Best care for ovarian cancer poses problems for patients

A new study from the Society of Gynecologic Oncology says only 37 percent of women with ovarian cancer receive the best care through surgery and life prolonging chemotherapy.

The abdominal surgery called “debulking” removes all visible traces of the tumor inside the abdomen. But oftentimes, even women who choose to undergo this surgery often seek out surgeons who aren’t experts in the area.

Denise Grady, a health and science reporter for The New York Times, says a number of ovarian cancer patients don’t receive this care because they don’t know there are specialists in this type of surgery.

“Doctors ought to be referring women to these expert surgeons who are called gynecologic oncologists, but the referrals are just not happening,” she said. “And the darkest interpretation is … that doctor’s do not want to lose the fees that they would lose by referring the patient.”

Some women, Grady says, also live in areas without a specialist. Others undergo surgery for something else, but find out they have ovarian cancer. 

People tend to think of ovarian cancer as one of the bad ones, because most of the time, it doesn’t have early symptoms.

“Something like 70 percent of the cases are diagnosed at stage three, which means that it has started spreading around, inside the abdomen. So you really need aggressive treatment. And if you are a candidate for this very rigorous kind of therapy, it really can extend your life — with a decent quality of life,” she said.

Few doctors perform this type of surgery because it’s difficult and the operation can take six or eight hours, Grady said. But ovarian cancer is less likely to get into the bloodstream and spread to distant organs with the surgery. Surgeons can actually pull the cancer off the abdomen.

The report found that another treatment called intraperitoneal therapy is also underused, because IP therapy is time consuming.

“This therapy involves taking the chemotherapy and … putting about two quarts of fluid into the abdomen,” she said. “So it is just a bit more complicated. But about three of the doctors I talked to … said ‘you know it’s a little more difficult, but it’s not rocket science,'” she said.