Gynecologic Cancer: What Every Woman Should Know
Breakthroughs Enhance Quality of Life for Cancer Survivors
Updated on: June 20, 2003
David M. Gershenson, M.D., Professor and Chairman, Department of Gynecology Oncology Director, Blanton-Davis Ovarian Cancer Research Program M.D. Anderson Cancer Center, Houston, Texas
"No matter how quietly your physician utters the words, ‘You have a malignancy,’ the sound is deafening, shocking. The diagnosis of cancer barely seems real. A part of you is screaming ‘no’ while another calmer part is saying ‘I can do this’. And while you are still practicing saying the word ‘cancer’ in your mind, all around you a plan of care is being drafted, and your team of doctors and nurses are trying to prepare you for what to expect over the coming days, weeks, and months, as you enter cancer treatment." — Maria Ciesla, ovarian cancer survivor & President, National Ovarian Cancer Coalition
"We know that patients face a real crisis as they anticipate starting treatment for their cancers. At the same time, we find that as our patients move beyond this crisis and the inevitable uncertainty concerning treatment side effects and out-comes, they discover that they can maintain a sense of control, which helps get them through this difficult time," said Michael Berman, M.D., professor, Department of OB/GYN, Division of Gynecologic Oncology, University of California Medical Center, Orange, Calif. Many people harbor intense fear of cancer therapy because of the outdated stories they've heard. It takes a while for patients to learn that control of treatment symptoms and side effects is so much better with modern cancer therapy than was true ten or twenty years ago.
Patients, for example, who have heard stories about the nausea and vomiting associated with chemotherapy will be surprised to see lunch trays being served on the chemotherapy unit, a change made possible by newer anti-nausea medications.
"I recall a patient who told me months after completing her chemotherapy regimen, ‘I was prepared for all of the side effects of chemotherapy but I was not prepared for how well I would feel and function during my chemotherapy,’" said Larry Copeland, M.D., professor and chair, OB/GYN, James Cancer Center, Ohio State University, Columbus, Ohio.
For each patient, current cancer therapy involves a highly individualized plan that can include chemotherapy, radiation therapy, surgery, or the newer immune activating therapies or biologic therapies. Often different therapies are given in combination.
"The growing list of effective chemotherapy drugs gives us the option to be flexible and responsive to the individual patient in making treatment recommendations to them," said Dr. Berman.
"For instance, if a patient with recurrent ovarian cancer recalls that a tingling sensation in her fingers and toes were her most troubling side effects from her first round of chemotherapy with paclitaxel and platinum, I have the option of changing to Taxotere, an alternate treatment option that is less likely to cause the tingling side effect. If another patient develops anemia with her chemotherapy, I have the option of switching her to a lower but more frequent dose of the same drug or of using a medication such as erythropoetin to give her bone marrow a boost."
Similarly, progress has been made in the field of radiation oncology. Radiation treatments that used to require hospitalization and strict bedrest for a couple of days can now be given as outpatient high dose rate (HDR) treatments over a couple of hours. Shorter periods of hospitalization and recovery for surgical treatments are also increasingly common as technologic advances permit less invasive surgeries for gynecologic cancer.
"Our patients can generally be discharged from the hospital just 24-48 hours after laparoscopic surgery for endometrial cancer. They can generally return to work in as little as two weeks," said Dr. Copeland.
I see patients every day that remind me of how much high quality living is being done by women currently in treatment for breast and gynecologic cancer.
One woman I saw recently just completed a long trip to Europe with her daughters. Another was excited about a new kayak that she purchased. Still another patient is looking forward to a daughter's wedding this summer while a fourth just threw a "celebrate life" party for her one year cancer anniversary.
Every woman hopes to avoid getting cancer. Yet when cancer is diagnosed, it is important to know that cancer survivors by the thousands are demonstrating that better treatment options are making it possible to face cancer treatment in greater comfort and with hope.
This article by the Gynecologic Cancer Foundation originally appeared in an advertising supplement to the New York Times on Sunday, June 22, 2003.
GCF gratefully acknowledges Aventis Oncology for its generous support of this educational supplement. The content of this supplement is the work of many individuals and does not reflect commercial interests.
Aventis Pharmaceuticals
www.AventisOncology.com
