When Karen Howley LaCamera, 58, went to the emergency room with sharp pain in her abdomen in January 2018, she thought she was having another gallbladder attack. Doctors in the emergency room ordered a CT scan and told her that she would likely need surgery to remove her gallbladder if things didn’t improve. She was released later that night. But when she got home, the ER doctor called to tell her the problem wasn’t her gallbladder, but an orange-sized tumor on her ovary.
After various tests, surgeries and a biopsy, LaCamera, who lives in Sudbury, Massachusetts, was diagnosed with stage 3 ovarian cancer. “I was like wow,” she recalls. “When I look back, I think about the symptoms I ruled out.”
LaCamera says he “always felt uncomfortable and excused it.” He had frequent urination and pain in the abdomen, pelvis, and back. He also had bloating, or as she called it, a tummy tuck. “No matter what I did for exercise, I couldn’t get rid of it,” she says. She thought that she was just getting old.
When LaCamera underwent surgery, doctors discovered that her cancer had spread to 11 different organs.
LaCamera isn’t alone in overlooking the symptoms of ovarian cancer.
“The common symptoms of ovarian cancer are indescribable,” he says. Dr. Bobbie J. Mascaradirector of cancer clinical trials and associate professor in the department of obstetrics and gynecology in the division of gynecologic oncology at Cedars-Sinai Medical Center in Los Angeles.
This is why cancer is usually not detected until later stages, when it can be deadly. “It is something really complicated. My heart breaks for all these women who go from doctor to doctor. [looking for answers]says Dr. Mascara.
Ovarian cancer is the second most common gynecologic cancer in the United States. It is also responsible for more deaths than any other cancer of the female reproductive system, according to the Centers for Disease Control and Prevention (CDC).
Early detection of ovarian cancer
Research has led to better ways to detect high-risk genetic mutations and assess a woman’s risk of ovarian cancer, according to the American Cancer Society (ACS). If detected at stage 1, the survival rate for ovarian cancer is about 93 percent, according to the DHW. In later stages, the survival rate drops to 75 and 31 percent.
Currently, the CA-125 blood test, which measures the amount of the cancer antigen 125 protein in the blood, is not accurate enough to detect ovarian cancer, says the Ovarian Cancer Research Alliance. This is because conditions such as menstruation, pregnancy and uterine fibroids can increase the level of the CA 125 protein and lead to false-positive results. The test can be used reliably only to monitor women with known ovarian cancer, says Rimel.
but in a study published in 2017 in the journal eLife, an ovarian cancer screening blood test developed by researchers at Brigham and Women’s Hospital and the Dana-Farber Cancer Institute, was shown to be more sensitive and specific with far fewer false positives. “Could be a game changer in detecting early-stage ovarian cancer,” says Dr Dipanjan Chowdhuryprofessor of radiation oncology at the Dana-Farber Cancer Institute in Boston and co-author of the study.
The test monitors part of the genome known as microRNA, which is secreted into the blood from cancerous or precancerous cells. Specific microRNA patterns can be used to detect ovarian cancer. With blood samples collected at Dana-Farber and other institutions from about 1,000 patients, Dr. Chowdhury says the test was able to diagnose the disease 99.1 percent of the time.
But what’s needed is an accuracy rate of 99.9 percent or better, Chowdhury says, to test the general population. “If you test 100,000 women with this precision [99.1 percent], we’re going to falsely diagnose 890 women with this test right now. That is not right. It is too high. Currently, a clinical study is underway in the Center for BRCA and Related Genes at Dana-Farbercalled the MiDe Study, to verify the accuracy of the test in high-risk patients and potentially improve it.
in a study published in Radiology in March 2022researchers developed a new ultrasound scoring system that may be an easier way to determine if tumors in the fallopian tubes and ovaries are potentially cancerous and need further study, he says. Dr. Deborah Baumgartenprofessor of radiology at the Mayo Clinic in Jacksonville, Florida.
“This can potentially prevent women from having unnecessary surgery,” says Dr. Baumgarten, who wrote a review of the study in Radiology.
When researchers at the University of Rochester Medical Center in New York tested the system on 878 women at average risk of ovarian cancer, they found it was sensitive enough to detect malignancies 93 percent of the time with a 73.1 percent accuracy.
By examining the genetic differences between cancer cells within the same tumor, scientists can find the best treatment for patients.
By combining ultrasound images with computed tomography (CT) images, researchers at the University of Cambridge in England developed a new technique for precision tumor tissue sampling that can create visual guidance and result in fewer biopsies. tumor and more precise. in a study published in 2020 in European RadiologyThe researchers tested the technique in six patients and found that it was more accurate to map and identify tissue samples for biopsy of large pelvic tumors than ultrasound alone, but they cautioned that the technique still needs to be tested in larger studies.
Fighting a treatment barrier: drug resistance
People who receive treatment, like LaCamera, can sometimes develop resistance to common chemotherapies, targeted therapies, and immunotherapies.
While platinum-based chemotherapy is the first line of treatment for most ovarian cancers, it doesn’t always work for some patients because their cancer progresses or comes back. Drug resistance in chemotherapy is one of the main obstacles to overcoming cancer, because patients who develop drug resistance often have a recurrence very quickly, according to Alessandro Santin, MD, professor of obstetrics, gynecology, and reproductive sciences at the Yale School of Medicine in New Haven, Connecticut. That’s why he and other researchers across the country are evaluating the use of new drug combinations to treat ovarian cancer when other drugs fail.
in a study published in June 2022 in the British Journal of CancerDr. Santin and colleagues examined the effectiveness of combining chemotherapy drugs ixabepilone Y bevacizumab and compared it with ixabepilone alone for platinum-resistant ovarian cancer.
They noted an improvement in the time it took for the cancer to progress or worsen and the overall survival rate in the 76 patients who received the combination therapy compared to the 37 patients who received ixabepilone alone. The cancer in the combination therapy group did not grow or spread for 5.5 months versus 2.2 months in the single therapy group, while the overall survival rate was 10 months and 6 months, respectively. “We are not going to cure these patients. We want to prolong life here,” says Santin.
in a January 2022 study Journal of Cancer Immunotherapy, investigators examined the safety and efficacy of camrelizumab plus famitinib in 37 patients with recurrent ovarian cancer who had varying degrees of resistance to standard platinum-based chemotherapies. Nine patients (24.3 percent) had a positive response to combination therapy. Either it shrank your tumors or your cancer remained stable while you were taking the drug. Although the results were “encouraging” and the side effects were “manageable,” the drug combination should be tested in people not receiving the comparison drug.
Finding the treatment that works
Since her diagnosis in February 2018, LaCamera has had two surgeries and five different chemotherapies, including two clinical trial therapies. I was in a investigation study enrolled from February 2020 to September 2020 and experienced encouraging results. She underwent surgery the following month to remove a residual tumor and went into remission in early 2021.
“That was the magic,” she says.
Without the help of her doctors to identify a suitable clinical trial, LaCamera says she would not be alive today. “But we need better detection to beat this insidious disease.”
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