Goal is early diagnosis: multipronged approach for detecting ovarian Ca.(Gynecology)

UNIVERSAL CITY, CALIF. -- No single test will revolutionize the diagnosis of epithelial ovarian cancer, but success may come in the form of a multipronged detection paradigm being developed by the National Ovarian Cancer Early Detection Program, according to the group's director.

The approach aims to harness for clinical use an array of rapid advances in techniques that spot telltale clues produced by ovarian cancer cells as they develop, replicate, detach from the ovary, adhere to the peritoneum, and invade and proliferate within other organs.

Biomarkers, protein patterns, vascular characteristics, and genetic profiles may all contribute to diagnosing ovarian cancer at an early stage, when the discovery can have a meaningful impact on survival. Dr. David A. Fishman said at a meeting of the Obstetrical and Gynecological Assembly of Southern California.

"Everything I'm going to share with you I think is going to become a clinical reality in the very near future," he promised clinicians in the audience, although he insisted that early detection tests should not be made widely available until they have been fully validated and have the confidence of researchers and clinicians alike.

Up to now, efforts to detect stage I epithelial ovarian cancer have been dismal, with 70%-75% of women still being diagnosed with advanced disease--about the same percentage as in 1960. Five-year survival for advanced disease hovers at about 12%-15%.

"Ovarian cancer is still essentially a death sentence," said Dr. Fishman, professor of gynecologic oncology at North-western University in Chicago.

In identifying biologic markers that could tip off a physician to early-stage cancer. "We have to be clever enough to understand the biology of the disease," he said.