Ovarian cancer forms outside ovaries
Sat Mar 3, 2012
In a startling revelation, a new study has found that the deadliest type of ovarian cancer, high grade serous cancer (HGSC), which accounts for 90 per cent of deaths, often starts in the fallopian tubes rather than the ovaries. If the symptoms are recognised early enough, it can be diagnosed and treated effectively, say the findings of the DOvE (Diagnosing Ovarian Cancer Early) study, led by a research team from the McGill University Health Centre (MUHC), Canada, and published in a recent issue of The Lancet Oncology. The study could revolutionise the way the disease is diagnosed.
The study also found that women over 50 years who suffer from bloating, high urinary frequency, abdominal or pelvic discomfort are about 10 times more likely to have ovarian cancer than those who do not.
The DOvE project was initiated in May 2008 to assess symptomatic women for ovarian cancer early, when chances of recovery are highest. During the pilot phase of the study, 1,455 women aged 50 years or more were assessed. As a result, cancers were diagnosed earlier, when 73 per cent of women could benefit from complete surgery, leaving no visible disease.
Dr Lucy Gilbert, Director of Gynaecologic Oncology at the MUHC and principal investigator of the DovE study conducted over a period of four years says, “Each year 2,16,000 women worldwide are diagnosed with ovarian cancer, and 70 per cent of them will die unless we act on the information we have without delay. We encourage healthcare professionals around the world to be aware that high grade serous cancer often starts in the fallopian tubes. So the traditional tests — ultrasound scan of the ovaries and the one-off CA125 blood test — are not enough to diagnose high grade serous cancer (HGSC) in time.
“As the killer variety of ovarian cancer is not really cancer of the ovary, we have to rethink the current diagnostic test, or these cancers will be missed,” adds Dr Gilbert, who is also an Associate Professor of Medicine at McGill University.
At Mumbai’s Tata Memorial Cancer Centre, Dr Amita Maheshwari, Associate Professor of Gynaecologic Oncology, agrees that the study is important and certain variant cancers can arise in the fallopian tubes. “There are 28,000 new cases of ovarian cancer every year in the country as against 1.34 lakh new cases of cervical cancer and one lakh new cases of breast cancer,” she says, adding that early detection is important and, sadly, there are no cost effective screening tests for ovarian cancer.
Dr Hemant Tongaonkar, gynaecologic oncologist at Mumbai’s Hinduja Hospital and Research Centre, says that since the early symptoms of ovarian cancer are vague and mimic other conditions, the DoVE study had been taken up to develop a probability tool for detection.
Dr A Nanda Kumar, Director of the National Cancer Registry Programme, Bangalore, says that due to the high mortality, the aetiology of the cancer of the ovary has been the subject of several investigations. Experts agree that ovarian cancer is less common but more deadly. Kumar says this is because we do not have a screening test and most cancers are diagnosed in the advanced stage.