I hope this is the information that you are requesting and that it is of help to
the decision your mother needs to make. I would also suggest that you call NCI
@ 1-800-4-cancer. Your friend, Lillian
Volume 8, Number 1
Winter 1997
Working to Prevent Recurrence
Photodynamic Therapy for Ovarian Cancer
novel treatment being tested at the
University of Pennsylvania Medical Center may
help prevent recurrence of ovarian cancer. The
treatment, called photodynamic therapy,
combines two elements - a photosensitizing agent
and laser light of a specific wavelength - to
produce a photochemical reaction that destroys
tumor cells. The trial is being conducted
exclusively at Penn.
For reasons that are not completely understood,
normal cells are relatively spared during the treatment. "As
best we can tell, the drug goes into all cells throughout the
body, but normal tissues seem to clear it very quickly, in a
matter of a few hours. Tumor cells appear to retain it for
several days," explained Eli Glatstein, MD, clinical
director of radiation oncology, who is co-investigator.
"This window of time allows us to target the tumor cells."
Glatstein participated in a Phase I trial for this
treatment while at the National Cancer Institute. Some of
the patients appeared disease-free after the treatment,
despite the fact that they entered the study with advanced
stage malignancies and were not expected to survive.
Trial Protocol
According to Stephen Hahn, MD, a Penn radiation oncologist who is principal
investigator,
participants in this Phase II trial receive Photofrin II, a photosensitizing
agent, on an outpatient
basis. Two days later, they return for an exploratory laparotomy to remove the
tumor. If the
tumor can be removed sufficiently, the laser light will be administered.
Because recurrent ovarian cancer often involves widespread peritoneal
seeding, the laser
light needs to penetrate multiple sites throughout the area. To do this, doctors
infuse a common
nutritional substance called Intralipid into the patient's abdomen with a saline
solution during the
laparotomy. Intralipid diffuses the light throughout the solution and the
abdomen.
"That will account for the nooks and crannies on the surface of the
peritoneum," said
Glatstein. "It literally bathes the contents with light of the appropriate
wavelength."
After the treatment, all patients remain hospitalized at Penn for four to
seven days with
follow-up care provided jointly by the referring physicians and physicians at
the University of
Pennsylvania Cancer Center.
New Photosensitizing Drugs
The major adverse reaction with
this treatment is enhanced skin
sensitivity to UV light, which can
last as long as 10 weeks. Prolonged
sun exposure can produce swelling
and pain in the skin, said
Glatstein.
Although Photofrin II is the
only
agent approved for clinical use in
this country, newer sensitizing
agents may reduce the problems
encountered thus far. These
synthetic agents are purer,
reducing
the likelihood of adverse
reactions.
They absorb at longer wavelengths,
thus offering better penetration
and
reduce the period of skin
sensitivity
to sunlight from 10 weeks to about
one week. As a result, treatment
can be repeated weekly, rather than
being limited to the single shot
therapy offered with Photofrin.
Despite the potential advantages
of the newer agents, however,
Glatstein explained that "we're
using
Photofrin because of our success in
the Phase I study. We want to
confirm that and show that this
treatment cures patients. Once
that's
done, we can refine it."
Safe Treatment
Stephen Rubin, MD, director of Penn's Gynecologic Oncology Division, believes
this
treatment is "promising. Currently, patients with recurring ovarian cancer face
treatment with
second and third line chemotherapy regimens, followed by additional surgery.
Nonetheless, few
are cured with this approach."
The clinical trial at Penn is open to women who have recurrent ovarian cancer
after
receiving first-line treatment of surgery and chemotherapy. Glatstein said he
hopes to enroll
approximately 30-50 patients in the study over the next one to two years.
"I think it is a very safe treatment, and I believe it will be useful for a
variety of problems that
are, at present, very challenging to us," concludes Glatstein. Other possible
targets include
tumors on the chest wall of patients with breast cancer, prostate cancer,
carcinoma in situ of the
bladder, head and neck tumors, cystic brain tumors, and leukoplakia.
For physician to physician consultation or referral call PENNLine
Eli Glatstein, MD
Stephen Hahn, MD
Stephen Rubin, MD
For all other inquiries go to the PENNHealth page
SKnapp1690@aol.com wrote:
> is belly wash more successful than chemotherapy?????????
> sknapp1690@aol.com. My mother-in-law has ovarian cancer and has to face this
> question right for the option of two different types of treatment. I' d like
> your opinion.
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