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Ovarian cancer will be diagnosed in 1 of 72 women; 14,000 will die. Please know the symptoms and risk factors: read Outshine: An Ovarian Cancer Memoir. Books at www.amazon.com. ALL PROCEEDS GO TO GYNECOLOGIC CANCER RESEARCH. I am a member of Rave Reviews Book Club and Rave Writer's International Society of Authors, and Patient Leadership Council for Tesaro, Inc. I WILL NOT USE YOUR EMAIL ADDRESS FOR ANY OTHER PURPOSE THAN CONTACTING YOU DIRECTLY. ALL ORIGINAL CONTENT COPYRIGHT 2011 THROUGH 2018.

Friday, September 23, 2016


                 What is recent research discovering about 
                             ovarian cancer treatments?
               Here are a variety of articles that you might find       
             informative, and may even answer some questions.

The Lancet study also used CA125, but in a different way. Instead of declaring a certain level abnormal, the researchers developed a mathematical formula that took into account a woman’s age and the degree of change in CA125 over time, and calculated a risk score.
An advocacy group, the Ovarian Cancer National Alliance, issued a statement that called the study promising, but said much more data analysis was needed to determine whether the test would be useful.

Ovarian, Fallopian Tube, and Peritoneal Cancer: Latest Research

Approved by the Cancer.Net Editorial Board, 08/2016
Doctors are working to learn more about ovarian, fallopian tube, and peritoneal cancer. They are looking for ways to prevent them, as well as looking for the best ways to treat them and provide care to people diagnosed with these diseases.
The following areas of research may include new options for patients through clinical trials. As mentioned in the Clinical Trials section, most ovarian cancer trials now include patients with fallopian tube and peritoneal cancers.
Always talk with your doctor about the diagnostic and treatment options best for you.
  • Screening. Screening is used to look for cancer before a person has any signs or symptoms. There are no effective screening methods for these diseases suitable for the general symptom-free population. A screening method that uses serial CA-125 blood tests and pelvic ultrasonography for detecting early-stage ovarian cancer has been completed, and it is not clear whether this approach will produce an improved survival rate. 
    Although some have recommended that women at high risk for ovarian cancer because of their family history or presence of BRCA1 or BRCA2 or other high-risk gene mutation(s) (see Risk Factors) should be screened with CA-125 blood tests and transvaginal ultrasound, this approach has not been shown to improve survival or detect cancers at an earlier and more curable stage.  Therefore, if a high-risk gene mutation exists, the recommendation is to remove both fallopian tubes and ovaries preventively (prophylactically) after the completion of child-bearing, in most women by age 40.
  • Targeted therapy. Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. Some targeted therapy drugs are directed at specific genes that might be found with abnormalities in certain types of epithelial ovarian cancer. 
    Anti-angiogenesis inhibitors. Drugs called anti-angiogenesis inhibitors block the action of a protein called vascular endothelial growth factor (VEGF). These drugs have been shown to increase the cancer’s response to treatment and delay the time it takes for the cancer to return. VEGF promotes angiogenesis, which is the formation of new blood vessels. Because a tumor needs nutrients delivered by blood vessels to grow and spread, the goal of anti-angiogenesis therapies is to “starve” the tumor. Bevacizumab (Avastin), an antibody that binds VEGF and prevents it from being active, has been shown to be effective in ovarian cancer.  FDA approval was given in the United States for its use in combination with selected chemotherapy for patients with platinum resistant recurrence 
    PARP inhibitors. Researchers are evaluating another class of drugs, called PARP inhibitors, for ovarian cancer. These drugs act on DNA repair in cancer cells, making it difficult for them to replicate. The BRCA genes (BRCA1 and BRCA2) are normally involved in DNA repair, and a mutation in these genes interferes with this pathway function. PARP inhibitors make it particularly difficult for cells that otherwise have a BRCA mutation to grow and divide.  
  • The FDA approved the PARP inhibitor olaparib (Lynparza) for recurrent disease in patients who have the inherited BRCA mutation and who have received 3 or more lines of chemotherapy. 
    Many other new targeted treatments are now in clinical trials. Increasingly, doctors are learning about each patient’s individual tumor's biology through direct molecular testing. This information may be useful in matching patients with a clinical trial for a specific targeted therapy. Learn more about the basics of targeted therapy.
  • Immunotherapy. Immunotherapy is usually designed to boost the body’s natural defenses to fight a cancer. It uses materials made either by the body or in a laboratory to bolster, target, or restore immune system function.
    Researchers are examining whether drugs called checkpoint inhibitors may boost the immune system's ability to destroy cancer cells. Examples of these drugs target PD-1, PD-L1, and CTLA4 and they have been shown to cause shrinkage in other cancer types such as melanoma and some lung cancers, as well as having some activity in patients with ovarian cancer.
    Cancer vaccines are another type of immunotherapy researchers are testing for use against ovarian cancer. Some approaches called “adoptive cell therapy” use killer T cells found as part of the immune system in an individual patient. Researchers grow them in the laboratory and train them to attack certain targets, such as MUC 16 (CA125), that are found on ovarian cancer cells. Doctors then give the T cells back intravenously to the patient.  Clinical trials are opening for ovarian cancer.  Learn more about the basics of immunotherapy.
  • Hormone therapy.  For treatment of recurrent or later-stage ovarian cancer, tamoxifen (Nolvadex, Soltamax), aromatase inhibitors, and enzalutamide (Xtandi), a blocker of the androgen receptor, are being used.
  • Gene therapy. A new area of research is discovering how damaged genes in ovarian cancer cells can be corrected or replaced. Researchers are studying the use of specially designed viruses that carry normal genes into the core of cancer cells and then replace the defective genes with the functional ones.
  • Palliative care. Clinical trials are underway to find better ways of reducing symptoms and side effects of standard cancer treatments, to improve a patient’s comfort and quality of life.

    Scientists continue to study the genes responsible for familial ovarian cancer. This research is beginning to yield clues about how these genes normally work and how disrupting their action can lead to cancer. 
    Research in this area has already led to better ways to detect high-risk genes and assess a woman's ovarian cancer risk. A better understanding of how genetic and hormonal factors (such as oral contraceptive use) interact may also lead to better ways to prevent ovarian cancer.
    Vintafolide (EC145) is a newer drug that targets the folic acid receptor. This receptor is found on some ovarian cancers. In one study, it helped stop the growth of cancers that had the folic acid receptor.
    Another approach is to develop tumor vaccines that program the immune system to better recognize 

    cancer cells. Also, monoclonal antibodies that specifically recognize and attack ovarian cancer cells are 

    being developed. These antibodies are man-made versions of the antibodies our bodies make to fight

     infection. They can be designed to home in on certain sites on the cancer cell. Farletuzumab is a 

    monoclonal antibody that is directed against the folic acid receptor, which is on the surface of some 

    ovarian cancer cells. It has shown promise in treating ovarian cancer in early studies. Another 

    monoclonal antibody being studied in ovarian cancer is called catumaxomab. It binds to a protein that is 

    in some cancer cells and some immune system cells. When it is administered into the abdominal cavity, it 

    can help treat fluid buildup (ascites) that can occur when cancer is present.

    Is ovarian cancer still possible after a hysterectomy?
Answers from Shannon K. Laughlin-Tommaso, M.D.

Yes, you still have a risk of ovarian cancer or a type of cancer that acts just like it (primary peritoneal cancer) if you've had a hysterectomy.

Your risk depends on the type of hysterectomy you had:

Partial hysterectomy or total hysterectomy. A partial hysterectomy removes your uterus, and a total hysterectomy removes your uterus and your cervix. Both procedures leave your ovaries intact, so you can still develop ovarian cancer.

Total hysterectomy with salpingo-oophorectomy. This procedure removes your cervix and uterus as well as both ovaries and fallopian tubes. This makes ovarian cancer less likely to occur, but it does not remove all risk.

You still have a small risk of what's called primary peritoneal cancer, which may result from ovarian cells that migrated to the peritoneal area during each menstrual cycle before your ovaries were removed. These cells can become cancerous later on. Alternatively, since the peritoneum and ovaries arise from the same tissues during embryonic development, it's possible that cancer could arise from the cells of the peritoneum.

Currently, there are no effective screening tests for ovarian cancer in women with an average risk of the disease. If you're concerned about your risk, discuss your options with your doctor.

Shannon K. Laughlin-Tommaso, M.D.

                                KNOW THE SYMPTOMS
                   IF PERSIST FOR 2 WEEKS, ACT ON THEM

  • Abdominal Bloating
  • Abdominal pain                            
  • Digestive issues
  • Painful intercourse
  • Back pain
  • Change in bowels
  • Change or frequency of urination
  • Unusual vaginal discharges
  • Fatigue


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