HEALTH DIVA! Ovarian Cancer – Everything You Need To KnowBy Dr. Janna Andrews | October 24, 2013 | Entertainment, Fitness
As Breast Cancer Month comes to a close, our resident Health Diva,Dr. Janna Andrews takes a look at the new personalized prevention in Ovarian cancer. Join Dr. Andrews tonight at her fundraiser, Kicked It In Heels.
Ovarian cancer is the leading cause of death from gynecological cancers in the United States. In 2013 there will be roughly 23,000 cases of ovarian cancer and approximately 14,000 deaths.
The incidence of ovarian cancer increases with age; the highest incidence is found in women age 50-59. The five-year survival for ovarian cancer is less than 45 percent, due mostly to the late stage of cancer that many women are diagnosed. The five-year survival for stage I disease, however, is closer to 90 percent.
One of the reasons so many women present with late stage disease are because there really arenΓÇÖt any effective proven screening mechanisms for ovarian cancer. In early stage disease, women can have vague symptoms such as abdominal pain, bloating, cramping that are often misdiagnosed and can lead to a delay in diagnosis.
Screening for ovarian cancer could aid in diagnosing the disease when it is still localized and curable therefore decreasing the number of deaths. Trials are ongoing in Japan, the United Kingdom and the US.
Much of the data, however, has shown that screening may not be effective for ovarian cancer. Data from a US trial assessed roughly 78,000 women with close to 40,000 women assigned to annual screening including a transvaginal ultrasound and blood test for CA 125 tumor markers. Findings from the trial revealed no difference in stage of presentation and no decrease in deaths.
Screening mechanisms that have been tested may not be optimal. Tools such as transvaginal ultrasound can be limited because often times if a tumor is detectable via ultrasound it may be advanced. Smaller tumors deep in the abdomen can be difficult to detect early. CA 125 is one of the tumor markers detectable by blood test that has been linked to ovarian cancer and has been found to be elevated in early and advanced stage disease.
Unfortunately CA 125 is elevated also in approximately 1 percent of normal women and can fluctuate more in premenopausal women, due to ethnicity, and in smokers. CA 125 levels can also be elevated in benign conditions like; endometriosis, fibroids, cirrhosis as well as breast, lung, or pancreatic cancer, so it is not the most specific marker for detecting ovarian cancer.
New data out of MD Anderson, University of Texas is making strides to detect ovarian cancer earlier. Researchers initiated a trial that assessed the CA 125 levels in 4051 women over 11 years. Based on their baseline CA 125 levels, women were stratified to an annual CA 125 marker, 3-month CA 125 markers, or a transvaginal US and referral to a surgeon. Stratifying the women to low, intermediate and high risk respectively. The CA 125 marker demonstrated more promise as a screening tool when assessed over a period of time. 10 women underwent surgery based on their ultrasound results. 4 women were found to have early stage ovarian cancer, 5 had benign disease and one had endometrial cancer.
Findings from the study demonstrated a high specificity for ovarian cancer in postmenopausal women and shows promise. It may eventually offer a personalized method to screen for ovarian cancer without an increase in unnecessary surgeries for healthy women due to false positives.
This personalized approach can take into consideration a womanΓÇÖs risk factors for ovarian cancer; a combination of genetic predisposition based on family history , age, a history of infertility or endometriosis can all increase a womanΓÇÖs risk of developing ovarian cancer.
If this subset of women can be identified, they may benefit from baseline CA 125 levels followed by risk stratification. This could be a huge breakthrough in ovarian cancer, a disease that has shown only a slight decrease in deaths in the past three decades.
photo credit: FDP.net