By Jenny Song

America’s Funny Girl

Gilda Radner’s death 20 years ago raised new awareness of a disease that women still face too frequently today

By Jenny Song

Changes in Drugs and Treatment
After Radner underwent surgery, she had nine rounds of chemotherapy—cisplatin and Cytoxan (cyclophosphamide)—over the course of six months. It was the beginning of a two-and-a-half-year ordeal that included a second-look surgery, more cisplatin, carboplatin (which was not yet approved by the FDA), radiation therapy, blood transfusions, and a combination chemotherapy regimen of 5-FU, methotrexate and Adriamycin (doxorubicin).

In the fall of 1988, when biopsies and a saline wash of her abdomen showed no signs of cancer, Radner was put on a maintenance chemotherapy treatment to prolong her remission. But later that same year, she learned that her cancer had returned after a routine blood test showed her levels of the tumor marker CA-125 had increased. On May 17, 1989, an anxious Radner was sedated before undergoing a CT scan. She never regained consciousness. She died three days later at Cedars-Sinai Hospital in Los Angeles, at age 42.

Twenty years after Radner’s death, many women are still diagnosed with late-stage ovarian cancer. However, says Lele, patients are living longer, thanks to advances in medicine and surgery. Today, the gold standard for late-stage ovarian cancer treatment is surgery by a gynecologic oncologist along with a combination of carboplatin and Taxol (paclitaxel). And with the rise of new therapies that target cancer cells more precisely, better treatments may be on the horizon to prolong survival. “When I started in 1968, the average survival was eight months and now the average is 36 months for stage III disease,” says Piver, who wrote the book Gilda’s Disease with Wilder. “That’s just an average. Some people go five, six years.”

There is currently no screening test for ovarian cancer. Although CA-125 has been used for more than two decades to help physicians diagnose ovarian cancer, the tumor marker is not used to screen asymptomatic women for the disease because elevated levels of the protein are present in many of these women. CA-125 is also often used today to monitor disease activity, but when Radner first became ill, physicians didn’t keep track of tumor activity by watching CA-125.

The tumor marker “wasn’t talked about much back then,” says Piver. “There’s a more liberal use of the tumor marker today than when Radner was alive.” Researchers are currently searching for more helpful protein patterns in the blood, says Lele, which could hopefully be used to detect cancer while it’s still in the ovary.

Although a screening test for ovarian cancer is still lacking, researchers have learned more about ways to prevent the disease since Radner’s death, says Goff. “We’ve learned that 10 percent to 15 percent of ovarian cancer cases are hereditary, linked with BRCA1 and BRCA2 genes,” she says. “Removing the ovaries of women who have a hereditary link to the disease can prevent them from developing ovarian cancer.”

Radner herself clearly had a family history of cancer. Her aunt and a first cousin had ovarian cancer. Her mother was diagnosed with breast cancer in her early 60s. There’s a possibility that Radner’s grandmother died of ovarian cancer, although the death certificate says stomach cancer, says Radner’s brother.