One of my areas of specialty is gynecologic cancers, and I see a lot of women with ovarian cancer. When I read Evelyn H. Lauder’s obituary in the New York Times this weekend, it reminded me of how little public attention ovarian cancer gets. Ms. Lauder was a breast cancer survivor and advocate. She helped create the pink ribbon campaign, and she founded the Breast Cancer Research Foundation. She was diagnosed with ovarian cancer in 2007.
She survived breast cancer, but she died of ovarian cancer.
This is the dilemma. We have made great strides in breast cancer diagnosis and treatment. Surgery has gotten better, radiation has become more precise, and chemotherapy has become more targeted. Ovarian cancer? Not so much.
Breast cancer is the number one cancer diagnosed in women, with an estimated 230,480 cases in 2011. The American Cancer Society estimates that 39,520 women will die of breast cancer this year. For ovarian cancer, the death rate is much more staggering, though the numbers are smaller. This year there will be an estimated 21,990 new cases but 15,460 deaths — a death rate of about 70%, compared to a death rate of about 17% for breast cancer.
Much of this is explained, of course, by the fact that there is no effective screening test for ovarian cancer. The symptoms are vague and can often be brushed away as something else, something not worrisome. Most ovarian cancer cases are diagnosed late, once the cancer has spread beyond the ovary and into the abdominal cavity or beyond. The surgery is about as good as it can get. The chemotherapy just doesn’t do what it needs to do, much of the time.
The bottom line is that we need more research on this disease. I only wish that ovarian cancer — the disease that ultimately killed Evelyn Lauder, one of the most famous breast cancer advocates — had the advocacy and awareness and support that breast cancer does.
We need more treatment options – treatment options that will be well tolerated, effective, and not outrageously expensive.
We need to be aware of this disease so that we don’t miss it in ourselves and our patients.
We need to not be afraid to talk about it.
