While it is tragic to think that today, 19 women in the UK will be diagnosed with ovarian cancer, they could be considered the lucky ones as this deadly disease can be easily misdiagnosed when women complain of bloating and abdominal pain. I hope that their cancer was diagnosed at its early states so it can be successfully treated.

This is why there was global media interest following the recent announcement of a US study at the University of Texas MD Anderson Cancer Centre showing there was “potential” for a new way of screening ovarian cancer. Their 11-year trial of 4,051 women, reported in the journal Cancer, showed it is possible to identify ovarian tumours through a blood test which measures the raised levels of a protein called CA 125, which is associated with ovarian cancer, and ultrasound and reported a low rate of errors. The study identified 10 women to be operated on, and four of whom were found to have invasive cancer.

Those two tests have been used together before, with disappointing results. But the current research differs in that it takes into account fluctuations in a woman’s blood test results. The important thing isn’t any single measure of CA-125 in the blood, but how it changes over time, the researchers said.

Each year, women in the study were given a CA-125 blood test. Researchers fed the women’s age and test results into a mathematical formula called Risk of Ovarian Cancer Algorithm, or ROCA, which was developed using a database of CA-125 test results from thousands of women in the United States and Sweden.

Unlike breast, cervical or colon cancer, there’s no reliable screening test to detect the disease. Many approaches to ovarian cancer screening have been tried, but none has proven accurate enough to use in the general population. Most produce high numbers of false positive results, which require doctors to perform invasive surgeries to rule out cancer.

The number of ovarian cancer incidence detected is low because ovarian cancer is relatively rare, but the study has aroused great interest in the outcomes of a major 10-year UK longitudinal study into ovarian cancer, the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) using 200,000 women who donated serum; the results will be announced in 2015. Preliminary results from the UKCTOCS trial, released in 2009, were positive, and researchers are eagerly awaiting the final results.

The report in The Guardian by health editor Sarah Bosely caught my attention, particularly this sentence: “The UK collaborative trial of ovarian cancer screening (UKCTOCS) study has a lot of hard questions to answer. The most important is whether identifying cancers actually saves lives. Screening is not helpful if it does not prolong the life of women whose cancers are picked up.”

The whole point of the US and UK studies are to develop improved diagnostic tools for ovarian cancer. As the BBC pointed out: “Researchers are now testing the idea of using the blood test to sort patients in risk groups based on levels of CA 125. Instead of going straight for surgery, low-risk patients are tested again in a year, medium-risk ones after three months and high-riskk patients have an ultrasound scan to hunt for tumours.”

Dr Adam Rosenthal, from Barts Cancer Institute, told Channel 4 that if the UKCTOCS study reports the same as the US trial, it is highly likely there will be improvement in mortality. And Debbie Saslow, director of breast and gynecologic cancers for the American Cancer Society in Atlanta, was delighted with the trial’s findings: “I was more excited reading this study than I have been in a really long time. Not only was [the screening] finding cancers in both of those studies, but it was finding them early, that’s what we want to do.”

Guardian readers were quick to comment on why they felt screening for ovarian cancer is vital – and I’m sure Pierce Brosman, who lost his wife and daughter to this ‘silent killer’, and Lord Saatchi, whose beloved wife from the disease too, would agree.

Dorice:

Of course screening is necessary !

For me, it’s personal. My mother and sister both died aged 46 because of ovarian cancer, and although I didn’t even know my mother was ill, I lived through my sister’s suffering and watched her die 4 years ago this month – 4 years ago tomorrow.

As a result both my daughters are now classified as ‘high risk’, and will be screened regularly.
This may make them nervous, obviously.
But they both loved their Aunt dearly, and don’t want to go the same way.
However, had my sister been screened, she could have had at worst another few years, and as she had lost her two teenage daughters to a very rare and incurable genetic condition in the preceding years, she deserved that extra time (last year I explained why the Guardian and other media outlets were partly responsible for her refusing to go into hospital when she was told a hysterectomy was an urgent requirement).

Screening WORKS !

When I was suspected of having bladder cancer last February, the CT scan ordered by my Consultant discovered another (and unrelated) tumour in one of my kidneys.
There were no symptoms relating to the kidney cancer, and the only symptom for the bladder cancer had disappeared within 48 hours.
Had I not done the ‘non-macho’ thing and phoned my surgery when I spotted blood in my urine, I’d have gone the same way as Ian Banks, and at the same age.

So ask my daughters whether their old Dad should have done what he did, and whether screening is a good thing !

Consultants and oncologists have given me a very good prognosis (around 95%), but I will have 5 years of regular check-ups, screenings, tests, and unpleasant things like 4-monthly cystoscopies.

So is screening and 5 years of monitoring it worth it ?

Damn right it is !

Katrin:

I have a friend here in Denmark who is one of the few lucky survivors of this lethal form for cancer. Her symptoms were as described in the article, stomach ache and bloating. She thought she had food poisoning. She was sent to a gastroenterologist, had a coloscopy, which found nothing. The specialist sent her to an ultrasound, which found som cysts around one ovary. Very quickly she was referred to one of the two specialist centres that are permitted to treat ovarian cancer in this country. She had extensive surgery, and luckily the tumor was an encapsulated stage 1A. The earlist stage, which is the case in under 2% of patients. She didn’t even have to have chemo or radiation. This is more than 5 years ago and she’s doing very well.

I think that the main reason for her survival was knowing that something was wrong, and to keep insisting that something was wrong. Many of us wait much too long, or we believe our doctors for too long, when we know, or suspect that something serious is going on.