A Truly Insidious Cancer

By: Joan Stewart, RT(T), BA HCA Clinical Services Project Coordinator, TCCC

As I begin making plans for September and the multiple cancer awareness events on the horizon, I took to the Internet for inspiration. There must be something out there new for Ovarian Cancer. Afterall, we have made much progress in melanoma, lung and kidney cancer; some of our deadliest just 10 years ago!

In my search I came across a blog from a Dr. Saul Rivkin, Swedish Cancer Institute Medical Oncologist, Founder and Chairman of the Rivkin Center. The Rivkin Center, based in Seattle, seeks to promote collaborative work and innovative research in early detection and treatment of ovarian cancer worldwide. The blog Dr. Rivkin had written called ovarian cancer ‘insidious’. That word jumped off the page; what a perfect descriptor!

Webster’s Dictionary defines insidious as it relates to disease as “developing so gradually as to be well established before becoming apparent”. As you may have heard numerous times, if we can find cancer early we have a much better chance of cure. There is no debating that fact. For ovarian cancer, women with Stage I or II disease can expect a 5 year survival. For women with Stage III or IV, the 5 year survival rate is a meager 28%. And unfortunately, 71-75% of all ovarian cancer patients are diagnosed in advanced stages – it was well established before becoming apparent!

There is no one test to diagnose ovarian cancer and the symptoms sound non-threatening, even routine:
• Abdominal fullness or bloating
• Pelvic or abdominal pain
• Difficulty eating or nausea
• Urinary frequency or urgency
• Constipation or diarrhea
• Vaginal bleeding

Most women experience one or more of these ‘signs’ each and every month. It is when more than one symptom or sign lingers more than a week and is unresponsive to the normal remedy that one should consider seeking medical attention.

I am sad to say my Internet search today found nothing new for early detection or innovative diagnostic testing for ovarian cancer. A visit to the National Cancer Institute’s clinical trials page and a search for any trial related to ovarian cancer resulted in 271 trials. A review of the first 20 listed finds 50% are trials not specific to ovarian cancer and nothing associated with early detection. Every late stage ovarian cancer patient hopes for the next breakthrough in treatment and we hope one or more of these trials will result in long-term disease free survival for the estimated 22,400 women that will be diagnosed with this disease every year.

An article published in a recent issue of Science magazine reported on the development of a test called CancerSEEK1 which, if successful, would detect several types of cancer at early stages; ovarian, liver, stomach, esophageal, pancreatic, colorectal, lung and breast. The test would look for gene mutations within the DNA found in blood that came from cancer cells and other biomarkers and proteins. The study shows promise, but much more work is needed to understand the effectiveness of this test for the detection of cancer. If the test resulted in a false positive (a misleading wrong answer), much unnecessary testing and mental anguish would be the only result for the patient.

The best recommendations we can make at this time for the early detection of ovarian cancer are for women to pay attention to their body and subtle changes, maintain a strong relationship with a primary care physician, and pursue a physical exam with a gynecologist annually. Though the US Preventative Services Task Force does not recommend routine screening for ovarian cancer, all healthcare agencies recommend an annual Well Woman Check for a physical exam, documenting health status and setting health goals. Remember, a PAP test is not an ovarian cancer test. Inform your doctor if you have a family history of breast and/or ovarian cancer as you may be at increased risk. Other factors that increase your risk of ovarian cancer include hormone replacement therapy, obesity or a history of endometriosis. If you have difficulty finding a healthcare provider or want more information, reach out to one the Tri-Cities Cancer Center’s Nurse Navigators at 783-9894.

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