Considerations for Treating Women with Cancer: A Review of Current Research

It is estimated that approximately 44.85 percent of the United States (US) population will develop cancer at some point in their lives.¹ According to the National Cancer Institute and the American Cancer Society, over 1.6 million new cases of cancer will occur in 2012 with over 577,000 cancer related deaths. Cancer accounts for 1 in 4 deaths and is the second leading cause of death in the US.^1,2

With respect to cancers affecting women, Table I highlights current statistics concerning incidence and survival.^1-3 As can be seen from this table, women remain challenged to address this health concern. Current approaches to prevention of women’s cancers include screenings such as a PAP test, HPV DNA test, self-examinations, and clinical examinations by specialists during routine gynecologic visits. Approaches to diagnosing women’s cancers range from physical examination and blood studies, to radiography evaluations (ultrasound, CT/PET scans, diagnostic mammograms, and MRI), and biopsy. Treatment of women’s cancers consists of surgery, radiotherapy, chemotherapy, nutrition, and complementary medicine. Although these methods are beneficial, there remains room for improvement. Fortunately, numerous research studies are being conducted to address women’s cancer prevention, diagnosis, and treatment. The purpose of this paper is to highlight current research related to women’s cancers demonstrating the prospect of hope for the future health of women.

Preventing women’s cancers requires due diligence on the part of females, their sexual partners, and health specialists. Surgeries, vaccinations, healthy lifestyle choices, and medication supplements are being investigated to determine the impact of prevention in lowering cancer risk. Table II presents preventive approaches that have shown promise in this regard.^4-6

Diagnostic markers are being studied to determine if there are other means of identifying early female cancers. Although the blood marker CA-125 has been available as a marker for ovarian cancer, it has limitations in terms of sensitivity and specificity. Current studies have been evaluating the effectiveness of lysophospholipids, growth factor, soluble urinary type plasminogen activator, matrix metalloproteinases, hypermethylated gene products, extracellular matrix proteins, HE4-protein overexpression, and ovarian screening using saliva testing as mechanisms for the detection of ovarian cancer. In addition, gene expression profiling and biomarkers, such as clusterin, TP53, and HE4, are being evaluated to predict ovarian cancer tumor behavior. In the near future, diagnostic markers for ovarian cancer may be available that are more accurate than CA-125.

Considerable research is being devoted to diagnostic HPV testing across the globe as it relates to cervical cancer. Studies are examining high risk types of HPV, the safety of delaying cervical cancer screening if HPV testing is negative, if the HPV test may be used as a reliable screening test for women in multiple age groups, the possibility of home kits for HPV testing, and the use of computerized PAP tests for cervical cancer screening. A new vaccine to target L2, a minor surface protein for HPV, for broader protection is being evaluated as well as the efficacy of HPV RNA testing. The overexpression of DEK oncogene is being studied to determine if it may be useful as a diagnostic test for cervical tumors and cancers. These studies may help to refine screening and diagnostic procedures for cervical cancer.

Diagnostic procedures being investigated for breast cancer include combinations of radiologic procedures including mammograms and ultrasounds, mammograms and PET scans, scintimmagraphy, tomosynthesis, and magnetic resonance elastography. Ductal lavage and a breath test identifying markers for those with breast cancer are being investigated. These studies may allow for more sophisticated evaluations of smaller and earlier breast cancer lesions.

Intervention trials for the treatment of ovarian, cervical and breast cancer are based primarily on the use of medications, vaccines, monoclonal antibodies, and consolidation therapy. Table III highlights descriptions of current research in women’s cancer treatment.⁷ Many of these targeted therapies focus on both treatment and prevention of recurrence offering opportunities for changing the landscape of treatment options for women.

Women who are experiencing ovarian, cervical or breast cancers may wish to participate in clinical trials. Further, additional organizations and website information is provided in Table IV to assist those female patients who present with newly diagnosed cancer conditions.

Although cancer impacts the health of women, research demonstrates continued efforts in addressing factors that improve prevention, diagnosis, treatment, and recurrence.⁸ It is anticipated that results of these clinical investigations will provide for more sophisticated regimens that will positively impact a return to health that is safe and effective.

Selected References:

1. American Cancer Society. Cancer Facts & Figures 2012. Atlanta: American Cancer Society; 2012.

2. Howlader N, Noone AM, Krapcho M, Neyman N, Aminou R, Altekruse SF, Kosary CL, Ruhl J, Tatalovich Z, Cho H, Mariotto A, Eisner MP, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds).SEER Cancer Statistics Review, 1975-2009 (Vintage 2009 Populations), National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2009_pops09/, based on November 2011 SEER data submission, posted to the SEER web site, 2012.

3. American Cancer Society. Breast Cancer Facts & Figures 2011-2012. Atlanta: American Cancer Society, Inc.

4. National Cancer Institute. Breast Cancer Prevention (PDQ®). Available at www.cancer.gov. Modified 3/29/12. Accessed 6/20/12.

5. National Cancer Institute. Ovarian Cancer Prevention (PDQ®) Available at www.cancer.gov. Modified 2/6/12. Accessed 6/20/12.

6. National Cancer Institute. Cervical Cancer Prevention (PDQ®). Available at www.cancer.gov. Modified 1/13/12. Accessed 6/20/12.

7. National Cancer Institute. NCI Funded Research Portfolio. Available at www.cancer.gov. Accessed 6/20/12.

8. National Cancer Institute. Cancer: Changing the conversation. The Nation’s investment in cancer research. An annual plan and budget proposed for fiscal year 2012. U.S. Department of Health and Human Services. NIH Publication No.11-7760. March 2011.

This manuscript was part of the proceedings from the conference Advances in Practice, hosted by the National Center for Dental Hygiene Research & Practice, held in Phoenix, Arizona, on June 12, 2012.