Ovarian Cancer: Diagnosis & Treatment Including Gene Therapy

In 2005, approximately 26,800 women were diagnosed with ovarian cancer. Of these women, 14,200 are expected to die of this disease or gynecologic cancer. In the United States and northern Europe have the highest ovarian cancer rates in the world. Most women diagnosed having ovarian cancer can expect, life expectancy three to four years, despite aggressive surgery and chemotherapy treatment. Ovarian cancer in the United States is the seventh most common cancer among women, and the fifth leading cause of cancer deaths, after lung and bronchus, breast, colorectal and pancreatic cancers. A women’s risk of getting ovarian cancer during their lifetime is about one in 58. When the disease is diagnosed in it’s early stages of development, there is 95 percent chance of survival. Approximately twenty-five percent of ovarian cancers are diagnosed at an early stage. Fortunately, according to American Cancer Society the rate of ovarian cancer has gone down since 1991. Also, statistics for ovarian cancer estimates, in 2006 new cases will be 22,200, and 15,310 deaths.

In the female reproductive system, a pair of ovary organs, located in the pelvis, one on each side of the uterus (where a baby develops). The ovaries have two functions: Produce eggs and female hormones (estrogen and progesterone). These hormones influence the development of woman’s breast, body shape and body hair. Also, regulate the menstrual cycle and pregnancy. Once a month, during the menstrual cycle, one ovary releases an egg called ovulation. The egg travels from the ovary through the fallopian tube to the uterus.

Ovarian cancer is a malignant tumor (When cells divide forming an abnormal mass of tissue called a growth or tumor, more than they should or do not die when they should. A tumor can either be benign or known to be malignant cancer), develops in the ovaries. One of several known types of ovarian cancers can develop. Ovarian cancer that begins on the surface of the ovary is epithelial carcinoma, is most common, and cancer that begins in the egg – producing cells and supportive tissue surrounding the ovaries is called stromal tumors. Ovarian cancer cells can travel from the ovary and spread to other tissues and organs, process called shedding. Also, this type of cancer can enter the bloodstream or lymphatic system (A network of vessels that assists in circulating body fluids. Important role in building an immune response by removing bacteria, and viruses.), and further develop, cancer cells which forms tumors in other parts of the body. Factors attributed to the cause of ovarian cancer: Family history, age (Most cases of ovarian cancer develop in women over the age of fifty, and higher risk in women over 60 years old.), childbearing (Women that have never had a child are more likely to develop this type of cancer), medical history (Women that had breast or colon cancer have a greater chance of developing ovarian cancer), taking fertility drugs have been linked to ovarian cancer, and use of talc (talcum powder) or genital deodorant sprays, which may contain asbestos, in some cases have shown a link to an increase of ovarian cancer. Women that have undergone tubal ligation (had their tubes “tied”) to prevent pregnancy had no correlation to develop ovarian cancer because any external carcinogens were prevented from reaching the ovaries through the vagina, uterus and fallopian tubes.

The beginning stage of ovarian cancer is hardly detected, have no symptoms or just mild symptoms. About ten percent of ovarian cancers are found in the early stage, and have a 90% survival rate. Seventy-five percent of women are diagnosed in the advanced stages and have a poor prognosis. Later, symptoms that become apparent includes: General abdominal discomfort and/or pain, nausea, diarrhea, fatigue, constipation or frequent urination, feeling of fullness even after a light meal, loss of appetite, weight gain/ loss unexplained, pain during intercourse and / or abdominal bleeding from the vagina. The symptoms are not always symptomatic for ovarian cancer.

Methods available detecting ovarian cancer includes: Measuring the level of CA 125 (a protein) in the blood of women, a substance called a tumor marker, which is found in higher then normal amounts in ovarian cancer. CA 125 test has shown positive results, about 50% of Stage 1 ovarian cancer patients, and a chance of 80% positive results for Stage 2, 3, and 4 ovarian cancer patients. False positive results have been attributed to ovarian cysts, first time pregnancy or pelvic inflammation disease The CA 125 test for ovarian cancer is considered, about sixty percent accurate. Additionally, undergoing a transvaginal ultrasound (The Ultrasound machine sends out a high – frequency sound waves, which bounces off the body structures to present a picture. Closer examination of the pelvic structure is done, by inserting directly into the vagina an ultrasound transducer (a hand – held probe). This test can be performed safely for women that are pregnant), has better accuracy for detecting ovarian cancer and should confirm or rectify results of CA 125 testing. Also, routine rectovaginal examination can be done, however no evidence to prove effective for early diagnosis. Definitely, removal of tissue for examination during a biopsy, a pathologist can make this diagnosis. If ovarian cancer is diagnosed the surgeon can perform an oophorectomy, removal of the entire ovary. Diagnosing early stage of ovarian cancer can prevent death, but unfortunately, two-thirds of patients diagnosed with this disease, the cancer has spread into the abdomen.

Partricia Kruk, Ph. D, a cell molecular biologist at the University of South Florida/H. Lee Moffitt Cancer Center in Tampa, Florida and her team, discovered by looking at protein in the urine called BCL-2, regardless of the stage of ovarian cancer, were at least ten times greater than women without ovarian cancer. The findings were more than ninety percent accurate. Funding for a large clinical study will be necessary to confirm the preliminary findings.

Study published in the August 28, 2006, edition of the Journal Cancer, the New York Times reported linking obesity to increase in deaths related to ovarian cancer. Andrew Li, assistant ob-gym professor of obstetrics and gynecology at the University of California Los Angels and colleagues, reviewed the medical records of 216 women age, height, weight and chronic conditions, who had undergone surgery for epithelial ovarian cancer at Ceder-Sinai Women’s Cancer Research Institute at the Samuel Oschin Comprehensive Cancer Institute in Los Angeles. The study suggests, women who are considered obese (Having body mass index of 30 and greater) have a lower survival rate, and recurrence of the cancer is sooner than expected, compared to women having an ideal body mass index 18.5 – 25.0. The basis of the study findings links fat tissue excreting a hormone or protein, causing ovarian cancer cells to grow more aggressively, but further molecular studies need to confirm this conclusion.

Available are treatment options for ovarian cancer. Specialists treating ovarian cancer include gynecologist, oncologist or radiation oncologist, educated, experienced, and having various degrees of knowledge. A surgical procedure called a hysterectomy maybe advisable to treat ovarian cancer, removes the ovaries, fallopian tubes, the uterus, and the cervix. More extensive surgery maybe required removing the lymph nodes (organs located along the channels of the lymphatic system), depending on the extent of the cancer spreading or stages of development. Chemotherapy (Administering drugs that can destroy cancer cells or “anticancer’ drugs.) often advisable after surgery to destroy any remaining cancerous cells or relieve symptoms of the disease. Radiation therapy uses high – energy rays to kill cancer cells. Any one of these treatments, incur some degree of side effects or permanently not being able to become pregnant in the future. Besides, physiological problems may develop, requiring counseling or support from a spouse.

Researchers at the University of Pittsburgh School of Medicine have developed a gene therapy technique (Technique whereby the absent or faulty gene is replaced by a working gene. The body can then make the correct enzyme or protein, and thus consequently eliminate the root of the cause of the disease.), which has shown to completely or significantly inhibit the tumor growth in mice, after being inoculated with ovarian cancer. The engineered vaccine virus containing a gene coding cytosine deaminase, performs as a suicide gene. The chief of the division of surgical oncology at the University of Pittsburgh School of Medicine, and professor of surgery Dr. David L. Bartlett said: “Current treatment for ovarian cancer are fairly harsh. Given the tumor selectivity and cancer killing potential, vaccine vector expressing recombinant gene products represents a potent, nontoxic alternative for treating this deadly disease. ” Hopefully, the future for the prognosis of ovarian cancer will greatly improve. The findings of this study, presented at the American Society of Gene Therapy annual meeting in Baltimore, May 31 to June 4, 2007.

The month of September is National Ovarian Cancer Awareness Month. Established in 1995, The National Ovarian Cancer Coalition (NOCC) will start premiering in September 2006, on national television and radio public service announcements, educating women about the signs and symptoms of ovarian cancer. According to NOCC national survey, fifteen percent of women are familiar with signs of ovarian cancer and eighty-two percent have never talked to their doctors, concerning the symptoms related to this disease and risk factors.

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