Deciding On an Ovarian Cancer Treatment
If you have been diagnosed with ovarian cancer, it is quite normal to feel overwhelmed. You may be in a state of shock or anxiety and feel like your head is spinning, unable to process information. These are completely normal reactions to a very difficult situation.
Much of the information on this website will help you find out more about ovarian cancer. But remember: Every situation is unique and the best person to talk to is your physician.
As you begin your journey, keep these thoughts in mind:
- Develop a relationship of trust with your physician. You are not expected to know everything about ovarian cancer, and your physician along with a team of medical experts will be there to guide you through every phase of your treatment.
- Use the information on this website as a starting point for discussions with your physician. Make a list of questions to ensure that you get the most out of your appointment.
- Every person is unique. You may not be ready to absorb all the information presented to you. You may not even want to know very much about the details, leaving that up to your physician. You are in control, and how much information you can handle at one time is a very personal and individual decision.
Types of Clinical Trials
A woman at any point in her experience with ovarian cancer may be eligible for clinical trial.
Many women only think of clinical trials as an option for the treatment of their cancer, and often only after other treatments have failed them. There are a lot of trials for women in this situation, but many other equally important trials are also available.
For example, we still do not have a test to detect ovarian cancer early or screen women at their annual exams, like a Pap smear does for cervical cancer. These tests would come from diagnostic and screening clinical trials.
Here are the different types of ovarian cancer clinical trials. Some studies may fall under a few different trial types because they aim to answer questions relevant to several aspects of patient care.
Prevention Trials (select for more information)
Screening Trials
Diagnostic Trials
Treatment Trials
Quality-of-Life/Supportive Care Trials
Genetic Trials
Additional Information on Clinical Trials is available at OvarianCancer.org
Blood Tests
The Ovarian Cancer National Alliance advocates that if you suspect you have ovarian cancer, ask about the CA 125 test.
Proteomics
The most promising prospect for the detection of cancer in it's erliset stages comes from the emerging field of clinical proteomics-the study of patterns of proteins in human blood or other tissue.
For additional information regarding this test please see our Information Library and click on the link to "Ovarian Cancer National Alliance."
CA125 Test
The CA 125 test has been available since 1983 when researchers at Harvard University discovered that levels of this protein were elevated in 80% of women with epithelial ovarian cancer.
- CA 125 levels are elevated in the majority of women with Stage 3 and Stage 4 ovarian cancer.
- Unfortunately, this test is less reliable in detecting early stage ovarian cancer, as CA 125 is only elevated 40- to 50% of the time in women with Stage 1 disease. In addition, CA 125 is also elevated as a result of a number of benign conditions such as endometriosis.
- A normal level of CA 125 is generally under 35u/ml, depending on the test used.
The problem with the CA 125 test is that there are too many false positives for use as a general screening tool. Many women can have an elevated result but do not have ovarian cancer.
Some factors which cause CA 125 levels to be elevated:
- Endometriosis
- Pelvic Inflammatory disease
- Uterine fibroids
- Uterine adenomyosis
- Ectopic pregnancy
- Benign ovarian tumors
- Pancreatitis
- Peritonitis
- Renal failure
- Heart failure
- First trimester pregnancy
- Menstruation
- Liver disease
Source Gildas' Disease - Steven Piver MD
False negatives are another big concern with this test. Many women, particularly those with Stage 1 or Stage 2 ovarian cancer, do not have an elevated result. This means that the CA 125 is not useful as a general screening tool to catch cancers at earlier and more curable stages.
LPA Test
LPA or lysophosphatidic acid is a substance that stimulates the growth of ovarian tumors. Preliminary studies have found that levels of LPA in blood plasma are elevated in about 90% of women with early ovarian cancer. There are clinical trials going on presently to determine the effectiveness of LPA in detecting ovarian cancer.
A blood test such as CA 125 should not be used to diagnose ovarian cancer. A proper diagnosis of ovarian cancer involves interpreting the results of the CA 125 test in conjunction with a number of other examinations including pelvic exam and ultrasound or CAT scan. At this time, surgery is the only definitive way to rule out ovarian cancer.