A new two-step ovarian cancer treatment in Queensland is having success in treating the deadly disease.
Thirty patients with advanced ovarian cancer have been part of Australia's first feasibility and safety study in using hyperthermic intraperitoneal chemotherapy (HIPEC) to treat ovarian cancer at Brisbane's Mater Hospital.
One of the recipients of the treatment was Brisbane GP Chamari Jayawardena following a diagnosis of advanced ovarian cancer. But she is now cancer-free.
Ovarian cancer is the deadliest of gynaecological cancers with only 49 per cent of patients surviving five years after diagnosis.
The study, which has been running since 2018, involves patients undergoing multiple cycles of chemotherapy to shrink the tumours, which are then surgically removed.
Then, in surgery, doctors flush the patient's abdomen for 90 minutes with a high dose of chemotherapy that's heated to 40 degrees Celsius. Following the surgery, the patient undergoes further cycles of chemotherapy.
Lewis Perrin is the hospital's director of gynaecological oncology and says, so far, the results are encouraging.
They are now investigating whether the treatment may be effective when the chemotherapy drugs are used at body temperature, in a study with the Peter MacCallum Cancer Centre in Melbourne and Chris O'Brien Lifehouse at Sydney's Royal Prince Albert Hospital.
"If this is found to be just as effective, this will open up opportunities for many centres around Australia to be able to use this technique," Dr Perrin said.
Doctor 'neglected' her own symptoms
Over the course of three months, Dr Jayawardena started experiencing bloating, different bowel and urinary habits, and a change in her sense of taste.
"So I actually had a little hernia before, so I thought that it was getting worse," she said.
Facing a heavy workload and prioritising her patients, the GP put off getting her symptoms checked.
Three months later, she couldn't fit into any of her clothes, which prompted her to get a CT scan.
She underwent further tests and was diagnosed with ovarian cancer.
"It was my darkest night, I would say, because I knew that I had to walk on this hard road in a dark tunnel," Dr Jayawardena said.
She was hesitant to start treatment in case she died before she could return to Sri Lanka to sort out her responsibilities with an orphanage that she has been supporting.
But her oncologist Vikram Jain encouraged her to seek treatment and, after responding well to chemotherapy, she was referred for HIPEC therapy.
Dr Jayawardena told Dr Perrin she wanted to live long enough to travel to Sri Lanka and say goodbye to the children in the orphanage.
"I said: 'Let's change that plan. Let me treat you and you can go to the orphanage and say 'hi' not 'bye'. And that's what we did," Dr Perrin said.
Women urged to take note
Following further chemotherapy, Dr Jayawardena is now in complete remission and is thankful to everyone involved in her treatment.
She wants to make sure people do not neglect their symptoms, no matter how insignificant they seem or how busy they are.
"Be aware of the vague symptoms you get," Dr Jayawardena said.
"I had bloating, so I blamed food … all these vague symptoms — people don't think that it could be something dangerous.
"Give the priority to yourself and drop everything and go and get tested."
Dr Perrin said while the therapy helped some patients, it had not helped everyone.
"The group that it seems to help very well are people with the type of cancer Chamari had," he said.
Dr Jayawardena does not have the inherited gene that causes ovarian cancer, Dr Perrin says.
Her cancer had mutations that made it susceptible to a type of treatment that involved maintenance chemotherapy with a PARP inhibitor, Dr Perrin said.
"In patients that have that, about 15 per cent in that group, the disease hasn't come back," he said.
Dr Perrin says it is "incredibly rewarding" that Dr Jayawardena is in remission and urges women to take note of their health.
Symptoms of ovarian cancer can include common things like abdominal discomfort, constipation, bloating, loss of appetite and urinary frequency.
"But when it occurs or keeps recurring for two or three weeks then it becomes significant," Dr Perrin said.
A separate study from the Netherlands found HIPEC could extend the life of ovarian cancer patients by 12 months.
