A recent study shows that an experimental blood test can distinguish pelvic cancer from benign masses with 91 percent accuracy.
WE DO NOT HAVE A GOOD OVARIAN CANCER SCREENING TOOL. Researchers recently reported an ovarian cancer detection breakthrough. Unmasking ovarian cancer: liquid biopsy’s sneak peek inside.
Now, a new blood test appears to distinguish between cancerous and benign pelvic masses. This breakthrough is our focus today.
First, a nod to Saturday Night Live former cast member and comedienne Gilda Radner. She had about ten months of testing and several misdiagnoses before being discovered to have ovarian cancer in 1986.
In her memory, this comedienne’s husband established Gilda’s Club in 1991. The organization provided emotional and social support to patients with cancer, their families, and friends.
Gilda’s Club merged with The Wellness Community to form the Cancer Support Community, the USA’s largest cancer support network.
The legacy of Gilda Radner is extraordinarily inspiring to me. Let’s examine some basic facts about ovarian cancer before looking at the recent encouraging research findings.
Ovarian Cancer Numbers
Here are the numbers, according to the U.S. National Cancer Institute Survey, Epidemiology, and End Results (SEER) database:
- New Cases and Deaths per 100,000: The number of new cases of ovarian cancer is ten per 100,000 women per year. The death rate is six per 100,000 women per year. These rates are age-adjusted and based on 2016–2020 cases and deaths.
- Lifetime Risk of Developing Cancer: Approximately one in 100 women will be diagnosed with ovarian cancer sometime during their lifetime.
- Prevalence of This Cancer: In 2020, an estimated 236,511 women had a history of ovarian cancer.
Ovarian Cancer is the #3 Gynecological Cancer
In 2020, ovarian cancer was the world’s third most common gynecological cancer. Approximately seven out of ten women who develop ovarian cancer have High-grade serous ovarian carcinoma.
Even if detected early, the 10-year survival rate for high-grade serous ovarian carcinoma is about 55 percent. Unfortunately, most cases of this cancer type are advanced, associated with a five-year survival rate of only 30 percent.
On a positive note, the relative survival improved in the 1975–2015 time frame.
Ovarian Cancer Is Hard to Diagnose
Doctors often don’t typically find ovarian cancer until it has progressed to an advanced stage.
Only about one in five women has their ovarian cancer caught in an early stage.
Early-stage tumors are easier to treat and even cure. However, as noted, many ovarian cancers are not found until stages 3 and 4; the cancer has spread within the pelvic region — and sometimes beyond.
Late detection puts patients at a disadvantage because of how quickly it has spread by this time.
Why is Ovarian Cancer Hard to Find?
While some of my fellow clinicians refer to ovarian cancer as a “silent” killer (given the often late detection), ovarian cancer is often not silent.
The problem is that ovarian cancer symptoms can be vague. A 2012 study offered these ovarian cancer symptoms:
- Abdominal bloating, pressure, or pain
- Feeling unusually full after a meal
- Difficulty eating or feeling full quickly
- Urinary changes such as frequency
- Back pain
- Menstruation changes
- Painful intercourse
If any of these symptoms are persistent or you experience them more than 12 times monthly, please get in touch with your healthcare provider for an evaluation.
No screening test
For cervix cancer, we have HPV testing. Mammograms are good screening tools for breast cancer. For colon cancer screening, colonoscopy and other screening tools provide value.
Unfortunately, we do not have an effective screening test for ovarian cancer. The U.S. Preventative Services Task Force offers this sobering observation:
The risks of possible screening tests are too great to make a case for the potential benefits.
Clinicians are left with physical exams and patients reporting symptoms to catch ovarian cancer early.
Alas, the ovaries are deep in the abdomen, making it hard to feel a mass. Pelvic exams are often not helpful.
While imaging can be valuable, clinicians do not typically order additional tests without suspicion that a tumor is present.
The Promise of a Liquid Biopsy
Scientists at the Keck School of Medicine of the University of Southern California (USA) are developing a new blood test to help detect early-stage ovarian cancer.
The blood test, or so-called liquid biopsy, can distinguish between cancerous and benign pelvic masses with up to 91% accuracy — a higher rate than other available tests. Still, we need validation studies.
Dr. Bodour Salhia, corresponding author of this study, offers her view to Medical News Today:
“If we can detect high-grade serous ovarian carcinoma in its earlier stages, we believe outcomes will be dramatically improved for women afflicted with this disease.”
The liquid biopsy is not a screening test.
Once doctors discover a mass, they often have trouble determining if the abnormal growth is cancerous or benign before surgery to remove it.
While many cancers are amenable to a needle biopsy, ovarian cancer often is not.
Knowing more about the mass before surgery can help the surgeon know what surgical approach is optimal for the patient.
Enter the liquid biopsy.
How Does a Liquid Biopsy Work?
The OvaPrint™ test detects small fragments of DNA shed by cancer cells into the blood.
These pieces are known as cell-free DNA, given they are free from the cells they came from and harbor alterations found in the primary tumor.
The liquid biopsy looks for circulating DNA — in the blood — that has had chemical modifications known as methylation.
I want to end with five risk factors for ovarian cancer.
Reducing Ovarian Cancer Risk
While there is no way to prevent ovarian cancer completely, there are some things that are linked with a lower chance of getting the disease:
- Having used birth control pills for at least five years.
- Having had a tubal ligation (getting your tubes tied), ovaries or fallopian tubes removed, or a hysterectomy (an operation in which the uterus, and sometimes the cervix, is removed).
- Having given birth.
- Breastfeeding. Some studies suggest that women who breastfeed for a year or more may have a moderately lower ovarian cancer risk.
- Physical activity may reduce ovarian cancer risk.
Please talk to your healthcare provider about ways to reduce your risk.
While the maneuvers noted above may help reduce the chance of getting ovarian cancer, they are not for everybody, and risks and benefits are associated with each.
Although you may lower your risk, this does not mean you will not get cancer.
Thank you for reading “Ovarian Cancer Breakthrough.”
