The U.S. is making gains on at least one war front, the “War on Cancer,” according to a new analysis of cancer death statistics.

Researchers found cancer deaths have dropped by 11% in men and 6% in women since 1971, when President Nixon signed the National Cancer Act declaring a “War on Cancer.”

Although cancer death rates rose during the first two decades of the cancer war, peaking in 1990, researchers say since then there has been a major downturn in cancer deaths, thanks largely to reductions in tobacco use, improvements in cancer screening to allow for early detection, and advances in cancer treatment.

“Contrary to the pessimistic news from the popular media, overall cancer death rates have decreased substantially in both men and women, whether measured against baseline rates in 1970/71 when the National Cancer Act was signed by President Nixon or when measured against the peak rates in 1990/91,” write researcher Ahmedin Jemal of the American Cancer Society and colleagues in PLos ONE.

Researchers say cancer death rates have been dropping steadily since the early 1990s, but some reports have declared the war on cancer a failure because of limited improvement in cancer death rates overall since 1971. But they say many of these analyses do not account for the dramatic increase in tobacco-related cancers in the latter part of the 20th century.

In the study, researchers analyzed cancer death statistics for all cancers combined, the four most common cancers (lung, colorectal, prostate in men, and breast in women), and cancers of 15 different sites from 1970 to 2006, using the SEER*Stat database, which reports long-term cancer trends.

The results showed that for all cancers combined, cancer death rates for men increased from 249.3 deaths per 100,000 in 1970 to 279.8 in 1990 and then decreased to 221.1 in 2006, a drop of 21% since the peak year of 1990 and 11% since 1970.

In women, the cancer death rate for all cancers increased from 163.0 in 1970 to 175.3 in 1991 (the peak year) and then decreased to 153.7 in 2006, which is a decline of 12% and 6%, respectively.

Overall, the decrease in cancer death rates since 1990-1991 represent a total of 561,400 prevented cancer deaths in men and 205,700 prevented cancer deaths in women.

Researchers say the decline in cancer deaths involved all age groups and racial/ethnic groups. However, black men and women still have cancer death rates 20%-50% higher than whites.

Death rates decreased for 15 of the 19 cancer sites studied, including the four major cancers. In fact, researchers say reductions in cancer death rates from the four major cancer sites accounted for 60%-80% of the total decrease in cancer death rates since 1990-1991.

Cancer deaths increased for esophageal cancer and melanoma in men, liver cancer in men and women, and pancreatic cancer in women.

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METHODS: p53-AAb were detected by ELISA in sera obtained preoperatively from women undergoing surgery for a pelvic mass. This group included women subsequently diagnosed with invasive serous ovarian cancer (n = 60), nonserous ovarian cancers (n = 30), and women with benign disease (n = 30). Age-matched controls were selected from the general population (n = 120). Receiver operating characteristic curves were constructed to compare the values of p53-AAb, CA 125, and HE4 as a screening biomarker. Kaplan-Meier curves and Cox proportional hazards modeling were used to assess its prognostic value on survival.

RESULTS: p53-AAb were detected in 25 of 60 (41.7%) of serous cases, 4 of 30 (13.3%) nonserous cases, 3 of 30 (10%) benign disease cases, and 10 of 120 (8.3%) controls (combined P = 0.0002). p53-AAb did not significantly improve the detection of cases [area under the curve (AUC), 0.69] or the discrimination of benign versus malignant disease (AUC, 0.64) compared with CA 125 (AUC, 0.99) or HE4 (AUC, 0.98). In multivariate analysis among cases, p53-AAb correlated only with a family history of breast cancer (P = 0.01). Detectable p53 antibodies in pretreatment sera were correlated with improved overall survival (P = 0.04; hazard ratio, 0.57; 95% confidence interval, 0.33-0.97) in serous ovarian cancer.

CONCLUSIONS: Antibodies to p53 are detected in the sera of 42% of patients with advanced serous ovarian cancer. Impact: Although their utility as a preoperative diagnostic biomarker, beyond CA 125 and HE4, is limited, p53-AAb are prognostic for improved overall survival.

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Aim To investigate whether a ‘triple-negative’ subtype also exists in ovarian cancer. Methods ER, PR and HER2 expressions in 116 Chinese women with primary epithelial ovarian cancer were reviewed. Triple-negative epithelial ovarian cancer (TNEOC) was defined based on negative ER, PR and HER2 expression. The clinicopathological characteristics and Ki-67, P53 and epidermal growth factor receptor (EGFR) expression in the TNEOC and non-TNEOC group were compared.

Results 15.5% of cases (18/116) were identified as TNEOC among 116 ovarian carcinomas. Histological grade 3 was found in a higher percentage of the TNEOC than of the non-TNEOC group (94.4% vs 62.2%). TNEOC also correlated with a high level of Ki-67 and p53 expression. EGFR overexpression and other clinicopathological characteristics were not significantly associated with TNEOC subtype. TNEOC was associated with a shorter progression free survival and overall survival in univariate and multivariate analyses.

Conclusions A novel subtype of ovarian carcinoma, which is negative for ER, PR and HER2 expression, has been identified; this specific ovarian subtype tends to have aggressive characteristics and a poor prognosis, which is similar to triple-negative breast cancer in most respects. TNEOC should be considered in future investigations of informative classification of ovarian cancer.

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When my aunt was diagnosed with ovarian cancer in 2001, shock waves rang out through my family. The prognosis looked grim; only 5 years. As for my aunt herself, she was determined to beat the disease and see her son, Matthew, marry and have children of his own.

Every three to six weeks, Aunt Kim and her wonderful husband, Steve, would travel a 200 mile round trip to Winston-Salem, North Carolina and back for her regular chemotherapy treatments, which took a painful and unimaginable toll on her body. Nevertheless, Aunt Kim still kept fighting. In 2005, the cancer entered remission! It appeared that my aunt had won. She had beaten the evil disease!

Sadly, the cancer returned in 2007. Aunt Kim was saddened and discouraged, but not beaten. The last 2 and 1/2 years of her life were hard and painful. I think that she kept fighting because of her son, husband, sister, brother, father, me, and all of the ones that she loved. She still had much to live for.

Up until the last few days of her life, when she was too weak, my aunt studied the Holy Bible, prayed, loved, cared, and tried to look at her situation from an optimistic perspective. She attended church in her hometown of Mountain City, Tennessee for as long as her health permitted. Aunt Kim was truly a saint.

To me, Aunt Kim was a mentor, role model, loving aunt, kind-hearted woman, and devoted Christian. There is no doubt in my mind that she is resting in heaven as I write this. She truly made the most out of the time that she had on this earth. May God rest her soul.

Ovarian cancer is not just a disease. It is a ruthless enemy, with a cold heart, whose sole purpose is to destroy its victims. However, it did not destroy my aunt. It made her stronger. It made all of us stronger. We will deeply miss Aunt Kim and grieve sorrowfully in the coming days, weeks, months, and years. It won’t be pity for her, but pity for ourselves. This evil disease has taken a beautiful woman from our lives.

One thing is for certain. Aunt Kim fought the good fight.

Story submitted by Christopher Watson

Story submitted by Brenda Boscaino

The results come from a mid-stage study of a drug candidate called NKTR-102. The company is testing the drug on women whose cancer has progressed despite treatment with platinum-based chemotherapy.

Nektar said women who took the drug every three weeks had a median survival of 21 weeks before their cancer began to progress again or the died. Women who took the drug once every two weeks had median survival of 12.2 weeks.

The company said currently approved drugs halt the progression of ovarian cancer for 9.1 weeks to 13.6 weeks.

Nektar said the results come from 39 women in the study. A total of 71 patients are involved in the study and full results are expected later this year. The company is also testing NKTR-102 as a treatment for cancers of the breast, colon, and cervix.

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Garo Harmandayan, DO, St. Louis University School of Medicine, St. Louis, Missouri, and colleagues analysed the responses to a survey completed by members of the Society for Gynecologic Oncologists (SGO).

“While the surveillance of patients after potentially curative treatment of ovarian cancer has important clinical, financial, and legal implications for patients, physicians, and society, the optimal surveillance strategy after initial curative-intent treatment is currently unknown,” Dr. Harmandayan pointed out.

Routine postoperative surveillance testing is practiced by gynaecologists and recommended by many organisations but there is little objective evidence to support any particular surveillance strategy in patients with ovarian cancer, he added.

For their study, the investigators constructed a survey based on 4 idealised vignettes depicting generally healthy women with ovarian cancer of various International Federation of Gynecology and Obstetrics stages.

The SGO members queried in the survey were asked to indicate the number of office visits, pelvic exams, Pap smears, complete blood counts, metabolic panels, serum, Ca-125 levels, chest x-rays, abdominal pelvic computed tomography’s (CTs), chest CTs, abdominal-pelvic magnetic resonance imaging, and transvaginal ultrasound exams they would recommend each year for 10 years after initial curative-intent treatment.

Analysis of 283 evaluable responses showed marked variation in the intensity of surveillance practices.

For example, the number of pelvic exams recommended in the first postoperative year for women with stage 1 ovarian cancer ranged from 1 to 12.

The results also showed that gynaecologist oncologists tended to recommend less testing with increasing postoperative years for all recommended tests. For example, the mean number of times an office visit was recommended for stage IV patients was 4.4 during the first year, which decreased to 1.1 by the tenth year.

The authors said that their study is the first to describe the self-reported practice of experienced clinicians who treat ovarian cancer patients.

Based on their results, they noted that it is now possible to devise well-controlled prospective trials to compare high-intensity versus low-intensity strategies of ovarian cancer patient surveillance strategies.

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Doctors and hospitals are getting a new test that many think will help fight ovarian cancer, one of the deadliest cancers, by helping them to more quickly distinguish cancerous from benign growths.

The test, which is called OVA1 and will be available for general use Tuesday, was shown to correctly flag 92% of cancers, when used along with radiological imaging and a standard patient work-up, in a study of 27 hospitals, doctors’ offices and clinics. Physicians using their usual detection methods but not OVA1 had previously found 72% of the cancers.

“It is an amazing move forward,” says Cara Tenenbaum, vice president of policy for the Ovarian Cancer National Alliance, a nonprofit patient advocacy group.

The test, though, has a serious downside: It generates a lot of false positives. Of the women flagged as likely having cancer, 64% didn’t, as determined by biopsies done during surgery. False positives might prompt, in addition to the likely emotional suffering, women to make an out-of-town trip to have surgery under a specialist’s care when it could have been done at a local hospital. The trial funded by Vermillion Inc., of Fremont, Calif., which developed the test, found that physicians’ current methods, which generally included another blood test, an exam and imaging, had a false-alarm rate of only 40%.

Ovarian cancer, the ninth most common cancer among women, has a dismal 47% survival rate, up from 38% in the mid-to-late 1970s. During that time, the overall five-year survival rate from cancer improved more dramatically: 68% for people diagnosed in 2001, up from 50%. An estimated 5% to 10% of women will undergo surgery for ovarian masses during their lifetimes, many of which will be benign.

Much of the problem is that ovarian cancer is often detected too late. Not everyone has symptoms, and the classic ones—bloating, pelvic pain, difficulty eating and urinary frequency, are easily confused with other maladies.

OVA1 won’t help find cancers earlier, but it might help get women faster to doctors best trained to treat the cancer. Two-thirds of ovarian cancers are first operated on by general gynecologists or surgeons, even though outcomes are better when the job is done by specialists called gynecologic oncologists, according to scientific literature.

Gynecologic oncologists have training to remove cancer that has spread beyond the original tumor, says Carolyn Muller, a University of New Mexico physician and a spokeswoman for the Society of Gynecologic Oncologists. They are also trained to “stage” the disease, or assess its severity, she says.

“Patients who get more thorough surgery or more thorough staging up-front will get more appropriate treatment, and therefore will have a better chance of living longer,” says Robert C. Bast Jr., a medical oncologist at the University of Texas M.D. Anderson Center. Dr. Bast, co-inventor of a blood test called CA125,currently cleared by the FDA for monitoring ovarian-cancer patients, is a paid member of Vermillion’s scientific advisory board.

Knowing cancer is present before surgery also prevents some patients from having to take a second trip to the operating room for a specialist to finish the job. Cindy Hastings, a 52-year-old nurse from Fremont, Calif., had a hysterectomy Sept. 3 to remove an ovarian mass her local gynecologist thought was benign. When the mass turned out to be cancer, Ms. Hastings had a second surgery six days later by a gynecologic oncologist, who removed 42 lymph nodes. She says the double surgery, including two anesthetics, was stressful on her body. After the second surgery, she says she was so bloated, “I looked four months pregnant.” She adds, “I was a couple of months too early” to benefit from OVA1.

The $650 test, which was cleared by the U.S. Food and Drug Administration in September, will be sold through Quest Diagnostics Inc., the nation’s largest medical-testing lab.

Tests for ovarian cancer have proved challenging to develop and gain FDA approval because it is difficult to prove a screening test is accurate. Laboratory Corp. of America in 2008 withdrew its OvaSure screen, designed to find cancer in high-risk women, from the market after the FDA and many physicians questioned its accuracy. Correlogic Systems Inc., Germantown, Md., was originally hoping to develop a test for finding cancer in high-risk women, but now is aiming for a more modest goal of a test with a purpose similar to the OVA1. Arrayit Corp., Sunnyvale, Calif., says it is working on a screening test, but it isn’t clear yet if it will pass muster with the FDA.

Two other ovarian-cancer tests cleared by the FDA are CA125, widely available since 1987, and HE4, which hit the market in 2008. The tests, which involve single proteins that are markers for the cancer, are cleared only for use in monitoring patients who have been treated for the cancer. CA125 is widely used off label to determine if masses are cancerous prior to surgery, but it misses many cancers, scientists say.

OVA1 is the first multi-protein ovarian-cancer test cleared by the FDA. The test combines the CA125 test with assays for four other proteins, levels of which are likely to either rise or fall as the body responds to cancer. Based on the results, patients are assigned a score from 0 to 10; a score of 4.4 or higher in post-menopausal women, and 5 or higher in pre-menopausal women, indicates an elevated risk of cancer.

Full results of the OVA1 trial, run by the University of Kentucky Medical Center and funded by Vermillion, will be presented March 17 at the Society of Gynecologic Oncologists. According to study data outlined in the FDA-approved package insert for OVA1, the study found the test plus a standard patient work-up by general gynecologists, including ultrasound or CT scans, correctly predicted 92% of the cancers prior to surgery. The same doctors found only 72% of the cancers using the standard work-up, which in most cases, included a CA125 test. When both the OVA1 test and the doctors’ assessments predicted masses were benign, the women were cancer-free 93% of the time.

A rival test being developed by Japan’s Fujirebio Inc., called Risk of Malignancy Algorithm, or ROMA, was shown in a trial published last year to detect 89% of cancers pre-surgery with only a 25% false-positive rate. Fujirebio is conducting more research and plans to apply for FDA clearance this fall. The test involves both the CA125 and HE4 markers.

So far no major insurers have told Vermillion that they will cover the cost of OVA1. Neither Aetna Inc. nor Cigna Corp. currently cover the test, but both say they may reconsider once further evidence becomes available.Wellpoint Inc. says it is reviewing the matter and in the meantime will decide whether to cover on a case-by-case basis. Wellpoint Inc. says it is reviewing the matter and in the meantime will decide whether to cover on a case-by-case basis.

Here is the story of Chris and his beloved Aunt Kim during her courageous battle with ovarian cancer:

On Thursday, February 25, 2010 at 11:33p.m., my family and I lost the bravest person that I have ever met. My aunt, Kim Marshall, fought for 9 years against the wretched disease that this fine organization is working to end.

When my aunt was diagnosed with ovarian cancer in 2001, shock waves rang out through my family. The prognosis looked grim; only 5 years. As for my aunt herself, she was determined to beat the disease and see her son, Matthew, marry and have children of his own.

Every three to six weeks, Aunt Kim and her wonderful husband, Steve, would travel a 200 mile round trip to Winston-Salem, North Carolina and back for her regular chemotherapy treatments, which took a painful and unimaginable toll on her body. Nevertheless, Aunt Kim still kept fighting. In 2005, the cancer entered remission! It appeared that my aunt had won. She had beaten the evil disease!

Sadly, the cancer returned in 2007. Aunt Kim was saddened and discouraged, but not beaten. The last 2 and 1/2 years of her life were hard and painful. I think that she kept fighting because of her son, husband, sister, brother, father, me, and all of the ones that she loved. She still had much to live for.

Up until the last few days of her life, when she was too weak, my aunt studied the Holy Bible, prayed, loved, cared, and tried to look at her situation from an optimistic perspective. She attended church in her hometown of Mountain City, Tennessee for as long as her health permitted. Aunt Kim was truly a saint.

To me, Aunt Kim was a mentor, role model, loving aunt, kind-hearted woman, and devoted Christian. There is no doubt in my mind that she is resting in heaven as I write this. She truly made the most out of the time that she had on this earth. May God rest her soul.

Ovarian cancer is not just a disease. It is a ruthless enemy, with a cold heart, whose sole purpose is to destroy its victims. However, it did not destroy my aunt. It made her stronger. It made all of us stronger. We will deeply miss Aunt Kim and grieve sorrowfully in the coming days, weeks, months, and years. It won’t be pity for her, but pity for ourselves. This evil disease has taken a beautiful woman from our lives.

One thing is for certain. Aunt Kim fought the good fight.

- Chris, 13

Chris, your story has touched us at the Ovarian Cancer National Alliance and has given us one more reason to work harder to spread awareness and education about the disease. Your composure and strength during this terrible time is admirable, and we look forward to seeing your passion at work for our cause. Thank you for sharing your story with us.

If you would like to share your story, please do so here. We’d love to hear from you!

I am a nine year survivor of stage IIB ovarian cancer. When I was diagnosed my mother was in her ninth year battling the disease. I was one of the fortunate ones who had a doctor that was paying attention to my family history and my silent symptoms.

It started out as a backache. I went to the doctor and saw the Physicians Assistant. She prescribed a muscle relaxer thinking that I had strained my back. When it had not gone away after a week I went back and saw my doctor. Because of the location of the pain and my family history she ordered an ultrasound. It came back showing a nasty cyst. She referred me to my gynecologist who did surgery within two weeks. When my doctor told me after my surgery that it was cancer, I was devastated. I had watched my mom fight this horrible disease for nine years and so I knew what was in store for me. I was only 40 and had two young daughters. I did six rounds of chemo and have been cancer free since my second chemo treatment. I am grateful that God walked with me in the journey along with my amazing family and friends. My mother lost her battle two years after my diagnosis but she was an amazing example for me on how to deal with cancer.

In January 2009, I was diagnosed with having the BRCA2 mutation gene. This diagnosis brought my odds of getting breast cancer to as high as 87%. After much prayer and discussion I decided to have a bilateral prophylactic mastectomy with reconstruction. The decision was hard but I chose to be proactive because my only other option was to wait to see if, when, and at what stage I would get breast cancer. My daughters were also tested and I am so grateful that they both tested negative along with two of my three sisters.