Ovarian cancer:
Do doctors know best?

90 percent of women in study
get sub-standard treatment

May 21, 1996
Web posted at: 11:55 p.m. EDT

From Medical Correspondent Jeff Levine

(CNN) -- New research shows that most women aren't getting the recommended treatment for the early stages of ovarian cancer, and that means the disease is more likely to come back. But the problem is avoidable.

Carnell Windley-Ginn is a living example. She thought she had conquered ovarian cancer after surgery in 1993, but the tumor returned.

"I was totally devastated," Windley-Ginn says. "I lost all focus, all energy. I don't know what I would've done without God and without family."

Windley-Ginn also got help from a different surgeon. This second time around, she worked with a specialist trained in cancers of the female reproductive system: Dr. Paul MacKoul of Washington Hospital Center in Washington, D.C.

Unlike the previous surgeon, MacKoul removed more than just the suspected tumor. He also sampled nearby lymph nodes to see if the cancer had spread. It had, and so he ordered drug treatment.

"It's not just the surgery," MacKoul says. "It's the chemotherapy, and a multi-disciplinary approach to the disease."

An estimated 26,000 women in the United States will be diagnosed with ovarian cancer this year. And medical experiences like those of Carnell Windley-Ginn are shockingly common.

In a new study of 785 women with ovarian cancer, only 10 percent got the recommended treatment in the early stages of the disease. Older patients are even less likely to get appropriate care than younger ones.

The research suggests that when it comes to ovarian cancer, women need to get doctors who really know how to deal with their particular disease. Otherwise, the results can be disastrous.

"The worst-case scenario is that the woman actually has advanced disease -- she has metastatic disease beyond her ovary -- but she doesn't get the effective chemotherapy," says Dr. Edward Trimble of the National Cancer Institute. "Her disease recurs, and she dies."

Trimble says a doctor may think that cancer hasn't spread, but the only way to be sure is by checking further. "So, by doing accurate staging, we can find two populations," he explains, using the medical term for identifying the stage of cancer progression. He says that's the only sure way to tell which women need chemotherapy, and which do not.

Fortunately for Carnell Windley-Ginn, it appears she's now cancer-free. But she believes her experience should send a message to other women concerned about ovarian cancer.

"Women need to be aware of their bodies," she says. And she adds, "They really do need to have physicians that are aware of what's going on with them."

Related sites:

• American Cancer Society
• CancerNet from the National Cancer Institute

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