Test For Relapse Of Ovarian Cancer Doesnt Improve Survival
A study of 529 women presented at the American Society of Clinical Oncology in Orlando, Florida, found no difference in those treated for recurrences five months earlier, based on rising levels of the CA-125 protein, compared with patients who didnt get therapy until they had pelvic pain or bloating.
Ovarian cancer, called “the silent cancer” because it is often detected late, will be diagnosed in 21,550 women and cause 14,600 deaths in the U.S. this year, the American Cancer Society estimates. The CA-125 blood test isnt recommended by U.S. officials for screening healthy women because it has many false- positive results. Doctors use the test in ovarian cancer patients to tell if they are responding to treatment, or if the malignancy is coming back.
“A lot of women are almost addicted to CA-125 and it causes huge anxiety,” said Gordon Rustin, the lead author and a professor of oncology at Mount Vernon Cancer Center in Hertfordshire, UK, in a news conference. Ovarian cancer patients worried about relapse may ask for the test repeatedly, he said, leading to overuse of toxic chemotherapy.
Mixed Reaction
“This isnt going to cause a 180-degree change in behavior, but it will change,” said Eric Winer, director of the Breast Oncology Center at the Dana-Farber Cancer Institute in Boston. While early detection of a first cancer may save lives, he added, “Detection of relapse doesnt save lives.”
Women in the study received different drugs and surgeries for their ovarian cancer, and the researchers didnt exclude the influence of those differences in drawing conclusions about the tests impact, said Beth Y. Karlan, Director of Womens Cancer Research at Cedars-Sinai Medical Center in Los Angeles, at the meeting. Optimal surgical techniques, she said, may improve survival two to three-fold.
“Results of the trial will make us reconsider our approach,” Karlan said. “Should CA-125 become obsolete? I dont think so.”