Cervical Cancer Treatment Side Effects

However, there are more deaths from this form ofwomen with high risk, early stage cancer (Stage I
cancer each year in the United States than fromgrade 3 or stage II disease), adjuvant chemotherapy
endometrial cancer and cervical cancer combined.with platinum based agents show an 11%
Cervical Cancer Treatment Side Effects The lifetimeimprovement in progression free survival and 8%
risk of developing spontaneous ovarian cancer isimprovement in overall survival. For stage III and IV
about 1.7%. Epithelial ovarian cancer was expecteddisease, the current standard of care include maximal
cause 15,520 deaths in 2008. Mean age at diagnosis isattempt at surgical cytoreduction followed by
60. There has been a significant improvement in thechemotherapy with platinum based agents.
five year survival rate for patients with ovarianOptimal debulking is an important part in the
cancer. This is likely a combination of better tumortreatment of cancer in the ovaries. Retrospective
debulking surgeries and better chemotherapeuticdata have shown that survival is better for women
options.who receive chemotherapy in the presence of low
Most patients with this type of ovarian cancer do notvolume disease. In the setting where optimal surgical
have signs or symptoms until disease spreads to thecytoreduction cannot be achieved, an alternative
upper abdomen. 70% of patients present withapproach is for the patient to receive chemotherapy
advanced disease. Symptoms for early stage ovarianup front. For patients who have a partial response to
cancer can include nonspecific pelvic discomfort,neoadjuvant chemotherapy, it may be appropriate to
urinary frequency and constipation which are causedattempt surgical removal of macroscopic disease at
by an enlarging pelvic mass. With advanced disease,that time.
patients experience abdominal pain, bloating, anorexia,As for the standard of care in chemotherapy for
nausea and constipation.advanced ovarian-type cancer, studies have shown
The best tumor marker for ovarian cancer is CA 125.that paclitaxel/cisplatin combination is superior to
Minor elevations in CA 125 can also be seen incyclophosphamide/cisplatin combination. Later studies
endometriosis, benign tumors, fibroids and in pregnantshowed that carboplatin/paclitaxel is at least as
and postpartum women. In addition, moderateeffective as cisplatin/paclitaxel.
elevation of CA 125 can be seen in otherIntraperitoneal chemotherapy is an appealing
adnocarcinoma such as breast and endometrialapproach for treating a disease that is largely
cancer. The sensitivity of CA 125 is 70% to 80% andconfined in the peritoneal space. GOG 172 which was
the specificity is 98.6% to 99.4%. However, in thea phase III clinical trials demonstrated that this
average risk population with low prevalence ofregional approach resulted in superior progression free
ovarian cancer, the false positive can besurvival and overall survival when compared with the
unacceptably high.intravenous approach alone. The disadvantage of this
Lung Cancer Secrets Revealed Click hereapproach includes local toxicity, and requirement for
The National Cancer Institute recommends screeningintraperitoneal catheter placement.
for ovarian female cancer with known geneticBecause of the high recurrence rate in patients with
syndromes associated with this disease and foradvanced ovarian cancer, the issue of whether
women with strong family history. Routine screeningconsolidation chemotherapy may improve time to
of women without family history of ovarian cancer isprogression and overall survival was examined in a
not recommended. The known genetic syndromesphase III trial comparing 3 and 12 cycles of taxol.
include hereditary breast and ovarian cancerProgression free survival favored the 12 cycle arm.
syndrome associated with BRCA 1, BRCA 2 andHowever, overall survival was not different between
Hereditary Nonpolyposis Colorectal Cancer Syndromethe two arms. Therefore, the oncologist needs to
(HNPCC). The absolute risk of ovarian cancer in thediscuss with the patient and allow them to decide
presence of either BRCA 1 or BRCA 2 mutationwhether the improved progression free survival
ranges from 16% to 60%. For patients with HNPCCjustifies toxicities including peripheral neuropathy and
syndrome, the lifetime risk of ovarian cancer is 9%alopecia.
to 12%.For many patients with advanced ovarian cancer who
Epithelial cancer accounts for about 90% of ovarianhave an initial treatment response, disease relapses
cancers. Common histologies include serous, mucinous,at a later time. The treatment of patients with
endometroid, transitiona and clear cell types. Germ cellrecurrent disease or resistant disease needs to be
tumors include dysgerminoma, endodermal sinusindividualized. For people with long treatment free
tumor, malignant teratoma embryonal carcinoma orinterval, similar drugs many be reused. There are also
primary choriocarcinoma. Stromal tumors includea number of single agent drugs with activity in
granulose tumor or Sertoli-Leydig tumor.ovarian cancer. These include altretamine,
Upon initial presentation, surgery is used forbevacizumab, docetaxel, etoposide, gemcitabine,
confirmation and staging the cancer. Stage I diseaseliposomal doxorubicin, paclitaxel, tamoxifen, topotecan
is confined to one or both ovaries. Stage II involvesand vinorelbine.
one or both ovaries with extension to the pelvicRadiation can also play a role in the palliation of some
viscera. Stage III is associated with implants on thepatients with recurrent ovarian cancer. Symptoms
abdominopelvic wall or the serosal surface of the liversuch as pain from growing pelvic mass or bone
or involves small bowel or omentum. Stage IVmetastasis can be palliated. Very rarely cerebral
disease involves distant metastasis. The 5 yearmetastasis can develop which can also be treated
survival for stage IA disease and grade 1 or 2with radiation.
histology is greater than 90%. For high risk stage IThe best treatment of ovarian cancer needs a team
disease and stage II disease, 5 year survival is 80%.approach between the primary care physician,
For patients with stage III disease after optimalgynecological oncology surgeon, medical oncologists
debulking, 5 year survival is 20% to 30%. Thisand radiation oncologists. As more chemotherapeutic
reduces to be less than 10% for stage III patientsagents become available and as we further
with suboptimal debulking and stage IV disease.understand the biology of epithelial ovarian cancer,
Stage I ovarian cancer with favorable prognosticwe hope to further improve the overall survival and
features can be treated with surgery alone. Forquality of life of our patients.