FYI~Novel test to help detect precancerous changes taking place in the Fallopian tubes but not yet "

LorettaMarshall
LorettaMarshall Member Posts: 662 Member
in Ovarian Cancer #1

Good afternoon ladies:

Normally I have one person in mind when trying to find references to help them, when it is something I don’t have personal knowledge of or experience with.  Much of my e-mail comes in the form of medical alerts relative to Ovarian or Esophageal Cancer because my husband is a 15-yr. survivor of Esophageal Cancer Stage III, and so far, I am close to surviving 6 years from Stage IV Ovarian Cancer.  My first diagnosis was Peritoneal Carcinomatosis, which I had never heard of, but quickly found out that it was metastatic in nature.  Then when I went to the University of Pittsburgh Medical Center for a second opinion, exploratory surgery and a PET/CT scan found cancer in my ovaries as well. 

So once again, even though it is still possible to have Ovarian Cancer, even with previous removal of the ovaries (oophorectomy), if I had to have another hysterectomy, I would want the surgeon to remove my tubes, ovaries and uterus, instead of just my uterus. That would lower the possibility of OC in the future, but would not totally eliminate that possibility.

 In this present time, it is widely believed that Ovarian cancer begins in the Fallopian tubes.  Note part of the article that is referenced below my name.  So I have no reason to believe that actually my OC began in the Fallopian tubes.  And wouldn’t it be fantastic if FINALLY some pre-screening test could actually become a reality and prevent millions of women from ever having to hear the words, “You have Ovarian Cancer”?  

And yet, I find that this is not going to be widespread testing any time soon.  However, every good thing has to begin somewhere.  But even now I am encouraged that something positive is promising to help detect Ovarian cancer before it advances to Stage IV as was the case with me and so many of you.

Currently there is great success in a small test, so larger tests are planned.  Researchers believe it will be possible to have a 2-part test—first a blood test to find “abnormal” blood markers.  This could help detect precancerous changes taking place in the Fallopian tubes.  Then secondly, a minimally invasive falloposcopy with advanced optical image capabilities could look for abnormalities in the tubes and ovaries.  Wow how great would that be?

So for all of us battling this beast, be encouraged that at least something has come on the scene with promise of early detection although it is by no means “just around the corner.”  Wouldn’t it be nice to have that part of a yearly gynecological exam?  I remember my gynecologist calling me up to express his sorrow at learning that I had been diagnosed with Stage IV OC.  During our conversation, he told me that it is widely believed NOW that OC actually begins in the Fallopian tubes, and that he was not going to continue to just “tie” tubes, but intended to remove them.  So I just can’t say it enough times, “If a woman is past childbearing, or has her family complete, and if her gynecologist suggests a hysterectomy, (for other possible reasons) please tell the surgeon to remove the tubes, ovaries and uterus.  I sure wish I had known this at age 36 when I had only my uterus removed.  But that was then and this is now! Frown Who wouldn’t like to trade dealing with “hot flashes” instead of facing Ovarian Cancer at any stage—much less Stage IV? 

During my consultation way back then, I remember my doctor giving me a little booklet that contained “questions and answers.”  Now remember there was no computer or Internet to which we could go to find answers.  One of the questions was, “Will it make me lose my mind?”  The answer was:  “Not unless you were going to anyway!”  Kiss

Just thought this medical alert was worth reading.  It has given me some encouragement that some slight progress is being made on our behalf of ladies who have cancers "below the belt!"  Wink  

Love Loretta

Peritoneal Carcinomatosis/Ovarian Cancer Stage IV

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1.      http://www.cancernetwork.com/ovarian-cancer-research-symposium/novel-early-screening-tool-ovarian-cancer?elq_cid=36150&elq_mid=3309&rememberme=1

[Bold text is mine for emphasis]

 “Novel Early Screening Tool for Ovarian Cancer

Optical coherence tomography (OCT) and multispectral fluorescence imaging (MFI) have demonstrated promising results in the early detection of ovarian cancer, as detailed in an abstract presented at the 12th Biennial Ovarian Cancer Research Symposium, held September 13–15 in Seattle.

“There appear to be unique markers in the blood of ovarian cancer patients, months and years prior to diagnosis, and optical imaging techniques can distinguish [between] normal, cancer, and benign abnormalities [in] ovarian and fallopian tube tissue,” said presenter Jennifer K. Barton, PhD, professor of biomedical engineering at the University of Arizona in Tucson.

Barton and colleagues are developing a screening test for early (i.e., premetastatic) ovarian cancer. The development of an early screening method is important because late ovarian cancer diagnosis results in a 5-year survival rate markedly below 50%.

“If the cancer can be identified while still confined to the fallopian tube, a very high survival rate is expected,” noted Barton.

Experts hypothesize that a substantial proportion of ovarian high-grade serous carcinoma (HGSC) actually begins in the fallopian tubes before spreading to the ovary and peritoneal cavity. Optical imaging approaches could help detect primary HGSC precancerous changes at the level of the fallopian tubes.

Barton and colleagues recently developed the smallest-diameter (0.8 mm) OCT/MFI imaging endoscope to date for the navigation through the natural orifice of the ostium of the uterus.

“In a small ex vivo study, we found that 5 MFI measurements were sufficient to distinguish between normal, cancerous, and benign fallopian tube and ovary tissue with 100% sensitivity and specificity,” the authors wrote. “We used laparoscopic OCT in an in vivo study of 17 women and revealed distinct image features for normal, cancerous, and benign abnormalities of the ovary.”

This minimally invasive imaging endoscope, however, is not intended for population-wide screening. Instead, the investigators propose using it as an adjunct confirmatory test.

“If these findings hold true in larger studies, it may be possible to develop a two-step ovarian cancer screening tool, where the first step is a blood test to identify women with possibly abnormal blood markers, and the second step is a minimally invasive falloposcopy with advanced optical imaging capabilities to look for any abnormalities in the fallopian tubes and ovaries,” said Barton.

The investigators have already identified potential serum HGSC protein biomarkers for the blood test, including FBG and PF4, which have a lead time of between 18 and 84 months. They have also verified a three-biomarker panel (FBG, PF4, and CA125) that classifies HGSC with more than 80% sensitivity and more than 70% specificity, and has a lead time of between 18 and 84 months. Finally, they identified overexpression of various glycolytic enzymes in serous tubal intraepithelial carcinoma lesions and human prediagnostic serum samples that could serve as screening biomarkers.

“Our continuing work is focused on refining the serum protein biomarker sensitivity and specificity, creating a second-generation falloposcope for a first-in-women feasibility study, and creating an integrated model that incorporates both sets of data into an early EOC detection method,” concluded the authors.

Related Articles

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2.      https://www.healthline.com/health/cancer/ovarian-cancer-hysterectomy

“Ovarian Cancer After Hysterectomy: Is it Possible?

Ovarian cancer and hysterectomies

If you’ve had a hysterectomy, you may assume that you cannot be diagnosed with ovarian cancer. In many cases, one or both ovaries are left in place after a hysterectomy. While having your uterus removed decreases your risk of developing ovarian cancer, it is still possible.

Ovarian cancer is cancer that develops from the ovarian cells. The ovaries are where eggs are produced and are the main source of the female hormones estrogen and progesterone. Most ovarian cancers start in the epithelial cells that cover the outer surface of the ovary. Cancer can also develop inside the germ cells that produce eggs or in the hormone-producing stromal cells.

A hysterectomy is a surgical procedure in which your uterus is removed. There are different kinds of hysterectomies:

  • partial or supracervical hysterectomy: The uterus is removed but the cervix is left intact.
  • total or pan hysterectomy: The uterus and the cervix are removed
  • radical hysterectomy: The uterus and the cervix are removed along with the tissue on both sides of the cervix and the upper part of the vagina.

In all of these procedures, the ovaries are left in place.

Types of hysterectomies

According to the American Cancer Society (ACS), having a hysterectomy (even when the ovaries are left in place) may reduce the chance of ovarian cancer by one-third. Sometimes the Fallopian tubes and both ovaries are removed during a hysterectomy. This is called a bilateral salpingo-oophorectomy or BSO.

Without ovaries, your risk of developing ovarian cancer is lower, but there’s still some risk. That’s because ovarian cells can migrate to the perineum, which is the area between the vagina and anus. If this migration happened before your ovaries were removed, those cells remain behind. These remaining ovarian cells can become cancerous just like the ovaries can. And if they do, it is still considered ovarian cancer even if the ovaries are removed before the cancer develops. Cancer can also develop from cells in the peritoneum, the tissue lining the wall of your abdomen and while this is not ovarian cancer it behaves in much the same way as ovarian cancer and is treated similarly…”

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3.      https://www.mayoclinic.org/tests-procedures/oophorectomy/about/pac-20385030

“Overview

Female reproductive system

An oophorectomy (oh-of-uh-REK-tuh-me) is a surgical procedure to remove one or both of your ovaries. Your ovaries are almond-shaped organs that sit on each side of the uterus in your pelvis. Your ovaries contain eggs and produce hormones that control your menstrual cycle.

When an oophorectomy involves removing both ovaries, it's called bilateral oophorectomy. When the surgery involves removing only one ovary, it's called unilateral oophorectomy…”

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4.      http://www.innerbody.com/image_repfov/repo03-new.html

Fallopian Tube

“The Fallopian tubes, also known as the uterine tubes, are a pair of 4-inch (10 cm) long narrow tubes connecting the ovaries to the uterus. Ova (egg cells) are carried to the uterus through the fallopian tubes following ovulation. The ova may also be fertilized while in the Fallopian tubes if sperm is present following sexual intercourse.

The Fallopian tubes are located in the pelvic cavity extending laterally from the corners of the superior edge of the uterus and passing superior to the ovaries…”

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