Ovarian Cancer: The Good News

Featured Article, Healthy Living, Ovarian Cancer, Women's Health
on September 5, 2012

We’ll say it straight out: When it comes to ovarian cancer, good news is hard to come by. Although it accounts for only about three percent of all cancers in women, ovarian cancer takes a deadly toll. In 2012, the American Cancer Society estimates that 22,280 women will be diagnosed with ovarian cancer and some 15,500 will die from it. Only 46 percent of women with the disease survive five years after diagnosis, compared with 89 percent for women with breast cancer.

What makes ovarian cancer so lethal is that many women don’t know they have it until the cancer is Stage 3 or 4; only 20 percent of women are diagnosed early enough for the cancer to be treated successfully. Amid these sobering facts, though, there is hope: Across the country, an army of researchers are looking for ways to better prevent, detect and treat ovarian cancer—and they’re making progress.“Without a doubt we are chipping away at this,” says Dr. Kristin Zorn, medical director of the Magee-Womens Hospital High Risk Ovarian Cancer Program in Pittsburgh. “In the last two years, our knowledge about the molecular mechanisms at work in ovarian cancer has increased dramatically. This is not a cancer that’s caused by a single mutation. We are not going to have one of those miracle home run success stories. Instead we’re increasing our knowledge through baby steps. But we are getting there.” Here—to mark September’s Ovarian Cancer Awareness Month—is an overview of the most promising news.

A new risk factor could lead to preventive medicines. Researchers from the Ovarian Cancer Association Consortium confirmed that women who have a history of endometriosis are at greater risk for three types of ovarian cancer. According to the study, published in Lancet Oncology, endometriosis is associated with more than a threefold chance of developing clear-cell ovarian cancer. It also doubles a woman’s risk of endometrioid tumors and low-grade serous ovarian cancer. While most women with endometriosis don’t develop ovarian cancer, say the researchers, healthcare providers should be aware of the increased risk.Next up: “What we need to figure out now as scientists is how do we identify the subset of endometriosis that is highest risk to become malignant,” says Zorn, who is also an assistant professor at the University of Pittsburgh School of Medicine.The hope is that one day doctors will be able to identify women with high risk endometriosis, and allow doctors to develop drugs to mitigate their risk, as tamoxifen works to medically manage breast cancer in high-risk patients, Zorn says.

Yoga helps survivors heal—physically and emotionally. A study published in the Journal of Evidence-Based Complementary & Alternative Medicine found that women who did yoga andregular exercise scored higher on measures of general health, emotional health and physical functioning than women who only exercised or women who didn’t work out at all. What’s more, they had fewer physical limitations, experienced less pain and had more vitality than women who only did regular exercise. Case in point: Neuropathy, a common chemo side effect in ovarian cancer survivors, was dramatically reduced in women who did regular exercise and yoga. Among women who neither exercised nor practiced yoga, 49 percent experienced neuropathy; among those who exercised regularly, 41 percent reported neuropathy.  But among women who both exercised and did yoga, just nine percent had neuropathy, characterized by pain, burning tingling, trouble using one’s fingers, balance problems, and muscle weakness, among other symptoms.

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Friends really do help. A study in a recent issue of the Journal of Clinical Oncology reported that 59 percent of women who had strong social connections to other people were still alive after 4.7 years compared to women who didn’t have them. The researchers found no effect on survival among women who had instrumental social support, defined as the availability of help, information and advice from other people. Strong social ties may blunt stress and activate the hormone oxytocin, both of which may slow tumor growth.

Freezing tumors adds years to survivors’ lives. According to researchers at Wayne State University in Detroit, 98 percent of 21 patients whose tumors were frozen using a procedure called cryoablation had a survival rate of 56 months–equivalent to 4.6 years. Most women whose tumors aren’t successfully removed live only seven months to two-and-one-half years. During the procedure, a super-cold needle is inserted through the skin, using ultrasound or another imaging technology to guide the needle to the tumor. The extreme cold destroys the tumor. Reality check: There’s no guarantee the cancer won’t recur.

Removing fallopian tubes may protect high-risk women. Many scientists now think that a deadly form of ovarian cancer—high-grade serous—may actually begin in the fallopian tubes. In Canada many doctors now discuss removal of the fallopian tubes with women who have finished having children and are already scheduled to have pelvic or abdominal surgery, such as a hysterectomy. “We don’t yet know if removing the tubes will provide adequate protection against cancer,” says Zorn. In addition, it’s an irreversible form of contraception and brings on menopause, which raises a woman’s risk for osteoporosis and heart disease. The upshot: While the new thinking is provocative, more research is needed.

More funding for ovarian cancer research. Thanks to the efforts of ovarian cancer advocates, federal ovarian cancer research dollars were not slashed for fiscal year 2012, as many feared they might be. Indeed, Congress appropriated $5 million for Johanna’s Law, which received no monies last fiscal year. Johanna’s Law:  The Gynecologic Education and Awareness Act directs the Centers for Disease Control and Prevention (CDC) to educate women about gynecological cancers, including ovarian cancer. The Ovarian Cancer Control Initiative, run by the CDC, received $4.9 million. The initiative focuses on improving early detection, symptom awareness and treatment of ovarian cancer. And the Department of Defense’s Ovarian Cancer Research Program, which funds studies across the country, received $16 million.