Ovarian Cancer: New Project Aims to Improve Care and Treatment
Ovarian cancer remains one of the most difficult tumors to treat, causing significant mortality rates in Italy. With 5,200 women affected by the disease each year, around 3,000 lose their lives due to late diagnosis and lack of specific symptoms in the initial stages. However, a new project called “Let’s change course” aims to improve the fate of patients and raise awareness about essential factors that can increase chances of recovery.
The white paper on ovarian cancer and a Manifesto with seven priority actions have been presented to the Ministry of Health by the Alliance Against Ovarian Cancer – Acto Italia. The project focuses on addressing the lack of information about the disease and specialized centers. Despite an increase in awareness from 30% to 70% over the last decade, less than three out of ten patients choose to be treated in specialized centers, unaware of the significant impact it can have on their treatment journey.
Nicoletta Cerana, president of Acto Italia, emphasizes the need for more information and support for research on early diagnosis. She emphasizes the importance of access to genomic tests for personalized treatments and addressing the forgotten area of sexuality and oncology, which is becoming increasingly important for ovarian cancer patients.
A survey conducted by Acto Italia shows that only 45% of patients have access to genomic profiling for targeted treatments based on their tumor’s characteristics. Moreover, 12% of patients have not been offered genetic testing for BRCA mutations. The availability and reimbursement of these tests by the National Health System are crucial to ensure equal treatment opportunities for all patients across the country.
The last five years have seen significant progress in the treatment of ovarian cancer. According to Nicoletta Colombo, director of the Gynecology Program at the European Oncology Institute in Milan, a “tsunami” has occurred in the treatment of ovarian cancer with the discovery of homologous recombination deficiency (HRD), a target that can be hit with targeted drugs. Genetic testing for prevention purposes in healthy individuals and genomic testing on tumor tissue, such as the HRD test, are essential for personalized treatment strategies.
However, ensuring uniform access to tests across the country is a challenge, and comprehensive genomic profiling should be provided under Essential Levels of Assistance (Lea). Experts must decide which strategy to use based on clinical evaluations, allowing every patient to receive the most suitable treatment.
Early detection of ovarian cancer is crucial for improving survival rates. Late diagnosis is often due to the disease’s lack of specific symptoms in the early stages. Giovanni Scambia, director of Gynecology Oncology at the Agostino Gemelli IRCCS University Hospital Foundation in Rome, highlights the importance of recognizing possible alarm bells. Non-specific symptoms such as feeling of satiety, abdominal swelling and pain, frequent urination, vaginal bleeding, and persistent constipation or diarrhea should not be overlooked.
Various risk factors, including age, family history, genetic alterations, and reproductive life, make certain individuals more susceptible to ovarian cancer. Access to specialized centers with the necessary expertise, technology, and organizational skills is essential for diagnosis and treatment. Surgical treatment is the therapy of choice, providing high recovery rates in the initial stage and eradication of the disease in advanced stages. Only specialized centers can ensure the experience and expertise of the surgical team.
The treatment of ovarian cancer usually involves surgery and chemotherapy. To reduce the risk of recurrence, maintenance therapy using anti-angiogenic drugs and targeted drugs called PARP inhibitors have been introduced. Domenica Lorusso, associate professor of Obstetrics and Gynecology at the Catholic University of the Sacred Heart Policlinico Gemelli in Rome, highlights the importance of personalized treatments and the involvement of a multidisciplinary team.
Sandro Pignata, director of Uro-Oncology Gynecology at the National Cancer Institute IRCSS Pascale Foundation of Naples, emphasizes the need for precise guidelines and a diagnostic-therapeutic care path (Pdta) for ovarian cancer. Each region should implement its Pdta to ensure equal access and quality of care for all ovarian cancer patients.
Improving care and treatment of ovarian cancer requires collaboration and action from all stakeholders to ensure early detection, personalized treatment, and access to specialized centers. With continued efforts and advancements in understanding the disease, there is hope for improving the outcomes and quality of life for women affected by ovarian cancer.