When Gene Wilder passed away this August, remembrances of him inevitably turned to his late wife Gilda Radner, her battle with ovarian cancer and the work he did to promote ovarian cancer detection and awareness in her honor. Unfortunately, Radner’s losing battle is all too familiar with this particular cancer, which is hard to detect and challenging to treat. September is National Ovarian Cancer Awareness Month, so it marks a good time to take another look at this disease.
Types of Ovarian Cancer
There are three main types of ovarian cancer, distinguished by the type of cells in which they start:
- Epithelial ovarian tumors – derived from the cells on the surface of the ovary or fallopian tube
- Germ cell ovarian tumors – derived from the cells that produce eggs
- Cord-stromal cell ovarian tumors – derived from the connective tissue within the ovary
When any of these types spread to other areas of the body, it is referred to as metastatic ovarian cancer.
Challenges of Ovarian Cancer
According to the American Cancer Society, ovarian cancer ranks fifth in cancer deaths among women, accounting for more deaths than any other cancer of the female reproductive system. In 2016, about 22,280 women will receive a new diagnosis of ovarian cancer, and 14,240 women will die from ovarian cancer.
The ovaries present a screening challenge because they’re not as accessible as other parts of the body—like breasts or lungs—making cancer screening tests unsuccessful up to this point. The annual PAP screen most women get, for instance, does not test for ovarian cancer. The PAP screens for cervical cancer. Currently, there are two tests used to screen for the cancer: transvaginal ultrasound (TVUS) and the CA-125 blood test. But according to the American Cancer Society, neither is definitive or 100 percent accurate.
Ovarian cancer symptoms—like a swollen or bloated abdomen, persistent pressure or pain in the abdomen or pelvis, urinary concerns and unexplained vaginal bleeding—are too similar to the symptoms of PMS and menopause to readily diagnose as cancer. Symptoms also do not typically present until the disease is well advanced and has metastasized in other parts of the body.
Current National Comprehensive Cancer Network (NCCN) guidelines recommend that initial treatment for ovarian cancer include surgery to remove tumors combined with chemotherapy drugs that work by disrupting the cell division process and killing fast-growing cells.
Unfortunately, 75-80 percent of the women who initially respond to treatment will have a recurrence of their disease, and the chemotherapy drugs used initially may no longer be effective.
Targeted therapy uses drugs that target a specific feature of the cancer cells. These therapies are less likely to harm normal, healthy cells than chemotherapy. Bevacizumab, olaparib and pazopanib are all approved to treat ovarian cancer.
Hormone therapy is sometimes used for recurrent ovarian cancer. It stops the body from making certain hormones that may be contributing to the growth of the cancer, thereby slowing the growth. Specific hormone therapy drugs include, tamoxifen, anastrozole, leuprolide acetate, megestrol acetate.
Molecular profiling of tumors is a more recent innovation in ovarian cancer treatment. This process enables a physician to select drugs based on a patient’s individual disease, which may lead to more effective drug use. This personalized treatment approach based on a molecular profile has been used successfully to make treatment choices for patients with conditions like breast, colon and lung cancer. It has been used less frequently with ovarian cancer, but shows promise.
Ovarian cancer is among the cancers that Dr. Perez has successfully treated in his practice since opening the Sierra Nevada Cancer Center (SNCC) in 2002. He takes a personalized approach to cancer fighting and uses the entire toolbox of cancer fighting tools at all SNCC locations and with all patients, regardless of their type of cancer.
If you or someone you love has recently been diagnosed with ovarian cancer and are looking for an oncologist, please contact us to schedule an appointment with Dr. Perez. To get current cancer-related news delivered to your inbox, subscribe to our newsletter and be sure to stay connected to Dr. Perez and Sierra Nevada Cancer Center on Facebook.