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Posted at 07:00 AM ET, 01/02/2012

Ovarian cancer drug fail (and that’s the good news?)

How bad is ovarian cancer? Here’s how bad: A drug that fails to prolong the lives of ovarian cancer patients was just declared the biggest breakthrough in 15 years.

According to results of two international clinical trials, published last week, the drug Avastin (aka bevacizumab) can interfere with blood vessel growth, and thereby slow disease progression in ovarian cancer patients.

For three months. Three and a half, actually.

But the drug has side effects. And it costs $58,000 a year.

And yet survival rates remain the same.

Oh.

This is what progress looks like in the bleak world of the most
Writer Donna Trussell and Dr. Steve Buie at her 10-year checkup, a decade after her ovarian cancer diagnosis.
lethal of all gynecologic cancers.

Even early detection, the battle cry for the war on cancer as long as I can remember, may not help much, according to a study published in June.

“Among women in the general US population, simultaneous screening with CA-125 and transvaginal ultrasound compared with usual care did not reduce ovarian cancer mortality.” An added non-bonus: The false positives led to a variety of unfortunate complications.

The dream of curbing the mortality of ovarian cancer through early detection may turn out to be a big ol’ FAIL.

Over time, researchers may learn that early-stage ovarian cancer is a whole different animal from late-stage ovarian cancer, which would explain these discouraging results. Experts already believe we use one word -- cancer -- to describe what in fact may be thousands of distinct diseases.

Recently there was a bit of good news out of Canada. Researchers discovered ABT-898, a peptide (amino acid formation) that will enhance the body’s ability to deliver chemotherapy drugs directly to cancer tumors.

“Women tend to succumb to ovarian cancer because the inefficient delivery of chemotherapy drugs allows the cells to build up resistance and they no longer respond to treatment,” said Jim Petrik, of the University of Guelph.

That’s reason to hope, but lab-mice evidence is a long way from aiding real women battling real ovarian cancer.

I didn’t know much about this disease when I was diagnosed in 2001 — on 9/11, actually. Yet I did know enough to scream, “Nooooo! But that’s fatal!” when my longtime family-practice doctor walked into my hospital room and broke the news.

Luckily, he steered me to an excellent gynecologic oncologist for surgery and treatment. My participation in a clinical trial had an unknown effect on my prognosis, but it was enough for me to contribute a few sentences about my experience to the 2003 book “Ovarian Cancer: Your Guide to Taking Control” by Kristine Conner and the late Lauren Langford.

The title says it all. Everyone -- patients, families, doctors, nurses -- would like to take control of this horrible disease.

“Each woman’s experience with and response to the disease is unique,” wrote gynecologic oncologist Beth Karlan in the introduction.

True enough. Certainly true for me, since I’m still in remission a decade after planning my funeral.

Dr. Karlan continued: “Thanks to advances in treatment, ovarian cancer now can be viewed as a chronic disease you can live with, not a fatal disease you die from.”

Seriously?

This way of thinking was very much in vogue when I was diagnosed. We were told that ovarian cancer was much like diabetes or AIDS; manage the disease, and get on with your life!

Too bad it’s not true.

Let’s look at the data. AIDS: “Since 1993, the average lifespan after diagnosis has more than tripled from seven years to 24 years, a testament to more effective treatments and better HIV care,” writes Dr. Alvaro Beltran.

Compare that to ovarian cancer: Average life span after diagnosis is two and a half to three years.

Twenty-four years versus three years. I would say the first disease is chronic and manageable. The second? Not so much.

I too wish something could really stop cancer once and for all. Lord knows the Internet is bursting with “cures,” everything from fermented tea (which may actually harm, not help) to positive thinking.

How about a negative-thinking cure? Negative thoughts as a “natural” form of chemotherapy, toxic to cancer cells. Or a nap cure. Or daily sex cure. Well, why not? There’s just as much proof.

Any cancer is bad news, but ovarian is worse than most, and progress has been particularly slow. For all cancers, five-year survival has improved from 50 percent in the 1970s to 68 percent in 2001. Ovarian cancer, meanwhile, went from 38 percent in the 1970s to only 47 percent.

Which means ovarian cancer hasn’t even caught up to where most cancers were in the 1970s.

It might be better if oncologists told their patients, “I look forward to the day that ovarian cancer is a chronic, manageable disease. But we’re not there yet.”

That’s not to say ovarian cancer patients would automatically turn around and call their representatives in Congress, and insist that decades of research with so little to show for it is unacceptable.

But what if they did?

By Donna Trussell  |  07:00 AM ET, 01/02/2012

 
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