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Ovarian Cancer

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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).

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.

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

ROCKVILLE, Md-Doxil (doxorubicin HCl liposome injection, ALZA Corporation) has won accelerated FDA approval of its supplemental New Drug Application for the treatment of metastatic ovarian cancer refractory to both paclitaxel (Taxol)- and platinum-based chemotherapy regimens. Accelerated approval requires the company to conduct additional research to demonstrate that the drug is associated with clinical benefit. Doxil, a liposomal formulation of doxorubicin, is currently approved for use in AIDS-related Kaposi’s sarcoma.

ROCKVILLE, Md-The FDA has approved Ethyol (amifostine for injection) as a therapy to decrease the incidence of moderate-to-severe xerostomia in patients undergoing postoperative radiation treatment for head and neck cancer. The approval came only 2 weeks after the Oncologic Drugs Advisory Committee (ODAC) recommendation.

SAN FRANCISCO–Ovarian cancers associated with mutations in the BRCA gene have a different underlying biology than nonhereditary cancers and may respond better to treatments not routinely applied in ovarian cancer, according to a study reported at the 30th Annual Meeting of the Society of Gynecologic Oncologists.

SAN FRANCISCO-Women who have survived breast cancer are at increased risk for subsequent ovarian cancer, and this risk is especially high in women diagnosed with breast cancer before age 50 and in African-American, Asian, and Hispanic women, according to data presented at the 30th Annual Meeting of the Society of Gynecologic Oncologists.

Depression serious enough to affect daily functioning occurs in one of every five patients who have epithelial ovarian cancer, according to data presented at the 30th Annual Meeting of the Society of Gynecologic Oncologists. Diane Bodurka-Bevers, MD, and her colleagues at the University of Texas M.D. Anderson Cancer Center studied this problem in 275 patients with ovarian cancer.

NEW ORLEANS-When talking with women about their personal risk of developing breast cancer, “terms such as relative risk are not very useful,” Patricia Kelly, PhD, said at the American Society of Breast Disease annual meeting, co-sponsored by the Ochsner Medical Foundation, New Orleans.

BALTIMORE-Physicians must help patients sort through the many diagnostic, predictive, and therapeutic alternatives raised by genetic testing, a trio of genetic specialists from Johns Hopkins said at a meeting on clinical cancer genetics and genetic testing.

SAN FRANCISCO-Five-year survival was significantly better for women with advanced-stage ovarian cancer diagnosed from 1988 to 1994 than for those diagnosed from 1983 to 1987, according to research presented at the 30th Annual Meeting of the Society of Gynecologic Oncologists. This improvement is thought to be due to increased use of surgical debulking and adjuvant platinum/paclitaxel (Taxol).