My Women of Teal

Over the past ten years I have met many women diagnosed with ovarian cancer as well as other gynecologic cancers. Some of these women I interacted with in real life - at events, support groups and through ovarian cancer awareness organizations.  Other women I got to know through online groups - Facebook, Inspire or Smart Patients. On this the last day of Gynecologic Cancer Awareness month I write this post to honor those diagnosed as well as to remember the women whose lives were lost to a gynecologic cancer. These women have touched my life. 

In Memory of Women of Teal

Jeanne Burton -NJ, endometrial

Linda Juarez - NJ
Joanie Triestain

Heidi Rogol- NJ

Stella Bentivenga- NJ

Colette Fitzpatrick- UK

Shari R. Widmayer - NJ

Kimberly MacDonald- DE

Teresa Whittle - UK
Grace Rocha - NJ
Erika Rocha - NJ

Dietlind Mayer Lawrence- Michigan

Deirdre Berry, NJ

Maggie - KS

Karen Koop Gregorovic- NJ

Carolie Byng- UK

Laurel Phillips- Texas

Pam Favocci- Wall, NJ

Rita Kay Thomas- Piscataway, NJ

Mary Jean Tonkovich- NJ

Shirley Harris - NJ, Endometrial

Ann Bugdal -NJ,  Endometrial

Nicole Christison- NJ

Mary Ellen Csehi - NJ, Endometrial

Monica Orloff- NJ

Jeanne Moran - NJ

Jo McGowran - UK

Gaynor Hall- UK

Sarah Feather

Patty Higgins

Janet Rigdon

Jayne Armstrong- CA

Ellen Santaniello- NJ

Courtney Clifford- Ohio

Denise Carter- NJ

Mary Slattery- NJ

Lisa Niebert- NJ

Fran- NJ

Lyn Rossi- NJ

Diane Waller, Michigan

Gail McNeil- NJ

Sharon Morris- NJ

Cindy Owens- Va

Ann Hall- NJ

In Honor of Survivors of Gynecological Cancer

Terry 

Tina

Susan

Theresa
Betsy
Emmie
Audrey

Theresa

Patricia

Carole F

Lois M

Maria C

Karen

Sandy

Sandhy

Victoria

Emily

MaryAnne

Kia

Rachel

Tracey

Claire

Stacy

Natalie

Rebecca

Alicia

Emily

Patricia

Susan

...too many lives impacted by this disease.

Dee
Every Day is a Blessing!

So Many Hashtags

Christina,co-moderator of #gyncsm chat, and I were discussing all the hashtags used during gynecologic cancer awareness month. Christina had compiled a pretty extensive list which I added 7 hashtags too.

Here is our list so far:

#30daysofteal (OCNA)

#actonfacts (@bebrightpink)

#Breakthesilence

#endwomenscancer

#Findthetealineveryday(SROCF) 

#GCAM
#globeathon

#GynCan 

#gyncsm

#HBOCweek

#OvarianCancer  

#ovariancancerawareness 
#ovariancancerawarenessmonth

#shareitseptember (OCRF)

#takeactionnotchances (NOCC)

#teal

#tealisabigdeal 
#Tealmatterstoo

#tealmorethanjustacolor

#Tealsthedeal

#tealtakeover 

#TealTuesday 

#turnitteal 
#turnthetownteal (Turn the Towns Teal)
#turnmyselfieteal

#wearteal

#whyteal 

Did we leave any out? Please let us know. 

Wouldn't it be great if we could unite behind one or two hashtags for next year? 

Dee 

Every Day is a Blessing!

A Great Way to Learn

If you have never been to an Ovarian Cancer Survivors Course given by the Foundation for Women's Cancer then you have missed out on a great opportunity to learn the latest about ovarian cancer - what we know about the disease, the lastest and best treatments and how to take care of yourself through all stages of the disease. I have been to three of these courses in the past 10 years, most recently on Sept 16th in Morristown, NJ. 

About 75 people attended the  course which was held at the Carol G Simon Cancer Center at Morristown Medical Center. There were survivors, caregivers, family, social workers and a number of ovarian cancer organizations in the audience. I was happy to see friends and fellow survivors manning the information tables of the Kaleidoscope of Hope Foundation , the NJ chapter of the NOCC, SHARE and Cancer Support Community.

After a welcome by Dr Daniel Tobias, Director of the Woman's Cancer Center, and listening to his patient, Theresa,  discussed how she dealt with her diagnosis, the Course began.

Dr Ilana Cass - Ovarian Cancer:Is Progress Being Made

Dr Allison Wagreich -Genetic Risk and Prevention of Ovarian Cancer 

Nana Tchabo -Clinical Trials and New Treatments

Dr Mark Einstein- The Importance of Being Treated by a Gynecologic Oncologists (l) , Dr Micheal Pearl - Supportive Care the Women with Cancer (center) and Dr Daniel Tobias during the question and answer period. 

Just a few of the important points shared during the Course :

• Surgery by gynecologic oncologists  who do large numbers of patients can improve survival.
• Neoadjuvant chemotherapy is not inferior to primary debulking surgery.
• The Cancer Genome Atlas  has provided information on genes responsible for OC.
• Exercise can improve quality of life which improves survival.
• Familial cancer syndromes include BRCA1,2 and Lynch Syndrome.
• 3-7% of the women with the BRCA mutations undergoing Risk Reducing Surgery were found to have cancer in their tissue.
• Clinical trials are NOT the last resort. 
• Making progress against cancer is dependent on clinical trials
• "Palliative Care is appropriate at any time during management of a serious illness." 
• Palliative Care is beneficial, improves survival and reduces cost.  

Check for future courses here.

Dee
Every Day is a Blessing! Blessed that the Foundation for Women's Cancer mission is to educate survivors and caregivers.

Awareness Campaigns

There are many local and national organizations that are helping to raise awareness this month and every month. Here are some examples.

NOCC

Share this poster as a way to raise awareness. 

Go to the website ( http://ovarian.org/earlierawareness) , print out the poster and share it.

Turn The Towns Teal®

Hanging teal ribbons on trees and post signs in towns across this country. 

Photo from Turn the Towns Teal website.

I love seeing ribbons as I drive around NJ. Check out their website for more information and put it on your calendar as something to do next year! http://www.turnthetownsteal.org/

In support of Turn The Towns Teal® , Folonari wine and Frederick Wildman and Sons will donate $10,000 to Turn The Towns Teal® for the first 10,000 selfies of people wearing teal on social media that are tagged with #turnmyselfieteal  . See http://folonariwines.com/turnmyselfieteal/ for more information. 


Teal Toes

This campaign in which women ( and some men and even pets) paint their toe nails TEAL was founded by Carey Elizabeth Fitzmaurice (1968- 20015).  It is the perfect way to start a conversation about ovarian cancer. I've painted my toes TEAL every September since hearing about it.

Do you know of other unique or fun ways to raise awareness of a gynecologic cancer?
Please let me know and I will add to this page.

Dee
Every Day is a Blessing!

"It's about your loved ones too" Cote De Pablo

For the past few years the CDC has been raising awareness of gynecologic cancers during Gynecologic Cancer Awareness month. They have done this through print ads and  public service announcements on the radio and TV. This year's PSA is Cote de Pablo speaking about cervical cancer and getting tested.



There are symptoms for gynecologic cancers which the CDC highlights in this year's PSA "Are you Listening" .





Dee
Every Day is a Blessing!

50 States of Teal

In 50 States of Teal: Ovarian Cancer Care Across America OCNA has evaluated the performance of each state in the US in 10 areas of ovarian cancer care. The metrics include prevention, treatment, survivorship,  and end-of-life care.

New Jersey scored 8 out of 10 and better than 42 other states.

 

For the complete report on NJ please visit http://www.50statesofteal.org/state/NJ 

Dee

Every Day is a Blessing! 

An Introduction to Genetics and Ovarian Cancer

When I was diagnosed with ovarian cancer I decided to learn as much as I could about the disease. While I was in treatment I was offered genetic testing for BRCA1 and 2 which I accepted. Our knowledge about the genetics of ovarian cancer has grown tremendously over the past ten years.

Let's start with this basic video from the NCI on genetics and cancer. 

Now let's talk about ovarian cancer in particular. 

About 15% of the ovarian cancers diagnosed are due to germline (inherited and passed on to offspring)  mutations in the BRCA1 and BRCA2 genes. Having these mutations increases the risk of ovarian cancer by 15-50%. “Nearly one-third of women with hereditary ovarian carcinoma have no close relatives with cancer, and 35% of women with hereditary ovarian carcinoma are older than 60 years at diagnosis”( NCI) .  The remaining ovarian cancers are due to what we call sporadic or somatic mutations. 

Following the BRCA mutations the next inherited syndrome that leads to ovarian cancer is Lynch Syndrome.  Mutations in the MLH1, MSH2, MSH6, PMS2 and EPCAM genes are linked to Lynch Syndrome.  Women who have Lynch syndrome have an estimated 9-12 % lifetime risk for developing ovarian cancer. (http://www.cancer.net/cancer-types/lynch-syndrome)

In June 2011, the The Cancer Genome Atlas (TCGA) Research Network issued the results of whole-exome sequencing of ovarian cancer tumors. They examinesd the protein-coding regions of the genome, of 316 ovarian cancer tumors. 

http://www.nature.com/nature/journal/v474/n7353/full/nature10166.html

  

The study found :

21 percent of the tumors studied showed mutations in BRCA1 and BRCA2 

six other statistically recurrently mutated genes: RB1, NF1, FAT3, CSMD3, GABRA6 and CDK12. CDK12 is involved in RNA splicing regulation 

96% of ovarian cancers had a T53 mutation. T53 controls a tumor suppressor protein that stops cancer from forming

108 genes were associated with poor survival

85 genes were associated with better survival

68 genes that could be targeted by existing Food and Drug Administration-approved or experimental therapeutic compounds 

Four related subtypes of ovarian cancer based on the patterns of DNA methylation—a chemical reaction in which a small molecule called a methyl group is added to DNA, changing the activity of individual genes. 

The SGO released a Clinical Practice statement in 2014 stating that all women diagnosed with ovarian, tubal and primary peritoneal cancer regardless of age or family history should receive counseling and offered a genetic test. (https://www.sgo.org/clinical-practice/guidelines/genetic-testing-for-ovarian-cancer/ ) Knowing a women has a BRCA mutation may allow her to receive PARP inhibitor treatment . Olaparib was recently approved by the FDA to treat women with recurrent ovarian cancer. 

In August  ASCO issued an updated policy statement on genetic and genomic testing. ( http://www.asco.org/press-center/asco-releases-updated-policy-statement-genetic-and-genomic-testing-cancer ) 

The more researchers understand the genetics of ovarian cancer the better they can  develop drugs to treat specific mutations and the more personalized women's treatment can become. 

Dee

Every Day is a Blessing! 

Additional Sources:

Lynch Syndrome and Ovarian Cancer

https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=85&ContentID=P08122

 

I Have Lynch Syndrome

http://www.ihavelynchsyndrome.com/

 
 Ovarian Cancer : The Choice to Be BRCA Tested

A Quick Overview of Vulvar Cancer

What is it? What causes it?

Vulvar cancer may be either squamous cell carcinoma or adenocarcinomas. The cancer is found on the vulva the external genitals of females. 

Human papillomavirus (HPV) causes about half of all vulvar cancers. 

How many women will be diagnosed?

 Vulvar cancer is a rare gynecologic cancer. An estimated 5,510 women  will be diagnosed with vulvar cancer in 2015. An estimated 1,080 women will die from the disease in 2015. The survival rate (2005-2011) is 71.2 %.

What are the symptoms of vulvar cancer?

"Abnormal cells can grow on the surface of the vulvar skin for a long time. This condition is called vulvar intraepithelial neoplasia (VIN). Because it is possible for VIN to become vulvar cancer, it is important to get treatment. " NCI

Signs and symptoms of vulvar cancer include a lump, bleeding, or itching.  

Is there a screening test for vulvar cancer ? 

There is no screening test for vulvar cancer. A physical exam, history  and biopsy will determine if the disease is present. 

What are the risk factors? 

vulvar intraepithelial neoplasia (VIN)

human papillomavirus (HPV) infection

history of genital warts

many sexual partners

first sexual intercourse at a young age

history of abnormal Pap tests (Pap smears).

What treatments are given to women diagnosed with cervical cancer? 

 Surgery

Radiation Therapy

Chemotherapy

Biologic Therapy

 For more information please view this video by the Foundation for Women's Cancer

 

Dee

Every Day is a Blessing !

Sources:

http://seer.cancer.gov/statfacts/html/vulva.html

http://www.cancer.gov/types/vulvar

A Quick Overview of Cervical Cancer

What is it? What causes it?
There are two types of cervical cancer: squamous cell carcinoma and adenocarcinoma. 
Squamous cell carcinoma begins in the thin, flat cells that line the cervix. 
Adenocarcinoma begins in cervical cells that make mucus and other fluids. The cervix is the end of the uterus and leads from the uterus to the vagina.  

There are certain types of human papillomavirus (HPV) that cause almost all cases of cervical cancer. Two HPV types, 16 and 18, are responsible for about 70 percent of all cases

How many women will be diagnosed?
There will be an estimated 12,900 women diagnosed with cervical cancer in the US in 2015. Cervical cancer will take the lives of an estimated 4,100 women in 2015.  The five year survival rate for cervical cancer is 67.8%. In 2012 there were an estimated 249,512 womenin the US living with cervical cancer.

What are the symptoms of cervical cancer?

Vaginal bleeding (including bleeding after sexual intercourse)

Unusual vaginal discharge. 

Pelvic pain

Pain during sexual intercourse.

Is there a screening test for cervical cancer ? 
 Regular screening of women between the ages of 21 and 65 years is done using the Pap Test. (http://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45978&version=Patient&language=English)

If the Pap test is positive and HPV test may be recommended. 

What are the risk factors? 
Though not all women who have the HPV infection will develop cervical cancer , HPV is the major cause of cervical cancer. Other risks include: 

• Giving birth to many children.
• Having many sexual partners.
• Having first sexual intercourse at a young age.
• Smoking cigarettes.
• Using oral contraceptives ("the Pill").

Is there a way to prevent cervical cancers?
Yes vaccines developed to prevent HPV infections can prevent cervical cancer. "The Food and Drug Administration (FDA) has approved three vaccines to prevent HPV infection: Gardasil®, Gardasil® 9, and Cervarix®. These vaccines provide strong protection against new HPV infections, but they are not effective at treating established HPV infections. "(NCI)

What treatments are given to women diagnosed with cervical cancer? 
Women may be treated with :
Surgery
Radiation
Chemotherapy

For more information please visit:
Foundation for Women's Cancer brochure Understanding Cervical Cancer (http://www.foundationforwomenscancer.org/wp-content/uploads/Understanding-Cervical-Cancer-2013.pdf)

Are you a cervical cancer survivor? Visit the Cervivor website http://cervivor.org/

Dee
Every day is a Blessing!


Sources:
http://www.cancer.gov/types/cervical
http://seer.cancer.gov/statfacts/html/cervix.html

Dr. Maya Soetoro-Ng Ovarian Cancer PSA , OCNA

On this Day 20 of #GCAM, I am pleased to share this Ovarian Cancer National Alliance (OCNA) PSA message featuring Dr Maya Soetoro-Ng.



Thank Dr Maya Soetoro-Ng.


Dee
Every Day is a Blessing!

A Fitting Tribute

Last night, I attended the Janice Lopez Ovarian Cancer Foundation's (JLOCF) Concert for a Cure to support ovarian cancer education and research. I have been friends with the Lopez family since 2006 when our families met to hang teal ribbons in Edison, NJ at the beginning of Ovarian Cancer Awareness Month. Both Janice and I were diagnosed with Stage 3 ovarian cancer in 2005. Sadly she passed away in 2009. But Team JLO continues to honor her through the wonderful works of their Foundation.

Before the Concert began Dr Lorna Rodriguez , Rutgers Cancer Institute of New Jersey talked about Precision Medicine and the efforts made to treat the mutations found in various types of ovarian cancers.

The Concert was performed by the ENCORE Orchestra of New Jersey. What an amazing and talented orchestra. They performed songs from a number of Broadway shows and films including The Phantom of the Opera, Wicked, Le Miserables, Into The Woods and Lion King just to name a few. It is hard to pick a favorite but my top two were  Star(Le Miserables) and In Whatever Time We Have (Children of Eden). 

Below are some photos from the concert.

Jenna Ravenda, Julie Galorenzo, Katherine Acosta- At the Ballet

Keith White - Star

Shari Gill - Momma Will Provide

Marc Dahlia & Jenna Rivenda - In Whatever Time We Have

Felica Moss Eaton - Amazing Grace

It was an incredible event and I look forward to attending next year's concert .

Dee
Every Day is a Blessing!Blessed to have heard the beautiful music of the ENCORE Orchestra.

"100 Questions and Answers about Ovarian Cancer"

I am so pleased to inform my followers that the book "100 Questions and Answers about Ovarian Cancer" is now for sale on Amazon.  I am priviledged to be the patient voice for this, the third edition of the book written by Dr Don Dizon. Thank your Don for asking me to join you on this project.

I wrote about being asked to be the patient voice in this book in the post From the Past to the Present.

You may purchase the book here.

Dee
Every Day is a Blessing! Blessed to be the pati 

The Adventures of Lillian Kate

Valisia and I , 6/8/14

I had the privilege of meeting Valisia LeKae  at the Rutgers Cancer Institute of New Jersey Survivors Day in 2014. I had reached out to her on Twitter when I first heard she was diagnosed with ovarian cancer. Introducing her to the other survivors and caregivers that day was a true honor.  Valisia is a survivor and Tony and Grammy nominated actress and my Teal sister.
Since finishing treatment Valisia has been dedicated to raising awareness of ovarian cancer. Recently she completed three episodes of "The Adventures of Lillian Kate"  a "true story" about Valisia's experiences.

I am pleased to share the episodes here on my blog.








Thank you Valisia for sharing your story with the world. May you continue to have many years of good health and happiness.


Dee
Every Day is a Blessing

Female Cancers World Wide

Thank you Annie Ellis for sharing this image.
Additional worldwide data for cancer may be found at the WHO website:  http://globocan.iarc.fr/Pages/online.aspx       

Dee
Every Day is a Blessing! 

You Never Know

I have been going to the same hairstylist for close to 20 years. I love how she cuts my hair and I enjoy our conversations every 6 weeks or so.

We have been through a lot together.

When I was first diagnosed we talked and I asked her to cut my shoulder length hair very short.  I remember as her eyes teared up a she cut it and she gave me a big hug when I left the salon. I was back about a year later for her to trim the curly fuzz that had appeared on my head. She didn't charge me for the trim or for the next 2 trims. 

She styled my daughter's hair for her wedding. And a few months later, when I recurred, she was cutting my hair short again. This was around the time her mother had a stroke. We talked about her rehab and how they made her parent's home better suited for a wheel chair. I would always ask how her mom was doing. I loved hearing about how her mom attended family weddings and took an occasional trip to the shore or Atlantic City.   I was sad when I learned her mom had passed.

I went to the salon the other day for a hair cut. It was our usual conversation catching up on how my daughter and grandsons are doing.  Then she stopped and said " My Aunt had a hysterectomy last week." She paused and went on to say " She learned yesterday she has stage 3 ovarian cancer - there was cancer in her lymph nodes". She said her aunt was scared and I said I know that weak in the knee feeling.  Then I told her I was stage 3 too. She then said to me "it's been about 5 years for you right?" When I said 10 years in July she looked up at me in the mirror and I could see her eyes tear up. She said "I can't wait to tell my Aunt".

As I got up from the chair I reached for my bag and gave her my card with my e-mail and phone number on it. I  told her to have her Aunt call or e-mail me if she has any questions or if she just wants to talk.

You never  know when you will hear of another woman diagnosed with ovarian cancer.


Dee
Every Day is a Blessing!

What You Need to Know About The CA-125 Test

Women who have ovarian cancer or are suspected of having ovarian cancer will usually have their blood tested for CA-125. CA-125 ( cancer antigen 125) is a protein that is produced on the surface of cells and can be measured in teh blood. You may also hear CA-125 be called a tumor biomarker for ovarian cancer.

The protein is elevated in 80% of the women with advanced disease and 50% of those with early stage cancer ( Source : OCRF) . I wrote about how the test method in this blog post.

The best source I have found explaining the CA-125 test is

Understanding CA-125 Levels: A Guide for Ovarian Cancer Patients

produced by the Foundation for Women's Cancer.

Since my CA-125 was still in the normal range when I recurred my gyn-onc and I look at the trend up in results not necessary the actual number.

Dee
Every Day is a Blessing!

Organizations Finding Ways to Make a Difference

When I was first diagnosed I didn't know that there were ovarian cancer organizations raising awareness and funds for research.  When I finished chemotherapy in 2006 I knew I wanted to get involved so I asked my gynecologic oncologist about organizations. She told me about Kaleidoscope of Hope Foundation and NOCC. I reached out by phone and joined those organizations.

If you want to help here is a list of organizations in NJ.

GRACEful Hope
Kaleidoscope of Hope Foundation
Janice Lopez Ovarian Cancer Foundation 
Mary Mazanec Ovarian Cancer Foundation
National Ovarian Cancer Coalition - New Jersey Chapter
Ovarian Cancer Research Fund - NJ events listed on their calendar
The Teal Tea Foundation
Teal Tender Hearts for Ovarian Cancer Awareness
Turn the Towns Teal 




I have volunteered with many of these organizations, attended events and personally know many of the founders / directors.  Each and every one of them has done outstanding work to either raise awareness, donate millions of dollars to research or have support women diagnosed with ovarian cancer. You can help those fighting this disease  and do it close to home.

 If you know of an organization in NJ missing from my list, please mention them in the comment section  below.Thanks.


Dee
Every Day is a Blessing!

Ovarian Cancer Treatment: Targeted Therapy

In recent years the FDA has approved a number of targeted therapy drugs for the treatment of ovarian cancer.
"Targeted cancer therapies are drugs or other substances that block the growth and spread of cancer by interfering with specific molecules ("molecular targets") that are involved in the growth, progression, and spread of cancer. "

Some targeted therapies interfere with proteins or receptors in ovarian cancer cells and stop their growth and others will prevent the growth of blood vessels which supply the cancer cell.

Bevacizumab ( Avastin)
"A recombinant humanized monoclonal antibody directed against the vascular endothelial growth factor (VEGF), a pro-angiogenic cytokine. Bevacizumab binds to VEGF and inhibits VEGF receptor binding, thereby preventing the growth and maintenance of tumor blood vessels. "NCI definition

Bevacizumab may be used along with carboplatin and paclitaxel as an option for women with Stage III, IV ovarian cancer as well as for women with a recurrence. ( NCCN guidelines)  

Olaparib (Lynparza)
"A small molecule inhibitor of the nuclear enzyme poly(ADP-ribose) polymerase (PARP) with potential chemosensitizing, radiosensitizing, and antineoplastic activities. Olaparib selectively binds to and inhibits PARP, inhibiting PARP-mediated repair of single strand DNA breaks; PARP inhibition may enhance the cytotoxicity of DNA-damaging agents and may reverse tumor cell chemoresistance and radioresistance. PARP catalyzes post-translational ADP-ribosylation of nuclear proteins and can be activated by single-stranded DNA breaks. "NCI definition


This oral treatment is approved for women with advanced ovarian cancer who have the BRCA1 or BRCA2 mutations and have had 3 prior chemotherapy treatments.

Dee
Every Day is a Blessing!


Sources:
http://www.mdanderson.org/patient-and-cancer-information/cancer-information/cancer-types/ovarian-cancer/treatment/index.html
NCI :http://www.cancer.gov/about-cancer/treatment/types/targeted-therapies/targeted-therapies-fact-sheet#q1

Ovarian Cancer Treatment: Chemotherapy

For the majority of  women diagnosed with ovarian cancer chemotherapy will follow surgery.

What is Chemotherapy?
Chemotherapy is the use of chemical drugs to kill the fast growing cancer cells.

For ovarian cancer the standard drugs used on initial diagnosis depends on stage at diagnosis. Below are the recommended chemotherapy treatments as given in the NCCN guidelines.

Stage I
Carboplatin with paclitaxel or docetaxel - IV ( intravenous)

Stage II, III, IV
Paclitaxel with cisplatin IP ( intraperitoneal injection)
Paclitaxel or docetaxel with Carboplatin - IV
Dose Dense  Paclitaxel with Carboplatin  - IV

The chemotherapy is given in cycles every 14, 21 or 28 days. I wrote about how different chemotherapy drugs work in this blog post. (http://womenofteal.blogspot.com/2012/01/how-do-those-ovarian-cancer-treatments.html)

IP, intraperitoneal chemotherapy allows the drugs to be injected into the peritoneal cavity . Studies have shown that treatment with IP / IV increase increases survival by 16 months over IV treatment alone.

Chemotherapy Drugs for Recurrences: 

When a women's cancer recurs she may be offered the same chemotherapy drugs or one of these approved drugs as found on the NCI website.

• Carboplatin
• Clafen (Cyclophosphamide)
• Cisplatin
• Cyclophosphamide
• Cytoxan (Cyclophosphamide)
• Doxorubicin Hydrochloride
• Dox-SL (Doxorubicin Hydrochloride Liposome)
• DOXIL (Doxorubicin Hydrochloride Liposome)
• Doxorubicin Hydrochloride Liposome
• Evacet (Doxorubicin Hydrochloride Liposome)
• Gemcitabine Hydrochloride
• Gemzar (Gemcitabine Hydrochloride)
• Hycamtin (Topotecan Hydrochloride)
• LipoDox (Doxorubicin Hydrochloride Liposome)
• Neosar (Cyclophosphamide)
• Paclitaxel
• Paraplat (Carboplatin)
• Paraplatin (Carboplatin)
• Platinol (Cisplatin)
• Platinol-AQ (Cisplatin)
• Taxol (Paclitaxel)
• Thiotepa
• Topotecan Hydrochloride

 Tomorrow's post will be on targeted therapies for ovarian cancer.
 
Dee
Every Day is a Blessing! 


Source:
NCCN guidelines
http://www.nccn.org/patients/guidelines/ovarian/index.html#42
JCO:
http://jco.ascopubs.org/content/early/2015/08/03/JCO.2015.61.4776.abstract

Ovarian Cancer Treatment: Surgery

There are a number of treatments for ovarian cancer including surgery, chemotherapy and targeted therapies. The next few days posts will focus on each type of treatment.

The stage and grade will help determine how your ovarian cancer will be treated.


Surgery:

Surgery is the main treatment for ovarian cancer . Studies have found that women whose surgery is completed by a gynecologic oncologist will have better outcomes.( http://www.nytimes.com/2013/03/12/health/ovarian-cancer-study-finds-widespread-flaws-in-treatment.html?_r=0) Studies have also found that survival increases when the gynecologic oncologist is able to remove all of the visible disease.

Depending on the extent of the disease  the gynecologic oncologist will remove the uterus ( hysterectomy), one or both ovaries and fallopian tubes ( Salpingo-oopherectomy) ,and fatty tissue in the pelvis( oomentum) as well as lymph nodes. ( Please see http://www.cancer.gov/images/cdr/live/CDR612116.jpg for an image of  the organs that may be removed.) You may hear the term debulking surgery . This is the term used for the removal of as much tumor as possible.

Most women will have surgery before chemotherapy but in the case of advanced disease at diagnosis (Stage 3C,  Stage 4) women may be offered chemotherapy ( neoadjuvant) first and then surgery after 3-4 chemotherapy treatments.

Dee
Every Day is a Blessing!

Sources:
NCI: http://www.cancer.gov/types/ovarian/patient/ovarian-epithelial-treatment-pdq#section/_156
MD Anderson: http://www.mdanderson.org/patient-and-cancer-information/cancer-information/cancer-types/ovarian-cancer/treatment/index.html

Staging Ovarian Cancer

Staging determines where the ovarian cancer is found in a women's body. Most ovarian cancers are staged during surgery when tissue samples are taken and examined. But cancers that have spread may be staged using biopsy and CT scans. The stage of your ovarian cancer will be used to determine the best treatments for you. 

Gynecologic oncologists / surgical oncologists use the FIGO scale while staging. Here are the main stages:

Stage I: Tumor confined to the ovary or fallopian tube.

Stage II: The cancer is in one or both ovaries or fallopian tubes and has spread to other organs (such as the uterus, fallopian tubes, bladder, the sigmoid colon, or the rectum) within the pelvis. It has not spread to lymph nodes or distant sites.

Stage III: The cancer is in one or both ovaries. And may have spread beyond the pelvis into the lining of the abdomen and/or has spread to lymph nodes in the back of the abdomen

Stage IV: The cancer has spread to the inside of the spleen, liver, lungs, or other organs located outside the peritoneal cavity. This is known as distant metastasis.

For complete staging please see this SGO FIGO staging document : 
https://www.sgo.org/wp-content/uploads/2012/09/FIGO-Ovarian-Cancer-Staging_1.10.14.pdf
or 
the ACS web page: http://www.cancer.org/cancer/ovariancancer/detailedguide/ovarian-cancer-staging

The tissue / fluid from the staging process is examined by a pathologist for type (Histologic type) and grade.  He/she will describe the cancer as Grade 1, 2 or 3. Grade 1 ovarian cancer tissue is most like ovarian tissue while Grade 3 is irregular and more likely to  metastasize. For ovarian cancer you may hear the terms "Low grade"  or "High grade" to describe your tissue.
(Source:

http://www.ocrf.org/about-ovarian-cancer/treatment-of-ovarian-cancer/staging-and-grading)

Recurrent ovarian cancer: The cancer has come back after it has been treated. It may appear in other parts of the body, but it is still ovarian cancer.

Dee
Every Day is a Blessing!

Join the #Gyncsm Chat - It's our 2nd Anniversary

As many of you know Christina Lizaso and I co-founded the #gyncsm community on Twitter in 2013. This month marks our 2nd anniversary as a Twitter community.

 Tonight at 9pm EST I will be co-moderating the #gyncsm chat. The chat topic is  Gyn Cancer Awareness Month - Spotlight on Uterine/Endometrial Cancer.  I hope you will join us and share what you are doing to raise awareness of gynecologic cancers this month and learn about uterine and endometrial cancers. We happy a few survivors will share their experience with uterine cancer with us.

If you haven't yet joined a chat it is easy. You don't even need to have a Twitter account but if you want to share or comment on a Tweet you need to have an account and log in. I blogged about getting started on twitter  in 2013. You can read it here. New to chats? Check out this #gyncsm post http://www.gyncsm.blogspot.com/2013/09/lets-chat.html .

Looking forward to having you join us.

Dee
Every Day is a Blessing!