Health & Fitness

New drugs improving the outcomes in some ovarian cancer cases

Dr. Ricardo Estape, meets with his patient, Mrs. Nilda Acosta, at South Miami Hospital on Monday, May 11, 2015, to discuss her treatment for ovarian cancer. He has used a type of chemo that had been used for appendix, but now is also being used for ovarian cancer.
Dr. Ricardo Estape, meets with his patient, Mrs. Nilda Acosta, at South Miami Hospital on Monday, May 11, 2015, to discuss her treatment for ovarian cancer. He has used a type of chemo that had been used for appendix, but now is also being used for ovarian cancer. MIAMI HERALD STAFF

Laura Grace Alexander was 25 when she was diagnosed with ovarian cancer in 1986. The high school teacher from Winter Park was supposed to undergo an exploratory surgery that would last about an hour. Instead, she woke up six hours later to discover she had an emergency hysterectomy after a tumor the size of a small football was found on her ovary.

“I am a teacher so I have lots of children and a real strong faith,’’ said Alexander of the surgery that left her unable to have any children. “My belief is nothing happens by accident and if this is meant for me so be it.”

For 26 years, Alexander, now 53, remained in remission until she noticed lumps on her neck. A biopsy revealed that the cancer was back. This time, it had spread to the lymph nodes of her neck, sternum and under her left arm.

Even still, Alexander has beaten the odds. More than 45 percent of women survive at least five years after being diagnosed with ovarian cancer, according to the National Cancer Institute (NCI).

In February, Alexander became part of a nationwide NCI clinical trial for low-grade ovarian cancer recurring patients at Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine. Low-grade ovarian cancer is defined as cancer cells that don’t divide as rapidly but are not as responsive to traditional chemotherapy. She will take the oral medication daily during the one-year trial and is evaluated monthly.

The drug is a Mek Inhibitor, which is a cancer drug that blocks the MEK protein. Small clinical trials have shown that these types of drugs can help improve the outcomes of some patients with ovarian cancer.

“It works against the machinery of the cell as opposed to chemo, which is like a weed killer that works on the whole area and acts like a poison,” said Dr. Brian Slomovitz, co-leader of gynecologic cancers site disease group and division director for UHealth – UM Health System as well as a professor of clinical obstetrics and gynecology with UM’s Miller School of Medicine. “It goes to the machinery without having to be a big sledgehammer that whacks everything over the head.”

Another treatment for ovarian cancer, hypothermic intraperitoneal chemotherapy (HIPEC), is offered at Baptist Health South Florida. HIPEC is a highly concentrated heated chemo that is applied directly during surgery. First, robotic surgery is performed through small incisions to remove the cancer. Surgeons then apply heated chemo during the surgery, a treatment that traditionally has been used to treat cancer of the appendix.

The heat causes damage directly to the cancer cells and makes the cells more prone to absorb the chemo fluid, said Dr. Ricardo Estape, gynecologic oncologist and medical director of Baptist Health South Florida's Center for Robotic Surgery. The patients, who have had recurrences of ovarian cancer and are sensitive to chemotherapy, are able to receive the benefits of chemo without the side effects.

“Chemotherapy and minimally invasive surgery prolong the life of a patient 48-60 months and they enjoy a good quality care of life,” Estape said.

The patient is usually released from the hospital within one to two days, Estape said. Patients begin chemotherapy three to four weeks after the surgery and receive chemo every three weeks.

Nilda Acosta, 70, has battled back from ovarian cancer three times since she was first diagnosed in July 2006. The robotic surgery with HIPEC she underwent two years ago didn’t stop her active lifestyle. Three weeks after her surgery, the retiree was back out on her boat with her husband. The couple have been avid boaters for more than 20 years. She retired a couple of years ago from the electrical consulting business she and her husband founded.

“I didn’t curtail my activities to the point where I wasn’t active,” said Acosta, who was walking two to three miles a day four weeks after her surgery. “I am pretty much his first mate.”

Acosta noted a positive attitude played a huge part in her recovery.

“After having all of these surgeries and combating cancer for almost nine years, I’ve had the great blessing to have two more grandchildren born into the family, have my youngest daughter get married and have two grandsons graduate from high school,” Acosta said.

The mother of four adult children and eight grandchildren will have another grandson graduate from high school this year.

“In life, you have your ups and downs but we are a tight family,” Acosta said. “I’ve had the blessing and support of my husband and family during all this time. It is like a puzzle and all of the parts have to fit together to complete it.”

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