Going After a Silent Killer
By: Source: AARP Bulletin Today Date Posted: 2004-11-12 15:08:00-05:00
Ovarian cancer has earned a reputation as a silent killer because it often eludes early detection. But scientists are finding that if they listen closely, this deadly disease announces itself more loudly than was once believed.
Researchers are investigating new ways to diagnose and treat ovarian cancer, a disease that spreads rapidly and has an alarmingly high death rate. Of 25,580 new cases expected this year, an estimated 16,000 women will die. But if the cancer is found early, treatment is successful 95 percent of the time.
The disease typically strikes women after age 50. Because some of its symptoms—fatigue, bloating, constipation and urinary problems—can be vague and are common after menopause, women tend to ignore them.
Now, researchers at the University of Washington in Seattle have found that women with early-stage ovarian cancer reported having several symptoms at once, including increased abdominal size, pelvic pain and urinary urgency. Women with the cancer were likely to experience symptoms 20 or 30 times a month, compared with two or three times a month for women without the disease.
"If you have symptoms such as these and they're getting worse," says Beth Karlan, director of the Women's Cancer Research Institute at Cedars-Sinai Medical Center in Los Angeles, "don't put off seeing your doctor because you've got a golf game."
What type of doctor you see matters. Women with symptoms often go to a family doctor or specialist in digestive diseases rather than a gynecologist, says Sara Olson, an epidemiologist at the Memorial Sloan-Kettering Cancer Center in New York who has studied symptoms of ovarian cancer. "These doctors are less likely to think of ovarian cancer than a gynecologist would. ...Women should bring up the possibility of cancer and be firm about having it looked into."
HELP IS ALMOST ON THE WAY
A way to pinpoint the presence of ovarian cancer even before symptoms appear would be a major breakthrough. One promising technique, a blood test called OvaCheck, raised hopes when it was introduced two years ago. Researchers had combined proteomics—the analysis of protein patterns—with computer science to find markers for early-stage ovarian cancer in the blood.
Based on their findings, which were published in the Lancet in 2002, Correlogic Systems Inc. of Bethesda, Md., developed OvaCheck, a new test that was eagerly awaited by patients and advocacy groups around the country.
But doctors who treat the disease took a more measured view. They thought OvaCheck needed more testing in large populations of women and are awaiting the results.
"I wouldn't tell a patient to have the test because I don't know the standards or the variation among normal," says Robert C. Young, president of Fox Chase Cancer Center in Philadelphia. "If the company said that test results were positive, I wouldn't know what to recommend."
In August scientists at the Johns Hopkins Kimmel Cancer Center announced that they had designed a blood test to detect three proteins that are common in women with ovarian cancer. The test, when used with other diagnostic tools, may help determine if a pelvic mass is ovarian cancer. The procedure will be tested further before it's publicly available.
ASSISTED CELL SUICIDE
Scientists have also made headway in the treatment of the disease. One procedure now undergoing study in a laboratory is a method of tricking the cancer cells into "committing suicide." All normal cells have a gene called Smac that triggers the normal process of cell self-destruction in response to disease or aging. But the Smac gene in cancer cells is faulty, allowing them to multiply nonstop.
Iain McNeish, a clinical research fellow at Cancer Research UK, and his colleagues used a modified virus to sneak the Smac gene into tumors. In addition to inducing large numbers of cancer cells to self-destruct, the gene therapy also made the cells more sensitive to chemotherapy—all without harming ordinary cells.
RAISE YOUR GLASS
Finally, researchers in Queensland, Australia, report that women who drink more than one glass of red wine a day are almost seven times less likely to develop ovarian cancer than women who never drink alcohol. (If you don't ordinarily drink alcohol, don't start without checking with your doctor.)
Meanwhile, let's hoist our glasses to these encouraging advances.
Nissa Simon is a freelance writer in New Haven, Conn.
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