What type of cancer do I have?

I was diagnosed with type IV cervical Cancer in April of 2007.  I had surgury in April where they found cancer on my ovaries, cervix, omentum and colon.  It was also in my Pelvic area and in one lymph node.  After the surgury it came back in my vaginal cuff.

I started chemo and radiation but my body did not tolerate the treatement.  My doctor then started me on Abraxane and Avastin.  I have been on Abraxane and Avastin for 4 months and feel a lot better.  My CT scan last week showed some of the cancer is now gone and some has shrunk considerably.

Here is where my questions lies.  My insurance company has decided to deny coverage of Abraxane and Avastin because there are no studies showing it helps with Cervical Cancer.  Do you know of any studies/articles showing Abraxane and Avastin helping with Cervical Cancer?

My second question is how do we know I don't have Ovarian Cancer and not Cervical Cancer?  I always thought I just had cancer and wasn't as concerned with what kind.  I think my Insurance company would pay for the treatment if I had Ovarian Cancer or Colan Cancer as there are some studies showing treatment with Abraxane and Avastin.

Thanks for your assistance.

[Annekathryn Goodman, M.D.]

Hi There,
Your doctor is going to have to fight for you by sending a detailed letter explaining why you could not tolerate the more common therapies for cervical cancer. The diagnosis of where a cancer starts and therefore what we call it comes from the pathology report. How the cells look under the microscope can usually determine where they started.
I have put down some general information about avastin, abraxane, and cervical cancer. But your doctor will have to write a detailed report with citation of studies to back up the treatment  decision. Looking at the literature, I think he/she can make a case for you
best wishes



Avastin (chemical name bevacizumab), a monoclonal antibody, inhibits the formation of new blood vessels by binding to a blood-vessel growth factor. Prior research has shown that the density of blood vessels within cervical tumors increases as cervical cancer advances, so by binding to the blood-vessel growth factor, Avastin targets a mechanism that plays a prominent role in cervical cancer development and progression.

1: Gynecol Oncol. 2006 Nov;103(2):489-93. Epub 2006 May 2. Links
Bevacizumab combination therapy in heavily pretreated, recurrent cervical cancer.Wright JD, Viviano D, Powell MA, Gibb RK, Mutch DG, Grigsby PW, Rader JS.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, MO 63110, USA. ***@****

OBJECTIVE: To report the utility of the monoclonal, anti-vascular endothelial growth factor antibody bevacizumab in combination with cytotoxic chemotherapy for women with recurrent cervical cancer. METHODS: A retrospective analysis of women with recurrent cervical cancer treated with bevacizumab combination therapy was performed. RESULTS: Six patients were identified. The patients had a median of 3 prior regimens. All of the patients had multisite, metastatic disease. The combination regimen included IV 5-fluorouracil in 5 (83%) patients and capecitabine in one (17%) subject. Treatment was well tolerated. Grade 4 toxicity occurred in one patient who developed neutropenic sepsis. Clinical benefit (CR, PR, or SD) was noted in 67% of the subjects. This included 1 (17%) complete response, 1 (17%) partial response and two (33%) patients with stable disease. The median time to progression for the four women who demonstrated clinical benefit was 4.3 months. CONCLUSIONS: Combination bevacizumab is well tolerated and displayed encouraging anti-tumor activity in heavily pretreated recurrent cervical cancer.



Paclitaxel Protein-bound

Trade Name: Abraxane®

Drug type:  Paclitaxel Protein-bound is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug.  Paclitaxel Protein-bound is classified as an "plant alkaloid," a "taxane" and an "antimicrotubule agent."  


Cervical Cancer
Paclitaxel is an active agent in the treatment of cervical cancer†. (See Uses: Cervical Cancer in Cisplatin 10:00 for an overview of therapy for cervical cancer.)
Paclitaxel and Radiation Therapy for Locally Advanced Cervical Cancer.

The use of paclitaxel as a radiation sensitizer is being investigated in patients with locally advanced cervical cancer†. Additional comparative studies are needed to determine the optimum chemotherapy regimens and schedules to be used concurrently with radiation therapy for the treatment of locally advanced cervical cancer.

Paclitaxel for Advanced Cervical Cancer.

Paclitaxel is an active agent in the treatment of metastatic or recurrent cervical cancer†. Objective response rates of 17–25% have been observed in patients receiving paclitaxel as a single agent for advanced squamous cell carcinoma of the cervix. An objective response rate of 31% was reported in patients receiving paclitaxel alone for advanced nonsquamous cervical cancer.

Paclitaxel and Cisplatin for Advanced Cervical Cancer.

Paclitaxel and cisplatin is used in the treatment of advanced cervical cancer. Objective responses of 40–45% for combination therapy with cisplatin and paclitaxel have been reported in patients who previously had not received chemotherapy for advanced or recurrent cervical cancer. In a randomized trial involving patients with advanced squamous cell cervical cancer, response rate was higher (36 versus 19%) and progression-free survival was longer (4.8 versus 2.8 months) in those receiving paclitaxel and cisplatin than in those receiving cisplatin alone; overall survival was similar between the groups (9.7 versus 8.8 months). In this study, patients received either paclitaxel and cisplatin (paclitaxel 135 mg/m2 by 24-hour IV infusion followed immediately by IV cisplatin 50 mg/m2) or single-agent cisplatin (same dosage of cisplatin used for combination therapy) every 3