Up to 50 per cent of women with advanced-stage ovarian cancer could be cured with one treatment model
January 20, 2016 | Download Release
Up to half of women with advanced-stage ovarian cancer might be cured, compared to the current 20 per cent survival rate, argues Dr. Steven Narod, senior scientist at Women’s College Research Institute, who calls for a new standard of treatment for women with late-stage ovarian cancer.
Based on an analysis of existing evidence, published in an opinion article in the Nature Reviews Clinical Oncology journal on January 20, Dr. Narod argues that to achieve a cure, rather than simply delay progression or reoccurrence of the disease, women should be first treated with aggressive surgery to remove all clinically-detectable cancer cells, followed by targeted chemotherapy to the abdomen (intraperitoneal chemotherapy).
The possibility of a 50 per cent cure rate would be a significant improvement over the current 20 per cent survival rate resulting from more conventional treatment options offered to patients, which consist of a combination of different methods including: chemotherapy before surgery; post-operative chemotherapy delivered intravenously to the whole body (as opposed to localized into the abdomen); and surgery that leaves minimal residual disease in the abdomen, rather than removing all visible cancer cells.
Dr. Narod, who is also a Tier 1 Canada Research Chair in Breast Cancer, recommends that doctors should consider adopting a standard model of care for all women diagnosed with advanced-stage ovarian cancer:
- Chemotherapy should be offered after the surgery, rather than before. Chemotherapy before surgery might provide a false assurance that there’s no more residual cancer, whereas microscopic tumour may remain after the surgery, leading to cancer recurrence and possibly, death.
- The surgery should be aggressive in an attempt to remove all visible signs of the tumour, and to avoid leaving any residual disease. The goal isto haveno cancer visible to the naked eye of the surgeon after the surgery.
- Surgery should be followed by intraperitoneal, or localized, chemotherapy delivered to the abdomen. Localized chemotherapy works best if there’s no residual cancer after the initial surgery. It is the combined effect of surgery and chemotherapy that works best.
“For decades, women have been treated with a combination of treatment options, resulting in poor prognosis for most women with advanced-stage ovarian cancer, but there are many survivors as well,” said Dr. Narod, senior scientist at Women’s College Research Institute.
“Women need support to endure surgery and the rigours of intraperitoneal chemotherapy, but should be encouraged to do so whenever possible, considering the potential survival benefits,” said Narod. “We should offer all women the possibility of a cure.”
Women’s College Hospital
For more than 100 years Women’s College Hospital (WCH) has been developing revolutionary advances in healthcare. Today, WCH is a world leader in the health of women and Canada’s leading, academic ambulatory hospital. A champion of health equity, WCH advocates for the health of all women from diverse cultures and backgrounds and ensures their needs are reflected in the care they receive. It focuses on delivering innovative solutions that address Canada’s most pressing issues related to population health, patient experience and system costs. The WCH Institute for Health System Solutions and Virtual Care (WIHV) is developing new, scalable models of care that deliver improved outcomes for patients and sustainable solutions for the health system as a whole.
Women’s College Research Institute (WCRI) is tackling some of the greatest health challenges of our time. Its scientists are conducting global research that advances the health of women and improves healthcare options for all, and are then translating those discoveries to provide much-needed improvements in healthcare worldwide.