they can be studied. Fortunately, for a pathologic entity that is poorly understood and also is unresponsive to current therapy, most LMP ovarian tumors carry a benign prognosis.

Low malignant potential (LMP) ovarian tumors represent a small subset of epithelial ovarian cancers that were first identified 70 years ago but were recognized in a systematic way only within the last 30 years. These lesions

WASHINGTON-All cancer patients should have the opportunity to participate in clinical trials, something that will occur only if Congress passes pending legislation to guarantee insurance coverage for the cost of routine patient care for study participants, speakers told a Capitol Hill briefing sponsored by the American Society of Clinical Oncology (ASCO).

SAN DIEGO-Annual transvaginal ultrasound screening permitted early detection of most ovarian cancers and improved 5-year survival from about 50% to 88% in screened patients, John R. van Nagell, MD, reported at a plenary session of the 31st Annual Meeting of the Society of Gynecologic Oncologists (SGO).

NEW ORLEANS-More than 300,000 US patients a year who receive chemotherapy will experience significant thrombocytopenia, Howard Ozer, MD, PhD, said at a symposium preceding the American Society of Hematology 41st annual meeting. The symposium was sponsored by MCP Hahnemann University, where Dr. Ozer is director of the Cancer Center, and supported by an unrestricted educational grant from Pharmacia & Upjohn.

Drs. Olin and Muss provide an excellent review of current state-of-the-art treatments and treatment strategies for patients with metastatic breast cancer. They explore a number of the existing questions in the treatment of metastatic breast cancer and emphasize the need for ongoing clinical trials.

Recent studies have elucidated some of the molecular and cellular mechanisms that determine the sensitivity or resistance to ionizing radiation. These findings ultimately may be useful in devising new strategies to improve the

NEW YORK-Cancer Care, Inc. has established a new program-The AVONCares Program for Medically Underserved Women-through a generous gift from The Avon Products Foundation. The program will provide financial assistance and relevant education and support to low-income, underinsured and uninsured, underserved women throughout the country in need of diagnostic and/or related services for the treatment of breast, cervical, and ovarian cancers.

SAN DIEGO-Data from a major randomized phase III trial show that carboplatin (Paraplatin)/paclitaxel (Taxol) should replace cisplatin (Platinol)/paclitaxel as standard treatment for optimal stage III ovarian cancer, Robert F. Ozols, MD, PhD, said at the Society of Gynecologic Oncologists 31st Annual Meeting.

A study released at the recent annual meeting of the Society of Gynecologic Oncologists (SGO) challenges the traditional management of ovarian cancer in young women by suggesting that conservative surgery (which often allows for future

Meta-analysis is a systematic, quantitative approach to the combination of data from several clinical trials that address the same question. This analytic approach can help resolve questions that remain unclear from the results

BUFFALO, NY-Survival in patients with ovarian cancer by stage is similar to that of other cancers, William Hoskins, MD, said at the Surgical Oncology Symposium, hosted by Roswell Park Cancer Institute. “However, the vast majority of women are diagnosed with advanced disease, and there are no screening methods available to change this truth. Until screening methods improve, the surgical treatment offered these women is critical to their survival,” said Dr. Hoskins, chief, Gynecology Service, Memorial Sloan-Kettering Cancer Center.

Prostate cancer is the most common form of noncutaneous cancer in men in the United States. Despite its prevalence, the natural history of this disease is remarkably heterogeneous. In many patients, the cancer

NEW YORK-Two new strategies for treating advanced ovarian cancer may improve the outlook for this difficult to treat disease. Early data from trials of repeating and sequential doublets of cisplatin (Platinol)-based drug combinations have shown encouraging results, according to presentations at the Chemotherapy Foundation Symposium XVII.

BETHESDA, Md-Four institutions have received SPORE (Specialized Program of Research Excellence) grants from the NCI for ovarian cancer research. The grants, totaling $5.85 million for the first year, went to:

ROCKVILLE, Md-The Food and Drug Administration has approved a new indication for Bristol-Myers Squibb’s Taxol (paclitaxel) for use in the adjuvant treatment of node-positive breast cancer administered sequentially to standard doxorubicin-based combination therapy. The approval does not exclude patients with receptor-positive tumors, even though a subgroup analysis of the supporting data suggested no benefit in this group.

Although endometrial cancer is the most common gynecologic malignancy diagnosed in US women, it has not received the same attention from health care professionals and the lay public as has its more lethal counterpart in the female gonad-epithelial ovarian cancer.

The article by Drs. Dan Labriola and Robert Livingston on possible interactions between dietary antioxidants and chemotherapy, published in the July issue of Oncology (13,1999), is based on a theoretical concern that has proven to be unfounded when actually tested in clinical trials. Contrary to the authors’ assertions, numerous studies, including in vitro experiments, animal trials, and small human trials, have consistently shown an enhancement of tumor kill and patient survival when antioxidants are combined with conventional cancer therapies.

Endometrial carcinoma is the most common gynecologic malignancy in the United States. Most cases are diagnosed at an early stage. However, the outcome for women diagnosed with advanced-stage disease remains poor. The etiology of most endometrial carcinomas stems from the effects of excess estrogen, whether this comes from exogenous or endogenous sources. Differences in epidemiology and presentation suggest the existence of two forms of endometrial cancer: those related to and those unrelated to hormonal stimulation. Most women with endometrial cancer present with abnormal uterine bleeding; endometrial sampling is essential to exclude endometrial carcinoma in such patients. Endometrial cancer is surgically staged, and staging usually includes a hysterectomy and bilateral salpingo-oophorectomy. Lymphadenectomy also should be performed in selective cases to better assess disease spread and to evaluate the need for adjuvant therapy. Adjuvant treatment may include the use of radiation, progestins, or cytotoxic chemotherapeutic agents. Several clinical trials are underway to compare these treatment modalities, as well as to determine the optimal combination of active chemotherapeutic agents, such as doxorubicin, platinum agents, and paclitaxel (Taxol). [ONCOLOGY 13(12):1665-1675, 1999]

WASHINGTON-“Cancer crosses party lines and so should the battle against it,” said Rep. Rick Lazio (R-NY), one of seven senators and congresspersons honored by the National Coalition for Cancer Research (NCCR) with its Congressional Champion Awards.

VIENNA, Austria-For Stanley Kaye, MD, of the University of Glasgow, the milestones of the ’90s in the treatment of ovarian cancer were the discovery that taxanes are superior to alkylating agents in combination with platinum and the recognition that the “soft option” carboplatin (Paraplatin) is equivalent in efficacy to cisplatin (Platinol).

NEW YORK-Ovarian cancer is on its way to becoming a chronic disease, William P. McGuire III, MD, said at a press conference of the advocacy group, Ovarian Cancer National Alliance.

SILVER SPRING, Md-The Oncologic Drugs Advisory Committee (ODAC) unanimously recommended that the FDA approve Taxol (paclitaxel for injection, Bristol-Myers Squibb) for use in the adjuvant treatment of node-positive breast cancer administered sequentially to standard doxorubicin-based combination therapy.

For many women under 40 years of age with breast cancer, surgery to remove the cancerous lump and accompanying radiation therapy seem to be the best option for eradicating the disease and preserving the natural breast. However, for women who carry a damaged version of the BRCA1 or BRCA2 gene, thus predisposing them to breast cancer, such treatment may be insufficient. Researchers at Jefferson Medical College have found that these women are at greater risk years later of either relapsing or developing new tumors than are similarly treated women who do not carry one of these genes.

A landmark study showed that a new drug combination-paclitaxel (Taxol) and carboplatin (Paraplatin)-is better for the treatment of advanced ovarian cancer because it is significantly less toxic in patients. The combination also maintained the

Combination chemoradiation, alone or as an adjuvant to surgery, has been shown to improve treatment outcomes in a number of human malignancies, but may be limited by normal tissue toxicities. A primary challenge in

The Gynecologic Cancer Foundation, along with the American Hospital Association, has declared September 1999 the first annual Gynecologic Cancer Awareness Month. Each year, 82,000 women in the United States (ie, 1 in every 25 women) are

New treatment strategies for small-cell lung cancer patients are required, as there have been few developments in the past 20 years. Paclitaxel (Taxol) has been shown to be effective in non–small-cell lung cancer when given in