Learning to Spy Killer Cancer Number Five

2009-09-18 | |
Last updated: 2009-09-18

Many diseases that carry the label “silent killer” have earned this notorious distinction because of their ability to avoid detection until they have caused too much damage in the body to allow effective treatment and the possibility of recovery. Aside from routine screening and symptoms that patients can describe to their doctor, we have no magical modern technology to proactively seek out disease and provide early warning. Instead, we rely on our bodies to give us some clue when something is not right, but sometimes the messages being sent are not clear.

Often described as a “silent killer” because it is frequently diagnosed after it has started spreading, ovarian cancer is not so much silent as it is subtle.

Though it is the 8th most common cancer in the US, it is the 5th leading cause of cancer death. It takes the lives of more than 70% of the 1 in 70 American women who will face the disease in their lifetime. In the UK, it is the fifth most common cancer and takes the lives of 63% of the same 1 in 70 women who will develop the disease.

The reason that the disease is more subtle than silent is because of the nature of the symptoms that it shows. Those who have ovarian cancer face symptoms such as difficulty eating, feeling full too quickly, a constant bloated feeling, ongoing pain in the pelvis and lower stomach area, and a larger-than-normal belly size. Considering how much these symptoms look like stomach and digestive problems, it is easy to see how patients will overlook the problem and not seek treatment.

Even when patients do seek treatment, their doctors frequently do not recognize the symptoms as being related to ovarian cancer and instead investigate the problem from the perspective of the digestive system. A recent study completed in the UK found that most women with the cancer required 3 to 5 visits to their doctor and a delay of up to 6 months before finally being diagnosed with the disease. The ambiguity of symptoms contributes to the fact that 70% of women will only receive the correct diagnosis once they have reached the advanced stage of the disease.

In situations where the diagnosis from symptoms is more difficult, blood and urine tests typically provide a more accurate means to diagnose those that doctors suspect have a disease. When the tests have a high level of accuracy, they serve to confirm what doctors may suspect. Unfortunately, such tests have not been available until very recently.

Last year, Yale School of Medicine researchers announced a blood test that they claimed was 99% percent accurate in early diagnosis of the disease. The test involves checking for specific proteins in the blood to indicate the presence of the disease. Unfortunately, because only one company has the legal rights to perform the test at this point, the American Food and Drug Association (FDA) is not yet regulating the test to ensure that the accuracy of the claims are authentic.

Even if this test does not meet expectations, other research work is also trying to understand the disease to allow the development of tests.
Over a period of 8 years, a world wide research team led by two UK research institutions performed large scale genetic analysis of the genes of thousands of woman with and without ovarian cancer. Their research, published in the journal Nature Genetics, finally identified a mutation in one gene that increases the risks of developing ovarian cancer by 40%. Their teamwork is ongoing and their hope is that more mutations will be found that also identify those at higher risk of developing the disease.

Other research taking place at the University of Arizona is also looking at the problem of earlier detection of ovarian cancer, but from the standpoint of medical imaging. The cross-discipline group of researchers involved is using customized image analysis software and fluorescent dyes to detect abnormalities in the structure of ovarian tissue. These abnormalities are usually the result of cancerous cells.

Their technology allows the medical device to be attached to an endoscope or thin tube that can be directed through a very small incision in the lower stomach area or through the vagina. The tube and device can be navigated to the ovaries in order to analyze the cells. The potential of the device is that even small numbers of cancerous cells can be detected which means the possibility of much earlier diagnosis and treatment.

When detected early, ovarian cancer is more than 90% treatable. However, without clear symptoms and accurate tests for the disease, ensuring early diagnosis is still difficult. While some potentially accurate tests are close to being available and knowledge that will allow earlier testing is being gained rapidly, such tests are still one or more years away. In the meantime, women must educate themselves and potentially their doctors regarding the symptoms of the disease in order to protect themselves.

A future blog entry will cover some of the treatments and preventative measures against the disease.

Do you have a family history of the disease that concerns you? Are you wondering about the latest tests available? Share your thoughts in the forums or in comments?

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