Almost every week, I see a story somewhere in a small town paper to a bigger magazine publication talking about how a screening CA125 could have saved a life. Although everyone is keenly interested in an effective screening test, the CA125 is not one of them. The results of screening with CA125 have been terrible, including exposure of patients who have no cancer to life threatening treatment and surgery. Conversely, CA125 is not elevated in over half of patients who have early curable cancer. Thus very few, if any, lives have been saved by CA125.
The above is the dark side, and speaks to frustration. On the good side is that there are more and more studies pointing towards breakthroughs which will lead to effective screening very soon. Some potentially “better” tools have been released, but were not ready for prime time. Understandably, this has made the FDA and a few others look bad in what outwardly might seem like a conspiracy of some kind. But in reality, no test is appropriate for screening to date. Having said the above, there is much reason for hope for the very near future. The following is but one of many breakthroughs, many of which are on the fast track towards approval.
Along the trail towards effective ovarian cancer screening, a small “pilot” study from Ohio State University Comprehensive Cancer Center showed that a blood test which screens for something called “microRNA” can be reliable in detecting early disease. Dr. Kimberly Resnick and colleagues have published their results in the journal Gynecologic Oncology and recently presented their findings at an international meeting held in Hollywood, Fla.
MicroRNAs are tiny genetic molecules which help regulate how proteins are made in your body. They are infinitely smaller than genes but are detectable in blood, including those which have a certain specific abnormal pattern found in patients known to have ovarian cancer. This technology is markedly different from CA125 testing which is far less sensitive or specific for ovarian cancer presence. This is early work, but there is more and more of it coming up with very promising results.
I have posted on this topic before, and it will not be long before we have the screening tools we need. Kudos to this group of researchers for advancing this goal.
I'd be interested in your thoughts. Please take a moment to post a comment.
The above is the dark side, and speaks to frustration. On the good side is that there are more and more studies pointing towards breakthroughs which will lead to effective screening very soon. Some potentially “better” tools have been released, but were not ready for prime time. Understandably, this has made the FDA and a few others look bad in what outwardly might seem like a conspiracy of some kind. But in reality, no test is appropriate for screening to date. Having said the above, there is much reason for hope for the very near future. The following is but one of many breakthroughs, many of which are on the fast track towards approval.
Along the trail towards effective ovarian cancer screening, a small “pilot” study from Ohio State University Comprehensive Cancer Center showed that a blood test which screens for something called “microRNA” can be reliable in detecting early disease. Dr. Kimberly Resnick and colleagues have published their results in the journal Gynecologic Oncology and recently presented their findings at an international meeting held in Hollywood, Fla.
MicroRNAs are tiny genetic molecules which help regulate how proteins are made in your body. They are infinitely smaller than genes but are detectable in blood, including those which have a certain specific abnormal pattern found in patients known to have ovarian cancer. This technology is markedly different from CA125 testing which is far less sensitive or specific for ovarian cancer presence. This is early work, but there is more and more of it coming up with very promising results.
I have posted on this topic before, and it will not be long before we have the screening tools we need. Kudos to this group of researchers for advancing this goal.
I'd be interested in your thoughts. Please take a moment to post a comment.
How accurate is the ca125 in gauging the progress of chemotherapy for Ovarian Ca stage IIIC?
Mine is 340, down from 860 after 3 carbo/taxol treatments. I was hoping for better numbers
Excellent question. Even though CA125 is not a good screening tool to detect ovarian cancer, it is a good tool to monitor treatment.
The only time this strategy does not work well is when the CA125 is not elevated when treatment starts. Otherwise, it does help with a GENERAL trend. What do I mean? The CA125 is not directly or exactly linked to the amount of cancer left. In other words, if it becomes normal it does NOT mean that ALL of the cancer is gone. In some cases that is true in others it is not. There is no way to be absolutely sure, even with surgery. However, in general, if it is going down the treatment is working, much of most of the cancer cells are being killed, and treatment should be continued.
Preferably, the CA125 should drop to normal within the first 3 cycles of chemotherapy. That is where the best results are found in the long run. In other words, the best chance for cure is found when the CA125 is normal after 3 cycles of chemo. If it does not, the treatment is usually still working and should be continued, but may mean that there is some resistant disease.
If the CA125 stalls or starts to rise, usually a scan is ordered (often a CT scan) and treatment may need to be changed if it looks like the cancer is growing back despite the current chemo.
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I am three years out from my last chemo for ovarian cancer.
I get check ups every six months but they consist mainly of the results of the CA125 and a few pushes on my abdomen followed by small talk. Not very reassuring. In your opinion is this thorough enough?
I found your article very interesting. It was recently discovered that I have a cantalope=sized tumor. I got a CMA-125 and, though I don’t have a number, it was apparently elevated. I know that the doctor is going to recommend surgery and has already arranged to refer me to a very good gyn oncologist to do it. I’m told that they will biopsy it at that time. (Also that the sonograph showed that the tumor had different planes to it which is another indication of cancer- ovarian by the way.)
The thing is – if it’s benign, I would prefer to try some other things first. Maybe even if it’s cancer. I feel some conern about the surgery. I feel like I could be in better shape going in to major surgery. I do have an orthomolecular doctor that I trust and have really amazing results from orthomolecular medicine in the past.
Any thought? Any comments? ANY WAY TO GET TO THE MICRO-RNA TEST NOW?! (SMILE) Really though, it sure would make the decision easier to make.
Excellent questions in this comment thread.
First, as far as followup, if the CA125 was elevated initially, then it is usually a good marker for recurrence. In that case, a basic pelvic and abdominal exam as well as CA125 may be adequate. If, on the other hand, the CA125 was never or barely elevated (say in the low 100s), then the CA125 may not be very good for detecting recurrence. In that case, it is also reasonable to use scans IF there are physical exam findings OR if you have some symptoms. This would be called a “targeted” scan to look in the area of concern. Some have recommended routine scans, but there is not a shred of medical evidence that this helps patients live longer or beat ovarian cancer. As a VERY important side note to this, the details are crucial and everyone should have a discussion with their doctor about the likelihood of recurrence and what the plan is should recurrence be found.
Regarding holding off on surgery….not a particularly good idea. If this is early cancer, then it may be early and you might avoid chemo if it is not spread. If this turns out to be benign, from what was described, it will not go away from mainstream or alternative medical approaches and will continue to grow…..that makes for a possible bigger surgery down the line. The same holds true for cancer, with greater consequences. While nutritional support and complementary therapies can always be considered, it is best to know what EXACTLY is the problem. There is really only one way to find this out….and that is surgery. No scan is that accurate. However, it is very appropriate to have a DETAILED discussion with your surgeon about what you want done (or not) after you hear the entire list of risks vs. benefits.
In general, if cancer is found, the very best chance for sure is related to allowing the surgeon to remove as much visible cancer as possible. If cancer is NOT found, then what is removed is up to an informed consent discussion with your physician/surgeon. It is crucial to have this discussion as soon as possible so you can make the best possible informed decisions…
My Mom recently died of ovarian cancer. Brutal. She lived over 3 years after her stage 3c diagnosis. My sister and I are trying to make sure we are several steps ahead of this. What about OvaSure? It uses six biomarkers(including CA125)for detecting (key word) early ovarian cancer. It sounds promising…
My onc/gyn is having me take the new HE4 test along with the CA125. I have Ova stage 3c and have had monthly CBC and CA125 blood work. This Friday I will begin the HE4 test for the first time. Looks like this may be more promising.