Image courtesy of Nephron, Wikimedia Commons
Micrograph of a mucinous ovarian carcinoma stained by H&E
A new paper from researchers at the University of California–Davis took an in-depth look at why women with ovarian cancer are living longer. These findings, published in the journal Obstetrics & Gynecology, add to the growing evidence that a diagnosis of ovarian cancer no longer means inevitable doom and gloom. Results showed that nearly a third of California women with ovarian cancer survive at least 10 years after their initial diagnosis.
Treatment of gynecologic cancers is improving for a multitude of reasons. “Five-year survival rates in patients with ovarian cancer have increased to about 42 percent,” says Dr. David Mutch, chief of the Division of Gynecologic Oncology at Barnes-Jewish Hospital at Washington University School of Medicine. What’s more significant about the UC–Davis study is that it breaks away from the former five-year model and posits a 10-year survival rate for studying ovarian cancer today.
The study also found that some of the women living more than 10 years with ovarian cancer were originally considered in the high-risk category, which means something could be at play besides known characteristics associated with ovarian cancer survival.
In general, says Mutch, incidence of ovarian cancer increases with age and with a number of other factors, such as family history, infertility, personal history of other cancers, and hereditary disease. Those traits also adversely affect survival rates once a woman is diagnosed. On the flip side, factors that reduce a woman’s chance of developing ovarian cancer—for instance, age, stage, multiple pregnancies, gynecological surgeries (like tubal ligation or hysterectomy), breastfeeding, and taking oral contraceptives—are attributed with higher survival rates.
One of the lessor-known factors that appears to increase survival odds for ovarian cancer patients is the presence of a BRCA genetic mutation. According to UC–Davis researchers, these mutations may explain why some high-risk patients without a number of the traits listed above are living longer with ovarian cancer. “A BRCA 1 or BRCA 2 mutation means you have an inability or decreased ability to repair DNA," Mutch explains. "Chemotherapy damages your DNA, so if you can’t repair it that’s an extra bonus and patients respond better to treatment." If you have a family history of ovarian cancer, the American Cancer Society recommends genetic counseling to help make the best decisions about prevention.
Patients seeking treatment should consider a physician who specializes in ovarian cancer, preferably at a facility dedicated to gynecologic oncology, Mutch suggests. “There is clear evidence that quality of treatment increases survival rates,” he says. "We have more options, more types of chemotherapy, and better ways to give them. An experienced surgeon now should be able to optimally remove or reduce at least 80 percent of the ovarian cancer in patients.”
Mutch himself has seen patients live for 20 years after being diagnosed with ovarian cancer. “They got to see their grandchildren born—maybe even great grandchildren," he says. "They got a lot of weddings and graduations. That’s huge.”
