April 7, 2006

SIU Physician Offers New Ovarian Cancer Treatment

Ovarian cancer is one of the most lethal cancers, with few patients surviving more than five years. But now there is new hope for women who have this disease because of a new treatment that increases a woman’s survival.

According to Dr. L. Stewart Massad, associate professor and chief of gynecologic oncology at Southern Illinois University School of Medicine in Springfield, only a few places in Illinois including Springfield are currently offering it. The new treatment, intraperitoneal (IP) chemotherapy, pumps large doses of drugs directly into a woman’s abdominal cavity. The survival rates have increased an average of 16 months.

"This treatment is used for stage 3 ovarian cancer patients who have had surgery to remove all of the bulky cancer," said Massad. IP chemotherapy allows higher doses and more frequent administration of drugs, and it seems to be more effective in killing cancer cells in the peritoneal cavity, which is the membrane lining in the abdominal and pelvic walls. Some patients have, however, experienced significant side effects, which forced them to stop treatment.

Other treatments for this cancer include surgery, chemotherapy and radiation therapy. In some cases, two or even all of these treatments might be recommended.

Symptoms for ovarian cancer are very subtle and include bloating, occasional irregularity, nausea, pressure on the bladder or rectum, and weight loss, all of which may be associated with a variety of different diseases. "Too often women with these vague symptoms wait to see their gynecologist until their cancer is in the advanced stages," explained Massad.

There are several other types of cancer referred to as gynecologic cancer, all of which affect a women’s reproductive system. The various types include cancer of the uterus, cervix, fallopian tubes, vagina and vulva. "About 80,000 American women are diagnosed with gynecologic cancer annually. Many of these cancers can be overcome if detected and treated early," he said.

Uterine cancer is the most common gynecologic cancer and is expected to affect 40,000 women in the U.S. this year. "We are seeing increases in the numbers of women who have uterine cancer as the obesity epidemic progresses," said Massad.

Most uterine cancers begin in the lining of the uterus after menopause, when a woman’s menstrual cycle ends. Symptoms include bleeding after menopause or irregular vaginal bleeding before menopause. Risk factors for uterine cancer include obesity, hypertension, diabetes, inappropriate estrogen use and late menopause. Weight loss helps protect women against uterine cancer.

Cervical cancer was previously the most common cancer of the female reproductive system, but with pap screenings it has become less common. "It is believed to be caused by a sexually transmitted virus, the human papillomavirus. Women who have multiple partners or who have a partner who has had more than one lifetime sexual partner are more at risk for cervical cancer," explained Massad.

Symptoms for cervical cancer include bleeding after intercourse, excessive discharge and abnormal bleeding between periods.

If diagnosed in the early stages, cervical cancer can be treated without hysterectomy and is usually curable. Invasive cervical cancer usually requires hysterectomy and radiation therapy. A vaccine for cervical cancer was shown to be effective in a recent clinical trial and maybe on the market within a few years.

Vulvar cancer appears as lesions on the surface of the vulva or labia. Symptoms include itching in the vulvar area. Risk factors are diabetes, being aged 70 or older and chronic vulvar irritation. Massad said it is a very curable type of cancer, which usually requires surgery.

"It is important for women to learn about their family histories of cancer, have annual gynecologic examinations, and alert their gynecologist so preventative steps can be discussed," said Massad.

Massad is active in various medical arenas. Last year, he traveled to Rwanda with a small group of U.S. physicians funded by the National Institutes of Health to study outcomes of Rwandan women infected with HIV. His role was to make recommendations for cervical cancer prevention and treatment in that country. He also is a member of the SimmonsCooper Cancer Institute at SIU, which is focusing the medical school’s efforts in cancer research, physician and public education, and treatment for patients from across central and southern Illinois.

Massad joined the SIU faculty in 2003. He is board certified in gynecologic oncology by the American Board of Obstetrics and Gynecology and is a fellow of the American College of Obstetrics and Gynecology.

More information about gynecologic cancer is available on SIU’s web site www.siumed.edu/cancer, the American Cancer Society site www.cancer.org, and the National Cancer Institute site www.cancer.gov.

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