Hope for ovarian cancer patients


TWICE as many Irish women will survive ovarian cancer than in the past thanks to a revolutionary new cancer drug developed partly in Swords, Co Dublin, details of which were announced in last Friday's Irish Times.

Taxol, a new semi synthesised drug derived from the bark of the California yew tree, is already dramatically improving the life expectancy of Irish women diagnosed with ovarian cancer being treated at certain specialist centres in the Republic.

Results from a multi centre randomised clinical trial involving nearly 400 women, published in the New England Journal of Medicine last Thursday, show that a new chemotherapy regimen of Taxol combined with cisplatin can extend the life of an advanced ovarian cancer patient by as much as 50 per cent.

Under the previous standard regime, cisplatin and cyclophosphamide, the average survival rate for women with ovarian cancer was 22 months. Under the new treatment, Taxol combined with cisplatin, women are surviving 37.5 months on average, according to Dr Des Carney, oncologist at the Mater Hospital in Dublin.

"This is a milestone in cancer treatment. You rarely see anything as dramatic as that with new drugs. It is a huge advance in terms of long term survival," says Dr Carney.

About 350 Irish women - and 26,000 in Western Europe - are diagnosed with ovarian cancer annually. Under the previous standard regimen about 20-30 per cent of these women survived beyond five years.

Most of those who survived were fortunate to have had their cancers diagnosed and treated at an early stage.

However, most affected women are not so lucky because early ovarian cancer rarely shows symptoms, so that it usually remains undetected until advanced disease occurs.

So far, these women are surviving a full 15 months longer on average on Taxol than on the previous regime. It is too soon to say what the five year survival rate will be, but Dr Carney predicts that it will double to 40-60 per cent.

The news is also hopeful for Irish women treated under the previous regimen who then experience recurrences. Such women are currently being treated with Taxol with encouraging results.

Taxol is a totally new class of cancer drug which works differently from any other cancer drug we have today by interfering with the external framework of the cancer cell, so that the cell becomes unstable, deteriorates and cannot divide itself.

Developed by scientists at the National Cancer Institute in the US and the Bristol Myers Squibb Company, Taxol is also significant in that it is one of the first fruits of co operation between academia and the pharmaceutical industry.

An important part of the research and development of Taxol took place at the Bristol Myers Squibb Company in Swords, Co. Dublin, which is manufacturing the drug.

For the women treated with Taxol, hope may sometimes be tempered by the discomfort of the regime, which involves side effects such as total hair loss, lowering of white cell counts, reversible cardiac problems and - in one per cent of cases - allergic reactions.

However, "such side effects are a small price to pay", says Dr Carney. He adds that Taxol costs about £1,000 per treatment and since about eight treatments are needed, Taxol can save a woman's life at a cost of about £8,000 per patient, which is not much when it comes to saving a life.