PINEHURST – This year, about 21,980 women will learn they have ovarian cancer. If they are diagnosed at an early stage, when the disease is still localized, about 94 percent of them will still be alive after five years.
|Michael Sundborg, M.D.|
That number is likely to increase with the results of several large studies now in progress to determine the best ways to find ovarian cancer in its earliest stages.
September's observance of Gynecologic and Ovarian Cancer Awareness Month is designed to bring this information to the attention of the public.
Michael Sundborg, M.D., a gynecologic oncologist with FirstHealth of the Carolinas, calls early diagnosis “critically important.” But, he points out, it can be difficult since the symptoms of ovarian cancer typically don’t become apparent until a later stage and are often signs of less serious ailments.
“There are certain things that may allow us to make a diagnosis,” Dr. Sundborg says. “We shouldn’t ignore those signs, especially in post-menopausal women.”
Those symptoms include:
- Persistent bloating
- Unexpected weight loss
- An increase in the size of the abdomen
- Changes in bowel or bladder habits, including frequent urination, constipation or diarrhea that is new
In addition, certain risk factors can affect a woman’s chances that she will develop ovarian cancer. Particularly significant is a family history of cancer, especially colon or breast cancer and especially breast cancer in pre-menopausal women.
“Hereditary symptoms can put a patient at risk, but that represents only about 10 percent,” Dr. Sundborg says. “About 90 percent appear spontaneously. The average age is usually 61.”
Treatment options will depend primarily on the type of cancer and the stage of the disease. Various factors including general state of health, plans for childbearing and other personal considerations will also have a role.
According to Dr. Sundborg, the two major treatment plans are surgery for staging and de-bulking (removing as much of the tumor as possible) followed by chemotherapy or chemotherapy followed by surgery and then more chemotherapy.
“Ovarian tumors are very responsive to chemotherapy, and many will shrink away,” he says. “This would be followed by surgery and then more chemo. If we can shrink large volumes with chemo upfront, then our surgical intervention can be minimally invasive, often robotically. That's what I’m doing now – robotic for de-bulking.”
Instead of being overwhelmed by the news, Dr. Sundborg points out, a patient should respond proactively to a diagnosis of ovarian cancer, especially given the availability of new therapies offered through clinical trials programs. FirstHealth participates in the Gynecologic Oncology Group, the investigative arm of the National Cancer Institute for the investigation and treatment of gynecologic cancer.
“Even with advanced cancer, the vast majority – 75 to 80 percent – will respond to therapy,” he says. “(The result) may not be curative, but it is responsive, and it can return the patient to a good quality of life.”
The area’s only gynecologic oncologist, Dr. Sundborg offers the full scope of gynecological cancer care (diagnosis, surgery, medical oncology, surveillance and palliative care) except for radiation therapy.
He earned his medical degree from the Uniformed Services University of Health Sciences in Bethesda, Md., and interned at Walter Reed Army Medical Center in Washington, D.C. He completed his residency in obstetrics and gynecology with the National Capital Area Consortium in Obstetrics and Gynecology and is fellowship trained and board certified.
“There is such a strong will to fight this cancer,” Dr. Sundborg says, “and I think that’s important. We're not buying months, we're buying years for patients.”