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September 2023 | George M. Pikler, M.D., Ph.D., FACP

How to Detect Ovarian Cancer Early

Epithelial ovarian cancer, which makes up 90 per cent of ovarian cancer cases, is one of the deadliest types of cancer, with only 30 per cent of those with the disease living for more than five years after diagnosis. One of the reasons for this is that most patients with epithelial ovarian cancer have no evident symptoms for much of its course and are diagnosed at a late stage.

Few biomarkers have been validated to be sufficiently effective for early detection in clinical practice. The CA125 blood test is commonly used for conventional diagnosis but it has limitations in both sensitivity and specificity.

To develop a better test, Pan Wang at Peking University in China (1) and his colleagues collected uterine fluid (which contains cells and metabolic products, or metabolites, that come from the ovaries and fallopian tubes) from 219 women with benign gynecological diseases, patients with early-stage ovarian cancer, patients with late-stage ovarian cancer, and patients with uterine corpus endometrial cancer. Using mass spectrometers, the researchers examined the fluid of 96 women to look for metabolites whose levels were markedly distinct for those with early-stage ovarian cancer. They identified a group of seven metabolites, including the amino acids tyrosine and phenylalanine, that could be used for diagnosis.

Next, they tested the fluids from an independent cohort of 123 women for these seven metabolites and carried out the CA125 test on them. The new test accurately identified most of those with early-stage ovarian cancer and performed much better than the CA125 test in diagnosing ovarian cancer at an earlier stage.

The results are promising, but the test needs to be validated in a larger group of people, says Eric Eisenhauer at Massachusetts General Hospital in Boston. “Effective non-surgical testing for early-stage ovarian cancer has been elusive for more than five decades,” he says. “Most currently available tests for early detection have difficulty identifying ovarian cancer while it is still at an early stage. I would like to see this profile validated in a larger prospective data set, but this initial report shows much promise.”

(1) Cell Rep Med. 2023 Jun 20; 4(6): 101061.
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Erica

Erica Cross, PA

PA

Erica is a board certified Physician Assistant. She obtained her Master’s degree in Physician Assistant studies from Our Lady of the Lake College in Baton Rouge, LA. She began practicing in 2011 and has worked clinically in Orthopedics and Dermatology. The majority of her career has been spent in a Dermatology practice where she assisted in Mohs surgery, treating various types of skin cancer. She also teaches in the medical simulation department at the University of South Alabama and enjoys every aspect of medical education.