The creation of a comprehensive care system in centers known as Ovarian Cancer Units and access to new drugs regardless of mutations in the BRCA1 and BRCA2 genes – these are currently the greatest needs of patients with ovarian cancer in Poland. The introduction of these changes may improve the treatment outcomes of patients with this insidious cancer.
- Ovarian cancer is one of the most common cancers among Polish women. Every year about 2 die because of it. women
- Detecting the disease is a big problem – there is no screening test and early symptoms are difficult to recognize
- According to specialists, patients should go to special ovarian cancer treatment centers, the so-called Ovarian Cancer Units
- The strict rules of reimbursement of modern drugs mean that most patients are not eligible for them – doctors are alarming
- You can find more such stories on the TvoiLokony home page
Ovarian cancer in Poland
Every year, ovarian cancer is diagnosed in approx. 3,7 thousand. women in Poland, and nearly 2 thousand. dies because of him. A huge problem is the fact that this cancer is detected in more than 70 percent. stage 3 and 4 patients. The lack of characteristic symptoms as well as an effective screening test are considered to be the main reasons for such a late diagnosis of ovarian cancer.
Due to diagnostic delays, good organization of treatment and access to all treatment options are key to prolonging the survival of patients with ovarian cancer.
Oncological gynecology specialists agree that in order to improve the effectiveness of ovarian cancer treatment in Poland, it is necessary to create a system of comprehensive care for patients and to appoint the so-called Ovarian Cancer Units.
– In countries where the health care system is professionally organized, the results of ovarian cancer treatment are much better than in Poland – explains prof. Mariusz Bidziński, head of the Gynecological Oncology Clinic of the National Institute of Oncology and national consultant in the field of oncological gynecology.
In countries where the organization of the care system for patients with ovarian cancer is good, even 70–75% of the five-year survival rate is high. sick. In Poland, this percentage is only 40 percent.
According to the concept of prof. Bidziński, women diagnosed with ovarian cancer should not go to random medical facilities for treatment, but to Ovarian Cancer Units – resources equipped with appropriate equipment, in which teams of specialists prepared to treat patients with ovarian cancer work.
– There are many random places where ovarian cancer is treated. For example, in the Mazowieckie Voivodeship in 2020, treatment of ovarian cancer was carried out by 27 hospitals. In most of them, individual cases were treated within a year – explains Prof. Bidziński. Meanwhile, according to his estimates, there should be no more than four such centers in the Mazowieckie Voivodeship, and in Poland there should be a total of around 30, up to 35.
Changes needed in the treatment of ovarian cancer
Another change that specialists and patients with ovarian cancer are waiting for is the possibility of treatment with new drugs from the group of the so-called PARP inhibitors in all patients – regardless of the presence of mutations in the BRCA1 and BRCA2 genes. Testing for this mutation can be purchased from Medonet Market.
According to prof. Paweł Blecharza, new drugs are very effective in preventing the recurrence of ovarian cancer. PARP inhibitors are most effective in patients with ovarian cancer and mutations in the BRCA1 and BRCA2 genes. – But they show their activity in practically all patients with ovarian cancer – although in some groups it is more, and in some it is less – explains the specialist.
For several years, Polish patients with advanced ovarian cancer have had the option of being treated with one of the PARP inhibitors (olaparib) in the second and subsequent lines of treatment. However, they must have the so-called cancer. serum, highly differentiated, and the patient must have a confirmed mutation in the BRCA1, BRCA2 genes and first respond to chemotherapy with platinum analogues. Importantly, from May 2021, olaparib can also be used in patients with newly diagnosed ovarian cancer, if they have responded to chemotherapy and have mutations in the BRCA genes.
The problem is that most of them – about 65-70 percent. – patients with ovarian cancer have no mutations in these genes. These patients still do not have access to PARP inhibitors, which could significantly prolong remission time and delay cancer recurrence.
Clinical trials (PRIMA, NOVA) show that the PARP inhibitor niraparib benefits all patients, regardless of the mutation status in the BRCA genes and in other homologous recombination genes – both in line XNUMX and line XNUMX maintenance therapy . The drug increases the time it takes for the disease to come back.
– Ovarian cancer treatment is progressing through the availability of different therapies at different stages of treatment. Having a certain portfolio of drugs, we can manage the patient very effectively even through her relapses. In the case of patients without mutations, access to drugs is very limited – in some cases it requires writing individual applications, and in some cases it is not possible at all – explains Prof. Blecharz.
An additional problem is that in Poland only about 30 percent. advanced ovarian cancer patients have a genetic test that determines the mutation status of the BRCA genes.
— In the current reimbursement conditions in Poland, the remaining 70 percent. women who do not have genetic tests lose their chance of being treated with PARP inhibitors – summarizes prof. Blecharz.
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Press material prepared by the Journalists for Health Association as part of a series of expert debates Live with ovarian cancer. Like a butterfly. True stories, under the patronage of the Polish Society of Oncological Gynecology and the Blue Butterfly Association
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