Research by the American Academy of Family Physicians demonstrates that vulvar cancer occurs most frequently in women age 65 to 75 years of age. Thirty percent of patients with vulvar cancer are age 70 or older, and the rate increases with age, reaching a peak of 20 per 100,000 women by 75 years of age.
A team of researchers headed by Ashley Stuckey, MD, and Don Dizon, MD, of the Program in Women’s Oncology at Women & Infants Hospital of Rhode Island, recently presented research to the International Gynecologic Cancer Society at a meeting in the Czech Republic, which concluded that the treatment for vulvar cancer in this age group was often more lethal than the disease itself.
“Many elderly women have multiple health care problems. This makes it complicated to administer radiation with sensitizing chemotherapy, which is the standard treatment for advanced vulvar cancer,” Dr. Stuckey explained. “The goal of our study was to investigate whether elderly patients are more likely to die of intercurrent diseases that intervene during the course of treatment or of treatment-related complications.”
Seventy women were identified from published data and a meta analysis was performed. The researchers compared the remission rates, death from intercurrent disease (ICD) or treatment complications, and rates of surgery. They collected such data as patient age, stage of cancer, treatment (chemotherapy, radiation and surgery), follow-up times, and whether death was disease-related, treatment-related or intercurrent.
“Three percent of the patients under 65 years of age died of ICD or treatment complications versus 11 percent of patients over the age of 65,” Dr. Stuckey noted. “Death from ICD or treatment complications, therefore, was nearly four-fold higher for elderly patients.
“This is a small sample size but the data is still compelling” she said, adding that future research should focus on treatment with chemoradiation in the elderly with regard to survival benefit, toxicity, and death from ICD or treatment complications.
About Women & Infants Hospital
Women & Infants Hospital of Rhode Island, a Care New England hospital, is one of the nation’s leading specialty hospitals for women and newborns and a U.S.News Best Hospital in Gynecology. The primary teaching affiliate of The Warren Alpert Medical School of Brown University for obstetrics, gynecology and newborn pediatrics, as well as a number of specialized programs in women’s medicine, Women & Infants is the seventh largest obstetrical service in the country with more than 9,000 deliveries per year. In 2009, Women & Infants opened the country’s largest, single-family room neonatal intensive care unit.
New England’s premier hospital for women and newborns, Women & Infants and Brown offer fellowship programs in gynecologic oncology, maternal-fetal medicine, urogynecology and reconstructive pelvic surgery, neonatal-perinatal medicine, pediatric and perinatal pathology, gynecologic pathology and cytopathology, and reproductive endocrinology and infertility, as well as the nation’s only fellowship program in obstetric medicine.
Women & Infants has been designated as a Breast Center of Excellence from the American College of Radiography; a Center for In Vitro Maturation Excellence by SAGE In Vitro Fertilization; a Center of Biomedical Research Excellence by the National Institutes of Health; and a Neonatal Resource Services Center of Excellence. It is one of the largest and most prestigious research facilities in high risk and normal obstetrics, gynecology and newborn pediatrics in the nation, and is a member of the National Cancer Institute’s Gynecologic Oncology Group.