Article : The Hunt for an Ovarian Cancer Test

by Patrick Sullivan - Share Care


One of the scariest cancers for women is ovarian cancer -- a sneaky, deadly cancer that often lurks without any serious symptoms. So, of course, finding a way to catch it early on could save thousands of lives. And it seems that goal may be closer to reality, based on the results of the largest study so far that has attempted to find a reliable screening method.

The study, published in The Lancet in December 2015, involved about 200,000 women from the UK and evaluated two screening methods -- a yearly ultrasound or a yearly blood test plus a special risk assessment.

The study found that neither type of screening had a major impact on the number of women who ended up dying from ovarian cancer. But the study did show 15% fewer deaths in the group of women who received yearly blood tests.

What Does This Mean?

The study was "a monumental undertaking and I think it moved in the right direction," says Tyler Ford, MD, a gynecological oncologist with Henrico Doctors' Hospital in Virginia, who was not involved in the study. "But I think by no means does it give hard-and-fast guidelines."

This is somewhat disappointing news because the chances of surviving ovarian cancer for even five years after a late diagnosis is low -- about 73% if the cancer has spread to nearby lymph nodes or 28% if the cancer has spread far beyond the ovary. 

"The bulk of ovarian cancer, around 70 to 80%, is diagnosed in advanced stagebecause symptoms are usually not noticed until it has spread," says Ford. "In the early stage, when the cancer is isolated in the ovary, symptoms are generally not felt." These two facts combine to make ovarian cancer a killer.

But Ford doesn't want anyone thinking we should give up on the idea of ovarian cancer screening just because the tests in this study weren't fully proven. "That's not what [the study is] saying. It's saying that of these two methods, we were unable to identify a statistically significant method to detect ovarian cancer," he explains. "That leaves it wide open for future possibilities." More studies will surely follow, possibly finding proof for one of these methods or something entirely different.

Ford says it's also important to note that the study looked at only women with an average risk of ovarian cancer, and excluded women with a family history of ovarian or breast cancer. "We view those women separately and take care of them differently," he says. "I don't want anyone to think that if they have a family history of breast or ovarian cancer that there's no screening or preventative treatment available, because in this situation the guidelines are clear."

Right now, screening isn't recommended for women with an average risk of ovarian cancer. But screening is sometimes done for women with a strong family history of ovarian cancer and certain genetic mutations. More research is needed to confirm the rules for who should be screened and how.

Warning Signs of Ovarian Cancer

While research continues to seek out an accurate test, it's important to know your own health. Ford says he looks for certain symptoms, such as:

  • Bloating (either a belly that looks swollen or just feels bloated)
  • early satiety (feeling full from a meal more quickly than usual)
  • changes in bowel or bladder habits
  • abdominal pain
  • pelvic pain or pressure
  • unexplained weight loss

The trouble is that these symptoms usually show up in later-stage ovarian cancer. Or, sometimes, these symptoms are just thought to be normal or ignored until they become severe. But taking note of these symptoms early could make a difference. The American Cancer Society urges women to see their gynecologist if they have symptoms like these almost daily for more than a few weeks that don't seem related to a more common condition.

For now, the best way to spot ovarian cancer is by having regular check-ups with your doctor. Pelvic exams are probably the most reliable way to identify earlier-stage ovarian cancer, says Ford, because a doctor may feel a tumor before a woman notices any symptoms. Also, if you have a strong family history of ovarian or breast cancer, you may want to ask your doctor about meeting with a genetic counselor and then deciding if screening makes sense for you.

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