Thursday, October 20, 2011

Screening for Ovarian cancer - experts still looking!

Many years ago a good friend of ours (also a patient at the time) was diagnosed with ovarian cancer. Like most women with this disease, the tumour was well advanced before she had any symptoms,  and in these cases the 5 year survival rate remains at 30%. She was one of the most optimistic and cheerful ladies we have ever known, even as the disease progressed and she struggled with all the impotent therapy that she was given.

Times, sadly, haven't moved on too far in all those years and so researchers are constantly on the look out for a screening tool that can pick up these "difficult to find" tumours at an early stage when treatment is so much more effective - a Stage 1 cancer has a 92% five year survival rate! There is a marker protein - CA125 - that is "associated" with these sorts of tumours, however it is not specific for the tumour and by itself it is not a good screening tool. It was thought that by adding Trans-vaginal Ultrasound to checking the level of CA125, that together they might be able to detect cancers at an early stage.

The news is not good. A 13 year study following 80,000 women in the US and just published in the Journal of the American Medical Association, reported that those in the "screened" group - CA125 plus transvaginal ultrasound - fared no better than those in the "not screened group" who did not have an ultrasound plus CA125. In fact the screened group underwent more interventions and had more ovaries removed and had more surgical complications.

Sometimes science does appear to move at a glacial pace, and when negative results come out it is always disappointing. But the upside is that now we know that this sort of screening is not valid, we can move on and redirect our energies and resources towards more fruitful ideas and solutions.

Here's hoping!
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