Video: New clue in detecting ovarian cancer

  1. Closed captioning of: New clue in detecting ovarian cancer

    >> al, thank you.

    >>> now to what could be a major break-through in women 's health. the nation's top cancer researchers have released results of a new study that shows what could be a way to catch ovarian cancer earlier than ever before. nbc's chief medical editor dr. nancy snyderman has details. nancy, good morning.

    >> hi, meredith.

    >> let's talk about what this study is and is not. they did not find a gene or marker for ovarian cancer . they just found a better way to analyze information that's already out there.

    >> ca-125, this tumor marker that a lot of women know about which is a simple blood test . it is a protein. it's been out for a long time. it is very sensitive, not very specific and it's been used primarily for women who have late-stage ovarian cancer . you can see the ovaries are really sort of in the lower abdominal cavity but they don't bump up against anything so tumors can grow and give off very nebulous signs like bloating, cramping. in late stage, the ca-125 can pop up but for women in early-stage cancer there hasn't been a great screening test . what the doctors did what they took ca-125 and in women between the ages of 50 and 74 they watched for a trend upward. if there were a trend upward, women then got an ultrasound. and then those women who had abnormalities on the ultrasound went in for surgery. what they found was they could zero in on cancers and the few that they did find, they were all early cancers. so they basically took tools we already have, but put them together smarter.

    >> why is it that 70% of ovarian cancers are diagnosed when it is very late in the game. is that because of the reason --

    >> because the ovaries are floating out there. if you have a tumor in your mouth or in your arm, you're going to see it or feel it. the problem is some of these organs, like the pancreas, ovaries, just don't have anything to bump up against so women brush them off.

    >> there is another larger study being done in great britain but the results won't come out --

    >> 2015 . the same kind of thing, showing, yes, these are the new way for guidelines.

    >> will doctors apply this science right now?

    >> i don't want women to, if you're below the age of 40, just go out and say i want the blood test because it seems to work. certainly you don't want an ultrasound every time you go in. but if women are between the ages of 50 and 74, if they've never had children, haven't been on birth control pills, if there is a tumor, ovarian or breast cancer in their families, they might say to a doctor, let's get this blood test , watch the trend and then i suspect doctors will apply this before the study comes out in london. but it's got to be part of a smart plan. we always talk about rationing is smart use of what we have. this is a really -- a sftep in the right direction.

    >> it is 7:15. here's matt.

By AP Medical Writer
updated 5/21/2010 9:19:30 AM ET 2010-05-21T13:19:30

Researchers may finally be closing in on a way to screen healthy women for ovarian cancer — a disease that rarely shows symptoms until it's too late to cure.

A simple blood test followed by ultrasound exams as needed found deadly tumors before they caused symptoms, and without giving too many false alarms, doctors reported Thursday.

The study, in more than 3,000 American women, is not big enough to justify screening with this method now. But doctors are encouraged because it confirms early results from a much larger study under way in England that will give a clear answer in a few years.

More important, the U.S. study suggests that this approach can find aggressive tumors — the ones that threaten lives — without putting many healthy women through unnecessary follow-up tests. Very few women needed exploratory surgery after screening, and of those who did, one in three turned out to have an invasive cancer.

The method "is starting to look very, very promising," said the study's leader, Dr. Karen Lu of the University of Texas M.D. Anderson Cancer Center in Houston. She gave results Thursday in a telephone briefing and will present them next month at an American Society of Clinical Oncology conference.

Federal grants and several foundations paid for the study. Lu's colleague, Dr. Robert Bast, helped invent the $150 blood test used in the study and gets royalties from its maker, Fujirebio Diagnostics Inc.

Few unnecessary surgeries
Other experts unconnected with the work said the results were encouraging.

"Not too many women were referred for unnecessary surgery," and all of the aggressive cancers that were detected were found in an early, curable stage, said Dr. Laura Havrilesky, a women's cancer specialist at Duke University.

OVARIAN CANCER
S. Chen  /  AP
Graphic shows number of new ovarian cancer cases and deaths between 1999 and 2009.

Ovarian cancer is so deadly because nearly 80 percent of cases are found at an advanced stage. About 21,550 women were diagnosed with it, and 14,600 died in the U.S. last year. When found early, five-year survival is 94 percent, according to the American Cancer Society.

Researchers have been testing CA-125, a protein in the blood that is high in many but not all women with ovarian cancer. It can be high for many reasons — uterine fibroids, harmless cysts and even other types of cancer — so it's not accurate enough to be used alone for screening.

The new study tested it as a first step for screening 3,252 women, ages 50 to 74, with no strong family history of breast or ovarian cancer. All had a baseline test and were grouped as low, medium or high risk based on their initial CA-125 levels and how much those levels changed over time.

The low risk group repeated the blood test in a year. The middle group got another test in three months.

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Those at high risk — about 1 percent of women each year — were referred for an ultrasound exam, which costs around $300, to look for signs of cancer.

Over nine years in the study, 85 women were sent for the exams, and eight ultimately had exploratory surgery to see if they had cancer. (Unlike many other forms of cancer, doctors can't do a biopsy for ovarian cancer without an operation).

Five of the eight women who had operations turned out to have cancer: Three had aggressive tumors, and two had cancer that had not yet become invasive. The other three had benign tumors. Two noninvasive cancers were missed by screening.

"We only needed to do three surgeries to pick up one case of invasive cancer," Lu said.

"That sounds a lot more acceptable" than the 10 surgeries needed to detect one case that a previous study found when using the blood test by itself, said Dr. Otis Brawley, the Cancer Society's chief medical officer.

"This may very well be getting closer to something useful," Brawley said of the new screening approach.

The real test, though, is whether it saves lives — what the study of 200,000 women in the United Kingdom will show.

Dianne Klefstad, 61, of Houston, is betting it will. She took part in the U.S. study, and her tumor was found after her fourth blood test.

When doctors said she had cancer, "I couldn't believe it. I had no symptoms," she said. The screening "saved my life, I think."

Copyright 2010 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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