GENE STUDY FINDS SILVER LINING : OVARIAN CANCER PATIENTS IMPROVE SURVIVAL RATES.

Byline: Tom Philp Scripps-McClatchy Western Service

Being unlucky enough to carry a faulty gene that causes cancer may have a bright side.

In tracking patients carrying the first gene ever identified as a precursor to breast and ovarian cancer, research published in Thursday's New England Journal of Medicine found that ovarian cancer patients had nearly triple the average survival rates.

``It raises a lot of interesting questions as to whether we should treat (these) cancer patients differently,'' said Dr. Stephen C. Rubin, a University of Pennsylvania cancer researcher and lead author of the study. ``I don't know.''

In Sacramento, local experts in breast and ovarian cancer viewed the findings as another piece of a puzzle that, perhaps within a decade, will reveal many different genes that cause cancers.

``I think it is a fairly significant piece of information to know that these patients generally do better,'' said Dr. Sidney Scudder, an ovarian cancer specialist and associate professor of medical oncology at the University of California, Davis. ``Just because they have a genetic mutation doesn't mean they're going to die.''

The study was on a mutation known as BRCA1, first identified in 1994 by researchers studying women with strong family histories of breast cancer. Familial breast cancer accounts for about 5 percent of the estimated 185,000 women diagnosed annually.

Researchers estimate that women carrying the BRCA1 genetic mutation stand an 85 percent chance of contracting breast cancer during their lifetime, and a 65 percent chance of contracting cancer in the ovaries.

Ovarian cancer killed 13,393 women in the United States in 1992 and ranked as the fifth deadliest cancer behind tumors in the lung, breast, colon and pancreas.

In the University of Pennsylvania study, Rubin and colleagues at other universities tracked 53 ovarian cancer patients with the defective gene and found two pieces of good news.

First, those with advanced ovarian cancer had an average survival of 77 months as compared to 29 months for similar patients without the genetic mutation.

And second, very few women contracted the cancer during their child-bearing years, meaning they may have time to have a family before deciding whether to have their ovaries surgically removed.

Experts, however, can only guess as to why this genetically influenced form of cancer may not be as deadly, or whether breast cancer patients with the same gene may also have longer survival rates. The study only tracked ovarian cancer patients.

``There (are) some very early suggestions that perhaps the breast cancer is not as virulent,'' said Dr. Gary Palmer, a breast cancer specialist at the UC Davis.

The next step for Rubin is to examine the cancer cells of those with the genetic mutation to find possible differences and new ways to attack them with drugs.