Abdominal Chemotherapy Extends Lives of Ovarian Cancer Patients

For women with advanced ovarian cancer, adding doses of chemotherapy delivered directly into the abdomen can help them survive up to 12 months longer, according to a study published today in the New England Journal of Medicine.

Traditionally, women received only tumor-removal surgery followed by intravenous chemotherapy, but the study's results should change that, said Dr. Harrison G. Ball, chief of gynecologic oncology at the UMass Memorial Medical Center in Boston. His hospital participated in the study that consisted of 429 women and was supported by the National Cancer Institute.

The study included women with advanced ovarian cancer who had first undergone successful surgical removal of cancer cells. Following the surgery, the women underwent either traditional IV-only treatment or a combined treatment of IV and abdominal chemotherapy, known as IP, which is delivered through an intraperitoneal catheter that is surgically inserted into the abdomen.

"In our trial, women who received part of their chemotherapy via an IP route had a median survival time of 16 months longer than women who received only IV chemotherapy," said Dr. Deborah Armstrong in a press release from the NCI. She is the lead author of the study and a medical oncologist at Johns Hopkins Kimmel Cancer Center in Baltimore.

New Recommendations for Cancer Patients

As a result, the NCI is changing its recommendations to state that women with advanced ovarian cancer who undergo effective surgery should receive a combination of IV and IP chemotherapy.

To achieve "effective" surgical results, Ball recommends that women recently diagnosed with the disease seek out gynecologic oncologists, who are the most skilled at surgically removing ovarian cancer cells.

Ball said the combined treatment of IV and IP chemotherapy was probably more effective because it gives women a much higher dose of medication, but he added the exact reason it worked better than traditional IV-only treatment was not known.

Ovarian cancer is one of the more challenging types of cancer to treat, in part because women typically don't have any symptoms until the disease has progressed beyond the ovaries. In 2005, more than 22,000 women in the United States were diagnosed with ovarian cancer, and 16,000 women died of the disease.

"My patients call it the silent killer," Ball said. "The important thing is to make sure, if you have symptoms that are not explainable, don't let it drop. If you're bloated, or your abdomen is getting bigger, be persistent with your physician."

Despite the study's promising findings, further research is needed to determine the optimal number of IP treatments, as well as how to reduce side effects, which are stronger than with IV therapy. IP catheters also make women more prone to infection, Ball said.