OVARIAN CANCEROvarian cancers are the most common serious gynecologic cancer. This disease is frequently diagnosed in an advanced stage, and represents the 5th most common cause of cancer death for women. It is estimated that ovarian cancer will occur in 1 in every 70 women.
Most ovarian cancers cause few symptoms until the disease has spread. As the tumor grows it may cause pain or bloating of the abdomen. A yearly examination, vaginal ultrasound and blood test has been advocated by some as a method of early detection, although this remains controversial.
Treatment of ovarian cancer depends on the extent of tumor spread. Generally surgery and chemotherapy are used in this disease. If treated when the disease is localized only to the ovary cure rates may approach 90%. However, if the tumor has spread, the cure rates drop dramatically. Aggressive "debulking" surgery is often required prior to chemotherapy in these women.
Bone marrow transplantation has been used in women with high risk and recurrent disease. Two recent reports have noted encouraging results in this disease. Legros (J Clin Oncol 1997; 15:1302) treated 53 women with high-risk disease with transplants after "second look" surgery. In this report nearly 60% of women remained alive at 5 years follow-up, which compared favorably to historical series that suggest a 20-30% survival rate for women treated with standard therapy. A report by Stiff (J Clin Oncol 1997; 15:1309) found favorable results among women with very advanced disease (averaging 2 prior chemotherapy treatments). Overall survival rates in the range of 3 years were obtained in women with disease that remained sensitive to platinum chemotherapy and who entered the transplant with less than 1 cm disease.
The Adult Stem Cell- Bone Marrow Transplant Program of Hackensack University Medical Center has active transplant treatment protocols for Ovarian cancers. For more information on this treatment or to schedule an appointment call (201) 996-5849.
One transplant trial examines the role of high-dose chemotherapy as part of the initial treatment of women with newly diagnosed ovarian cancer. After surgery women receive 3-4 cycles of standard dose chemotherapy (taxol and cisplatin) followed by a transplant using cyclophosphamide, mitoxantrone, and carboplatin. Additional information on this protocol can be obtained by clicking here
A second transplant study examines the role of high-dose chemotherapy in women who have persistent or recurrent disease following traditional chemotherapy. Patients will be asked to receive platinum-based chemotherapy. Responding women will be offered transplantation with cyclophosphamide, mitoxantrone, and carboplatin. Additional information on this protocol can be obtained by clicking here.
A national protocol (ECOG G0164) is also available at Hackensack University Medical Center. The study is comparing standard dose chemotherapy with transplantation in women with persistent or chemosensitive relapse disease.. Additional information on this protocol can be obtained by clicking here.
In addition to the transplant protocols, the physicians at the Northern New Jersey Cancer Center are experienced in the diagnosis and treatment of this disease. Non-transplant research treatments also available include (1) prolonged infusion of topotecan plus cisplatin, (2) 9-AC in advanced disease, and (3) Perillyl alcohol in advanced disease. For more information about these treatments call (201) 996-5800.
ENDOMETRIAL CANCER
Endometrial cancers are the most common gynecologic cancer, with over 30,000 new cases per year. This is usually a disease of women over the age of 60. Obesity, no pregnancies, late menopause, diabetes, and use of estrogens have all been associated with an increased risk of this cancer. Vaginal bleeding is the most common early symptom.
Treatment of endometrial cancer depends on the extent of disease. Patients with limited disease have an excellent chance at cure. Surgical resection is often the mainstay of treatment. Patients with High risk disease may benefit from post-operative chemotherapy and/or radiotherapy. Patients with advanced disease (that has spread) may be treated with radiotherapy, hormonal treatments and/or chemotherapy.
Endometrial cancers are not currently treated with transplantation at Hackensack University Medical Center. However, the physicians at the Northern New Jersey Cancer Center are experienced in the diagnosis and treatment of this disease.
CERVICAL CANCER
Cervical cancer is a major gynecologic health problem. Infection with the human papillomavirus and multiple sexual partners has been associated with a higher risk of this cancer. A yearly pap smear may discover this cancer when local treatments can be curative. Cervical cancer is usually asymptotic during its early stages. A vaginal discharge may be noted as the disease progresses.
Treatment of cervical cancer depends on the extent of spread at the time of diagnosis. Surgery or radiation may be curative if the disease has been diagnosed early. More advanced disease may require chemotherapy with medications such as cisplatin, ifosfamide, 5-FU and hydroxyurea.
Cervical cancers are not currently treated with transplantation at Hackensack University Medical Center. However, the physicians at the Northern New Jersey Cancer Center are experienced in the diagnosis and treatment of this disease.
VAGINAL CANCER
Vaginal cancers are rare, accounting for only 1% of gynecologic cancers. Symptoms may include abnormal vaginal bleeding, discharge, or painful urination.
Treatment of vaginal cancers may include surgery, radiation and chemotherapy. For many early cancers, local treatments can be curative. This lends support to a yearly exam.
Vaginal cancers are not currently treated with transplantation at Hackensack University Medical Center. However, the physicians at the Northern New Jersey Cancer Center are experienced in the diagnosis and treatment of this disease.
VULVAR CANCER
Vulvar cancers are frequently without symptoms, but may cause pain, itching or burning. Early diagnosis with yearly exams is helpful.
Treatment of vulvar cancer generally consists of surgery. Topical chemotherapy may also have a role.
Vulvar cancers are not currently treated with transplantation at Hackensack University Medical Center. However, the physicians at the Northern New Jersey Cancer Center are experienced in the diagnosis and treatment of this disease.
