This is an alarming report! Here are two takes on things, beginning with the first part of an editorial from the New York Times, followed by another article about the report by the Boston Globe:
Inadequate Treatment of Ovarian Cancer
Published: March 13, 2013
A new study has found widespread failure among doctors to follow clinical guidelines for treating ovarian cancer, which kills 15,000 women a year in this country. This disturbing news shows the kind of challenge that health care reformers are up against in improving medical care — even when cost is not the issue.
The study, presented at a conference on gynecologic cancers on Monday, analyzed the treatment of more than 13,000 women with ovarian cancer who received their diagnoses between 1999 and 2006. Only 37 percent received the care recommended in guidelines set by the National Comprehensive Cancer Network, an alliance of 21 major cancer centers.
This kind of failure is not uncommon in American medicine. A decade ago, RAND Corporation researchers reported that just 55 percent of a large sample of patients suffering from a broad range of diseases received care that met quality guidelines. Numerous studies since then focusing on specific diseases have found similar problems.
In the case of ovarian cancer, the consequences of inadequate care are tragic. The recommended guidelines specify combinations of surgery and chemotherapy, depending on the stage of the disease, including debulking surgery to remove all visible traces of the tumor and aggressive chemotherapy that can prolong life. Women who received the recommended treatment were 30 percent less likely to die than those who did not. Among those with advanced cancer, the stage at which ovarian cancer is usually first found, 35 percent of the women treated in accordance with the guidelines survived at least five years compared with 25 percent for those whose care fell short…
Read the rest by clicking-on the link below:
Next, the Boston Globe wrote about it, too:
Why do most women with ovarian cancer get sub-standard treatment?
March 13, 2013
By Deborah Kotz, Globe Staff
It’s hard to believe in this age of patient empowerment and instant Internet access to the latest cancer research that most women diagnosed with ovarian cancer are getting sub-standard care, but that’s exactly what a new study found — and it could be subtracting a year or more from their lives.
While rarer than breast cancer, ovarian cancer kills about 15,000 American women each year because there’s no reliable screening test, so the cancer goes undetected until bloating, nausea, and other symptoms develop after the tumor has spread beyond the ovary.
Surgery to remove the cancer often involves removing the ovaries, fallopian tubes, and uterus, and sometimes part of the bowel, while scraping away dozens or hundreds of tiny growths dotting the abdominal cavity and surrounding organs — known as debulking. In the hands of the wrong surgeon, cancer may remain, potentially shortening a woman’s life.
“A general surgeon who doesn’t see much ovarian cancer may not have the capability to do this procedure,” said Dr. Ursula Matulonis, director of the gynecological oncology program at the Dana-Farber Cancer Institute. A 2006 study conducted by Dana-Farber researchers and others found that ovarian cancer patients were more likely to undergo a debulking procedure if they were operated on by a gynecologic oncologist than a general surgeon and were less likely to die of any cause — a finding that was confirmed in a 2010 study conducted by California researchers.
The new University of California, Irvine, research study, presented at last Monday’s meeting of the Society of Gynecologic Oncology in Los Angeles, found that only 37 percent of ovarian cancer patients treated from 1999 to 2006 in California received the standard of care that’s recommended in clinical practice guidelines issued by the National Comprehensive Cancer Network, an non-profit alliance group that represents 21 cancer treatment centers.
The study also found that surgeons who treated at least 10 ovarian cancer patients each year and high-volume hospitals with at least 20 ovarian cancer patients annually were more likely to follow these practice guidelines, which are based on the most up to date evidence for maximizing a patient’s survival chances and quality of life.
Providing the optimal form of chemotherapy is as crucial as surgery, yet many community hospitals and private oncology practices, according to the new research finding, have neglected to administer a newer form that’s delivered directly into the abdominal cavity through a port.
“It’s complicated to administer and involves more side effects, which is why it’s mainly available only through academic medical centers,” Matulonis said. Yet, researchers found in 2006 that the treatment regimen, called intraperitoneal or IP therapy, extended the average patient’s life by nearly 16 months over standard chemotherapy treatments delivered through an IV into the blood stream…
Like the New York Times editorial above, click-on the link below to read more:
Please listen. Many cancers can be treated effectively by a local medical oncologist. But like Pat’s multiple myeloma and my ovarian cancer, it is always best to see a specialist for a second opinion–and in this case probably treatment, too.
Please get that second opinion!
Feel good and keep smiling! Pattie