Learn how proper assessment of pelvic mass can lead to a more confident diagnosis of ovarian cancer.
The Ovarian Cancer Diagnosis Dilemma.
It is well-recognized that the critical challenge in ovarian cancer is identifying it as early as possible in the work-up and getting patient to the proper care.
Earle, et al. showed that as few as 33% of ovarian cancer patients were initially referred and treated by a gynecologic oncologist. This suggests that a significant number of ovarian cancers are not preoperatively identified as high-risk, and as a result, taken to surgery by a non-specialist instead.
Why is the pathway to a specialist important? Patients with advanced disease who were seen by a gynecologic oncologist had a significant survival advantage compared to those that were not (median survival of 26 and 15 months, respectively, P < 0.01).
The evidence supporting stratifying patients to this optimal care pathway is reinforced in major medical society guidelines.
Ovarian Cancer Today.
Over 22,000 women are diagnosed with ovarian cancer each year in the U.S. and it is estimated that 14,000 women die annually from this disease2. According to the National Cancer Institute SEER Data Base, if a woman is diagnosed today, she has a 45% chance of living for another 5 years. While ovarian cancer diagnosis and treatment have come a long way, it remains the deadliest gynecologic cancer.
5-year survival for advance stage ovarian cancer was 7 percent.
Researchers find that levels of CA-125, a specific protein in the blood, are linked to ovarian cancer. While CA-125 is routinely used to track women’s response to treatment and to monitor treatment, efforts to CA-125 testing for early detection or screening are difficult.
Scientists discover that women who have gene mutations identified as BRCA1 and BRCA2 have a 50-85 likelihood of developing breast and ovarian cancers. The mutations are particularly common among women of Ashkenazi Jewish descent.
While borderline tumors of the ovary had been described since the late 1920’s, researchers discovered low malignant potential and low grade ovarian tumors. The discovery leads to more personalized regimens for each subtype with the goal of getting patients the best treatment.
- Earle CC, et al., J Natl Cancer Inst. 2006 Feb 1;98(3):172-80
- National Cancer Institute, “SEER Stat Fact Sheets: Ovary Cancer,” http://seer.cancer.gov/statfacts/html/ovary.html
- Bagley, C.M. et al., New England Journal of Medicine. 1972 October 26; 287:856-862
- Collaborative Group on Epidemiological Studies of Ovarian Cancer, The Lancet. 2008 January 26;371:303-314
- Bast, R.C. et al., New England Journal of Medicine. 1983 October 13; 309:883-887
- Wooster, R. Nature Publishing Group. 1995 December 28; 378;789-792
- Rosen, D.G. et al., National Institutes of Health. 2009 Jan 1; 14:2089-2102