Early Ovarian Cancer Test In the Works

Vanessa Ehrlich’s diagnosis for ovarian cancer started with a pain in her lower back that didn’t go away. A physician in the emergency room she visited did a high-tech CT scan and noticed right away the growth on what doctors call the omentum, a flap of tissue where cancer cells from the ovaries often grow.

A follow-up visit to an oncologist and a biopsy confirmed the bad news. This 59-year-old professional educator, a wife and the mother of three adult children, was told she had stage 3C ovarian cancer, just short of the terminal diagnosis of stage 4. With the few symptoms that she had, she felt totally unprepared for what her doctor told her.

“When you go in to see the oncologist the first time after you have the results of the biopsy and he tells you what stage it is, it’s terrible. It’s absolutely devastating,” she said.

Ehrlich’s experience, as heart-breaking as it is, is not that unusual. Many women may, at first, experience relatively minor symptoms. They may have some minor abdominal pain, bloating, or will feel full quickly after eating. They may also, initially, experience nothing.

For a diagnosis like Ehrlich’s, the future is not very promising. sixty-one percent of women with stage 3C ovarian cancer don’t survive. For those with stage 4, that number increases to 83 percent. Unlike other forms of cancer that threaten women’s lives, there is nothing like a mammogram to provide an early warning sign of disease.

According to years of research, Jewish women with Ashkenazi heritage, like Ehrlich, may have a predisposition to develop ovarian cancer, particularly if they carry a mutated version of the BRCA1 or BRCA2 gene. If they have the BRCA mutation and have previously had breast cancer, their chance of developing ovarian cancer could be as high as 70 percent.

With the BRCA genetic disorder, Jewish women have a 1 in 40 chance of developing the disease. In the general population, where the gene is normal, the odds drop to 1 in 300.

Dr. Benedict Benigno, a distinguished gynecologic oncologist in Atlanta and the CEO of the Ovarian Cancer Institute, believes that an easy test for ovarian cancer could save many lives.

“I look at a test like that as, potentially, the pap smear of ovarian cancer. Because of the pap smear test nobody has to die of cervical cancer anymore. Just get a pap smear every two years. But there is no such thing for ovarian cancer.”

Benigno has been on the Ovarian Cancer Steering Committee of the National Institutes of Health and director of gynecologic oncology at Northside Hospital. For decades, he’s been searching for a way to provide this early warning.

Researchers at Georgia Tech, led by Dr. John McDonald, are using machine learning to test for ovarian cancer.

Now Benigno and his research partners at Georgia Tech feel that such a test may soon be ready. The program, according to Benigno, depends on newly developed artificial intelligence tools.

These tools, which scientists call machine learning, use computers to search for the presence of a series of substances called metabolites that develop at the cellular level and can be analyzed.

Over the years, researchers have developed a profile of these substances that are found in the blood of ovarian cancer patients. Dr. John McDonald, who directs the Integrated Cancer Research Center at Georgia Tech, has worked with Dr. Benigno’s Ovarian Cancer Institute for over a decade to develop the program.

“We asked the computer to look at all of those metabolites and tell us which correlate with people with cancer and which ones do not. The computer can look through 100,000 features. What it’s doing is looking for those correlations that it can use as a prediction of cancer.”

So far the computers have successfully predicted cancer in about 95 percent of tissue samples. In the next six months, McDonald’s and Benigno’s research teams will be looking at 800 tissue samples from all over the world to see if those predictions can get as close to 100 percent as possible.

As hopeful as that is, the test still has a number of hurdles to navigate. It must first be approved by the Food and Drug Administration, which might order lengthy clinical trials before the test is commercially available.

In the meantime, each year more than 22,000 women are given an ovarian cancer diagnosis. Many confront a daunting series of tests and treatments that are more often than not unsuccessful. Roughly 14,000 women die of the disease every year.

Sharsheret is a national organization that provides Jewish women with support and information about ovarian cancer.

Organizations like Benigno’s Ovarian Cancer Institute in Atlanta and Sharsheret, a national support network primarily for Jewish women who suffer from breast and ovarian cancers, provide guidance and information. September is Ovarian Cancer Awareness Month.

Vanessa Ehrlich is one of the lucky ones. In the three years since receiving her diagnosis, she has lived to welcome a new granddaughter into the family. She also has hope that, one day, before the child is grown, the search for a better way to discover ovarian cancer will finally be found.

“When I tell people about myself, I tell them not to say I’m sorry. I tell them hineni, like Abraham said: ‘here I am’.”

For more information, visit the Ovarian Cancer Institute, www.ovariancancerinstitute.org and Sharsheret, www.sharsheret.org