Text/Yangcheng Evening News all-media reporter Zhang Hua
Ovarian cancer is one of the three most common malignant tumors in the female reproductive system, with a high degree of malignancy and the highest mortality rate. In 2020, the number of new cases of ovarian cancer in China was about 55,000, and the number of deaths was about 37,000. For a long time, the 5-year survival rate in patients with advanced ovarian cancer (stage III/IV) was only about 30%, and most patients died of recurrent systemic metastasis and drug resistance.
Recently, Professor Zhang Bingzhong, director of the Gynecology Oncology Department of Sun Yat-sen Memorial Hospital of Sun Yat-sen University, said in an interview with reporters that since 2018, the treatment of ovarian cancer has ushered in a turnaround, due to the three major advances in treatment, especially the application of PARP inhibitors, which have delayed the progression of the disease in ovarian cancer patients. From January 1, 2022, individual PARP inhibitors are included in medical insurance, and local patients in Guangzhou only need to pay less than 800 yuan per month to use drugs, which greatly improves the accessibility of drugs and brings the hope of "life" to ovarian cancer patients.
Professor Zhang Bingzhong made a round in the ward to check the condition of ovarian cancer patients
In the past five years, more than 600 new cases of ovarian cancer have been confirmed
50 to 60 years is the peak age of onset
The ovaries are unique to women's reproductive organs, which are located deep in the abdominal cavity, about the size of quail eggs, mainly secrete sex hormones, so that women's skin is smooth, delicate, bone health, energetic, etc., so as to maintain youth and vitality. In women of childbearing age, the ovaries also release one mature egg each month. Therefore, women take great care of it, especially worried about premature ovarian failure.
However, the ovaries are a predisposing site for tumors in women. Professor Zhang Bingzhong pointed out that for adult women, due to the ovary releasing eggs every month, their tissue cells are repeatedly damaged, coupled with endocrine changes, genetic mutations and microbial infections and other factors, which eventually induce ovarian cancer, of which ovarian epithelial cancer is the most common.
"In recent years, the incidence of ovarian cancer in women in China has shown a gradual upward trend. According to statistics, in the past five years, the cumulative number of newly diagnosed ovarian cancers in the gynecological tumors of Sun Yat-sen Memorial Hospital of Sun Yat-sen University has accumulated 647 cases, and the peak period of incidence is between 50-60 years old. Professor Zhang Bingzhong believes that it may be related to menstrual abnormalities, obesity (causing hormone level disorders), and no fertility and less fertility. In turn, women are pregnant and breastfeeding, the ovaries do not ovulate, and the tissues are avoided damaged, thus playing a certain protective role for the ovaries.
Ovarian cancer is difficult to detect early
Advocate women's physical examination to do cavity B ultrasound
For a long time, patients with advanced ovarian cancer had only a five-year survival of only 30%. This has frustrated many gynecological oncology experts. "Because it's hard to detect ovarian cancer early. The ovaries grow in the abdominal cavity, and after the tumor grows slowly to a certain extent, it compresses the tissue in the abdominal cavity, and after the tumor is widely implanted, symptoms such as bloating, ascites, and digestive tract are not seen. And during this period, the patient has almost no feeling of discomfort. Therefore, nearly 70% of patients are in advanced stages at the time of diagnosis. Professor Zhang Bingzhong said.
In order to detect ovarian cancer early, traces of ovarian cancer can also be found in numerous examinations. At present, Professor Zhang Bingzhong first recommends cavity B ultrasound, that is, vaginal B ultrasound. "Because when doing vaginal ultrasound, the probe is close to the ovaries, ultrasound can use the fluoroscopic effect to observe the organs in the pelvis up close, and clearly view the size, morphology, tumor characteristics and other conditions of the female ovarian tumor, so as to more accurately judge the benign and malignant tumors." The second is to draw blood to check serum HE4, CEA, CA125 and other indicators, this combination test helps to improve the diagnosis and detection rate of ovarian cancer, and can be used as an important indicator for the early diagnosis and efficacy evaluation of ovarian cancer. ”
In addition, some experts recommend BRCA genetic testing for patients with suspicious hereditary ovarian cancer, because whether the gene is mutated can predict how much risk of ovarian cancer is, and some preventive measures can be taken. This is the surest way to prevent ovarian cancer.
Ovarian cancer patients often undergo the treatment phases of surgery and chemotherapy
In 2018, there were three major advances in the diagnosis and treatment of ovarian cancer
The five-year survival rate for patients nearly doubled
Ovarian cancer has long been less effective in treatment. The quality of life of many patients is not high, because of long-term repeated chemotherapy, some patients even experience more than a dozen chemotherapy, and the pain they experience is also lamentable.
Professor Zhang Bingzhong said: "Until 2017, the treatment of ovarian cancer began to rise to a new level, which is mainly due to the emergence of new targeted drugs, that is, oral PARP inhibitors represented by nilapali and olaparibal. ”
After entering 2018, the diagnosis and treatment of ovarian cancer has taken a revolutionary turn. Zhang Bingzhong said: "Thanks to the three major advances of anti-vascular survival drugs, PARP inhibitors and immunotherapy, coupled with the combination of traditional chemotherapy and other regimens, the overall five-year survival rate of ovarian cancer has nearly doubled to 50%." ”
"After ovarian cancer patients have undergone surgery, after 6-8 rounds of chemotherapy, no tumors have been found under CT, and there are no abnormal indicators of blood draw, and they can start oral targeted drugs." Professor Zhang Bingzhong said: "At present, PARP inhibitors are used for the maintenance treatment of newly diagnosed ovarian cancer patients and platinum-sensitive recurrent ovarian cancer, that is, whether the patient has BRCA gene mutation or not, it has become one of the standard treatment methods to reduce the risk of recurrence and prolong the survival without progression, which can be said to have gradually changed the treatment of ovarian cancer in the world. ”
Professor Zhang Bingzhong (center) treatment team
Improved access to targeted drugs
Guangzhou ovarian cancer patients have a minimum self-payment of only 800 yuan
According to the reporter's understanding, from January 1, 2022, Nilapa's use of front-line population-wide maintenance treatment for ovarian cancer (regardless of the patient's biomarker status) has been extended to the scope of national medical insurance reimbursement.
From the beginning of the listing in China in 2019, Nilapalli has undergone two medical insurance price reductions, from the initial 25,000 yuan a box has been reduced to less than 5,000 yuan a box, coupled with medical insurance reimbursement, the reimbursement ratio of various medical insurance types in Guangzhou is about 74%-92%, local patients only need to pay less than 800 yuan per month, which is more than 20,000 yuan less than before medical insurance, and now more ovarian cancer patients can afford this innovative drug!
In fact, targeted drugs have always been a high threshold for ovarian cancer patients. The inability to use medicine is a pain in the hearts of many patients. Professor Zhang Bingzhong told reporters about a patient he was impressed with. She developed ovarian cancer at the age of 50 and after surgery and two rounds of chemotherapy, she began to take targeted drugs, but the price of Nilapally was very high at that time, and in the year from July 2019, she had a heavy financial burden until the end of December 2020, when Nilapali first entered the national health insurance, and the price dropped to 6,000 yuan a box, and she was able to reduce the financial burden. From January 1, 2022, the scope of Nilapali medical insurance has been expanded, and the price has been reduced to 4584 yuan a box again, plus Guangzhou medical insurance reimbursement, 800 yuan per month. She told me that the drug was very happy to get into health insurance, and it was finally affordable. ”
"According to statistics, 80% of patients treated with ovarian cancer are suitable for taking nilapali." Zhang Bingzhong said, "For ovarian cancer patients, early medication benefits early, especially newly diagnosed ovarian cancer patients, regardless of whether BRCA has mutations, should be based on satisfactory surgery and standardized platinum-containing chemotherapy to start parp inhibitor first-line maintenance therapy as soon as possible, and strive to delay tumor recurrence to the greatest extent." ”
It is believed that with the improvement of the accessibility of innovative drugs brought about by the medical insurance policy, more ovarian cancer patients can use good drugs as soon as possible, prolong life, delay recurrence, and gain the hope of life. (For more news, please pay attention to Yangcheng Pie pai.ycwb.com)
Source | Yangcheng Evening News Yangcheng Pie
Image | Courtesy of respondents
Editor-in-charge | Sun Wei