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National celebrations of "Learn From Lei Feng Day," which was observed last Tuesday, turned into something of a public relations debacle after the party icon's celluloid resurrection in not one but three films about his life was thwarted by a distinctly capitalist weapon: the box office bomb.

In cities across the country, many theaters were unable to sell even a single ticket, an embarrassment for the Communist Party, which has been seeking to burnish its moral luster during the annual legislative sessions of China's rubber-stamp Parliament taking place in the capital, where Lei Feng was venerated as an inspiration for all.

Also last Tuesday, the octogenarian photographer famous for taking 200 photos of Lei Feng suffered a fatal heart attack after giving his last of over 1,260 speeches honoring Lei Feng to a roomful of military personnel in China's northeast. Chinese media widely reported his dramatic death, featuring footage of the photographer slumped in his chair and receiving CPR, and finally a photograph of his corpse reverently draped with a Communist Party flag.

The unwelcome developments in the Lei Feng narrative subverted the carefully scripted celebration of the Communist role model. By the time Lei Feng died at 21 — in 1962, slain by a falling telephone pole — a slew of government paparazzi had captured him fixing military trucks, darning his fellow soldiers' socks or diligently studying the works of Chairman Mao by flashlight. After his death, a diary detailing his many selfless acts was supposedly discovered and then swiftly disseminated among the masses to be studied and, it was hoped, emulated.

As the Communist Party formally orchestrates a transfer of power to a new generation of leaders, the nation has been fixated on what many say is society's declining morality, highlighted by a seemingly incessant flood of government corruption scandals replete with bribes and mistresses.

Last month, a Beijing woman was caught using a silicone prosthesis to pretend she was pregnant and fool subway riders into giving her their seats. Last week, a fresh round of outrage erupted after news spread that a carjacker in the northeastern city of Changchun had strangled a baby boy he had found in a stolen vehicle and then buried him in the snow. After thousands took to the streets for a candlelight vigil honoring the infant, the authorities banned further media coverage of the episode.

The evolving cult of Lei Feng — from the man to the myth — opens a window into how the Communist Party has sought to adapt ideologically while remaining firmly in control of a rapidly changing society. While Mao used him as a tool for inspiring absolute political obedience, propaganda officials have been struggling to rebrand Lei Feng and make him relevant to a nation where smartphones vastly outnumber copies of Mao's Little Red Book.

Today, social media apps include Micro Lei Feng, meant to inspire good deeds among the technologically adept. The state media has been championing him as "a role model for Chinese society today as the government is trying to improve the social moral environment."

But experts agree that the relentless portrayal of Lei Feng as a panacea for China's social ills has rung hollow for those who have doubts about the party's moral authority.

"The Chinese government no longer enjoys high credibility among people," said Zhang Ming, a professor of political science at Renmin University in Beijing. "It begs the question: the government keeps bringing up the Lei Feng spirit and calling on people to be more helping to others, but what has the government done to follow the Lei Feng spirit?"

At a time when China's incoming president, Xi Jinping, has begun a highly publicized campaign against corruption that cynics say is largely cosmetic, many wonder whether Lei Feng the saint should be buried once and for all. For them, the box office disaster of the Lei Feng-themed films is the nail in the coffin.

In the central Chinese city of Taiyuan, in Shanxi Province, an employee of a cinema confessed that it had pulled the films — "Young Lei Feng," "Lei Feng's Smile" and "Lei Feng 1959" — after the theaters remained empty on opening day.

The films suffered a similar fate in coastal Nanjing. Reached by telephone, a Nanjing International Cinema employee said the cinema had not sold a single ticket for "Young Lei Feng" and had canceled further screenings. An employee at another theater, the Nanjing Xingfu Lanhai Cinema, said, " 'Young Lei Feng' has been on the screen for four days but no tickets have been sold so far."

Even in Beijing, where thousands of delegates to the National People's Congress were gathering, the films were doing poorly. One local cinema reported it had sold only 43 tickets for "Young Lei Feng" in four days — compared with over 450 for "Les Misérables."

When Chinese media reports revealed that the public was largely ignoring the films, the studio behind "Young Lei Feng" denied it was a dud, saying an article in The Yangtse Evening Post about dismal ticket sales in Nanjing was incorrect. "This story has imposed irreparable negative impacts on this movie and has misled people into believing it's lousy," the Xiaoxiang Film Group said in a statement.

Ardent Lei Feng supporters are eager to portray the films' poor performance as a problem with form, not content. "Lots of people think the 'Lei Feng spirit' is a 50-year-old cliché," said Wang Wei, director of the Lei Feng Spirit Research Institute in China's northeastern Liaoning Province. "Once they hear about those movies, they instantly decided that they are not worth seeing. These films should have adopted new propaganda angles to attract audiences."

The government is instead resorting to old-school tactics to fill theaters. The State Administration of Radio, Film and Television has ordered film studios and cinemas to better promote the films and has exhorted party cadres to organize group viewings, particularly by rural audiences.

But the tattered hagiography has lost more than just its cinematic appeal. At the "Forever Lei Feng" exhibition in Beijing on Friday, almost all visitors were government workers or schoolchildren, even though municipal officials had sent a text message to millions of cellphone subscribers announcing the show.

Strolling past large propaganda posters of a uniformed Lei Feng grinning at the camera while polishing cars, and display cases filled with Lei Feng's image on lighters, backpacks and T-shirts, the crowd of sailors and city maintenance workers — all of them had been dispatched by their government employers — posed for photos before heading quickly for the exits.

Zhen Lifu, a professor at Peking University who was volunteering as a docent on Friday, spent the day lecturing about Lei Feng's generosity toward his comrades. But away from the crowds, Mr. Zhen admitted that he thought Lei Feng himself would have been depressed by the moral decay that plagues modern Chinese society.

"Frankly, Lei Feng wouldn't be the only one," he said. "These days, we're all pretty dissatisfied, which is why we need Lei Feng."

Argentina claims sovereignty over the clutch of tiny islands 310 miles from its shores, which President Cristina Fernández de Kirchner contends have been illegally occupied by "colonial implants" since the 1830s. A 74-day war that Argentina lost to Britain over the islands in 1982 cost the lives of 255 British and 649 Argentine soldiers, sailors and airmen, as well as 3 civilians.

Both chambers of Argentina's Congress are expected to pass resolutions this week rejecting the result of the referendum, in which 1,672 people were eligible to vote.

Education Ministry documents say that Argentina inherited the islands when it won independence from Spain in 1816, while Falklanders say Britain has maintained a claim on the islands since the English sea captain John Davis charted them in 1592.

Britain granted the islanders the right to citizenship in 1983, although some 40 nationalities are represented in the territory.

The referendum, financed and organized by the Falklands Legislative Assembly, was intended to demonstrate the islanders' will to remain a part of Britain, according to Dick Sawle, an Assembly member.

 "Our job now is to get the message out to the rest of the world," he said.

In the Senate, Democrats were putting the finishing touches on a budget they plan to introduce on Wednesday, their first in four years, while House Republicans were preparing to introduce a spending plan of their own on Tuesday morning.

The two proposals, which would set spending targets for the fiscal year that begins Oct. 1, will be miles apart ideologically and difficult to merge. Democrats plan to rely heavily on closing tax loopholes that benefit corporations and the wealthy to produce new revenue, while Republicans will focus on slashing spending to balance the budget in 10 years.

But the fact that both houses of Congress are working on their budgets simultaneously after years of impasse raised some measure of hope — albeit slight — that Democrats and Republicans might be able to work out some sort of compromise.

Compromise between the two parties, however, is only half of a more complicated bargain. Democrats also have to bridge the divide among a politically diverse group of Democrats on the Senate Budget Committee.

The committee chairwoman, Senator Patty Murray of Washington, said Monday that she expected all 12 members of her majority to vote in favor of the Democrats' budget, even if some members so far remain uncommitted.

"I have a really diverse committee," Mrs. Murray said, adding, "They all recognize that we have some really common goals, and we have worked it out."

That diversity is one of the major reasons Senate Democrats have not written a spending plan of their own since 2009, given the challenge of bringing together senators from Oregon to Virginia to Vermont who do not always agree on issues like whether cuts should fall more heavily on military or nonmilitary programs, and which tax loopholes to eliminate.

"Dealing with the difference of opinion is tough," said Senator Bernard Sanders of Vermont, an independent who has tried to ensure that the Democrats' budget does not include an adjustment to the inflation rate that would calculate it in a way that would decrease federal benefits. Mr. Sanders said he was confident the inflation rate calculation would be untouched, but he was not prepared to sign on to Mrs. Murray's plan until he sees the final document.

"We've had long talks; we'll see what happens," he said.

The committee is closely divided between 12 Democratic votes and 10 Republican votes.

In another sign that both parties continue to look for ways to meet in the middle, President Obama is to visit Capitol Hill for four separate meetings this week with the Democratic and Republican conferences of both houses. The president and his aides have said that this rare display of bipartisan outreach, coming a week after Mr. Obama dined with a dozen Republican senators, is intended to help foster cooperation between the parties.

Against this backdrop, the Senate Appropriations Committee was preparing to lay out a separate stopgap spending plan to keep the government financed through September. The House passed its plan last week.

Senator Harry Reid, the majority leader, who framed the Senate's action as a first step in a longer process, said, "This week will offer another opportunity for the Senate to return to regular order, an opportunity for this body to legislate through cooperation, through compromise, as we used to do."

"This legislation," Mr. Reid continued, "will be a test of the Senate's good will. America's economy is poised to grow and expand. The last thing it needs is another manufactured crisis such as a government shutdown to derail its progress."

The movement expected in Congress this week will draw attention to one of the more unusual aspects of business in Washington. When it comes to writing budget resolutions, the House and the Senate have worked on entirely separate paths. Senate Democrats, unable to always agree and not eager to take votes that could prove politically unpopular, have avoided drawing up large-scale a budget.

House Republicans, meanwhile, have made the budget the focus of their efforts. And they have seized on the issue as a way of portraying Democrats as inept and unfocused.

The National Republican Senatorial Committee snidely commented on Monday that Democrats had claimed "for more than 1,400 days that the dog ate their homework." And Republican senators have churned out news releases noting what could have been accomplished since the Democrats last passed a budget, like 179 round-trip missions to the moon and 292 expeditions to the summit of Mount Everest.

But even if Democrats do pass a budget in the Senate, it will mean little unless it can be merged with the House Republican budget and pass both houses of Congress.

"I think because of all the attention on the failure to pass a budget in regular order, Democrats are at least obligated to," said Senator Benjamin L. Cardin, Democrat of Maryland, who was until recently a member of the Budget Committee.

"But I don't think there's much optimism that we're going to reconcile a budget with this House quickly," he added.

And on Monday, the rats of the New York City subway system received another shot across the bow from the Metropolitan Transportation Authority.

"I want to warn you," Mark Lebow, chairman of the authority's transit and bus committee, said at a public meeting at the agency's Midtown Manhattan headquarters. "We're going to discuss rat sterilization."

The authority detailed its plans on Monday for a pilot program intended to curb the fertility of female rats, pledging to test a product — administered to rats orally — that accelerates natural egg loss and sterilizes the animals permanently.

"This technology, if successful, could complement our current strategies of poisoning and exclusion for rodent management," Thomas Lamb, the chief of innovation and technology for New York City Transit, told the committee.

The authority's partner in the endeavor, SenesTech, a company based in Flagstaff, Ariz., has conducted research in Laos, India and the Philippines, often in agricultural communities where rats pose a threat to rice farmers.

But Loretta Mayer, SenesTech's co-founder, said the work had been largely untested within transportation networks. "The only transportation, to my knowledge, that has ever been impacted has been the rickshaws of Indonesia," she said.

She added that researchers would draw explicitly on their "knowledge base of the ecology of the New York City rat." Sterilization products will be placed in bait boxes inside the authority's trash rooms.

The authority said that the typical city rat, known as the Norway rat, reaches sexual maturity at 8 to 12 weeks and can have as many as 12 pups a litter and as many as seven litters a year, "depending on refuse and track litter access." The rats' typical life span is 5 to 12 months. There is no reliable estimate of the subway rat population, transit officials said.

The authority's chosen remedy, called ContraPest, is not a contraceptive but irreversibly sterilizes female rodents by targeting the ovarian follicles that lead to births.

Dr. Mayer said the product posed no danger to humans. "I've been studying this compound for over 22 years," she said, "and I probably have the highest incidence of pregnant graduate students of anybody in academia."

A committee member asked what would happen if a person ingested the bait. "Well, it's quite sweet, quite salty and there's a lot of fat," Dr. Mayer said. "She would probably gain weight from the fat."

One challenge, the authority said, was offering the rats a bait that they might prefer to the subway system's daily treasures — half-eaten gyros and chicken fried rice, stale pizza and discarded churros.

According to a fact sheet distributed by the authority, rats would need to consume roughly 10 percent of their body weight in ContraPest for 5 to 10 days to become sterile. If they do, litter sizes will shrink within four weeks, the sheet said, before fertility is lost entirely. If a rat ingests ContraPest while pregnant, her offspring are likely to be born without complications but female pups are often sterile, the authority said.

The authority has long explored ways to chase its rats away, including a recent push to remove trash cans from a small number of stations in an effort to reduce garbage in the system. But a report released last week by the Straphangers Campaign, a rider advocacy group, found that riders had a roughly 1 in 10 chance of seeing a rat while waiting for a train.

Mindful of the rats' resiliency through the years, the authority's team cautioned that expectations must be managed accordingly.

"In the words of Albert Einstein," Dr. Mayer said, "if we knew what we were doing, they wouldn't call it research."

Mr. Hagel's decision to intervene comes amid mounting criticism from Congress as well as outside advocacy groups of the Pentagon's handling of a series of high-profile sexual assault cases in the military. In particular, critics have complained about the power of commanders to unilaterally dismiss criminal charges or convictions without explanation, which they say makes it less likely that women in the military will report sexual assaults for fear of retaliation.

Mr. Hagel said he would review the decision by Lt. Gen. Craig A. Franklin, the commander of the Third Air Force, to dismiss the sexual assault conviction of Lt. Col. James Wilkerson, a pilot who was also the inspector general of the 31st Fighter Wing at Aviano Air Base in Italy. Colonel Wilkerson was found guilty in November of aggravated sexual assault and was sentenced to one year in military prison. General Franklin's decision to overturn the findings of the court-martial freed Colonel Wilkerson, and allowed him to be reinstated in the Air Force.

In a March 7 letter to Senator Barbara Boxer, a California Democrat, and Senator Jeanne Shaheen, a New Hampshire Democrat, Mr. Hagel said that while General Franklin's decision could not be overturned, he had asked Pentagon lawyers and the secretary of the Air Force to review the way in which General Franklin decided the case. He also said he wanted a review of whether the military should change the way it handles sexual assault cases.

The furor over Colonel Wilkerson's case comes as the issue of sexual assaults in the military has been gaining prominence because of a recent string of scandals. The most wide-ranging case involves the Air Force's basic training program at Lackland Air Force Base in Texas, where 62 trainees were the victims of assault or other inappropriate actions by their instructors between 2009 and 2012. So far, 32 training instructors at Lackland have been charged, convicted or investigated in connection with the scandal.

On Wednesday, a Senate Armed Services subcommittee plans to hold a hearing on sexual assaults in the military, the first Senate hearing on the issue in nearly a decade, and Colonel Wilkerson's case is expected to be one of the focuses of the hearing.

The Wilkerson case has gained attention because it highlights what critics say is one of the biggest problems in how the military justice system handles sexual assault cases. In the system, senior commanders decide whether criminal charges are brought against military personnel, and even after charges are brought, the commanders also have the ability to veto the findings of a court-martial. That means the military justice system lacks the independence of the civilian law enforcement and judicial systems. For women who have been sexually assaulted, it means that their bosses decide whether charges are brought against their assailants, and that information about their assaults is shared in their workplaces.

Several women in the military have complained about the commanders' control of the legal process. Last year, the secretary of defense, Leon E. Panetta, said that while there were 3,191 reported cases of sexual assault in the military in 2011, the actual number of incidents was believed to be as high as 19,000, because most women do not report the assaults.

General Franklin's decision to overturn Colonel Wilkerson's conviction by a jury came after Colonel Wilkerson had failed a polygraph examination concerning the offenses, according to several people close to the case. General Franklin did not check with the victim before making his decision to dismiss the case, for which he has not given a detailed public explanation, and instead tried to promote Colonel Wilkerson and give him a new command, according to people familiar with the case.

General Franklin "was looking for a way to show the pilot community he had their backs," said one person familiar with the case.

Documents obtained in connection with Colonel Wilkerson's case also provide a glimpse into the fighter pilot culture of the Air Force that some women say encourages misogynistic behavior. In a personal e-mail he wrote while he was at Aviano in November 2011, Colonel Wilkerson, who had recently been named the inspector general of the Air Force's 31st Fighter Wing, describes his own behavior in a confrontation with military police. The e-mail, filled with bravado, expletives and fighter pilot jargon, describes an incident in which Colonel Wilkerson and other fighter pilots burned a couch in the middle of the base and then barked at the police and pulled rank to get them to back down when they came to investigate.

He wrote to another pilot that he deserved an award for helping ensure "the ability for the bros to either continue their merriment or skip away without notice." He added that he cared "about bros and traditions," and that he wanted to be remembered by his fellow pilots as someone who is "willing to stand up to the man, flip him the most wary of middle fingers, and then daring him to touch it."

The couch-burning incident was a small matter, but Colonel Wilkerson's belligerent treatment of the military security personnel who responded to the fire was considered more serious. The day after the incident, Colonel Wilkerson was dressed down by his commander, and the incident came back to haunt him during his trial, according to a person close to the case. After he attempted to provide evidence about his good military character, prosecutors were able to enter evidence about other incidents, including the couch-burning matter. Colonel Wilkerson's attorney, Frank Spinner, did not respond to a request for comment.

The 11-month-old infant was the son of a BBC journalist in Gaza, Jihad al-Masharawi, and photographs of the distraught father carrying the body of his son, Omar, wrapped in a white shroud were printed in newspapers worldwide and widely distributed on social media.

At the time, Mr. Masharawi and human rights organizations attributed the deaths of Omar and two relatives on Nov. 14 to Israeli airstrikes as the military launched its attacks on Gaza.

A day after the deaths, the Palestinian Center for Human Rights, based in Gaza, said the Masharawi home had been hit by a missile fired by an Israeli warplane. Human Rights Watch also said that the house had been hit by an Israeli strike, citing news reports and witnesses who spoke to the group.  

Paul Danahar, the BBC Middle East bureau chief, wrote on his Twitter account that an Israeli shell had come through the roof of the small Gaza home. Mr. Danahar visited his grieving colleague there on Nov. 15 and posted a photograph of a roundish hole in the roof of a burned-out room.

But a March 6 report by the Office of the United Nations High Commissioner for Human Rights on the eight-day conflict, which ended with a cease-fire, stated that three people in the home — Omar, a woman and an 18-year-old youth — were most likely the victims of "what appeared to be a Palestinian rocket that fell short of Israel."

The circumstances of those deaths are likely to remain in dispute. Israel's military has not determined whether it hit the house or not, saying it does not have clear information about what happened. The BBC has reported that privately, military officials told journalists at the time that Israel had aimed at a militant who was hiding in the building.

On Monday, the BBC News Web site said Mr. Masharawi, the journalist, called the United Nations findings "rubbish."

A United Nations official, Matthias Behnke, told The Associated Press that he could not "unequivocally conclude" that a Palestinian rocket was responsible for the deaths.  He said information gathered from witnesses led his investigators to report that "it appeared to be attributable to a Palestinian rocket."

But the select Senate panel debating the expansion proposed a compromise: to accept the federal money but use it to put low-income people into private insurance plans. Accepting the money would please the governor and a number of Floridians, while steering people away from Medicaid, which many lawmakers and residents view as troubled.

The committee vote to reject a Medicaid expansion under President Obama's health care overhaul was 7 to 4, with Democrats voting for the expansion.

Last week, a Florida House committee voted to reject Medicaid expansion altogether, saying that the system was broken and that adding people to the rolls would cost taxpayers too much money in the long run. The House speaker, Will Weatherford, a Republican, said it was the wrong approach, calling it a "dangerous path."

From the start, Mr. Scott knew it would be difficult for the Florida Legislature to embrace Medicaid expansion, even for only three years, which is what he proposed. The governor had staked his political career on derailing what he calls "Obamacare," and his abrupt reversal did not endear him to conservatives in Florida or in the Legislature.

Mr. Scott had a measured but optimistic reaction to Monday's Senate committee vote, expressing confidence that the Senate would ultimately craft a bill that would use federal money. The federal government would provide 100 percent coverage for new enrollees for three years.

"I am confident that the Legislature will do the right thing and find a way to protect taxpayers and the uninsured in our state while the new health care law provides 100 percent funding," Mr. Scott said in a statement after the vote.

A Senate committee will convene to craft a plan that would use federal dollars under the law to expand Florida Healthy Kids, a well-established, well-liked health care exchange for low-income children. The proposal would allow the one million uninsured adults who qualify under the health care law to join the exchange and choose among various insurance plans. They would pay on a sliding scale, depending on income.  

The results highlight what many experts say is a neglected problem: widespread, persistent flaws in the care of women with this disease, which kills 15,000 a year in the United States. About 22,000 new cases are diagnosed annually, most of them discovered at an advanced stage and needing aggressive treatment. Worldwide, there are about 200,000 new cases a year.

Cancer specialists around the country say the main reason for the poor care is that most women are treated by doctors and hospitals that see few cases of the disease and lack expertise in the complex surgery and chemotherapy that can prolong life.

"If we could just make sure that women get to the people who are trained to take care of them, the impact would be much greater than that of any new chemotherapy drug or biological agent," said Dr. Robert E. Bristow, the director of gynecologic oncology at the University of California, Irvine, and lead author of the new study presented on Monday at a meeting of the Society of Gynecologic Oncology in Los Angeles.

The study found that only a little more than a third of patients received the best possible care, confirming a troubling pattern that other studies have also documented.

Karen Mason, 61, from Pitman, N.J., had been a nurse for 28 years when she was found to have ovarian cancer in 2001. She scheduled surgery with her gynecologist, who was not a cancer surgeon.

But her sisters would not allow it. They had gone on the Internet, and became convinced — rightly, according to experts — that she should go to a major cancer center.

"They took the reins out of my hands," Ms. Mason said.

She wound up having a long, complicated operation performed by a gynecologic oncologist, which she does not believe her gynecologist could have done.

Dr. Barbara A. Goff, a professor of gynecologic oncology at the University of Washington, in Seattle, who was not part of Dr. Bristow's study, said the problem with ovarian cancer care was clear: "We're not making the most use of things that we know work well."

What works best is meticulous, extensive surgery and aggressive chemotherapy. Ovarian cancer spreads inside the abdomen, and studies have shown that survival improves if women have surgery called debulking, to remove all visible traces of the disease. Taking out as much cancer as possible gives the drugs a better chance of killing whatever is left. The surgery may involve removing the spleen, parts of the intestine, stomach and other organs, as well as the reproductive system.

The operations should be done by gynecologic oncologists, said Dr. Deborah Armstrong of Johns Hopkins University, who is not a surgeon. But many women, she said, are operated on by general surgeons and gynecologists.

Some women prefer the obstetricians who delivered their children. Many are desperate to start treatment and think there is no time to find a specialist. Some do not know that gynecologic oncologists exist. Some inexperienced doctors may find the cancer unexpectedly during surgery and try to remove it, but not do a thorough job.

"If this was breast cancer, and two-thirds of women were not getting guideline care that improves survival, you know what kind of hue and cry there would be," said Dr. Armstrong, who was not involved in the study. But in ovarian cancer, she said: "There's not as big an advocacy community. The women are a little older, sicker and less prone to be activists."

A patient advocacy group, the Ovarian Cancer National Alliance, urges women with the disease to seek care from gynecologic oncologists; their availability is one the group's criteria in comparing the quality of care among states.

Surgeons who lack expertise in ovarian cancer should refer women to specialists if the women are suspected to have the disease, but often do not, Dr. Goff said.

Dr. Bristow's research, which has been submitted to a medical journal but not yet published, was based on the medical records of 13,321 women with ovarian cancer diagnosed from 1999 to 2006 in California. They had the most common type, called epithelial. Only 37 percent received treatment that adhered to guidelines set by the National Comprehensive Cancer Network, an alliance of 21 major cancer centers with expert panels that analyze research and recommend treatments. The guidelines for ovarian cancer specify surgical procedures and chemotherapy, depending on the stage of the disease.

Surgeons who operated on 10 or more women a year for ovarian cancer, and hospitals that treated 20 or more a year, were more likely to stick to the guidelines, the study found. And their patients lived longer. Among women with advanced disease — the stage at which ovarian cancer is usually first found — 35 percent survived at least five years if their care met the guidelines, compared with 25 percent of those whose care fell short.

But most of the women in the study, more than 80 percent, were treated by what the researchers called "low-volume" providers — surgeons with 10 or fewer cases a year, and hospitals with 20 or fewer.

Dr. Bristow said women should ask surgeons how often they operate on women with ovarian cancer and how often they achieve complete debulking. But he also acknowledged that many patients hesitate to ask for fear of offending the doctor who may operate on them.

Ovarian cancer has unusual traits that make it more treatable than some other cancers. It is less likely to spread through the bloodstream and lymph system to distant organs like the lungs and brain. The tumors do spread, but usually within the abdomen and pelvis, where they tend to coat other organs but not eat into them and destroy them, said Dr. Matthew A. Powell, a gynecologic oncologist and associate professor at Washington University School of Medicine in St. Louis.

And most ovarian cancers are extremely sensitive to chemotherapy, experts said.

In 2006, a study was published that many doctors thought would change the field forever. It compared standard intravenous chemotherapy with a regimen that pumped the drugs directly into the abdomen. The test regimen was highly toxic, and not all patients could tolerate it. But median survival on it was 65.6 months, compared with 49.7 months on the standard treatment — a survival difference of 15.9 months.

The gain was huge, almost unheard of. New cancer drugs are often approved if they buy patients just a few months. The test treatment — called intraperitoneal, or IP therapy — did not even use new drugs. It just gave the old ones in a different way. Several previous studies had had similar findings for IP therapy, but the 2006 study, led by Dr. Armstrong, had the most definitive results.

The National Cancer Institute took a rare step, one it reserves for major advances. It issued a "clinical announcement" to encourage doctors to use the IP treatment, and to urge patients to ask about it. Cancer specialists predicted that the announcement would lead to widespread changes in treatment. Expert guidelines said it should be offered to every patient considered strong enough to endure it.

Seven years later, Dr. Armstrong and other physicians said, IP therapy still has not caught on.

Part of the reason may involve money, Dr. Armstrong said. With IP chemotherapy, patients also need a lot of intravenous fluids, which means unusually long treatment sessions. Oncologists are paid for treatments, not for time, so for those in private practice, long sessions can eat away at income.

"You don't make a lot of money with somebody in the chair getting IV fluids," Dr. Armstrong said. "Chair time is money. I'm being a cynic here, but I think that is part of the issue."

Dr. Goff said: "Where I live, in the Pacific Northwest, IP chemotherapy is pretty much only being done in the major medical centers, and by very few private-practice oncologists. Many say it's too difficult, and they don't even offer it to patients, which I think is unethical."

Ms. Mason had six hours of surgery at the Fox Chase Cancer Center in Philadelphia, with a gynecologic oncologist. The cancer had spread to lymph nodes, and was Stage 3. The surgeon removed her ovaries, fallopian tubes, various lymph nodes, uterus, cervix and omentum (part of the tissue that lines the inside of the abdomen).

"Ovarian cancer looks like Rice Krispies all over the place," Ms. Mason said. "She spent most of the time picking out each little visible Rice Krispy, and left nothing behind that she could see with her naked eye."

Then, Ms. Mason had chemotherapy (not IP, because it was not being done at the time). The disease has not recurred. Had she stuck with the first doctor, she believes, "I would be gone."

"I feel so strongly about letting women know that you need to get to a center of excellence," Ms. Mason said. "It's shocking to think it's still not happening."

Familiar — and not. In this bakery, wall-mounted religious icons watched over the proceedings. Words on a poster speculated about how the Nativity would have been more efficient, nurturing and peaceful if Three Wise Women had been at the scene. Most strikingly, except for the clatter of aluminum spring-form pans being oiled by hand, the bakery was mostly quiet. When the nuns of New Skete bake, they pray.

"Scripture says, 'Pray always,' " said Sister Cecelia Harvey, prioress of this monastery in rural upstate New York. She is a petite white-haired nun with an easy laugh and a wry sense of humor. "Can you not be aware of God while you're putting cheese in a bowl and mixing things up?"

For at least 1,500 years, monastic orders have been producing fine foods and spirits to barter and sell. Today, monastic gourmet still pays the bills. In cupboards worldwide, the association of "Trappist" and "preserves" has become as commonplace as "Benedictine" and "brandy." In December, the Belgian monks of the St. Sixtus abbey, who usually sell their prized dark beer, Westvleteren 12, at the monastery, permitted a one-time, wickedly expensive shipment (about $85 for a gift box of six bottles and two glasses), to cover costs of repairs, like a new roof.

In contrast to the solemnity of the monastic vow, the marketing of monastic food has become contemporary, even tongue-in-cheek. According to Will Keller, founder of monasterygreetings.com, a distributor who represents about 75 monasteries, popular items include Nun Better Cookies, baked by the Sisters of the Holy Spirit in Cleveland, and Praylines made by the nuns at the St. Benedictine monastery in Canyon, Tex. Mystic Monk Coffee, roasted by the Carmelite monks of Cody, Wyo., even features a single-serving pod called a "monk shot."

But as the population of many orders ages and dwindles, monastic kitchens face the challenge of maintaining their business while trying to protect the contemplative quality of their lives and the standards of their products.

That's the battle joined by the Eastern Orthodox Nuns of New Skete, who bake, freeze and ship 13 flavors of cheesecake. The nuns have been self-supporting since 1969, when they left the Roman Catholic church to found their monastery. But now the seven nuns, including two who live in a nursing home, range in age from 61 to 90. How to persevere?

In the last year and a half, the nuns and the nearby Monks of New Skete, known for their German shepherd breeding programs and puppy training books, started sharing a business manager, marketing director and a technology expert for their online businesses. In 2012, over 10,000 cheesecakes were sold through their online store, gift shop, fund-raisers and wholesale distribution. Their bakery facility has the capacity to produce 400 cakes per baking session. Currently, the nuns, with five part-time assistants, bake one to two days a week, about 37 weeks of the year.

Last winter, the nuns introduced a new flavor, raspberry chocolate. They are developing a gluten-free cheesecake. They recently took over the making of cheese spreads from the monks, whose gift line now includes German shepherd plush toys and kitchen towels.

With the monks, they have a Facebook page and a Web site for their commercial products, and a second set for homilies and spiritual beliefs. "But I have the password," Sister Cecelia said.

Some 35 years ago, the nuns were casting about for ways to remain solvent. They had cleaned houses in town, sewn sacramental vestments and helped the monks raise the dogs.

Then an abbot from their affiliated church, the Orthodox Church of America, suggested they try selling a specialty food — "not inexpensive, because even in an economic slump, people will want to treat themselves," Sister Patricia Lawless said he advised them.

Sister Magdalene Oliver, who joined New Skete in 1975 and died in 2003, loved to bake. Her recipe still informs their basic cheesecake. The four-pounder, which serves 16, has lemon accents, is lined by pulverized vanilla cookie crumbs and retails for about $41. "You don't put 'plain' on the label," noted Sister Patricia. "Deluxe sounds better."

In the bakery, Sister Patricia and Sister Rebecca Cown tamped down crumbs that rimmed the quivering cheesecakes. They carefully placed pans on oven racks that would rotate like a Ferris wheel, from hotter to cooler temperatures, to prevent tops from cracking. The cakes, whose acclaim grew by word-of-mouth, are now shipped in ice packs and a cardboard container that reads, "Voted Best Cheesecake in the Tri-Cities Area" — Albany, Schenectady, Troy.

"Anything that can go wrong, has gone wrong," Sister Cecelia said on a tour of the bakery that the nuns designed with energy-efficient freezers and coolers. She noted that the nuns had made the cheese-slicers, carts and boxing frames in their carpentry shop, and had the frozen-cake slicers and spinning cake stands custom-built. "But we are always looking for ways to do things better," she added.

The search — for a better cheesecake, a more prayerful life — has always animated the nuns. In 1960, Sister Cecelia was a teenager when she joined the Sisters of Poor Clare. "I hated snakes and bugs, so I couldn't become a missionary," she said.

Cloistered behind walls in Evansville, Ind., she prayed eight times daily, baked communal wafers and was not permitted contact with the public. "I wasn't allowed to look up at the blue sky because it would detract from prayer," Sister Cecelia said. She stayed nine years.

In 1969, seven nuns, ages 21 to 40, left together, searching for a way to live contemplatively and also engage with the world. After visiting the Monks of New Skete, they settled on a 12-acre hilly, wooded property, doing much of the construction themselves.

The nuns' pride in their self-reliance permeates their monastery. Sister Cecelia discovered a talent for iconography; she has sold about 350 gold-leaf religious paintings. Sister Patricia studied architecture and building codes so she could draw blueprints for a sunlit addition with a guest suite and a chapel.

Most of the present nuns chose New Skete after setting aside other lives: they include women who were Roman Catholic missionaries in China, Zaire, Burundi; an Episcopalian psychologist; a soil conservationist and widowed mother of eight.

Every evening, they join their brother monks at Vespers. They celebrate feast days with them and a small community known as the "companions of New Skete" — married believers.

But their own communal day begins at 7:15 a.m. with Matins. Their pet German shepherds respectfully patrol the hallway. The nuns, in simple robes, file silently into their modest chapel and, after seven candles are lighted, chant prayers a cappella. "O God, create in me a pure heart," they harmonize. "In my belly, a new and constant spirit."

Sister Patricia has another ritual that she observes faithfully. "I enjoy a small slice of cheesecake every day," she said.

"I don't like liqueurs," added the nun, who lived in the Evansville cloister for 18 years before setting forth. "But now our Kahlúa cheesecake is one of my favorites."