The actor Patrick Dempsey is known for being incredibly attractive and really good at his job on the longtime hit Grey’s Anatomy. Beyond the lady’s-man appeal, his devotion to ovarian cancer reveals tender and lovable side.
September is ovarian cancer awareness month, and in honor of all the women like Dempsey’s mom, who have been diagnosed with the illness and may be wondering what treatment options are available, this is SurvivorNet’s guide to standard care and new treatment options for ovarian cancer.
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When it's detected early enough, ovarian cancer has a better than 90% cure rate. The problem is, it's not an easy disease to diagnose, especially in its nascent stages, so only 20% of cases are caught early on.
Ovarian cancer has been called the ‘Cancer that Whispers’ because women do not experience symptoms until the cancer is in such late stages. Once it is diagnosed, it is difficult to treat.
Standard of care for ovarian cancer
With ovarian cancer, the standard of care is a "very, very effective" chemotherapy. When ovarian cancer patients are diagnosed, according to Dr. Chase, they are usually given chemotherapy, which puts about 80% of patients into remission.
Because the remission rate is so high, Dr. Chase says that she highly recommends her patients try the standard chemotherapy. The treatment, however, can be adjusted on an as-needed basis from woman to woman.
Dr. Dana Chase, Gynecologic Oncologist at Arizona Oncology on the standard of care for ovarian cancer
The standard treatment for ovarian cancer is made up of two drugs working in combination for "initial chemotherapy" Carboplatin and Paclitaxel. These treatments are typically given to a woman through an IV every three to four weeks, according to the American Cancer Society. The typical course of chemotherapy is made up of three to six treatment cycles based on what stage of cancer the patient has, but different drugs have different treatment cycles.
PARP Inhibitors as an early stage treatment
PARP inhibitors are some of the newest additions to ovarian cancer treatment and are receiving a lot of attention from oncologists. The inhibitors operate by blocking the ability of cancer cells to repair damaged DNA, eventually leading to the death of these cells and helping patients toward remission.
Dr. Ursula Matulonis, chief of Gynecologic Oncology at the Dana Farber Cancer Institute on PARP inhibitors as an early stage treatment
While PARP inhibitors have traditionally been used as a late-stage treatment after cancer has come back, new evidence from a clinical trial suggests that they may be an effective initial treatment in women with a BRCA mutation, according to Dr. Ursula Matulonis, chief of Gynecologic Oncology at the Dana Farber Cancer Institute. SurvivorNet sat down with Dr. Matulonis to talk about the trial and its compelling data about PARP inhibitors.
Stimulating the immune system in early stages of treatment
Typically, the first line of treatment for ovarian cancer is chemotherapy. However, researchers and doctors are investigating alternatives for initial treatment for ovarian cancer, as well as alternative options for maintenance therapy. One of the drugs that they are working with is called atezolizumab, which is the molecular name for the drug Tecentriq.
"We stimulate the immune system in a way that helps us control the tumor for as long time to come, after the completion for the first round of chemotherapy," says Dr. Oliver Dorigo, gynecologic oncologist at Stanford Medicine "Atezolizumab is a drug that we call an immune checkpoint inhibitor."
Dr. Oliver Dorigo, Gynecologic Oncologist at Stanford University Medical Center, on stimulating the immune system during ovarian cancer
Checkpoint inhibitors help enhance the immune system's ability to fight cancer.
"Those immune checkpoint inhibitors have made a huge difference for patients," says Dorigo. Many tumors have been responsive to immune checkpoint inhibitorsincluding melanoma tumors and lung cancer tumors among many other types, according to Dorigo.
Now, clinical trials are being conducted to evaluate how ovarian cancer tumors will respond to this type of drug.
Bevacizumab (Avastin) for maintenance after initial ovarian cancer treatment
For maintenance therapy, after the initial treatment, there are two other drugs: Olaparib (which is a PARP inhibitor) and Bevacizumab (also known as Avastin). Bevacizumab is somewhat commonly used as part of a maintenance regimen to keep ovarian cancer in remission, as well as during initial treatment and full blown recurrence. Both are targeted therapies, meaning they block the growth of cancer cells by interfering with specific targeted molecules that the cells need to grow.
There are not many effective targeted treatments for ovarian cancer but there are a number that do really work in terms of meaningfully extending life, says Dr. Beth Karlan, gynecologic oncologist at the UCLA Medical Center. One of those treatments is Bevacizumab.
Dr. Beth Karlan, gynecologic oncologist at the UCLA Medical Center, on a drug called Avastin, used for maintenance therapy during ovarian cancer.
Bevacizumab blocks a certain protein called a "vascular endothelial growth factor" which help tumors grow. So rather than killing cancer cells themselves, as chemotherapy does, bevacizumab chokes the cells at their roots, attacking the blood cells that feed the tumors. Karlan explains that ovarian cancer cells are like weeds growing in a garden and Avastin is like a pesticide.
Bevacizumab can be used in combination with chemotherapy for women who have recurring ovarian cancer. Dr. Karlan says that it can be a very effective treatment option when the cancer returns. Bevacizumab can also be used for maintenance, to help prevent a cancer from returning after it has been treated. The drug has been through multiple clinical trials and is FDA approved.
The Dempsey Center
The center isn't a medical facility that provides conventional treatment; instead, it offers supportive services such as yoga, meditation, reiki, acupuncture, support groups, and grief counseling, which are all free of charge. (The Dempsey Center is able to provide these services through donations, corporate sponsorships, and foundation grants).
This kind of approachthat is, complimenting conventional medicine with holistic healing methods and supporting, whole-person careis called "integrative medicine," and many doctors believe in its benefits, given that the effects of the disease go beyond the physical impact of the cancer itself.
"Integrative medicine is an approach to care that puts the patient in the center of care and everything flows from that," Dr. Brian Berman, Director of the Center for Integrative Medicine at the University of Maryland School of Medicine, told SurvivorNet in a previous conversation about the difference between alternative medicine and integrative medicine. "It emphasizes lifestyle behavior, like diet, stress management, nutrition, and it also blends the best of conventional medicine and complementary therapies."
Dempsey spoke about his cancer center at the premier for the movie his recently produced, "The Art of Racing in the Rain."
"We don't treat the disease, we treat the person," Dempsey told the attendees at the film screening. Importantly, Dempsey pointed out that his center and the services it provides are not supposed to be an alternative to conventional treatment. "It's a compliment to what the doctor is doing, and we're seeing the benefits of that," he said.
Dempsey's mother lived with her ovarian cancer for 17 years, during which she had 12 recurrences, and while the disease ultimately took her life, her years living with the cancer were the inspiration behind Dempsey's center. "As Amanda's cancer journey unfolded, her loved ones realized how much a cancer diagnosis impacts the entire family," the Dempsey Center's website reads.
At the screening fundraiser, Dempsey also shared that he hopes to expand the Dempsey Center, which currently has two locations in Dempsey's home state, Maine.
"At some point, we'll have a center here [in Boston],' Dempsey said, adding that, during her 17-year cancer journey, his mother often traveled down to Boston from Maine for cancer treatment at Massachusetts General Hospital. "This is a community that is very important to me. It was an opportunity to bring everyone together."
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