Royal Adelaide Hospital North Terrace, SA

Over the past couple of years, there has been a greater emphasis on ovarian cancer, both in the research setting and also in terms of public awareness.

This is entirely fitting, as, while total numbers of cases of ovarian cancer are not huge, the impact of the disease on society certainly is, with three-quarters of the cases presenting as late stage (stages III and IV) disease.  While many respond to chemotherapy, there is a high relapse rate and ultimately, three-quarters of women with advanced cancer will ultimately die from the disease.

An Australian Cancer Network working party has spent the past two years refining the Guidelines for the Management of Ovarian Cancer, and this document has now been sent to the National Health and Medical Research Council for ratification. Dissemination of these Guidelines is expected early in the new year.

At the same time, an expert advisory group, under the umbrella of the National Breast Cancer Centre, is working on strategies to disseminate these guidelines to the profession, and develop a separate consumer version.

On the research front, the Australia New Zealand Gynaecological Oncology Group is collaborating in a multi-centre, multi-pronged study. This study is supported by funding from the Department of Defence, in part.

The three major components include:

  1. An epidemiological study – case-controlled, looking at lifestyles of all women newly diagnosed with ovarian cancer over the next three years, and comparing them with age-matched controls, seeking to tease out any risk factors, lifestyle changes, etc. They expect to recruit at least 1,000 women, making it the largest study of its kind in the world, building on a previous eastern states study conducted in the early 1990s.
  2. A biospecimen collection, with samples of tumour and blood taken from women at the time of their surgery for ovarian cancer. Microassay studies will be undertaken, and there are plans to establish a tissue bank for future collaborative studies also.
  3. A chemotherapy treatment study, comparing in a blinded randomised way four different treatment arms; comparing doublets and triplets of chemotherapy with the “gold standard” of Paclitaxel and Carboplatin. Other drugs to be studied are Topotecan, Gemcitabine and Caelyx.

This review of the current state-of-the-art in ovarian cancer is not meant to be a forerunner of the Guidelines, but rather to highlight areas of change or special areas of interest to Australian researchers.

In compiling these articles, I am also very conscious of the work being undertaken by cancer consumer groups, especially in ovarian cancer, where they are making an impact on women and their families with the disease both in lobbying and in fundraising to assist research.

Ovarian cancer is still a major problem today, but the research effort can be expected to make an impact over the next few years.

Cancer Forum cover Nov 2003

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