Experts of cancer prevention have, for a long time, felt the need for a meaningful way to screen women for possible ovarian cancer. Ovarian cancer is a rare disease and one of its key problems is lack of substantial symptoms that render an early diagnosis almost impossible.

By the time it is diagnosed, the cancer cells spread far enough. Besides, another major problem is that the biomarker used in screening, CA125, is also associated to other disorders.

And as per the latest findings by scientists at the Duke Cancer Institute, it would appear that the potential value of screening has become more insignificant. MD Laura Havrilesky states that a whole lot of work needs to be done to protect women from this deadly disease. Apart from finding preventive strategies, a better approach to screening has to be found.

It has, recently, come to light that contrary to the established norm that considers ovarian cancer as a single disease, it has got two subtypes- one is a slow form that takes years for advancement while the other is a vigorous Type that moves on to the next stages in much quicker time.

The research team, led by Laura Havrilesky, has used information in the SEER database to design a model that screens ovarian cancer. The model suggests that screening may curtail the rate of ovarian cancer amidst 50-plus US women by as much as 15 percent. However, while incorporating the two subtypes, the model could predict a fall in deaths by only 11 percent. Havrilesky agrees with the prediction of the model.

However, another senior investigator Patricia Hartge maintains that screening for women who are at a higher risk of ovarian cancer may benefit them more. But Havrilesky has her doubts and cites that benefits of screening even in higher risk population have yet not surfaced and experts may have to resort to some futuristic method.

Source: http://www.eurekalert.org/pub_releases/2010-12/dumc-bdo120910.php

Researchers have now discovered an ideal way of detecting the advanced ovarian cancer by checking the point mutations, which is actually a mis-spelling in a single character of the  genetic code  leading to the development and growth of the cancerous cells. The technique employed successfully for the detection is known as OncoMap. This finding opens up the possibilities of personalized treatment wherein the cancerous tumor can be targeted for each patient, their mutations checked and specific drugs given to stop further growth of the tumor.

The researchers are expected to present the details of how the use of OncoMap can help them to identify the mutations in cancerous tumor samples obtained from women with advanced, high grade, serous  ovarian cancer. The procedure wil be explained at the Molecular Targets and Cancer Therapeutics to be held at Berlin on 17^th November 2010. The presentation will be included in the 22nd EORTC-NCI-AACR [1] Symposium there.

Dr Ursula  Matulonis of the Dana Farber Cancer Institute,  Boston, USA,  along with  her colleagues utilized the OncoMap to find out the various mutation status of the high grade, serous ovarian cancer which are not caused by the mutations in the inherited BCRA ½ genes. The researchers found the KRAS, BRAF, CTNNB1 and PIK3CA mutations which had previously been linked to ovarian cancer. They also found  KRAS and PIK3CA to be quite common while the  BRAF mutations were rarer. The researchers also identified low frequency of such mutations in a number of other oncogenes.

The study also revealed that it was possible to use the OncoMap in order to identify a specific mutation within the oncogenes of an affected woman. Targeting the gene by known drugs will then help to keep a check on the cancer. The members involved in the study now hope to utilize the OncoMap as a clinical test resource in order to obtain the genetic information of the patients. The treatment would be based on the information thus obtained and would be totally personalized.

Source: Public Release by ECCO-the European CanCer Organisation on 16^th November, 2010

Women, who are considered to have a breast or ovarian cancer risk often miss diagnosing it early enough. This could well be for the fact that the family history on the father’s side is often not taken into account.

Researchers associated with Lancet Oncology say that the women are more likely to refer to the disease on their mother’s side of the family. Consequently, the incidences of women having maternal histories of cancer are referred almost five times more than others by their family doctors.

A charity associated with cancer in the UK also stated that the history of the father is often overlooked especially when it is a case of breast or ovarian cancer. Studies have revealed that almost 5% to 10% of such cancers are usually associated with genetic inheritance. A significant amount of the genetic risk manifests itself as a BRCA1 or BRCA2 defect. This is associated with the possibility of the concerned woman being diagnosed by breast or ovarian cancer in her life time.

A woman having a family history of cancer is therefore at a risk and can take the necessary precaution by being referred for genetic testing in order to find out whether she has the defect.

Jeanna McCuaig, the leader of the research team and attached to the Princess Margaret Hospital, Toronto  found out that in spite of the chances of inheriting a defective gene from the father and mother being 50-50, the maternal history is the only one taken into consideration most of the time. A study of records from their own clinic showed the disparity in referral rates.

The reason for overlooking the paternal history might be due to ignorance feel the researchers. McCuaig stated knowing of two prominent cases where the women concerned were falsely reassured despite having a history of BRCA2 gene mutation and incidences of breast/ovarian cancer in their paternal families.

Dr Caitlin Palframan said that it was important to understand the importance of paternal family history of cancers as the faulty genes can be inherited from either side of the family.

Source: http://www.bbc.co.uk/news/health-11607396

Removing the Fallopian tubes completely may be safer that just clipping or burning them following a hysterectomy or ligation, said a researcher at Vancouver General Hospital.

Sarah Finlayson, a gynecological oncologist at the hospital, says the tubes are the site for origination of ovarian cancer.

Finlayson pointed to work by a team of Canadian researchers which found cutting the tubes could, in fact, reduce the number of ovarian cancer casualties by 30%. She added that the finding was a lucky one since the researchers were engaged in studying the women carrying the BRCA gene, which is known to be associated with the triggering of breast cancer. Earlier, it was believed that ovarian cancer originated in the ovaries. However, recent research reveals that this particular form of cancer occurs in the fallopian tubes, which has been overlooked as a possible source up until now. The gynecologists associated with the ‘Ovarian Cancer Research Program’ at the Vancouver General Hospital as well as the BC Cancer Agency are now urging medical professionals to change their standard practice of leaving the tubes intact after a hysterectomy or ligation.

Statistics reveal that ovarian cancer affects about 70% of women in Canada, with only 37% of them surviving beyond five years after diagnosis. Women with mutated BRCA gene have a greater possibility of developing cancer of either the ovaries or the uterus, and the organs are usually removed as a form of precaution against cancer.

Pathologist Blake Gilks also added that a woman may not have a history of ovarian cancer in her family yet she and her progeny might be at risk. It is possible to screen them genetically and take adequate measures now.

Source: http://www.google.com/hostednews/afp/article/ALeqM5jReNQfdWEsVL-MrDBUzJjBm2oMGQ

http://www.prnewswire.com/news-releases/ovarian-cancer-researchers-request-practice-changes-to-protect-against-ovarian-cancer-deaths-could-be-reduced-50-percent-over-20-years-102474624.html

Deviation of a tumor suppressing gene has been found to be associated with ovarian cancer. The cancerous cells are said to be the result of an endometriosis turning into cancer.  Two different studies have reported similar facts where the mutated form of the gene ARID1A was found in 50% of all clear cell ovarian carcinomas.  The results of one of the studies have also reported finding the particular gene in 30% of all endometrioid carcinomas with none being obvious in serious cases of ovarian cancer.

An abnormal chromatin remodeling has been held responsible by the researchers involved in both the studies. This is being considered as the primary factor for the development of cancer from endometriosis.

David G. Huntsman, MD, author of the online publication of the study result in the New England Journal of Medicine, said that the mutations of the gene ARID1A along with the loss of the BAF250a expressions in the tumors were a surprising find in two of the patients. The same loss in contiguous endometriosis, atypical in nature, was not evident in the distant lesions of endometriosis. This led the researchers to believe that it was, in fact, an early step during the transformation of endometriosis to cancer.

Dr. Huntsman also elaborates on the effectiveness of this study and hopes that the discovery would enable the physicians use it as a tool for screening endometriosis patients who have a high risk of developing ovarian cancer.

Another study by Siân Jones and his team of colleagues associated with Johns Hopkins Kimmel Cancer Cente, Baltimore, Maryland, also reported finding four different mutated genes in ovarian clear cell cancers. Of these, 2 of them had been previously known to scientists while ARID1A and PPP2R1A are new finds in the category. The results of this particular study had been published on the same day as that of the other one in Science.

Source: New England Journal of Medicine  published online on September 8, 2010.

Science. 2010; published online on September 8, 2010

http://www.medscape.com/viewarticle/728251