Blood test for early ovarian cancer may be recommended for all
Dianne Klefstad's quilting group may have saved her life.
Klefstad, 61, was rescued from deadly ovarian cancer by a $30 blood test after the group signed up for a study that detected her disease. The recently released research may lead to an annual test recommended for all women older than age 50.
For the majority of ovarian cancer patients, tumors go undiagnosed until the disease progresses to its fatal stages. Researchers were able to detect early development of three aggressive cancer cases and two borderline tumors when doctors monitored fluctuations of a protein known as CA-125, according to the study of 3,252 women.
About 21,550 patients were diagnosed with ovarian cancer in the U.S. last year, and 14,600 died from the disease, according to the National Cancer Institute. The cancer can be permanently removed if caught before it spreads. The new CA-125 testing method is now being evaluated in 200,000 women in the U.K., and results are expected by 2015.
"I've been in this field for over 10 years and have seen a lot of false starts, so I'm excited when I see these results," said Karen Lu, the study's lead author and the doctor who removed Klefstad's tumor at MD Anderson Cancer Center in Houston. "Finding a screening mechanism would be the holy grail in the fight against ovarian cancer."
The ovarian cancer study was highlighted among 4,500 research project summaries released ahead of the annual meeting of the American Society of Clinical Oncology, which begins Friday in Chicago.
The CA-125 protein was identified as a tumor marker in the 1980s and has long been used by doctors to watch for relapse in patients who have been treated for ovarian cancer. However, until now the test was considered a failure at detecting new cases, because it missed some tumors and falsely identified too many healthy women as having cancer.
Researchers in the MD Anderson study used an algorithm that took into consideration age and subtle changes in the CA-125 score. When a score rose too much, the patient was asked to come in for another test three months later. If the tests were still high, she was given an ultrasound and moved into surgery if necessary. The testing regimen was a success.
Klefstad, who has quilted blankets as a hobby for 30 years, joined a quilting group in 2004 to meet new friends after she moved from one side of Houston to the other. One of the quilters was a volunteer at the hospital and suggested they join the clinical trial. Klefstad thought the drives to the hospital and the free lunches would be a way to bond with her new friends.
Klefstad's first CA-125 tests were well below the level that would have raised flags before the new testing algorithm. It wasn't until the fourth year of annual tests that a slight rise in CA-125 indicated she should return for an ultrasound, which revealed a small cyst. A second ultrasound showed the cyst had grown, and when she went in for surgery in June 2008, the doctors knew it was cancer.
The algorithm in the ovarian cancer study isn't publicly available yet, and healthy women shouldn't rush out and be tested until the U.K. study results are released, Lu said. Without the testing method, the CA-125 test leads to too many unnecessary surgeries and would miss cases like Klefstad's, where levels remain low.
In Klefstad's case, the tumor was caught early and hadn't spread through her abdominal wall. She says she has her quilting group to thank for it.
"I'm cancer free now. It probably saved my life," she said in a telephone interview. "I go to my OB-GYN every year, but I was in pretty good physical shape and didn't have any symptoms. They wouldn't have been able to catch it."