Gynecologic Cancers: Case 1 - Episode 1
Recent advances in treating newly diagnosed, advanced ovarian cancer have focused on better surgery, namely, by gynecologic oncologists attempting to achieve compete resection. When complete resection is not feasible, neoadjuvant chemotherapy has become common, with surgery then being performed after 3 cycles. Chemotherapy has also changed. In a single Japanese study, dose-dense weekly paclitaxel (80 mg weekly without a break) combined with every-3-week carboplatin prolonged progression-free survival (PFS) and overall survival (OS). Another advancement in first-line treatment is adding bevacizumab. This appears to be most effective in those with large-volume residual disease after debulking and in stage IV patients where survival may be improved by about 8 months.
CASE 1: Epithelial Ovarian Cancer
Sarah W. is a 62-year-old Caucasian woman who works as a travel agent.
In June of 2013, the patient presented with bloating and abdominal distension. Prior medical history is notable for nulliparity, and medication-controlled hypertension.
In December of 2014, the patient presents for her 6-month evaluation with rising CA-125 level, mild abdominal distension and fatigue, and inability to work.