Another weapon to fight ovarian cancer

By Levi Downs, Jr., M.D.

About 2,000 Minnesota women are diagnosed and treated each year for ovarian cancer. For most of these women, the cancer will recur.

Standard chemotherapy treatments can put recurrent ovarian cancer in remission, often more than once. However, when the cancer resists the standard treatments, we need new options to help these women. One of the new options being explored is the old drug thalidomide.

Thalidomide is not a cure for recurrent ovarian cancer, but our research, published last month, shows it has promise as a safe and effective treatment for the disease. The University of Minnesota Cancer Center study is the first randomized clinical trial to test thalidomide for recurrent ovarian cancer. Researchers at other cancer centers are testing it for treatment of multiple myeloma, a type of blood cancer, and for lung, prostate, and pancreatic cancers.

Many women reading this column will correctly recognize thalidomide as a drug blamed in the 1950s for causing birth defects. The reason for the renewed research interest in thalidomide is that the drug has been found to interfere with the development of new blood vessels. (Cancer tumors need a supply of blood to grow.) It's also been shown to boost the body's immune system to fight cancer.

Our research study compared the combination of thalidomide and topotecan, a chemotherapy often used for ovarian cancer, to topotecan alone in women who had received prior treatment for recurrent epithelial ovarian cancer. Thirty women were randomly selected to receive thalidomide and topotecan, and another 30 women received only topotecan. In 47 percent of the women who received thalidomide and topotecan, the tumor either shrank in size or disappeared. This compares to 21 percent of women who received only topotecan having a similar result. We also found that the drug combination slowed the recurrence of the cancer.

While these results are promising, more research definitely needs to be done. Plans are underway to develop a new clinical trial at the University of Minnesota that will test a newer member of the class of drugs containing thalidomide for treatment of recurrent ovarian cancer.

Meanwhile, I encourage all women to learn about ovarian cancer. Unfortunately, no routine screening test exists for ovarian cancer. Nonetheless, an annual gynecologic examination is recommended because it can pick up ovarian cancer in some women. Another recommendation is that women be attuned to changes in their body.

Women with ovarian cancer are more likely to experience these symptoms: bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly, and an urgent need to urinate or frequent urination. A woman who experiences these symptoms persistently for a few weeks should make an appointment to see her health care provider.

Levi Downs, Jr., M.D., is assistant professor of obstetrics and gynecology at the University of Minnesota Medical School and a member of the Cancer Center.

Health Talk & You is an educational service of the University of Minnesota. Advice presented should not take the place of an examination by a health-care professional. For more health-related information, go to http://www.healthtalk.umn.edu. For comments or questions about Health Talk & You e-mail buss@umn.edu.