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Old 11-17-2005, 11:13 AM   #1
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New trial on the efficacy of CA 125 for Ovarian Cancer Detection

Your Life: HEALTH : The Hidden Killer ; OVARIAN CANCER OFTEN GOES UNDIAGNOSED UNTIL IT's TOO LATE, BUT A NEW TRIAL MAY LEAD TO A NATIONAL SCREENING PROGRAMME THAT COULD SAVE THOUSANDS OF LIVES
Source: Daily Mirror
Publication date: 2005-11-17

By CHARLOTTE HAIGH

BEING told you have cancer is devastating, and ovarian cancer is more frightening than most because it kills 71 per cent of sufferers.

But it needn't be this way. Like most cancers, it is highly treatable if caught quickly.

Ovarian cancer is the fourth most common among women and affects 7,000 a year, compared to 41,000 who get breast cancer.

But while two-thirds of breast-cancer patients can expect to survive for at least another 20 years, ovarian cancer is often diagnosed when it is already too late.

Sean Kehoe, Professor of Gynaecological Cancer at Oxford University and spokesman for the charity Wellbeing of Women, explains: "The problem is that the illness has few clear-cut signs in the beginning and causes symptoms only when it's spread to other parts of the body. In fact, in 10 per cent of cases it causes no symptoms at all."

New research being carried out at the Institute for Women's Health, University College London, due to be completed by 2011, could lead to a national screening programme - as for breast and cervical cancers - which will save many lives by detecting the disease early.

WHAT IS OVARIAN CANCER?

THE ovaries are two small organs on either side of the womb, which produce eggs and female hormones. Every time you ovulate, the ovary ruptures to release an egg, and then repairs itself, leading to rapid cell regrowth. As cancers form when normal cell division goes wrong, the more times cells regrow, the higher the probability of cancer developing.

"The risk is proportional to the number of times you ovulate," explains Professor Kehoe. When ovarian cancer is diagnosed, doctors stage it according to how far it's spread. Most women are diagnosed during the later stages, when the tumour has grown and spread, causing symptoms - for example, pressing on the bladder so you need the loo more often.

A woman with ovarian cancer will have surgery to remove the ovaries, womb and omentum, a sheet of fatty tissue behind the abdomen. "If it's been caught in the early stages, surgery might be enough," says Professor Kehoe. But most will need chemotherapy and possibly radiotherapy.

NEW HOPE

THE new trial, known as the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS), may offer the best hope yet for slashing death rates. It's one of the biggest research trials ever done, involving 200,000 women over 50 at 13 different centres.

A quarter of the women will receive a blood test for a protein called CA125, which suggests ovarian cancer. If it's positive, they'll have an ultrasound scan to confirm - and surgery if necessary.

Another quarter will have the ultrasound, without the blood test, to help the researchers determine the best method of screening.

The remaining 100,000 will have no screening for cancer. This group is known as a "control" group. At the end of the study, in 2011, researchers will compare death rates from the disease among the three groups.

"I desperately hope the figures will show that the screening tests we're using will save many lives," says study leader Professor Ian Jacobs, consultant gynaecological surgeon and director of the Institute for Women's Health.

"On the basis of previous research we've done, I'm hopeful. It'll also give us more information about markers for cancer that can show up in blood and we may even find a more effective blood test, too."

BE AWARE

BUT for now, campaigners want more general awareness of ovarian cancer.

Although there are no obvious signs, such as lumps or bleeding, it's important to see your doctor if you experience certain symptoms (see When To See Your GP).

"Most of these will be caused by another condition and your doctor is unlikely to associate them with ovarian cancer as most GPs will only see a handful of cases in their career. If you're worried, explain that to your doctor," says Professor Kehoe.

CAN YOU PREVENT IT?

OVARIAN cancer isn't directly associated with lifestyle in the way that lung cancer, for example, is linked to smoking. But the two factors proven to cut your risk are having children and the contraceptive pill.

"That's because both of these reduce the number of times you ovulate in your lifetime," says Professor Kehoe. "Some research has shown that even being on the pill for a short time could cut the risk by between 20 and 50 per cent."

There's no clear link with diet, though. "We do know that women in Japan have very low rates, and that if they move to the West, these rates start to rise," says Professor Kehoe. "But it's not clear whether this is because of diet or environmental factors."

However, numerous studies prove that a diet high in fruit and vegetables and low in animal fat helps prevent other cancers.

KNOW YOUR RISK

YOU may be at a slightly higher risk if:

You have close relatives who have had ovarian cancer. This could mean you carry the genes for the disease. If concerned, discuss a genetic test with your GP.

You've had breast cancer, or have two close relatives who've had it under 60.

You're over 65. According to Cancer Research UK, most ovarian cancers occur in women after the menopause, and half are in women aged over 65.

You've never had children or had your first baby after 30. Studies suggest having babies younger has a protective effect although doctors are not sure why.

You started your periods early and had a late menopause. Scientists think the more menstrual cycles, the higher your risk.

You've had prolonged fertility treatment. Doctors are uncertain whether this is because of the drugs themselves, or because of infertility.

You use talcum powder between your legs. Some studies suggest this could raise your risk but the jury's out.

WHEN TO SEE A GP

THESE are all far more likely to be caused by a more minor condition. But if any of these symptoms are unusual for you, and persist, get checked out:

abdominal discomfort or pain

persistent bloating

indigestion that doesn't respond to the usual remedies

the need to pass water more often and more urgently than usual

a change in bowel habits

loss of appetite or unexplained weight loss

I'M IN REMISSION

SIAN Cartwright, 42, a nurse from Cardiff and married mum-of- two, was diagnosed with stage-four cancer - the most advanced form of the disease - last year. She says:

I DIDN'T have any of the classic symptoms but in September last year, I had a heavy bleed inbetween my periods. I didn't think much of it but I decided to check it out with my GP. Blood tests and a smear showed nothing, so two weeks later the doctor gave me an internal examination.

He could feel a solid mass about 9cm across so he sent me straight to the hospital for a scan and a blood test. This showed I had elevated levels of the CA125 protein, linked to ovarian cancer. I was so shocked. I thought it only affected older women, and no one in my family had had the disease.

Things happened very quickly. The cancer had reached stage four - I had a radical hysterectomy and during the operation they found that the cancer had attached itself to my bladder and bowel, so they had to operate on those areas as well.

Ten days later doctors also found I had fluid on my lung because the cancer had spread there, too. I needed six cycles of chemotherapy, which I dreaded - but actually it wasn't as bad as I'd expected. I lost most of my hair and felt tired but the doctors and my family and friends were amazing.

I was lucky in that I responded well and my CA125 count was back to normal after the first session. I'm now in remission from the cancer. I still have CA125 tests every three months to keep an eye on things but I'm very optimistic. A friend's mother had stage-four ovarian cancer like me and is still alive seven years on. In May I went back to my job as a nurse for children with epilepsy and I feel fantastic.

HELP

FOR more information about ovarian cancer, visit The Eve Appeal's website on www.eveappeal.org.uk or Wellbeing of Women at www.wellbeing ofwomen. org.uk

Publication date: 2005-11-17


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Old 11-22-2005, 10:58 AM   #2
AlaskaAngel
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Clinical trial

Interesting. I have had bc and am in a clinical trial in the U.S. for monitoring for ovarian cancer. I copied the risk factors from the report and put a star by the ones that do apply to me. For the clinical trial I am in, I receive an annual transvaginal ultrasound and quarterly CA-125's. I have participated for 3 years and am about to have the 3rd TVUS with this quarter's CA-125 and this is the last time they will test me for it. I have no signs or symptoms and good test results so far. I am a decade away from being 65 so I know my risk is only beginning.

-AlaskaAngel

KNOW YOUR RISK

YOU may be at a slightly higher risk if:

*You have close relatives who have had ovarian cancer. This could mean you carry the genes for the disease. If concerned, discuss a genetic test with your GP.

*You've had breast cancer, or have two close relatives who've had it under 60.

You're over 65. According to Cancer Research
UK, most ovarian cancers occur in women after the menopause, and half are in women aged over 65.

*You've never had children or had your first baby after 30. Studies suggest having babies younger has a protective effect although doctors are not sure why.

*You started your periods early and had a late menopause. Scientists think the more menstrual cycles, the higher your risk.

You've had prolonged fertility treatment. Doctors are uncertain whether this is because of the drugs themselves, or because of infertility.

You use talcum powder between your legs. Some studies suggest this could raise your risk but the jury's out.


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