This year, about 30,000 American women will be diagnosed with ovarian cancer. In 2006, between 15,000 and 16,000 women are likely to die from this silent killer. Ovarian cancer is the fifth leading cause of death among women and is responsible for approximately five percent of all cancer deaths. Your doctor has likely misdiagnosed you. That is often the case. A recent British study found that 60 percent of all UK GPs had misdiagnosed their patients.
Three-quarters of British doctors surveyed incorrectly assumed that symptoms only occurred in the late stages of ovarian cancer. Based on that information, it should come as no surprise that Britain has one of the lowest survival rates for ovarian cancer in the Western world: out of 6,800 cases diagnosed each year, more than 4,600 die.
Researchers at the University of California made a similar discovery, announcing last year: “Four out of 10 women with ovarian cancer have symptoms that they report to their doctors at least four months, and up to a year, before being diagnosed.” . According to their study of nearly 2,000 women with ovarian cancer, the researchers found out to doctors:
o First ordered abdominal images or performed gastrointestinal procedures instead of the more appropriate pelvic images and / or CA-125 (a blood test that can detect ovarian cancer).
o Only 25 percent of patients, who reported ovarian cancer symptoms four or more months before diagnosis, received pelvic imaging or CA-125 blood tests.
Patients with early symptoms are often misdiagnosed. Abdominal or gastrointestinal imaging tests are less likely to detect ovarian cancer. According to the American Cancer Society website, “The most common symptom is back pain, followed by fatigue, bloating, constipation, abdominal pain, and urinary urgency. These symptoms tend to occur very frequently and become more severe. over time. Most women with ovarian cancer have at least two of these symptoms. “
When a woman reaches stage four of ovarian cancer, her first-line treatment is usually Carboplatin, Paclitaxel, and Cisplatin as specific chemotherapy for ovarian cancer. In the first stage, the cancer is contained within one or both ovaries. In stage two, the cancer has spread to the fallopian tubes or other pelvic tissues, such as the bladder or rectum. When cancer has spread outside the pelvic area into the abdominal cavity, especially when tumor growths are larger than two centimeters in the lining of the abdomen, ovarian cancer has reached stage three. The fourth and final stage of ovarian cancer is when the cancer has spread to other organs in the body, such as the liver or lungs.
If caught early, survival rates can reach 90 percent. Detected in the advanced stage, the survival rate falls between 30 and 40 percent. Several imaging tests, such as computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound studies, can confirm if there is a pelvic mass. A laparoscopy can help the doctor look at the ovaries and other pelvic tissues to plan a surgical procedure or to determine the stage of ovarian cancer. A biopsy, or tissue sample, would confirm if there is cancer in your pelvic region and help determine how advanced it is. An elevated CA-125 blood test generally suggests that the cancer has progressed to an advanced stage.
About 50 percent of ovarian cancer patients are already in an advanced stage when a correct diagnosis is made. Only 10 to 14 percent of women with advanced cancer are likely to survive more than five years.
Therapy evaluation
While research shows that drinking black (or green) tea or taking the herbal supplement gingko biloba may be helpful, as a preventive measure or to reduce risk, a woman has few options when her cancer has progressed to an advanced stage. In the first stage, a woman is faced with surgical removal of the tumor, and possibly one or both ovaries, to increase her chances of survival. Beyond that, your choice is chemotherapy.
A major problem with chemotherapy is side effects. The more advanced the cancer is, the weaker it can be, reducing the potential for survival. Survival rates haven’t changed much in the last fifteen years. Chemotherapy can increase survival time by up to 50 percent. Objective, the quality of life suffers. The side effects and increased toxicity that accompany chemotherapy reduce how one spends a long survival time.
Some of the minor side effects of paclitaxel, as reported by Medline Plus, can include nausea, vomiting, loss of appetite, changes in taste, thin or brittle hair, pain in the joints of the arms or legs, changes in the color of fingernails and / or tingling in the hands or toes. More serious side effects can include mouth blisters or fatigue. Some alarming side effects could include unusual bleeding or bruising, dizziness, shortness of breath, severe exhaustion, chest pain, or trouble swallowing. The most common side effect of paclitaxel is a decrease in blood cells.
Carboplatin has its own list of side effects. It can reduce platelet production, which can interfere with the blood’s ability to clot. You may become anemic, feel tired, or feel short of breath. Nausea, vomiting, loss of appetite, and a general feeling of weakness are common with this chemotherapeutic agent.
The latest generation of drugs, like Eli Lilly’s Gemzar, hardly gets any praise. On March 10, the Food and Drug Administration (FDA) said it was skeptical about the benefits of Eli Lilly’s Gemzar, which was used with carboplatin to treat ovarian cancer patients. The FDA considered that the 2.8-month increase in survival time provided by the Gemzar / Carboplatin combination failed to offset the increased toxicity of the treatment.
In January, the New England Journal of Medicine reported on a remarkable new chemotherapy delivery system, called “intra-abdominal or intraperitoneal” chemotherapy. Those who received the “abdominal bath,” as the media now call it, can survive 16 months longer than those who received intravenous chemotherapy. The biggest drawback is that 60 percent of the women in the study were unable to complete all six cycles of this chemotherapy. Those who did survived longer, but only two out of five women were able to advance to the final phase of therapy.
A novel approach, now in phase III trials at more than 60 research centers in the United States, is OvaRex® MAb, a murine monoclonal antibody, a type of biotech drug derived from mouse cells. It is being tested by the prestigious United Therapeutics, based in Silver Springs, Maryland. Its main drug Remodulin, an injection that treats pulmonary arterial hypertension, is currently marketed in and outside the United States. More than $ 32 million has been spent on research and development for OvaRex and it may be commercially available in 2008.
OvaRex was developed in Canada by a company called ViRexx Medical Corp and tested for the first time in that country. According to Dr. Lorne Tyrrell, CEO of ViRexx, “The entire study has been set up with the FDA. This is a study where the drug has received rapid approval and orphan drug status.” Dr. Tyrrell is also on leave (until OvaRex is commercially available) as a professor of medical microbiology and immunology at the University of Alberta and director of the National Center of Excellence for Viral Hepatitis Research.
OvaRex was tested in Canada, prior to the current Phase III trials in the US “There have been several patients who have received OvaRex,” said Dr. Tyrrell, “We have really had no adverse effects from these patients.” Dr. Tyrrell explained the procedure: “After being injected intravenously, OvaRex binds to an antigen that circulates in the blood.” The general purpose of an antibody is to neutralize an antigen. After an injection of OvaRex, the murine monoclonal antibody binds to the CA-125 antigen.
In a way, the body is fooled. But the body is tricked into helping “save” itself from the harmful antigen. When the OvaRex antibody binds to the CA-125 antigen, the new combination is identified as a harmful unit. Before that, the antigen roams the body, without alerting the body’s defense systems, the dendritic cells, to attack and destroy the harmful antigen. Because the body is trained to identify and focus on a foreign protein, in this case a mouse protein, it alerts dendritic cells. Until then, dendritic cells “tolerate” cancer cells. Tolerance is what allows cancer to spread throughout the body.
OvaRex seeks to break that tolerance. The murine monoclonal antibody is designed to target and bind exclusively to the free floating CA-125 antigen.
Dendritic cells refuse to tolerate the foreign protein. When the antibody binds to the free-floating antigen, the dendritic cells recognize the complex (antibody plus antigen) as foreign and engulf the new unit. Dendritic cells break down the key proteins of this unit, presenting all the parts on the surface of the cells. At that point, the body’s killer T cells are alerted to fight the internal threat of the body. Once activated, the T cells will replicate and create more killer T cells. Any tumor cell that expresses the CA-125 antigen is targeted for destruction. The T-cell army moves to attack the ovarian cancer tumor.
The principle behind OvaRex is to reprogram the immune system to harness the body’s defenses to prevent the growth and spread of ovarian cancer. Will it cure ovarian cancer? “In most cases, it will be a delay,” explained Dr. Tyrrell. “However, I believe that, and everyone hopes that, often in some of these tumors, you are making gradual progress through careful clinical trials and adding a new therapy. Every single thing we do improves the outcome when you start to consider. the long-term benefits of these, we hope that one day we can cure this disease. We believe this is one step. This has the potential to be an important step to help stimulate the immune response to achieve a better outcome. day we can improve that as far as a cure “.
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