Early diagnosis of ovarian cancer

Many women are surprised when they find out about their disease, as they notice only some vague symptoms, while there are no really effective methods for detecting the disease at an early stage.

Three quarters of ovarian cancer cases are not диагностируются until the disease reaches stages III and IV. With standard diagnostic methods such as ultrasound using a transvaginal sensor, CT and laparoscopy (minimally invasive surgery), it is also possible to skip the lesion in the early stages with a small tumor size. Ninety-five women who are diagnosed with cancer before the tumor spreads beyond the ovary have a five-year or longer survival rate, which means that early detection is a key aspect of managing patients with this disease.

Although doctors and scientists from various medical organizations have set goals for improving patient management programs, progress in the fight against ovarian cancer is incredibly slow. Not only because this disease is difficult to diagnose, but also because research in this area is traditionally underfunded, which is why the number of scientists dealing with this problem is decreasing. Fortunately, the increased interest in this disease and the attraction of new sources of funding contribute to the advancement of research in the field of finding more effective methods of therapy and diagnosis.

Search for markers of ovarian cancer

Many women have heard that a blood test to detect the CA 125 marker can diagnose early signs of ovarian cancer. Unfortunately, only some types of ovarian cancer secrete the CA 125 protein at an early stage of the disease. Part of the problem is determining the size of the tumor. Large tumors secrete large amounts of CA 125, while small ones secrete small amounts of protein. Since the main purpose of screening is to identify a tumor as small as possible, this marker is not a significant enough tumor marker from a diagnostic point of view.

Nevertheless, the CA 125 test developed by scientists is a good method for monitoring the response of ovarian tumors to therapy and determining the recurrence of the disease in patients who have previously undergone therapy for this issue. But it doesn't make much sense for the average woman to regularly determine CA 125, since the level of this protein can increase in many conditions, including endometriosis (in which there is an overgrowth of uterine tissue outside the pelvis), fibrosis, menstruation, and even pregnancy.

To study potential biomarkers, scientists collect blood, urine, and/or tissue samples from women undergoing elective surgery for possible ovarian cancer. (It is difficult to obtain tissue samples of ovarian cancer in the early stages, since most patients are diagnosed with the tumor in the late stages).

Next, the scientist can choose one of two approaches. The first approach involves the use of proteomics methods with the study of all proteins in the cell when analyzing serum samples in order to identify a unique set of proteins that distinguish a cancer cell from a normal one. Another approach is to use genomics methods to study DNA and RNA changes in a cell. One of the tools for detecting such changes is to determine the transcription profile, which measures the levels of all the molecules encoding the RNA protein in the cell. There is an assumption that ovarian cancer at an early stage has a different set of genes or proteins from the normal one — a kind of "fingerprint".

Symptoms of ovarian cancer at an early stage

The most common symptoms of ovarian cancer are:

• bloat;
• abdominal or pelvic pain;
• difficulty eating or feeling quickly overwhelmed;
• imperative urge to urinate (which feels like the need to go to the toilet immediately) or frequent urination.

Since these symptoms often appear in the case of other non-oncological diseases, women usually do not have thoughts about the possible development of ovarian cancer. When such symptoms are caused by the development of ovarian cancer, they are characterized by constancy and differ significantly from normal sensations. If such symptoms occur daily for several weeks, or if there is an increase in the severity of symptoms, it is necessary to consult a gynecologist.