ovarian cancer

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A Simple Survey Could Determine Your Risk for Ovarian Cancer

Monday, October 8th, 2012

As women, we have to go through countless medical tests throughout our lives. Mammograms, pregnancy tests, HIV tests, and bone-mineral density tests are all par for the course when you become an adult. In fact, few women haven’t gotten all of these tests and more. Don’t get me wrong- as a physician, I genuinely appreciate our ability to screen for life-threatening conditions, and I wouldn’t have it any other way. However, as a woman, I understand the patient side of it as well.  Wouldn’t it be easier if medical screening tests were simpler? According to a new study, simplicity might just be attainable.

Researchers have developed a new screening tool for ovarian cancer that can be completed in minutes by a simple survey. That’s right, no heavy machinery, foul-tasting chemicals, or drafty hospital gowns required, just a simple pen and paper.  The study questionnaire that was tested was based on a symptom-screening index developed in 2006 by M. Robyn Andersen, Ph.D and co-author Barbara Goff, M.D., professor and director of Gynecologic Oncology at the University of Washington School of Medicine.   The survey asks women three questions about their current symptoms that have been most commonly associated with women that screened positive for ovarian cancer. A few of the symptoms might be passed off as menopause or menstruation symptoms, so the key in early diagnoses is recognizing the symptoms as they are happening. Some of these symptoms include abdominal or pelvic pain, a sensation of feeling full too quickly, and abdominal bloating. You have to admit, you’d never attribute any of these symptoms to cancer.

Traditionally, ovarian cancer is thought to have no early warning signs, such as bleeding or an abnormal Pap smear, as one sees in uterine cancer or cervical cancer, respectively.  In comparison to breast cancer, which is the most frequent cancer in women, with about 212,000 new cases a year, ovarian cancer has only 25,000 new cases a year. But, because there are no early warning signs or tests to detect ovarian cancer, and the cancer has progressed to a more advanced stage prior to diagnosis, the death rate is higher—about 62 percent in ovarian cancer, as opposed to 18 percent in breast cancer and 32 percent in cervical cancer.  With that said, this new study takes into consideration symptoms, which are commonly dismissed by many patients and by combining them together, have proven to be significant factor in trying to diagnose ovarian cancer at an earlier stage.

Of course, these symptoms are minor and can easily be associated with other issues. However, the results are proving the survey effective so far. Of 60 women who submitted the survey with positive indication, one was diagnosed with ovarian cancer. Of the 1,140 women who did not claim to have the symptoms, none tested positive for ovarian cancer over the course of the following year.


The survey will also serve as a research tool for doctors. Women who take the short survey and indicate that they have all of the symptoms will also be asked to write any additional symptoms. If those women screen positive for ovarian cancer, those additional symptoms will be analyzed, and common additional symptoms might be added to the survey to further screen patients.

Early detection is extremely important in treating ovarian cancer.  If you have these symptoms, talk to your physician about ovarian cancer to rule out the possibility that you might have it. If he or she thinks you should get tested, do so, as it could save your life.

 – Yvonne S. Thornton, M. D., M. P. H.

A court says that genes can’t be patented – and why that’s good news for women

Wednesday, March 31st, 2010

For many years, corporations have been filing patents to claim ownership of the genes that researchers have discovered. Nevermind that these genes exist in our bodies and were designed, not by scientists, but by nature. Once a corporation or other institution gets a gene patent, that gene becomes its property.

Those who control the genes get to decide whether to allow other researchers to use the gene in further research. The gene’s “owners” also get to corner the market in potentially life-saving tests involving the gene.

That’s led to some pretty significant price-gouging of women whose genetics put them at risk for certain breast and ovarian cancers. Myriad Genetics controls the patents for the genes that are associated with about 10 percent of breast and ovarian cancers. So if your doctor told you that you needed a test to see whether you carry a gene that makes you more susceptible to these cancers, you could get hit with a bill from Myriad for a whopping $3,000.

But that’s about to change.

This week, a federal court ruled, in a lawsuit against Myriad Genetics, that its gene patents were invalid because genes occur naturally. From an article about the court’s ruling that appeared in The New York Times:

Judge Sweet… said that many critics of gene patents considered the idea that isolating a gene made it patentable “a ‘lawyer’s trick’ that circumvents the prohibition on the direct patenting of the DNA in our bodies but which, in practice, reaches the same result.”

The case could have far-reaching implications. About 20 percent of human genes have been patented, and multibillion-dollar industries have been built atop the intellectual property rights that the patents grant.

“If a decision like this were upheld, it would have a pretty significant impact on the future of medicine,” said Kenneth Chahine, a visiting law professor at the University of Utah who filed an amicus brief on the side of Myriad. He said that medicine was becoming more personalized, with genetic tests used not only to diagnose diseases but to determine which medicine was best for which patient.

Mr. Chahine, who once ran a biotechnology company, said the decision could also make it harder for young companies to raise money from investors. “The industry is going to have to get more creative about how to retain exclusivity and attract capital in the face of potentially weaker patent protection,” he said.

I take issue with anyone who claims that denying patents on what nature creates will thwart research. And I am in total agreement with the court’s decision to invalidate these patents on genes. Patenting genes invites a type of commercial perversion of what is a natural occurrence. As a researcher myself, I disagree that invalidating gene patents removes incentives for future research. There will always be research. However, the results of that research will have checks and balances rather than the current focus on the “bottom line” of profit, that takes advantage of patients and the medical community.

– Yvonne S. Thornton, MD, MPH

Danish study links hormone replacement therapy to ovarian cancer. Should you worry?

Tuesday, July 14th, 2009

In the news today is a Danish study, published in the Journal of the American Medical Association (JAMA), that indicates there may be an increased risk of ovarian cancer among users of hormone replacement therapy.

While this may sound like scary new information, it’s not actually news. Thirteen years ago, for my masters degree in public health, I wrote my final epidemiology paper on the link between hormone therapy and ovarian cancer.

Other studies link hormone replacement therapy, especially estrogen alone rather than estrogen plus progesterone, to breast cancer and endometrial cancer.

After reviewing the available information, you and your doctor may still decide that estrogen’s benefits outweigh any risk. Or you may want to try a different tactic to alleviate menopausal symptoms. As I mentioned in a previous blog post, other treatment options, including SSRIs and blood pressure medications, may work as well and cause fewer concerns.

– Yvonne S. Thornton, MD, MPH