- SUNDAY, Oct. 19 (HealthDay News) — Ovarian cancer is one of the
most difficult cancers to diagnose, making it one of the most lethal.

The ovaries aren't easily accessible for examination, unlike a woman's
skin or breast or cervix. And the symptoms that accompany ovarian cancer
are vague and can be confused with other less life-threatening
conditions.

“A lot of women with ovarian cancer will retrospectively say, 'Yes, I
had these symptoms,' but the symptoms are vague and can be associated with
other illnesses,” said Debbie Saslow, director of breast and gynecologic
cancer for the American Cancer Society.

Because of its elusive nature, ovarian cancer often isn't caught in
time to save the patient. Three of every four ovarian cancer cases are
diagnosed at an advanced stage, after the malignancy has spread beyond the
ovary, according to the U.S. National Cancer Institute.

Although the fight against the disease has been slow and at times
frustrating, doctors believe they are finally making some headway toward
saving more lives.

When ovarian cancer is found at an early stage — about 20 percent of
the time — it proves crucial to the woman's chances. About 94 percent of
patients who receive an early diagnosis live longer than five years,
according to the American Cancer Society.

That compares to an overall 46 percent survival rate for all women with
ovarian cancer — a rate that has improved a poor 8 percent over the last
30 years. During that same period, leaps in research have made a host of
other cancers much more survivable.

“That's what makes ovarian cancer such a miserable diagnosis, because
it's diagnosed so late that the best treatment isn't likely to really
work,” said M. Robyn Andersen, an associate member of the Public Health
Sciences Division at Fred Hutchinson Cancer Research Center in Seattle.
“If we can increase the rate of early diagnosis, that's probably the most
likely way we're going to change the survival rate for ovarian
cancer.”

Andersen recently led a study that boosted the level of early stage
ovarian cancer detection by 20 percent by combining a blood test with a
questionnaire of potential symptoms.

And in another development, researchers are working on therapeutic
vaccines to fight ovarian and breast cancer.

Ovarian cancer is relatively rare. There are about 40 to 45 new cases
for every 100,000 women, Andersen said. A woman has a one in 72 chance of
developing ovarian cancer in her lifetime, and a one in 95 chance of dying
from it. The disease typically strikes older women, with about two-thirds
of cases diagnosed in women 55 or older.

There are some symptoms that have been linked to ovarian cancer. They
include pelvic or abdominal pain, bloating or increased abdominal size,
difficulty eating or feeling full quickly, or more frequent urination or a
recurrent urgent need to urinate.

Unfortunately, those symptoms are shared with a number of common
ailments like irritable bowel syndrome, Saslow noted. “If a woman has had
these symptoms for years, it's probably not ovarian cancer,” she said.
“It's probably something else.”

Andersen's research found that a questionnaire in which a woman checks
off these sort of symptoms ended up uncovering early stage ovarian cancer
about 60 percent of the time in a group of high-risk women. And a blood
test commonly used to track the health of women with ovarian cancer was
able to detect early stage disease about 60 percent of the time, the
research found.

But when the two tests were combined, they were able to identify 80
percent of early stage ovarian cancers in the group of women.

“That's very exciting, because that suggests the combination can detect
women who need further diagnostic testing quickly,” Andersen said.

Diagnostic tools ranging from ultrasound and X-rays to biopsy and blood
tests can help confirm or reject a positive reading for early stage
cancer.

While the research is promising, Saslow said the testing being explored
by Andersen still isn't accurate enough to provide a true picture for
women. Cancer is too often detected in healthy women, causing them
unnecessary worry and pain.

“The problem, as the authors point out in that paper, is that in order
to detect a good percentage of ovarian cancer, you also get a lot of
false-positives,” Saslow said. “You can either find a lot more cancers and
have a lot more false-positives, or limit the number of false-positives
but also limit the cancers you find.”

As researchers close in on a better way to detect ovarian cancer, other
teams are pursuing improved means to treat the disease.

A vaccine has been created that appears to prompt the patient's immune
system to target and destroy cancer cells. The vaccine, developed by Dr.
George Coukos of the University of Pennsylvania's division of gynecologic
oncology, is currently undergoing clinical trial testing.

Another development involves the administration of chemotherapy inside
the peritoneum, Andersen said.

“You're actually putting the chemicals much more directly into the area
where the cancer is, while not exposing more of the surrounding area to
chemotherapy,” she said.

More information

To learn more, visit the National Ovarian Cancer Coalition.