Vim & Vigor - Winter 2016 - University of Virginia - 51


Like many diagnosed with ovarian
cancer, Oswald recalls no early signs or
symptoms. When she began experiencing abdominal bloating, the cancer had
already spread into her pelvis.
"Ovarian cancer has been known in
the past as the 'silent killer,'" says Linda
Duska, MD, a gynecologic oncologist at
University of Virginia Cancer Center.
Unlike breast, cervical or colon cancer,
there isn't a screening test for ovarian
cancer. Recent data show that many
women have symptoms in the months
before the diagnosis is made, but these
problems are common-bloating, constipation, frequent urination-and so they
are frequently overlooked, especially
among postmenopausal women, who
are at an increased risk for the disease.
"Approximately 75 percent of ovarian cancers are diagnosed at stage 3 or
4, when they are more difficult to treat,"
Duska explains. "With good surgery and
the right chemotherapy, approximately
80 percent of those patients will go into
remission; however, most will experience a recurrence."

Changing the Odds

One reason this cancer returns is chemotherapy resistance, when cancer cells
stop responding to a drug that was once
preventing their growth. "There is a lot
of research currently on how to combat
and prevent chemotherapy resistance,"
Duska says. Many oncologists are now
looking at alternatives to traditional
chemotherapy, including immunotherapy
(activating the body's own immune system to attack cancer cells), delivering
chemotherapy directly to the site of the
cancer rather than via the bloodstream,
and drugs designed to target the genetic
mutations of specific cancers.
"This is the road we're going down
with cancer treatment overall," Duska
says. "Because these approaches are
more cancer-specific, theoretically they
will have fewer broad side effects like
nerve damage and hair loss, so they're
less taxing on the patient."

Being treated at a center that specializes in gynecologic cancers helps
ensure that ovarian cancer patients
have access to the latest treatment
options (see "Exploring All Options")
and, importantly, the most appropriate
surgical treatment done by a gynecologic
oncologist. UVA is one of those centers.
"There are four specially trained gynecologic oncologists at UVA," Duska says.
"We are all researchers, so we have our
fi nger on the pulse of what's going on
in this field."
For Oswald, Duska recommended
extensive surgery to remove all of the
tumor, followed by a three-month chemotherapy regimen made available to
her through a clinical trial. "It was the
right combination for me," Oswald says.
"I handled the treatment very well. The
pain from surgery was managed appropriately, and I was never sick." The best
part: Oswald went into remission.
Less than a year later, however, the
cancer returned. "It was disappointing
news, but Dr. Duska was wonderful, and
I felt very prepared for the next steps,"
Oswald says. "She gave me different
options for treatment. I chose to do

another trial because I wanted to help
others with this disease and because
those already on the trial were having
good results."

Managing a Chronic
Disease

Once a week, Oswald now travels to
UVA from her home in Amissville, Va.,
with one of her three daughters, who
take turns accompanying their mom to
her infusion treatments. "I have been
managing very well. I have no real side
effects. Just a little fatigue," she says.
"I realize this is now a chronic condition, and I'm living with it as normally
as possible."
"She's a very strong-willed person,"
says Oswald's daughter, Stephanie Settle.
"She's found a way to balance this and
hasn't stopped living. We're actually
planning a family trip to Ireland. It's a
new thing we started last year-to see
countries we've never seen."
Duska adds: "Now that we have more
options beyond chemotherapy to fight it,
women can live with this disease with a
good quality of life. Ideally, we'd like to
cure this disease." ■

EXPLORING ALL OPTIONS
According to gynecologic oncologist Linda Duska, MD, close to half of all ovarian
cancer patients treated at University of Virginia Cancer Center are involved in clinical trials. "I inform all of my patients with ovarian cancer about the trials currently
available. This is a devastating disease, and I want my patients to have every possible
opportunity to do well," Duska says. "Trials give women the opportunity to participate
in cutting-edge therapies. Even if they're not interested, it is empowering for many
to know that there are other options available to them."
Standard therapy is always available and can be effective. If, however, you are
considering participating in a clinical trial, here are some points to keep in mind:
Trials may allow you to help yourself and others by giving doctors a better understanding of whether a particular treatment is effective.
There are possible risks, including side effects, to consider when participating in
any clinical trial, so be sure to ask your care team.
There is no guarantee that a trial will have a positive outcome, and not all patients
are eligible for every study.
For more information about the trials currently available at UVA Cancer Center,
go to cancer.uvahealth.com/research/clinical-trials.

WINTE R 2016

51


http://cancer.uvahealth.com/research/clinical-trials

Table of Contents for the Digital Edition of Vim & Vigor - Winter 2016 - University of Virginia

Contents
Vim & Vigor - Winter 2016 - University of Virginia - Cover1
Vim & Vigor - Winter 2016 - University of Virginia - Cover2
Vim & Vigor - Winter 2016 - University of Virginia - Contents
Vim & Vigor - Winter 2016 - University of Virginia - 2
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