In 2016, the American Cancer Society projected that the number of women dying worldwide from cancer was expected to rise to 5.5 million by 2030.1 In the realm of women’s cancers, ovarian cancer is prominent and serious. A woman is diagnosed with ovarian cancer every 23 minutes in the United States, and it is the number one cause of gynecological cancer deaths and the fifth cause of cancer-related deaths in women.2
September is Ovarian Cancer Awareness Month, an important time to acknowledge the impact and severity of this rare disease as well as the clinical advancements that have been developed to combat it. If treated in the earliest stages, the rate of ovarian cancer survival is very high. If regional cancer – cancer that has spread to nearby lymph nodes, tissues or organs – or localized cancer – cancer that is limited to the place where it started, with no sign that it has spread – is found within the first year, patients have a nearly 90 to 98 percent chance of surviving.3 This makes early detection absolutely key. Unfortunately, only about 20 percent of ovarian cancer cases are found early – women with ovarian cancer may be asymptomatic, and there is a need for more tests geared toward early detection.4
Fortunately, ovarian cancer diagnoses have been decreasing over the past 20 years.5 According to a study by the European Society for Medical Oncology, the use of oral contraceptives, the decline in hormone replacement therapy (HRT) to manage menopausal symptoms, and better diagnosis play a role in declining ovarian cancer rates. Ovarian cancer death rates in Europe decreased by 10 percent and in the U.S. by 16 percent between 2002 and 2012, according to the same study.6
Clinical advancements in screening tests, surgical procedures, chemotherapy, radiation, oral oncolytic and cell and gene therapies are also helping to control this rare disease. Poly (ADP-ribose) polymerase (PARP) inhibitors have been a major therapeutic advancement in managing ovarian cancer. Before PARP inhibitors, there weren’t many options to help maintain remission between chemotherapy cycles. Cancer cells use an enzyme, poly ADP-ribose polymerase, to repair DNA after chemotherapy. This oral therapy is targeted at women who have undergone chemotherapy treatment but are at risk for cancer relapse. PARP inhibitors seek to block this enzyme to delay cancer relapse. There are three PARP inhibitors now available on the market, and more progress in this space is eagerly anticipated.
Even with ovarian cancer rates declining and promising advancements in therapeutic options, more work needs to be done by stakeholders across the healthcare system to support women facing the many burdens associated with this rare disease. All of us supporting ovarian cancer patients should focus on three core areas: alleviating financial burdens, providing highly coordinated clinical care and lastly, understanding the patient holistically.
The fact remains that cancer continues to be one of the most expensive diseases to treat. According to the Agency for Health Care Research and Quality, cancer patients paid nearly $4 billion in out-of-pocket costs for cancer treatment in 2014.7 Ovarian cancer patients are not immune from costly treatments. As high-deductible health plans require more consumer cost-sharing, increasing out-of-pocket costs may prevent women from seeking or adhering to a treatment regimen.
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