I thought that since this will be my last post as the Ovarian Cancer guide, I'd briefly reflect on the past year and give some encouragement about the future. As we enter 2009, there is much hope for new screening tools, biologicals are coming of age and it won't be long before they overtake toxic chemotherapy. Into the intermediate future, we are looking at genetic therapy, both pre-birth and influencing epi-genetics via medical and dietary interventions. There is reason to be VERY optimistic.

We have covered a lot of this during the past year, and I had hoped to continue along the same vein of presenting today's sometimes harsh treatment reality choices, look towards the better and brighter future and fill in with complementary and alternative approaches that seem to have some promise, proven or not. But that is not meant to be.

Our forum has grown from zero to very active in a very few short months, and I hope you have found a good "home" for healthy discussion regarding experiences, good and bad. I tried to pop in and say hello often, and if I have not caught everyone, a warm welcome to a safe discussion zone for the moment. I think the site may serve you well for that, although I have no idea who will be recruited to answer the medical questions. About is usually pretty good about seeking out good folks, so I hope for the best.

Overall, it has been an honor serving your information needs, hearing from you individually and recommending what I would consider as options. You are true survivors and for the newbies on the block, listen and you shall find iron wills and very strong support from those that have been there, done that.....right here in this forum.

I bid you farewell. In case you need to find me, I can't really put in an email address here for conflict of interest reasons, but if you Google me, I am not hard to find. I anticipate a much bigger presence on the web and hope to see you around. Live long and keep your eye on the prize.

Kind Regards,
Dr.Steve

We've gone round and round on the relative major inaccuracies of CA-125 blood tests to detect ovarian cancer. There are a number of research avenues that are being investigated to improve early detection, and this is one of them.

Researchers at the University of South Florida have just reported their results on a protein, called Bcl-2, which can be picked up by a urine test. Bcl-2 is something called an "anti-apoptotic" protein, which can be found in many cancers, but they investigated it by testing healthy women, women with benign non-cancerous gynecologic conditions, and in women with early or advanced ovarian cancer. In many cases, they compared the result with a CA-125 blood test level.

Women who had been diagnosed with ovarian cancer, regardless of stage, had a significantly elevated level of Bcl-2 in the urine compared to women who had either no disease or benign conditions. Furthermore, the levels roughly correlated with CA-125 elevation. Is this THE answer? Probably not....or at least not the only answer. However, it is a step in the right direction towards effective screening.

Although this is early laboratory research, it caught my interest. We know that one of the most useful drugs for ovarian cancer treatment has been cisplatin. The way the tumor responds to this drug will often define the prognosis.

Initially, most patients do respond to this chemotherapy for their ovarian cancer. Eventually the majority of the ovarian cancers become resistant to the cisplatin. This lab study could give some hope. If the power of cisplatin can be improved by this method, it would have a major impact in the fight against ovarian cancer.

The drug I'm alluding to is called Arsenite (arsenic trioxide). It begins by working to attack the ovarian cancer cells but also works by using multiple biological processes to enhance the effectiveness of cisplatin to inhibit DNA repair. There have been some in-vitro studies (in the lab) that show Arsenite can enhance the activity of cisplatin in other cell types as well.

If some of you recognized the word "arsenic" in this compound, yes it is the same thing as the drug we have all just considered a poison in the past. However, Arsenite has been used to treat some types of leukemias for some time now, which shows it can be used safely. Granted this seems odd, but not the first time a "poison" has been used towards a good cause. Watch for upcoming clinical research in this area.

Researchers at the University of Hawaii have been tracking the incidence of papillary serous Primary Peritoneal cancer. We have known about this “uncommon” malignancy for about 5 decades, and now it may be on the rise.

In the USA, this is generally a disease of older white women, usually not seen under the age of 40. However, it is also diagnosed in other ethnic groups. The majority (68%) is diagnosed at an advanced stage.

This research group tracked the incidence of primary peritoneal cancer in the US from 1995-2004. Unfortunately, they found that there is a dramatic increase with the greatest rise (>13% per year) among non-Hispanic and white women. Reasons are unknown at this time, and some of this may be due to how ovarian cancer was classified in this set of databases.

So what does this mean? Well, hopefully some of it is related to the last reason, which is essentially how things are recorded rather than real increases. However, it may also be a disturbing trend, adding to our already poor sensitivity for ovarian cancer screening. Over the next few years, the blood tests that are being developed for ovarian cancer screening will help find this disease. On the other hand, primary peritoneal cancer usually means that many areas of the peritoneum have gone bad. Because of this, an “early diagnosis” is uncommon.