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Ovarian cancer aggressive treatment can help older patients

Ovarian cancer is mainly a disease of older women.  But what is older?  In today’s world with better technology options and a general trend towards healthy longevity, in those that seek it, an arbitrary age cutoff makes no sense. At the Gynecologic Oncology Institute in Los Angeles, California, Dr. Steven Vasilev MD takes a very personalized approach to caring for women with ovarian cancer. The following study that our investigative team uncovered is but one of many that support this approach, and HIPEC is not for everyone.  Ovarian cancer is curable, even in advanced stages. Age is not always a factor, but the care strategy has to be individualized in expert hands. It should not be cookie-cutter, same-for-all.

Personalized options include gentler surgery using high tech robotic minimally invasive approaches, tailored chemotherapy, and biological agents, including immunotherapy, based on molecular analysis, and integrative holistic support. With this multimodality approach, not only is cure attainable even for advanced disease, but good quality of life during the survivorship fight is also front and center and very possible.

“Certain older women with ovarian cancer could benefit from aggressive treatments, a study recently published in Annals of Surgical Oncology found.  Although women 65 and over have a generally worse prognosis than younger patients with epithelial ovarian cancer (EOC) there is still no consensus on this how best to treat them.

The study analyzed a group of 148 patients treated for EOC between 1998 and 2019 to evaluate outcomes in patients treated with cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC), an aggressive and complex treatment regimen, were treated.

The researchers compared the effects and results of the surgery by type of treatment. Of the 148 identified patients, 42 received CRS plus HIPEC, 48 were treated with neoadjuvant chemotherapy plus CRS and HIPEC, and 58 received salvage CRS plus HIPEC. Age at the time of surgery (<65 years versus ≥ 65 years) was also taken into account.

With a median follow-up of 44.6 months, the results showed that women pre-treated with CRS plus HIPEC had the longest median overall survival (OS) of 69.2 months for women under 65 years of age and 69.3 months for women over 65 years. In women who received neoadjuvant chemotherapy plus CRS and HIPEC, the median OS was 26.9 months in the younger cohort and 32.9 months in the older group. Younger patients treated with Salvage CRS plus HIPEC had a median OS of 45.6 months, compared with 23.9 months in the older cohort.”

References

1. Zambrano-Vera K., Sardi A., Lopez-Ramirez F. et al. Results for elderly ovarian cancer patients treated with cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). Ann Surg Oncol. Published online January 3, 2021. doi: 10.1245 / s10434-020-09415-4

2. Southall J. Older women with ovarian cancer may benefit from more aggressive treatment. Healio. January 14, 2021. Accessed January 15, 2021.

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Dr Steve Vasilev MD
“I help and guide women to defeat gynecologic cancers and advanced pelvic conditions such as endometriosis, using a unique combination of minimally invasive robotic surgery, precision medicine therapies and complementary holistic natural support towards thriving in survivorship." Dr. Vasilev is the only physician quadruple board certified in Ob-Gyn, Gynecologic Oncology and Integrative & Holistic Medicine in the United States. He is an accomplished advanced robotic surgeon and serves as Medical Director of Integrative Medicine and Integrative Gynecologic Oncology at Providence Saint John's Health Center, Professor at John Wayne Cancer Institute in Santa Monica, California and is Clinical Professor at Loma Linda University School of Medicine. He is former faculty and professor at UC Irvine, UCLA, USC and City of Hope. He is an active member of multiple medical societies and has been nationally listed in "Best Doctors" for 18 years.

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