Showing posts with label CA-125. Show all posts
Showing posts with label CA-125. Show all posts

Tuesday, June 5, 2018

#ASCO18 Twitter Highlights June 4, 2018

Many gyn cancer research topics as well as survivorship issue  were covered on Monday at the ASCO Annual Meeting.

If you were at the meeting and think I missed any important developments please share a link to it in my comments section below.

Genetics / Genetics Counseling




Risk Reducing Surgery




CA-125


Endometriosis and Cannibis Treatment
Mindfulness

Neuropathy


Patient Reported Outcomes- Pain
Enodmetrial Cancer- Posters

Ovarian Cancer - Posters

Fertility Preservation

Metformin in Cancer Treatment

HIPEC

Palliative Care

Recurrent Ovarian Cancer

Neoadjuvant Chemotherapy - OC

 Further details may be found at 
https://meetinglibrary.asco.org/record/160515/abstract

Cediranib and Olaparib for recurrent OC
Further info may be found at
https://meetinglibrary.asco.org/record/160525/abstract


Thank you to all the researchers , advocates, and cancer centers who tweeted from this year's Annual Meeting.

Dee
Every Day is a Blessing!


 
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Monday, September 18, 2017

Day 18 A Month of Teal : Ovarian Cancer - Recurrence is Common

Recurrence was one thing I tried not to think about when I was initially diagnosed. But more than 80% of women diagnosed with ovarian cancer ( or fallopian tube or primary peritoneal cancer ) have a recurrence after completing initial treatment

Most likely once you finish front line treatment for ovarian cancer your doctor will follow up with you on a regular basis. He/she may ask you to have your CA-125 level checked every 1-3 months . Increases over time in your level of CA-125 may signal a recurrence. A trial by the Medical Research Council (MRC) and the EORTC  showed there was no benefit to women in detecting and treating a rising CA-125. If your CA125 rises you may be asked to have a CT scan.

Patients with confirmed recurrent disease are separated into two groups:
  • Platinum resistant or platinum refractory recurrence is when a women 's disease will progress while on initial treatment or when the disease returns within 6 months of completing initial treatment.  A women will usually begin treatment with a drug other than the carboplatin/cisplatin taxol combination that she was given originally.
  • Platinum sensitive recurrence  is when the disease recurs more than  6 months from finishing initial treatment. In this case, most women are given a platinum drug and another chemotherapy agent. 
Sources:
NCI
https://www.cancer.gov/types/ovarian/hp/ovarian-epithelial-treatment-pdq#section/_82
OCRFA
https://ocrfa.org/patients/about-ovarian-cancer/recurrence/

Over the next two days  I will share more information on the chemotherapy and targeted therapy treatments a women might receive after a recurrence.

Dee
Every Day is a Blessing!
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Saturday, September 2, 2017

A Month of Teal- Is there a Screening Test for Ovarian Cancer ?

NO !
There is no screening test for ovarian cancer.

You may have heard about the CA-125 blood test. This test is not specific enough to be used on the general population to detect ovarian cancer.

You can learn more about CA-125 by reading this newly updated brochure, CA-125 Levels: Your Guide  by the Foundation for Women's Cancer.

The PAP test does not screen for ovarian cancer - it screens for cervical cancer.

Dee
Every Day is a Blessing!
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Wednesday, February 22, 2017

CA-125xiety !

Recently there have been a number of articles written about "scanxiety".
You may read one written by an ovarian cancer survivor here.  Another was posted on Medscape aand titled Cancer 'Scanxiety' Is a Real (Terrifying) Thing. You may read it here.

In response to a tweet about that Medscape article I tweeted:

Well the past few days my CA-125xiety has kicked in.

This morning I went for the blood test so the results would be ready for my appointment with my gynecologic oncologist next week. Am I anxious? My brain says I shouldn't be nervous. I feel ok for the most part although I have been more fatigued recently. 

I've read many articles about screening using CA-125 and CT scans. One study reported last year in JAMA Oncology says, "CA-125 tests and CT scans are still routinely used for surveillance testing in patients with ovarian cancer, although their benefit has not been proven and their use may have significant implications for patients’ quality of life as well as costs".  I get it. My CA-125 result was in the normal range up a few points when I recurred in 2008. I shouldn't worry, yet I do. 

 It is a funny feeling and hard to describe to one who has never been in this type of situation.  I am merrily going along in my new normal and then a sense of dread comes over me. I get anxious about finding the time to get things done. I hesitate making plans a year or two out. I start to rethink what brings me joy. What should I not be doing right now? What should be at the top of my priority list? Spending more time with family and friends goes back to the top of my list if other commitments were heading to the top.  I go on a cleaning out spree. I get rid of things I won't need if I recur. I get upset with people who "Sweat the small stuff".

I am uneasy because I know, maybe too much, about ovarian cancer. It is a sneaky disease. I know women who have gone years and out of the blue have a recurrence. Sure I can eat healthy and exercise but there is no magic pill that I can take to prevent my cancer from returning. How I wish there was.

It is difficult to get over this feeling. I try all those things that have helped me cope with this sense of apprehension in the past but I am not always successful. I will feel much better when the myQuest app sends me a notification that my results are ready to view. Good or bad at least then I will know.

Until then I will just try to enjoy each day.

Dee
Every Day is a Blessing! 

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Monday, October 17, 2016

Ovarian Cancer Research News - Fall 2016

I am pleased to share a number of recently released research studies. The list was compiled by Sarah DeFeo of OCRFA. Links to journal articles may be found on the OCRF page describing each study.

Risk-reducing Oophorectomy is Risky, Study Shows
A Mayo Clinic research team has found evidence suggesting that premenopausal women who are not at high risk of ovarian cancer should not have their ovaries removed for the purpose of cancer prevention. 
Dee's Note: Removal of the ovaries should only be considered if you have a BRCA mutation. The side effects from ovary removal may lead to other health issues - cardiac, bone etc.

Niraparib Significantly Improves Outcome of Ovarian Cancer Patients
According to research published this month in the New England Journal of Medicine, the PARP inhibitor niraparib improves progression free survival in recurrent, platinum-sensitive women both with and without germline BRCA mutations.
 Dee's Note: This Parp inhibitor showed significant improved progression-free survival versus placebo for women with and without BRCA mutations or homologous recombination deficiency.

Low Volume Surgeons Lead to Poorer Outcomes
A new analysis published in the American Journal of Obstetrics and Gynecology determined the impact of gynecologic surgeon volumes on patient outcomes.
Dee's Note: Previous studies showed similar results. Low volume surgeon had higher mortality rates. Have your surgery done by a gynecologic oncologist who has completed many of these surgeries. 
 

OCRFA Research Shows Drugs Help Anti-tumor Immunity
New OCRFA-funded research demonstrates how a drug already in clinical trials could be used to boost anti-tumor immunity and cause T-cells to target the cancer directly while minimizing side effects.
Dee's Notes: PDL-1 and PD-1 work to prevent T-cells from fighting cancer cells. It was found that BET ( bromodomain and extraterminal domain)inhibitors can stop BRD4 (bromodomain-containing protein 4) which contributes to PDL-1 expression. 

Oral Contraceptives Play Role in Decline of Deaths from Ovarian Cancer
The European Society of Medical Oncology published a study last week that indicated the reasons for a decrease in deaths from ovarian cancer in both young women and post-menopausal women. 
 Dee's Notes: I am confused about how the deaths from ovarian cancer can decrease if the number of women diagnosed has stayed constant. Women diagnosed with ovarian cancer are no longer on oral contraceptives. Anyone have insight into this issue please leave a comment below. 

SGO and ASCO Agree on Guidelines for Common Type of Ovarian Cancer
While primary cytoreductive surgery followed by chemotherapy is the standard of care for newly diagnosed women with advanced ovarian cancer, newly issued practice guidelines suggest that some patients may benefit more from first-line neoadjuvant chemotherapy (NACT) and followed by surgery.
 Dee's Notes: Newly diagnosed women with stage IIIC or IV epithelial ovarian cancer who may only achieve suboptimal debulking ( less than 1 cm) should receive chemotherapy first.


Women Still Getting CA-125 and CT Testing After Ovarian Cancer, Despite Lack of Clear Benefit
A study published recently in JAMA Oncology showed that CA-125 tests and CT scans are routinely used in ovarian cancer surveillance testing, even though evidence has shown there is no clinical benefit to using these tests
 Dee's Notes: This prospective study showed no benefit to using CA-125 / CT scans as surveillance for OC. "During a 12-month period, there was a mean of 4.6 CA-125 tests and 1.7 CT scans performed per patient" 

Write up from Annie Ellis:  Research Round-Up: 11th Biennial Ovarian Cancer Research Symposium September 12-13, 2014 in Seattle, Washington
The Biennial Ovarian Cancer Research Symposium is presented by the Rivkin Center for Ovarian Cancer and the American Association for Cancer Research. 
 Dee's Note: Good Summary of presentations on OC screening, treatment, microenvironments and disease mechanisms. 


Dee
Every Day is a Blessing!  
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Wednesday, August 24, 2016

Between a Rock and Hard Place - Surveillance after an Ovarian Cancer Diagnosis

The Study:
A recent journal article in JAMA Oncology,  " Use of CA-125 Tests and Computed Tomographic Scans for Surveillance in Ovarian Cancer"  concluded
"CA-125 tests and CT scans are still routinely used for surveillance testing in patients with ovarian cancer, although their benefit has not been proven and their use may have significant implications for patients’ quality of life as well as costs."

I am unable to read the entire article since it is by subscription only but will summarize the information that was provided and in other articles I read regarding the research.

In 2009, a study (Rustin)  found that treating ovarian cancer recurrence on rising cancer antigen blood test CA125 increased the use of chemotherapy treatment and decreased quality of life.

This prospective cohort study of over 1200 women, in remission after initial surgery and chemotherapy, took place at 6 NCI Comprehensive Cancer Centers. They looked at the use of CA-125 and CT scan before and after 2009.

The results showed the use of CA-125  and CT scan before and after 2009 was similar. In those women whose CA-125 doubled there was not difference in re-treatment before or after 2009. The study found in a 12 month period "a mean of 4.6 CA-125 tests and 1.7 CT scans performed per patient". They found that this resulted in  "a US population surveillance cost estimate of $1 999 029 per year for CA-125 tests alone and $16 194 647 per year with CT scans added." 

 The Guidelines:
NCCN
Why has the use of CA-125 and CT not change since 2009? Maybe a reduction was not seen because of what is written in the NCCN Guideline for Ovarian Cancer released in 2015.
The NCCN Guideline for Ovarian Cancer recommends follow up tests every 2-4 months for 2 years then every 3-6 months for 3 years then once a year after 5 years. The tests recommended are :
Physical and pelvic exam
CA-125 if initial results were high. 
CBC
CT, MRI , PET as needed
Chest X-ray as needed
Genetic counseling if not already done.

SGO Recommendations:
In 2011 the paper
Post-treatment surveillance and diagnosis of recurrence in women with gynecologic malignancies: Society of Gynecologic Oncologists recommendations

These recommendations were made:
 
SGO lists  the CA-125  as optional for surveillance in previously diagnosed women.

They stated: "Until the ideal surveillance is determined, individualized patient plans that consist of a thorough assessment of symptoms and physical examination, which includes a pelvic examination,should be undertaken. The role for CA125 level monitoring should be discussed with patients. The pros and cons of imaging should be discussed with the patients who do not have an elevated CA125 level at the time of diagnosis.When a recurrence is suspected based on symptoms, examination, or CA125 level,a CT scan of the chest, abdomen, and pelvis should be obtained to determine the extent of the disease. PET scans are a useful adjunct when CT scans are indeterminate (Table 3)."
54

My Commentary: 


My recurrence on my liver and spleen in 2008 was picked up on a follow-up CT scan.  My CA-125 was 17 up from 13. I wasn't worried about a recurrence at the time because my CA-125 was still normal but there it was. I'm thankful that the CT scan was done so that one of my treatment options could be surgery then chemo. My CT showed only 2 distinct lesions so I chose to have surgery first.

When the 2009 study came out, I told my gyn onc that I no longer wanted to have the CA-125 test done.  We agreed that I would not begin treatment for a recurrence unless I had symptoms or something showed up on a CT scan but I continued to have the CA-125 test.

Based on my personal experience when CA-125 goes up even a little bit I get anxious and think recurrence.  I agree and understand that chemotherapy treatment should not begin on a rising CA-125 alone. But what about the fear and anxiety that a women feels during the watch and wait period?

I also know that radiation from multiple CT scans raises my risk for other cancers.  But right now there is no other way ( unless I use an MRI or PET) to determine if I am having a recurrence. With data showing the rate of recurrence in ovarian cancer is very high, what is a woman to do? 

Based on the SGO and NCCN guidelines a  personalized approach to determining surveillance is what is needed until as the SGO paper stated "the ideal surveillance is determined"


 Dee 
Every Day is a Blessing!





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Tuesday, September 15, 2015

What You Need to Know About The CA-125 Test

Women who have ovarian cancer or are suspected of having ovarian cancer will usually have their blood tested for CA-125. CA-125 ( cancer antigen 125) is a protein that is produced on the surface of cells and can be measured in teh blood. You may also hear CA-125 be called a tumor biomarker for ovarian cancer.

The protein is elevated in 80% of the women with advanced disease and 50% of those with early stage cancer ( Source : OCRF) . I wrote about how the test method in this blog post.

The best source I have found explaining the CA-125 test is

Understanding CA-125 Levels: A Guide for Ovarian Cancer Patients

produced by the Foundation for Women's Cancer.

Since my CA-125 was still in the normal range when I recurred my gyn-onc and I look at the trend up in results not necessary the actual number.

Dee
Every Day is a Blessing!


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Saturday, September 5, 2015

I Have Symptoms - Now What?

If you have any of the  symptoms that I mentioned in my post of September  3rd , you should make an appointment to see a physician, preferably your gynecologist. There is NO screening test for ovarian cancer for the general public. But there are a few tests that your doctor may run if he/she suspects you have ovarian cancer.
At your appointment with the gynecologist you may have a pelvic exam. If you are due for a PAP test your gynecologist may do it at this time too. Remember a PAP test is a screening test for cervical cancer.

In addition to the medical tests she may do, you doctor will ask questions about your personal medical history as well as that of your family.  Be sure to mention to your doctor if anyone in your immediate family (aunts /uncles too) has had breast or ovarian cancer or has Lynch syndrome. About 10 % of ovarian cancers are hereditary. (Tomorrow's post will discuss risk factors.)

If your doctor has concerns during the exam she may do for a trans-vaginal ultrasound.  You can find more info about the transvaginal ultrasound here.  She may also ask you to have blood drawn to test the level of  the ovarian cancer tumor antigen, CA-125. ( I'll provide additional information on the CA-125 test in a future post.)

For more information and diagrams of screening methods please visit : http://www.cancer.gov/types/ovarian/patient/ovarian-screening-pdq#section/_12

My Story / Advice:  I recommend going to the doctor with a small notebook and writing down information your doctor has given you. That way you won't forget  important information and appointments. I used a small pocket-size notebook to keep track of information and to write down any questions I had so that I could remember to ask my doctor when I saw her. 
Dee
Every Day is a Blessing!
 
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Friday, February 20, 2015

Another Six Months

Yesterday was my routine follow-up exam appointment with my Gynecologic Oncologist.  I had not seen my doctor in six months so it was nice to catch up on things.  First up were the non-medical questions beginning with "So where are the pictures of those grandbabies? Then she asked about my son's upcoming wedding, where my daughter and her family are living now and lastly about my advocacy work. By asking those questions about me first she has over the years gotten to know me as Dee not just some woman with Stage 3 serous epithelial ovarian cancer. She has been "patient-centered" for as long as I have known her.

When we got down to the business of how I was doing medically, the first thing on the agenda was my CA-125. I have posted here about the up tick in my CA-125 result recently and how the method to determine CA-125 was changed at the lab where I have my blood work done.  We discussed how though my recent numbers were higher than with the other test method, they where stable ( 21, 20 U/ML) and she was comfortable with those results. 

We then turned to discussing the results of my recent CT scan. She turned to me with a big smile on her face and said - all clear. I had read the results two days after the scan on my patient portal but it was still great to hear her say it. 

The internal exam, not my favorite part of the apointment,  ended with "You're good". Hurrah! So while there was some concern that there was a different cause for my rising CA-125 it appears that based on the clear scan and exam , the method change is the true cause of the bump up.

With so many exciting things happening in the next month or two I am happy that I can put my recurrence worries back on the shelf for 6 more months.


Dee
Every Day is a blessing!

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Thursday, January 29, 2015

The things that make you go Ugh!


In November I had a CA-125 blood test. It came back 21.  The previous result was 14. I went for a retest in December and it came back 20. So it looks like it is now stable but at a different level. Keep in mind that my CA-125 was 17 when I recurred on my liver and spleen in 2008 so of course there is concern that my number was trending up - even in the normal range.

I decided to look more closely at the test results sheet because the results were reported as normal < 35 and I had thought the normal for the tests I had been having was < 21. 

Here is what I found on the sheet: 
" THIS TEST WAS PERFORMED USING THE BECKMAN COULTER CHEMILUMINESCENT METHOD. VALUES OBTAINED FROM DIFFERENT ASSAY METHODS CANNOT BE USED INTERCHANGEABLY. CA125 LEVELS, REGARDLESS OF VALUE, SHOULD NOT BE INTERPRETED AS ABSOLUTE EVIDENCE OF THE PRESENCE OR ABSENCE OF DISEASE.
"

So I went back to the report from August 2014 and sure enough the  normal for the test was reported < 21. 

The report said:

 " THIS TEST WAS PERFORMED USING THE SIEMENS (DPC) CHEMILUMINESCENT METHOD. VALUES OBTAINED FROM DIFFERENT ASSAY METHODS CANNOT BE USED INTERCHANGEABLY. CA 125 LEVELS, REGARDLESS OF VALUE, SHOULD NOT BE INTERPRETED AS ABSOLUTE EVIDENCE OF THE PRESENCE OR ABSENCE OF DISEASE."

Ugh!  "Look they went and changed the method!" Maybe that is why my CA-125 went up. The last time the method was changed the lab followed it using both tests for a few months to see how the results correlated.  I was in treatment then and we were following it closely to make sure the chemo was working.

Being the research "hound" that I am I got on Google and investigated how the tests are done and what the difference was between the two methods.

I learned that both tests -  are chemiluminescent immunoassay tests. They use a monoclonal anti-CA125 antigen alkaline phosphatase conjugate and paramagnetic particles which are then separated in a magnetic field. A chemiluminescent substrate is added and the light generated by the reaction is measured with a luminometer. The light produced is proportional to the concentration of CA-125 antigen. 

From what I read the Beckman test uses two mouse monoclonal antibodies while the Siemen uses one mouse antibody and one rabbit monoclonal antibody. I am going to assume that is was causes the difference in results since all the tests were being done by the same lab.

The up and down of CA-125 results causes enough anxiety without having a different  method which could be the cause of the change thrown into the mix. 

I probably should have looked more closely at the results when they first came in before getting nervous. 

I will be seeing my gyn onc in February and had a CT scan today so I think I will have my answer if it is something I should really worry about. 

Dee
Every Day is a Blessing!


 

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Friday, February 21, 2014

Not for Six Months

Yesterday, I had an appointment with my gynecologic oncologist. It was originally scheduled for last Thursday but my cancer center was closed that day due to the snow storm .

My Gyn-Onc always starts her appointments with asking how I feel and how my family is doing. She asked to see photos of my grandkids, so out came my iPhone and of course I shared the good news that my son had gotten engaged. She was so happy to hear the news and to see the photos. Then the conversation turned to the blog post I had written for the SGO blog. We both agreed that I would not be the advocate I am today if she hadn't recommending that I apply to attend the LiveSTRONG Survivors Summit back in 2006. Yes,  she is ultimately to blame for all this blogging.

Then we got down to business. First we talked about how my CA-125 had dropped back down to 13 from 21 back in October. I had been a bit worried that the results might continue going up instead of down, a sign I could be recurring. Next, we discussed the results of the genetic testing I had done for one of the Center's clinical trials. The results included recommendations for future treatment if  I should recur. Having a plan for if and when I should recur sure makes me feel good. Then it was exam time.  I won't go into the details here but many of my readers know exactly what that is like. Everything looked good. What a relief!

Next she turned to me and said "When do you want to see me again? Six months?". I said, "Well I'll miss seeing you but sure I can do six months". And six months it is.  Life is good.

Dee
Every Day is a Blessing! Blessed to have such a caring gynecologic oncologist on this journey with me.





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Thursday, October 17, 2013

Unremarkable Again


On the evening of October 1st I drank my first Readi-cat drink in preparation for the first CT scan in a year . I added some chocolate syrup to the rather thick, chalky drink to make it more palatable. Drinking through a straw helps and using a Minnie mouse glass just makes it a bit fun. I also try to imagine it is a chocolate shake not a barium sulfate drink.

The morning of October 2nd I drove to the radiology facility. The nurse there was great and gently started the IV for contrast. I was done in a short period of time and drove home. Later in the day my gynecologic oncologist's nurse called me to say the scan was clear. But you know I wasn't totally convinced I was a-ok I wouldn't feel that way until I saw my doctor and she did an exam. I was going to have to wait for that to happen though since my appointment wasn't until the 17th.

On Tuesday I went for a port flush and blood draw for the CA-125 test ( the tumor marker test for ovarian cancer). The nurse who did the flush was excellent and after saying hello to one of my favorite nurses I drove home.

Today( Oct 17th) I had my 4 month visit to my gyn-onc at the Rutgers Cancer Center of New Jersey. She did the internal exam, told me my CA-125 result and that my CT scan results were good. Then she asked me when I wanted to see her again. It is nice to finally be a part of the decision.  I'm not quite ready for going 6 months so she said another appointment in 4 months would be fine.

As I left her nurse handed me a copy of the CA-125 results and CT scan report.  I've gotten pretty good a reading those reports. I checked that they found my port in the chest CT, and didn't find my spleen in my abdominal CT.The report show no fluid or lesions. All three scans used the word-  Unremarkable. I like being unremarkable. I feel pretty wonderful.

If only I can get less anxious before scans and doctor visits. That would be remarkable.

Dee
Every Day is a Blessing!
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Wednesday, December 5, 2012

OVA1 Research Results

OVA1 test by Vermillion is a blood test that evaluates whether an ovarian mass is cancerous prior to surgery. OVA1 is FDA approved for that purpose. CA-125 is one of the five biomarkers used in the OVA1 test. The other markers are Beta-2 microglobulin, apoliprprotein A-1, prealbumin, and transferrin. The test results are evaluated using a proprietary algorithm to produce a result.  The resulting number is between 0-10.

Recently a study of OVA1 was published in the Journal Gynecologic Oncology .

Ovarian malignancy risk stratification of the adnexal mass using a multivariate index assay


The study included 494 patients from multiple centers. Blood samples (taken prior to surgery) and physicians risk assessments were correlated with surgical pathology reports.
Ova1 correctly predicted ovarian cancer 91% of the cases of early stage cancer vs 65.7% using CA-125 alone. The OVA1 test was also better at  predicting the absence of disease with a negative predicitive vale of 98.1%.

The study concluded that the OVA1 - 5 marker test "demonstrated higher sensitivity and negative predictive value for ovarian malignancy compared to clinical impression and CA125-II in an intended-use population of non-gynecologic oncology practices."

It is a very interesting study.

Dee
Every Day is a Blessing!


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Tuesday, September 11, 2012

OC Awareness #11- Task Force Recommendation

Just yesterday the US Preventative Services Task Force released its recommendation regarding ovarian cancer screening in the general population.

The recommendation is for adult women and does not apply to women who are at risk for the disease ( genetic mutation) or women already diagnosed with the disease.

"The Task force recommends against screening women for the disease. "

This recommendation was made because screening using CA-125 and ultrasound did not have any benefit (reduce mortality)  and if fact those tests could lead to harm (unnecessary surgery) .

The task forced used three large trials( including the Prostate, Lung and  Ovarian Cancer Screening Study) to reach their conclusion . A discussion of the test can be found on the USPSTF website here and the consumer fact sheet ( pdf)  can be found on their website.


Here is a good article to read for a very complete explanation of the studies behind the recommendation.
http://annals.org/article.aspx?articleid=1357339


Dee
Every Day is a Blessing!
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Wednesday, February 8, 2012

Doctors Don't Follow OC Guidelines

The has been a buzz on the internet about a study published in the Annals of Internal Medicine titled " Vignette-Based Study of Ovarian Cancer Screening: Do U.S. Physicians Report Adhering to Evidence-Based Recommendations?". In the study , 1800 family physicians,internists and gynecologists answered a 12 page survey regarding women's annual exams and their offers or orders for a transvaginal ultrasound (TVU) or CA-125 blood test .

The conclusion of the study was
"One in 3 physicians believed that ovarian cancer screening was effective, despite evidence to the contrary. Substantial proportions of physicians reported routinely offering or ordering ovarian cancer screening, thereby exposing women to the documented risks of these tests"

The report also stated that 33% of the doctors offered TVU and the CA-125 to low risk women. Everyone should know that physicians answered questions based on patient scenarios. The doctors were not answering questions about their actual patients.

Although I am happy that physicians are aware of ovarian cancer there appears to be a need to better educate physicians that screening of asymptomatic women is not recommended by any professional medical organization or government agency . Maybe one of the ovarian cancer organizations ( OCNA or NOCC or even FORCE) might develop some continuing education training for physicians regarding ovarian cancer symptoms, risk factors, the CA-125 test, a review of the studies regarding screening and the different way they should interact with both low risk and high risk women.

If you would like to read further commentary on this study please see:
Wall Street Journal

Huffington Post


Dee
Every Day is a Blessing
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Monday, January 16, 2012

So about that CA-125

This past week I wrote about going for my CA-125 blood test. Waiting for the results is always nerve wracking for me even after all these years.

The CA-125 is a biomarker protein that may be elevated in the blood of women who have ovarian cancer. But the CA-125 is not specific to ovarian cancer since it can be elevated for reasons other than ovarian cancer such as diverticulitis and other abdominal inflammations.

When I was first diagnosed with ovarian cancer ( Stage 3B) my CA-125 was 177. Yes, it was above the normal guideline (0-21 and now 0-35 )but so much lower than other women with the same disease load whose numbers were in the thousands. When I recurred my CA-125 was 16 up from 9. And, yes, that would be a normal reading. At that point I had a diseased spleen and tumors on the surface of my liver. So my doctors and I don't necessarily look at the absolute value of the CA-125 result but we are looking at the trend , even if the results are in the normal range. We have also agreed that if I am asymptomatic she will not treat me because of a rising CA-125 unless there is evidence on a scan.

In December of 2010 my CA-125 was 10 and during 2011 my results were between 10 and 13 until December when it shot up to 16.7. Uh Oh it is rising! Of course the fact that I could be recurring entered my brain but there was no way that was going to stop me from having an awesome Christmas and New Years. It would have to wait.

I had my follow-up blood test on Thursday. My nurse e-mailed me on Friday that the result was 11. Right there between 10 and 13. I'm not sure why there was that jump in December. But I am happy with the 11 . And I'll be happy going in to see my gyn-onc later this month knowing that it is 11.

Dee
Every Day is a Blessing!
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Friday, June 3, 2011

ASCO Day 1

This will be a short post because it is late and I have an 8am session tomorrow morning.

Education Session: Survivorship Care: Whose Job is It?
Dr Paul Han (NCI) presented the initial results of the Survey of Physician Attitudes Regarding the Care of Patients. The study is not yet published. The survey asked oncologists and primary care physicians about their attitudes regarding knowledge, and practices with regard to breast and colorectal cancer follow-up care. Over 1000 oncologists and 1000 PCP's answered the survey. Not a surprise that oncologists prefer an oncologists centered plan. While 40% of the PCP's preferred a shared care plan. ( http://healthservices.cancer.gov/surveys/sparccs/)

Gynecological Poster Session and Discussion

25 posters. Where do I begin? Here are just two that might be of interest to my readers.

The Role of Bevacizumab in combination with peglated liposomal doxorubicin in patients with platinum-resistant recurrent or refractory ovarian cancers. Phase II study.
Conclusions: Bevacizumab seemed to enhance effect of Doxorubicin in platinum-resistant recurrent or refractory ovarian cancer patients. Weekly B-D warrants further clinical study in such clinical settings.
Median progression free survival was 8 months. This is an interesting combo.

A multivariate longitudinal algorithm for early detection of ovarian cancer using

multiple biomarkers.

This study developed an algorithm to assess the risk of Ovarian Cancer using CA-125 versus a composite index from multiple biomarkers(CA125, CA15.3, CA72.4, CA19.9, and HE4 )at 98% specificity.
Conclusions: Multiple biomarkers can be combined in a longitudinal algorithm to improve detection of early stage ovarian cancer. Additional sample sets that include independent samples of longitudinally detected cancer cases will be needed to further validate the algorithm.

More exciting research results to come.

Dee
Every Day is a Blessing! I am blessed with the opportunity to talk to so many OC researchers about their work.



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Thursday, June 19, 2008

Take The Right Path - New CA-125 website

I received the following in an e-mail from NOCC :

"Fujirebio Diagnostics, Inc., an NOCC sponsor, launched the website Take the Right Path, http://taketherightpath.com/ to communicate to patients, family members and healthcare professionals about CA125. The site features profiles and testimonials of women surviving ovarian cancer. These profiles were provided by NOCC volunteers across the country."

You need to choose the US or Other Country on entering the site. I found the site to be informative with good links to information about Ovarian Cancer and reliable sources.
The site also provides information regarding HE-4 / CA-125 which has been shown to be a better predictor of Ovarian Cancer.



Dee
Living Well and enjoying each day!
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