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Long‑term survival in ovarian cancer patients with FIGO IV classification
01/2019 MUDr. Adam Guňka
Ovarian cancer is one of the most aggressive oncological diseases and it has the highest mortality amongst gynecological malignancies. It is the fifth most common cause of death in women with malignant neoplasms all over the world. A wide variety of histological units is present in ovarian cancer and the most common type is a serosal ovarian cancer that belongs to a group called epithelial tumours.1 In 2016, 998 new patients were diagnosed with ovarian cancer and in the same year 628 women died from the ovarian cancer in the Czech Republic.2 The statistics show that this type of neoplasm is not very common, however, the mortality rates are one of the highest for this type of cancer. 75 % of diagnosed patients are already in advanced or metastatic stages. The main reasons are rapid tumour growth and late onset of symptoms. On top of that we are still very behind with getting tested and diagnosed in time. Despite aggressive treatment the percentage to survive at least five years is 23-35 % with Stage III, 10 % with Stage IV.3 The standard treatment of ovarian cancer is the combination of surgical treatment and chemotherapy. With surgery the tumours should drastically shrink and then systemic therapy should be in place. The ovarian cancer is generally highly chemo sensitive tumor and platinum derivative preparations are primarily used in the treatment. Primarily, for relapse we use systemic treatment, surgical treatment is used very rarely. Depending on the time when the primary or prior treatment ended we can distinguish platinum-resistant disease (relapse within six months of termination of the platinum-based treatment) and platinum-sensitive disease (relapse after more than six months after termination of the platinum-based treatment). Based on these two types of diseases we then choose other products for systemic therapy of the disease. Most common chemotherapeutic agents are carboplatin or cisplatin, paclitaxel, docetaxel, gemcitabine or pegylated liposomal doxorubicin. Medicine with a non-cytotoxic mechanism used in palliative systemic therapy can be for example bevacizumab or olaparib.
ENTIRE ARTICLE
Ovarian cancer is one of the most aggressive oncological diseases and it has the highest mortality amongst gynecological malignancies. It is the fifth most common cause of death in women with malignant neoplasms all over the world. A wide variety of histological units is present in ovarian cancer and the most common type is a serosal ovarian cancer that belongs to a group called epithelial tumours.1 In 2016, 998 new patients were diagnosed with ovarian cancer and in the same year 628 women died from the ovarian cancer in the Czech Republic.2 The statistics show that this type of neoplasm is not very common, however, the mortality rates are one of the highest for this type of cancer. 75 % of diagnosed patients are already in advanced or metastatic stages. The main reasons are rapid tumour growth and late onset of symptoms. On top of that we are still very behind with getting tested and diagnosed in time. Despite aggressive treatment the percentage to survive at least five years is 23-35 % with Stage III, 10 % with Stage IV.3 The standard treatment of ovarian cancer is the combination of surgical treatment and chemotherapy. With surgery the tumours should drastically shrink and then systemic therapy should be in place. The ovarian cancer is generally highly chemo sensitive tumor and platinum derivative preparations are primarily used in the treatment. Primarily, for relapse we use systemic treatment, surgical treatment is used very rarely. Depending on the time when the primary or prior treatment ended we can distinguish platinum-resistant disease (relapse within six months of termination of the platinum-based treatment) and platinum-sensitive disease (relapse after more than six months after termination of the platinum-based treatment). Based on these two types of diseases we then choose other products for systemic therapy of the disease. Most common chemotherapeutic agents are carboplatin or cisplatin, paclitaxel, docetaxel, gemcitabine or pegylated liposomal doxorubicin. Medicine with a non-cytotoxic mechanism used in palliative systemic therapy can be for example bevacizumab or olaparib.
Long‐term treatment of prostate cancer with a well‐chosen treatment algorithm while maintaining a good quality of life
02/2018 MUDr. Adam Guňka, MUDr. Markéta Pospíšková, MUDr. Milan Kohoutek
Prostate cancer is after lung cancer the most common type of malignant tumor in the male population worldwide. We can gradually decrease the number of lung patients by educating the population and using anti-smoking campaigns and hopefully the incidence and prevalence of the illness can be changed in the future. The probability of prostate cancer rises with age. Despite frequent occurrence this disease is not one of the diagnoses with poor prognosis depending on incidence. 80% of the patients are diagnosed with the disease which is not locally advanced and there is approximately 95% survival rate that the patients would live up to five years. This is not only thanks to early diagnosis but also thanks to new medications available in clinical practice. In Hormone-Dependent Prostate Cancer, the development of hormone-resistant disease can be delayed by an average of three years by the luteinizing hormone-releasing hormone analog. Subsequently, the inclusion of androgen receptor targeted agents in the therapeutic algorithm of cast rationally-resistant prostate cancer has brought great advances in the treatment. Also, we cannot forget about the chemotherapy systematic treatment for generalized carcinoma where, for example, the Tax 327 study in 2004 showed a significantly longer survival of docetaxel-treated patients in combination with prednisone against mitoxantrone with prednisone.
ENTIRE ARTICLE
Prostate cancer is after lung cancer the most common type of malignant tumor in the male population worldwide. We can gradually decrease the number of lung patients by educating the population and using anti-smoking campaigns and hopefully the incidence and prevalence of the illness can be changed in the future. The probability of prostate cancer rises with age. Despite frequent occurrence this disease is not one of the diagnoses with poor prognosis depending on incidence. 80% of the patients are diagnosed with the disease which is not locally advanced and there is approximately 95% survival rate that the patients would live up to five years. This is not only thanks to early diagnosis but also thanks to new medications available in clinical practice. In Hormone-Dependent Prostate Cancer, the development of hormone-resistant disease can be delayed by an average of three years by the luteinizing hormone-releasing hormone analog. Subsequently, the inclusion of androgen receptor targeted agents in the therapeutic algorithm of cast rationally-resistant prostate cancer has brought great advances in the treatment. Also, we cannot forget about the chemotherapy systematic treatment for generalized carcinoma where, for example, the Tax 327 study in 2004 showed a significantly longer survival of docetaxel-treated patients in combination with prednisone against mitoxantrone with prednisone.