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This isn't an article about a miraculous cure for ovarian cancer. It's about a way to extend life, in many cases, by about a year, without using larger doses of drugs or increasing radiation. It's about a method that's, sadly, largely ignored.

Ovarian cancer is a particularly insidious disease. Its early stages present symptoms, but nothing that can't be interpreted as several of a number of other, less serious diseases. The cancer generates biomarkers that can be measured with blood tests, but these biomarkers can also indicate other kinds of cancer or no cancer at all.

By the time ovarian cancer is finally diagnosed, it is usually too late to treat it. In the United States alone, in 2015, epidemiologists estimate that 21,290 women will be diagnosed with the disease and 14,180 will die of it. Most American women do not receive a life-extending treatment, however, that can add an average of 16 months to their lives.

Not A Recent Innovation In Cancer Treatment

What is this innovation in treating ovarian cancer? It's not an especially complicated technique. Nearly 10 years ago, in 2006, the (US) National Cancer Institute took the rare step of making an "important clinical announcement," advising doctors of a change in treatment methods so significant that they should modify their treatment protocols immediately. A major study found that pumping the standard chemotherapy drugs for ovarian cancer directly into the peritoneum (the membrane lining the) abdomen, rather than through a vein in the arm, could add more than a year, 16 months on average, to the lives of women with the disease. 
Cancer experts urged that the method of administering chemo be used for women ovarian cancer immediately.
Now nearly 10 years later, fewer than half of American women who have this form of cancer get their chemotherapy intraperitoneally, through a port in the abdomen. Every year, thousands of years of life are needlessly lost. As Dr Maurie Markman, president of medicine and science at Cancer Treatment Centers of America, told the New York Times, "It's unfortunate, but it's the real world. To call the situation 'tragic' would be fair."

Why Don't Oncologists Use Intraperitoneal Administration Of Chemotherapy?

A cynical, but probably accurate understanding of the reason more oncologists don't give chemotherapy for ovarian cancer through an abdominal port is that it doesn't make them more money. This method uses generic anti-cancer drugs that cost less, on which the cancer clinic makes a smaller profit. It takes more time to administer chemotherapy this way, and insurance companies don't compensate doctors or cancer clinics for the additional time required for the procedure. It also takes clinical skills that some nurses don't have. 
Because the technique doesn't involve new medications or new instruments that can make pharmaceutical companies or medical device makers more money, no one is eager to make sure clinic staff are educated to be able to give the treatment.
Even worse, there are some hospitals and cancer treatment centers that don't use the recommended treatment method at all. Among "prestigious" hospitals, from just 4 percent to 67 percent of women with ovarian carcinoma get their chemotherapy in this recommended way, and the smaller the hospital, the less likely it is that a patient will get chemo through this method. What can women who have ovarian cancer do to make sure that they get not only the right chemotherapy but chemotherapy in the right way, as they need it?
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  • Alexi A. Wright, Angel Cronin, Dana E. Milne, Michael A. Bookman, Robert A. Burger, David E. Cohn, Mihaela C. Cristea, Jennifer J. Griggs, Nancy L. Keating, Charles F. Levenback, Gina Mantia-Smaldone, Ursula A. Matulonis, Larissa A. Meyer, Joyce C. Niland, Jane C. Weeks and David M. O'Malley. Use and Effectiveness of Intraperitoneal Chemotherapy for Treatment of Ovarian Cancer. Presented, in part, at the 50th Annual Meeting of the American Society of Clinical Oncology, Chicago, IL, May 30-June 3, 2014.
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