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New test for ovarian cancer developed

Saturday October 25 2014
ovarian cancer

Stages IA and IB of ovarian cancer. PHOTO | FILE

A new test to screen for ovarian cancer has been developed. The new test, called ADNEX, if confirmed in clinical trials, could become a routine screening procedure for women worldwide.

It was developed by University of Leuven and Imperial College London scientists to help doctors detect the cancer early and help the patient get the right surgical treatment. According to the researchers, the test is designed to distinguish accurately between benign cysts and malignant tumours as well as identify how aggressive the tumours are.

The test uses a combination of patient information, blood test results and ultrasound scans to predict the malignancy, type and stage of the cancer. Doctors can therefore use the test in a clinical database or by entering the patient’s details into a smartphone app.

“If a tumour is benign, a woman may not need any treatment at all. If it is malignant, you need to know what type of tumour it is to choose the best treatment and that treatment needs to be carried out by a specialist gynaecological cancer surgeon,” say the researchers in their report published in the British Medical Journal.

The current screening methods used to assess women with ovarian cysts for the presence of cancer and select treatment lack accuracy.

READ: High costs, lack of equipment pushing up cancer deaths in the region

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“This new approach to classifying ovarian tumours can help doctors make the right management decisions. It will also reduce the likelihood of women with all types of cysts having excessive or unnecessary treatment that may impact on their fertility,” said Tom Bourne the lead study researcher and a professor at the Imperial College, London.

Successful ovarian cancer treatment depends in part on accurately identifying the type of tumour, but this can be difficult. As a result, many women with cancer are not sent to the right specialist surgeon, or those with a benign cyst may have a more serious operation than needed.

Apart from the tumour type, the choice of treatment sometimes has to take into account implications for the woman’s fertility.

“Existing prediction models discriminate between benign and malignant tumours but lack accuracy and don’t sub-classify malignant tumours. The ADNEX model can discriminate between benign, borderline, stage I invasive, stage II-IV invasive, and secondary metastatic tumours,” said Prof Bourne.

According to Catherine Nyongesa an oncologist at Kenyatta National Hospital, in any cancer treatment, is important to get the pre-operative diagnosis right.

“If it isn’t right, the patient may have a more extensive operation than they need, for example having an ovary removed unnecessarily,” said Dr Nyongesa.

She said that ovarian cancer can be difficult to diagnose early, because symptoms such as bloating and abdominal pain can be put down to other common illnesses. It is the most aggressive gynaecological cancer, with only about 40 per cent survival after diagnosis.

“One of the main factors in survival is how early the cancer is diagnosed. There is currently no screening available, so patients have to rely on seeing a doctor and being correctly diagnosed in time,” she said.

“If women ae diagnosed in the early stages of ovarian cancer they have a 90 per cent chance of surviving the next five years, but if the cancer is found at a later stage, the five-year survival rate reduced to 22 per cent.”

Moreover there are so many changes in ovarian cancer, it is hard to know which ones are causing the tumour to be more aggressive, and which ones are just tagging along.

“A woman may have abdominal bloating or urinary symptoms, for instance, but those problems are much more likely to have causes other than ovarian cancer. And right now, there is no effective screening test for the disease,” she said.

Other symptoms she said, include persistent pelvic and abdominal pain, difficulty eating or feeling full quickly, need to urinate urgently or more often than normal, changes in bowel habits, extreme fatigue and unexplained weight loss.

Like breast cancer, ovarian cancer is not one disease but a range of diverse tumour types. But of the five types of ovarian cancer, the high grade serous is responsible for 75 per cent of ovarian cancer occurrence and 90 per cent of ovarian cancer mortality.

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