HealthWatch: Fighting Ovarian Cancer: HIPEC Procedure Improves Late Stage Survival

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Ovarian cancer often goes undetected until it spreads to other areas. In its late stages it’s harder to treat. Now there’s an unconventional treatment being used to get rid of it. 
When her stomach kept ballooning, Brenda Gotlen knew something was wrong.  
Gotlen told Ivanhoe, “I was like, wait a minute. What did you just say? Then I started crying.”
The prognosis, Stage III C. Doctors told Gotlen if she didn’t have surgery, she would die. That’s when she learned about the HIPEC surgery, short for hyperthermic intraperitoneal chemotherapy for ovarian cancer. Thomas Rutherford, MD, a gynecologic oncologist at Tampa General Hospital in Florida is among a small group of surgeons using it. 
“There’s been a couple trials and more and more people are starting to look at it,” detailed Dr. Rutherford. 
The risky operation only for advanced ovarian cancer uses heated chemotherapy in the abdomen. After the cancerous tumor has been removed, the surgery is over in an hour and a half. For Gotlen, it was a life saver. 
Gotlen explained, “I had two choices. I could either live with what cancer was left after the first surgery because they couldn’t get it all, or either I could have the HIPEC surgery and live most likely cancer free.” 
Even her recovery went better than expected.
“I was supposed to be in the hospital like eight days and I went home in six days,” said Gotlen.
She’s enjoying time with family now and has cancer in her rear-view mirror.  
Again, it’s important to note the HIPEC surgery is only for advanced ovarian cancer patients. While Gotlen recovered quickly, doctors say it often takes weeks if not months to recover. 
Contributors to this news report include: Sarah Rosario, Field Producer; Roque Correa, Editor; Angela Clooney, Videographer.

REPORT #2569

BACKGROUND: Ovarian cancer is a type of cancer that begins in the ovaries, the female reproductive organs that produce eggs as well as the hormones estrogen and progesterone. It often goes undetected until spreading within the pelvis and abdomen. Early-stage ovarian cancer rarely causes symptoms, while advanced-stage ovarian cancer may cause few symptoms that are often mistaken for more common benign conditions. Signs and symptoms include abdominal bloating or swelling, quickly feeling full when eating, weight loss, pelvic discomfort, changes in bowel habits, and a frequent need to urinate. Ovarian cancer can occur at any age, but is most common in women aged 50 to 60. People with two or more close relatives with ovarian cancer have an increased risk. The same inherited genes that can increase the risk of breast cancer also increase the risk of ovarian cancer. Estrogen hormone replacement therapy can also increase the risk, especially with long-term use and in large doses. There’s no sure way to prevent ovarian cancer, but women who take birth control pills have a reduced risk. If a woman has a gene mutation that increases her risk, she may consider removing her ovaries to prevent cancer.

DIAGNOSIS AND TREATMENT: Tests used to diagnose ovarian cancer include pelvic exams, imaging tests, blood tests, and surgery. Surgical options for removing ovarian cancer include removing one or both ovaries and their fallopian tubes. If the cancer is more extensive and the patient doesn’t wish to preserve their ability to have children, the uterus can be removed as well. Chemotherapy can be used and is sometimes injected directly into the abdomen. Targeted therapy uses medications that attack the specific vulnerabilities present within the cancer cells, but those drugs are usually reserved for treating ovarian cancer that returns after initial treatment or cancer that resists other treatment. Palliative care, or supportive care, exists for providing relief from pain and other symptoms of a serious illness.

NEW IMMUNE THERAPY FOR OVARIAN CANCER: Researchers at the University of Virginia have developed a type of antibody approach that can effectively destroy ovarian cancer and possibly breast cancer, prostate cancer, and other solid tumors. A major problem with former immune therapies for ovarian cancer is that the immune cells intended to kill the cancer cells could not infiltrate the solid tumor bed effectively. Some unusually large receptors form a protective fence around tumor cells, so even if the immune cells reach there, there are many obstacles. This new antibody strikes what is known as the death receptor on the cancer cells, forcing them to die, and then strikes a receptor known as FOLR1, a well-established marker that suggests a poor prognosis. The newly engineered antibodies are over 100 times more effective at killing cancer cells than the antibodies that have made it to clinical trials. Another problem for many antibodies has been liver toxicity because they are taken out of the blood too fast and accumulate where not needed. Since these new antibodies remain in the tumor, they can be kept away from the liver.

? For More Information, Contact:

Thomas Rutherford, PhD, MD                Ellen Fiss, Public Relations
Director of Gynecologic Oncology                Tampa General Hospital
Tampa General Hospital                    (813) 844-6397
(813)     844-7585    

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