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The ovarian cancer quandary: should women be screened?

December 7, 2012 5:26:14 AM PST
For most women diagnosed with ovarian cancer, it's a death sentence.

When it comes to her health, Jennifer Bruns is not interested in rolling the dice.

"I am a ticking time bomb," Bruns said. "In theory ovarian cancers will come back 10 years earlier with each generation so I'm right on the bubble."

It's been about 10 years since we first met Bruns. Then she was a new mom determined not to let what happened to her own mother happen to her.

Her mother Shelly Ross died at the age of 59.

After months of complaining about bloating and abdominal pain and being told not worry, Ross was finally diagnosed with ovarian cancer.

Fifteen months later she was gone.

Bruns enrolled in the ovarian cancer early detection program at Northwestern.

"I'd rather have extra tests and not get the disease or be able to treat the disease early when the survival rate is higher than not have the test and wind up like my mom," she said.

And here lies the dilemma.

For Bruns the screening makes sense since she is considered at risk.

"Once it spreads elsewhere it spreads very quickly but when it's in the ovary it can be very small and rather insidious," Northwestern Medicine Gynecologic Oncologist Dr. Julian Schink said.

Study after study shows the tests commonly recommended to screen healthy women don't always work and could even be a hazard.

"So what the study found was screening actually harmed patients that underwent screening for ovarian cancer," University of Chicago Medicine Gynecologic Oncologist Dr. Ernst Lengyel said.

The screenings, which involve a blood test and an ultrasound, tend to give many false positive results. So women can end up having operations to look for a cancer that is many times not there.

Most major doctor groups and medical panels now advise against screening for healthy women.

Bruns, who remains cancer free, thinks this is wrong.

"Don't be afraid to question your doctor. Don't be afraid to insist on having tests that you think are necessary," she said.

Patients are still demanding these screenings and many physicians are compelled to oblige.

Researchers at University of Chicago medicine say this is a big mistake.

"It is hard to explain to women," Lengyel said. "You can't let emotions guide decision about diagnostic testing because surgery is a big intervention."

Scientists are just as frustrated at the lack of progress.

However they're drilling in on the research and are confident once they decode the biology of this cancer, they'll devise a test sensitive enough to find it when it's most treatable.


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