Showing posts with label ovarian cancer. Show all posts
Showing posts with label ovarian cancer. Show all posts
Inaccurate Medical Tests

Inaccurate Medical Tests

With new medical research, medical 'tests' are springing up all over to test for genetic defects in unborn babies, best treatments for medical conditions, and risks of certain diseases, among other issues. The problem is not all these tests are accurate and are leading to unnecessary surgeries, putting patients on unneeded medications, and raising medical costs.

The problem is when tests are run at a single facility so the FDA is relying on manufacturer reported problems including deaths or injuries to patients.

"Diagnostic tests are now regulated differently depending on where they were developed and manufactured. Products that will be sold to multiple labs — “commercial test kits” — are typically subject to FDA review before they go on the market.

Manufacturers are supposed to inform the government if they learn that their products may have contributed to a death or a serious injury, and they may have to notify the government if they recall defective products.

But for tests manufactured and used within a single laboratory, the agency has not actively enforced regulatory requirements, even though doctors around the country may submit samples to that lab for testing."

The tests included here are the OncotypeDX for breast cancer recurrence risk and the CA-125 test for ovarian cancer. Using the CA-125 test as an example:

One blood test to help detect ovarian cancer was never shown to be effective, the report said, but was used anyway. False-positive tests may have led to “unnecessary surgery to remove healthy ovaries.”

According to the American Cancer Society:

"In studies of women at average risk of ovarian cancer, using TVUS and CA-125 for screening led to more testing and sometimes more surgeries, but did not lower the number of deaths caused by ovarian cancer. For that reason, no major medical or professional organization recommends the routine use of TVUS or the CA-125 blood test to screen for ovarian cancer."

There are also studies out looking at the validity of these two tests and others. The current administration as well as much of Congress is looking at ways to close loopholes and require additional testing and validation of the tests to ensure patients are not harmed or subject to unneeded treatments.

My doctors have never mentioned either of these two tests for me. I do not  think they are used at the hospital where I am treated either. Sometimes I have wondered why these tests were not offered. But now I am happy I didn't make any decisions based on their results.
Genetic mutations

Genetic mutations

As I hear the news that Angelina has had another surgery, this one to remove her ovaries and fallopian tubes, I ponder, what would I do? But as I listen to the doctors on TV talking about how she has reduced her risk of ovarian cancer significantly through this surgery, I am inclined to agree with her.

She has had a difficult medical journey with a BRCA 1 gene mutation and a strong family history of breast and ovarian cancer. I would think that anyone faced with this type of decision would agree that all need to make their own decisions but her decisions sound logical and she seems to be comfortable with them.

One thing that has always concerned me about genetic research is what if I had one? What would I do? I have no idea. At one point I was tested to see if I had a specific genetic mutation, one that is found in women who have both breast and thyroid cancers, and was told I didn't have it. Which was a big relief.

I mean if I had a genetic mutation, what would I do? First of all, genetic mutations can be inherited or can occur in individuals. Then you get a label - being a mutant - and you get stress. Now you have to make decisions on how to deal with it. There is often not much you can do about a mutation, other than watchful waiting.

Some of them, like BRCA, you can have surgeries or take medications and reduce your risk of health issues. Many others, there is much less you can do. You just get more medical visits and follow ups to test for issues. I think you would be stuck, waiting for the inevitable to happen. Not fun.

You may call me a weinie but I have never had any desire to find out what mutations I might have. I know I seem to have been dealt the unlucky hand in the health lottery, but I do not want to know if more ailments might be in store for me. I prefer to enjoy my life as it is now instead of stewing over what might be. I know what my life is now but I have no way of knowing what might be.
Practice makes perfect

Practice makes perfect

Down under, ovarian cancer research is going to be based on the model for researching breast cancer - many subtypes, etc. Ovarian cancer is much rarer and has much higher fatality rates. The biggest problem with ovarian is it is often not detected until it is later stage. Their is no 'mammogram' for ovarian cancer for screening for high risk women.

"Ovarian Cancer Australia has announced a landmark national action plan, following in the footsteps of breast cancer researchers.

They hope the plan will see the same gains in survival rates and treatment options that similar strategies have made for other cancers.

The plan aims to diversify clinical trials and tailor treatment to specific subgroups of the disease that have only recently been discovered.

"What we know about ovarian cancer now is there are many more subgroups than we previously thought - that's come from understanding the gene wiring of the cancers," researcher Professor Clare Scott said.

An initial investment of $1 million between Ovarian Cancer Australia and the Peter McCallum Cancer Centre has been put towards establishing new clinical trials that target the unique molecular characteristics of each cancer subgroup."

So after practicing cancer research for decades, the advancements are going to be applied to ovarian cancer as well. Its about time.