A new exam may help detect ovarian cancer earlier and improve the chances of survival (Digital Blood Screens)

Researchers from Johns Hopkins University reported in the Journal of the National Cancer Institute that a simple blood test might help doctors pick up on early stage ovarian cancer. One of the major reasons ovarian cancer is so deadly is because it typically does not produce any symptoms until it has reached an advanced stage, when it is much harder to beat the disease. Finding a screening exam that will identify it in the early stages could greatly improve the patient?s chances of survival.

This new test is based on digital SNP (single-nucleotide polymorphisms) analysis, which can detect a genetic imbalance in patients. Typically, we inherit DNA from our parents in equal proportions, one copy from our mother and one copy from our father. But cancer patients develop multiple copies of one parent?s genetic markers and less of the other parent?s. It?s this imbalance that doctors can measure in blood samples and analyze with the specialized digital technology.

In their study, researchers were able to identify the imbalances in 87 percent of women with early-stage ovarian cancer and 95 percent of women with advanced disease. To make sure the test was specific for ovarian cancer, researchers collected blood samples from 31 cancer-free women. There were no genetic imbalances found in any of the healthy women-more support that this test could differentiate between those with cancer and those who are disease-free.

Dr. Le-Ming Shih, the lead researcher on the study, cautions that while these results are extremely encouraging, they are only preliminary. ?This study is important, because it tells us that this technology can detect ovarian cancer early. Now we will do more studies to see if we can combine the test with others to achieve an even higher detection rate.? Shih added that one of the remaining concerns is cost. This new blood test could be expensive, costing as much as $350. The goal would be to get the test closer to $100.

Symptoms

New research suggests that the frequency and severity of these problems provide clues that can help detect the disease.

Bloating
Back pain
Abdominal pain or pressure
Increased abdominal size
Constipation
Fatigue
Frequent urination or urinary urgency
Inability to eat normally
Unexplained weight loss

Source: Journal of the American Medical Association

Ovarian cancer is much more curable if detected early, but the disease doesn't usually produce symptoms until it is advanced and current blood tests are not very sensitive in picking it up. A new test may improve the situation, researchers have shown.

Blood levels of a protein called YKL-40 are more accurate than standard tests for other proteins -- CA125 and CA15-3 -- for detecting early-stage ovarian cancer, Dr. Jakob Dupont of the Memorial Sloan-Kettering Cancer Center in New York and colleagues report.

The team measured YKL-40 in blood samples from 46 healthy women, 61 women at high risk for ovarian cancer, 33 women with non-malignant gynecologic disorders, and 50 pre-operative patients subsequently diagnosed with early ovarian cancer. The investigators also measured CA125 and CA15-3 levels.

"YKL-40 levels distinguished normal individuals and high-risk patients from ovarian cancer patients very reliably," the authors report in the Journal of Clinical Oncology.

They note that YKL levels were high in 72 percent of the women with early ovarian cancer, while CA125 levels were elevated in only 46 percent and CA15-3 levels in only 26 percent.

The YKL assay "has the advantage of being commercially available, easily reproducible, and inexpensive," Jakob and colleagues add.

Further studies of YKL-40 are warranted, they say, "to define the performance of the marker throughout the history of an ovarian cancer patient, including preoperative, postoperative, chemotherapy, and tumor-monitoring periods."

SOURCE: Journal of Clinical Oncology, August 15, 2004.