Breast, prostate, lung and colorectal cancer have earned a notorious nickname—the Big Four. Together, they account for more than half of all cancer diagnoses and cancer deaths. But further down the list are cancers that may strike less frequently, but no less ferociously. Here are a few of the less-common killers.

Cancer: Ovarian
New diagnoses each year: 20,180
Deaths per year: 15,310

Ovarian cancer can grow stealthily for years, avoiding diagnosis. Because the ovaries are deep inside the body, it’s hard for doctors to feel abnormal growths until they are large. And symptoms—bloating, unusual vaginal bleeding, pelvic pressure, and back or leg pain—can stem from lots of less serious conditions. Just 25 percent of ovarian cancers are diagnosed in the earliest, most treatable stages.

“The best screening tests are mammograms for breast cancer and Pap tests for cervical cancer,” he says. “We’re looking for the same type of screening for ovarian cancer. We don’t want to raise fears in women who get a false positive, especially since women don’t generally do that well with ovarian cancer.”

A blood test that identifies ovarian cancer in earlier stages might be the solution. Researchers are studying the Risk of Ovarian Cancer Algorithm (ROCA) to see if it identifies women with symptomless ovarian cancer without a high rate of false positives.

And for women diagnosed with ovarian cancer, a chemotherapy regimen studied under Dr. Barnes adds to survival time and is likely on track to become standard treatment. With the treatment, called intraperitoneal (IP) chemotherapy, the medication is delivered directly into the abdomen rather than intravenously throughout the body.

Cancer: Cervical
New diagnoses each year: 9,710
Deaths per year: 3,700

Cervical cancer used to be one of the top causes of cancer death in U.S. women. Thanks to widespread use of the Pap smear, which checks for signs of precancerous changes before cancer or symptoms appear, the death rate has plummeted and continues to fall about 4 percent a year.

And there’s more good news. Unlike most cancers, doctors know what causes cervical cancer. It’s a virus family called the human papillomaviruses (HPV). These viruses spread through sexual activity and often there’s no symptom of the infection. While not every woman infected with HPV will get cervical cancer, doctors believe that you can’t develop cervical cancer unless you’ve been infected.

UAB researchers were involved in cervical cancer vaccine studies that helped lead to Food and Drug Administration (FDA) approval of Gardasil, a vaccine that will be administered to females ages 9 to 26 to help prevent most cases of cervical cancer and genital warts caused by four specific HPV types.

While development of a vaccine is an important step in the United States, it also has huge implications in Third World countries, where Pap smears are uncommon and cervical cancer is a leading cause of death in women.

Cancer: Chronic myeloid leukemia
New diagnoses each year: 4,500
Deaths per year: 600

Scientists are now studying a new medication, AMN107, to battle leukemia cells that are resistant to Gleevec. “It is much more potent than Gleevec, with very few side effects,” says Dr. Emanuel, who expects to see FDA approval for this drug within a few months.

Cancer: Non-Hodgkin’s lymphoma
New diagnoses each year: 58,870
Deaths per year: 18,840

Non-Hodgkin’s lymphoma (NHL) affects the lymph nodes and lymphatic system, the part of the body that builds and stores the white blood cells your body uses to fight infection.

Monoclonal antibodies, a technology developed in part by the UAB Comprehensive Cancer Center, fight this form of cancer by both attaching to the cancer cells and alerting the immune system to the cancer cells’ presence. They work in combination with chemotherapy.

Researchers are now developing second- and third-generation monoclonal antibodies that are more potent, and better targeted to the cancerous cells, sparing normal tissue.

Cancer: Kidney
New diagnoses each year: 38,890
Deaths per year: 12,840

More than 90 percent of the time, kidney cancer comes in the form of renal cell cancer.

There’s a new, FDA-approved drug, Sorafenib, that targets this cancer more accurately than chemotherapy, interferon or interleukin-2, the mainstays of renal cell cancer treatment.

“Targeted agents are the key. We’re moving away from chemotherapy and radiation and toward targeted therapies that spare normal tissue,” Dr. Emanuel explains. “We haven’t hit tons of home runs yet, but cancer care is moving to targeted therapies, or combining them with chemotherapy and radiation for better effectiveness.” 

To schedule an appointment with a UAB oncologist, call Cancer Answers at (205) 975-8222 or 1-800-UAB-0933.