Tuesday, July 16, 2019

THE CA125 BLOOD TEST: YOUR QUESTIONS ANSWERED

What is a CA125 blood test?

CA125 is a protein that both men and women have in their blood. The normal level of this is 35 units per millilitre (U/mL), or lower.
A CA125 blood test is used to check the level of the protein in the blood. It can be carried out at a local doctor’s surgery if they have the facilities, or the patient will be referred to their local hospital the same way they would for any other blood test. 

When might a CA125 blood test be necessary? 

A CA125 blood test should be requested if a doctor suspects a patient's symptoms could be caused by ovarian cancer. A referral for this blood test should be made if a woman is presenting with any of the four main symptoms of ovarian cancer:
  • Persistent stomach pain
  • Persistent bloating
  • Needing to wee more frequently or urgently
  • Difficulty eating or feeling full more quickly
A referral for a CA125 blood test on presentation of these symptoms is particularly important if they are persistent, frequent and out of the ordinary with no other obvious explanation. A doctor would usually refer for a CA125 blood test following a physical abdominal or internal vaginal examination. 

Does an increased CA125 level mean ovarian cancer?

An elevated CA125 level is not a diagnosis of ovarian cancer. More investigations are required to determine what is causing the elevated CA125 level. Patients will be referred for a pelvic or transvaginal ultrasound scan to gain a better internal picture and to identify any abnormal masses on or around the ovaries.
If abnormal masses are seen a patient would usually then require more scans, and some explorative surgery in order to make a certain diagnosis of ovarian cancer. You can find out more about how ovarian cancer is diagnosed here.

What else can cause a CA125 to be elevated?

There are a number of conditions that can cause a CA125 level to be elevated. They include the following:
  • Pregnancy
  • Endometriosis 
  • Pelvic inflammatory disease
  • Endometriosis 
  • Menstruation 
  • Fibroids
  • Benign ovarian cysts
  • Pancreatitis 
  • Renal failure 
  • Liver cirrhosis 
  • Chest infection 
  • It is also important to note that some women will have naturally high CA125 levels in their blood.

    Can a CA125 blood test be used as a screening tool for ovarian cancer? 

    Currently, it is not possible to use CA125 blood tests as a way of screening women for ovarian cancer for a number of reasons. 
    As previously discussed it is not just ovarian cancer that can cause an elevated CA125 reading, there are many other things that can cause this to be the case, along with the fact that some women will have a naturally elevated level with no cause for concern. So not all women with a raised CA125 level will have ovarian cancer, and it is also important to consider some women may have ovarian cancer but have a normal CA125 reading. 
    Annually screening all women with a CA125 blood test could lead to many being referred for further investigations that are unnecessary, causing needless worry and the possibility of having to undergo inappropriate surgery for no reason.
    In 2015 the results of a long-term study looking at the effectiveness of annual CA125 blood tests and ultrasound scans found that in some instances more women were diagnosed with the disease earlier, and in some of these cases death rates from the disease were reduced. However, further analysis is required to determine if these results can be conclusive and cost-effective enough for CA125 blood tests and ultrasound scans to form part of a national screening programme.

    What other research is happening in screening for ovarian cancer?  

    Ovarian Cancer Action funds the work of Professor Ahmed at the University of Oxford and so far, the team have made several exciting discoveries that have taken them closer to answering that question. They have found that the number of cells that have a protein called SOX2 is markedly increased in the fallopian tubes of women with or at high risk of ovarian cancer. Having a better understanding of how the disease develops is key to developing a screening tool.
    Although they have made some exciting discoveries, there is still a lot more research to be done. Identifying the SOX2 protein is an important step forward but it’s very difficult to get to, meaning a screening tool centred around it would be quite invasive. They are now looking for other changes that take place in the body simultaneously to the SOX2 protein production and, by harnessing different markers, they hope to find another marker that is easier to test for. 
    They hope to complete their next stage of investigations within the next five years and then the next step would be to translate their findings into clinical research. 
    This article was published by Ovarian Cancer Action.

Friday, July 12, 2019

Register for the Ovations 13th Annual Learning for Living Symposium on Sept. 14, 2019

This is always such a great event that is free to women and their guests. The day begins with breakfast at 8 a.m. followed by presentations by leading ovarian cancer experts. It is followed by lunch. Parking is at a reduced rate.

To find out more about this important event and to register, follow this link

Thursday, July 11, 2019

Donna Wiegle's TEAL on WHEELS: Ovarian Cancer Awareness Tour

Do you know the signs and symptoms of ovarian cancer?  I didn't think so.
My name is Donna Wiegle and I am living with advanced stage cancer. Three years ago, I was diagnosed with stage IIIB ovarian cancer and given a 5-year prognosis. It took my medical team more than two years to figure out what was wrong with me.
Over the past three years, I have heard many stories that were like mine. I have met women who knew something was wrong with them and they felt like no one was listening. They received diagnoses of irritable bowel syndrome, GERD, urinary tract infection, diverticulitis, chronic fatigue, and even suggestions of mental health issues—no one suspected ovarian cancer.

In her lifetime, a woman’s chance of getting breast cancer is 1 in 8.  Her chance of getting ovarian cancer is 1 in 78.  With no screening tests for ovarian cancer, by the time most women are diagnosed, they have stage III or IV cancer with  5-year survival rates of less than 39% and 17%. Ovarian cancer ranks fifth in cancer deaths among women, accounting for more deaths than any other cancer of the female reproductive system.  

Breast cancer’s color PINK is everywhere helping to raise awareness about the disease.  Ovarian cancer’s color is TEAL, which is virtually nowhere to be found.  If I asked the next ten women I meet what the symptoms of ovarian cancer are, I would be surprised if any could tell me.  I would also be surprised if the next ten people working in the medical field could tell me the symptoms of ovarian cancer.  This MUST change!

TEAL on WHEELS will encompass my mission of spreading ovarian cancer awareness across the United States. I plan to make this ride solo—just me, my bike, and my message.
I found the perfect bike...a teal and white 2016 Harley Davidson Heritage Classic motorcycle that I will ride across the country.   A leather jacket with a TEAL on WHEELS logo on the back and a flag with a teal cancer ribbon proudly displayed on the back of the bike will draw attention to me and the bike.  This will allow me to share my message at gas stations, hotel parking lots, restaurants, highway toll booths—everywhere I go. 
I plan to schedule stops along with way to talk with women’s groups, to doctors and nurses at medical centers—I might even show up at churches on Sunday mornings to spread my message.

I will be carrying business cards with the symptoms of ovarian cancer—abdominal bloating, lower back pain, frequent and urgent need to urinate, fatigue—symptoms that are easily dismissed by women and their doctors.  Unlike other cancers, there are no screening tests for ovarian cancer, only symptoms.

September is Ovarian Cancer Awareness month and that is when I will be riding across the country sharing my message.  TEAL on WHEELS will be a month-long ride.

In addition to raising awareness, I want to raise money to be donated to two non-profit cancer organizations.  The first, Ovarian Cancer Research Fund Alliance (OCRFA) is the largest ovarian cancer research organization in the world.  OCRFA works to advance research to prevent, treat and defeat ovarian cancer.  

The second non-profit organization, Turning the Tide Ovarian Cancer Retreats, Inc. has a different mission. Since 2012, Turning the Tide has hosted ovarian cancer patients and survivors living in the Northeast, for a 5-day retreat at Camp Kieve in Nobleboro, Maine. Turning the Tide Ovarian Cancer Retreats offers women the opportunity to come together and bond creating a Teal Sisterhood at a beautiful lakefront setting.  

All the donations received through this GoFundME campaign for the TEAL on WHEELS Ovarian Cancer Awareness Tour will be handled by the Beth C. Wright Cancer Resource Center, a non-profit organization in Ellsworth, Maine.  Michael Reisman is the Executive Director of the Beth C. Wright Center and will be managing all of the donations for TEAL on WHEELS.

I intend to make this ride as a solo journey, but I can’t do it alone—I need your support. 
Won’t you help me by donating to TEAL on WHEELS?

Tuesday, July 9, 2019

Novel Treatment Turns Tumors into "Cancer Vaccine Factories"

I found this article online at ClearityFoundation.org
By Mark L. Fuerst
In-situ vaccine may enhance immunotherapy response in resistant cancers, study shows.
A novel approach to cancer immunotherapy injects immune stimulants directly into a tumor to “teach,” induce the immune system to destroy the cancer and other tumor cells throughout the body. The three-step approach works as an in-situ cancer vaccine, researchers said.
A preliminary study could point to a new way of making immunotherapy more effective in cancers that have proven to be resistant to treatment and also enhance the effects of checkpoint blockade.
“The in-situ vaccine approach has broad implications for multiple types of cancer,” the study’s lead author, Joshua Brody, MD, of the Icahn School of Medicine at Mount Sinai in New York City, told the Reading Room. “This method could also increase the success of other immunotherapies, such as checkpoint blockade. The in-situ vaccine has multiple benefits: it’s simple, more practicable, costs a fraction of a personalized vaccine [does], and lets us optimize therapy.”
So far, Brody and colleagues have treated 11 patients, median age of 54, with indolent non-Hodgkin lymphoma (NHL), a cancer that, in general, does not respond to immunotherapy. Of the 11 patients who received the experimental therapeutic vaccine, one had a complete remission, two had partial remissions, and six had stable disease.
“This adds a new way to make anti-programmed death-1 (PD-1) agents effective in tumors where they are generally not effective,” Brody said. “PD-1 blockers help 20% of NHL patients, but that leaves the other 80% without effective immunotherapy. This is a novel solution to fix that problem. We have seen dramatic results in the laboratory to make PD-1 blockers more effective, and the vaccine induces systemic clinical remissions that can last for months.”
As immunotherapy continues to benefit from novel approaches to cut immune brake pedals, such as anti‐PD-1 and anti‐cytotoxic T-lymphocyte antigen 4 antibodies, there will be an increasing need to develop immune “steering wheels,” such as vaccines to guide the immune system specifically toward tumor-associated antigens, he noted. One hurdle in cancer vaccines has been the identification of universal antigens to be used in “off‐the‐shelf” vaccines for common cancers. Another hurdle is production of individualized whole tumor cell vaccines.
The new vaccine essentially turns the tumor into cancer vaccine factories by teaching the immune cells to recognize the cancer cells, said Brody. Once identified, the immune cells actively seek out all the cancer cells of the body and kill them. The three-step approach consists of (1) recruiting dendritic cells, (2) loading dendritic cell tumor antigens, and (3) activating the antigen-loaded dendritic cells.
The treatment consists of administering a series of immune stimulants directly into one tumor site. In the first step, a human protein form of FMS-like tyrosine kinase-3 ligand (FLT3L) recruits dendritic cells, which are important immune cells that act like generals of the immune army, Brody explained.
In the second step, low-dose radiation therapy activates the dendritic cells, which then instruct T cells, the immune system’s soldiers, to kill cancer cells and spare non-cancer cells.
In the third step, a toll-like receptor-3 agonist activates the dendritic cells and stimulates the immune army to recognize features of the tumor cells so it can seek them out and destroy them throughout the body.
In laboratory tests in mice, the vaccine drastically increased the success of checkpoint blockade immunotherapy. PD-1 blockade didn’t cure any large tumors, but after adding the vaccine, the cure rate increased to 75%. Side effects were grade 1 or 2 flu-like symptoms and muscle aches that last for a day. “We did not see any autoimmune adverse events,” said Brody.
Clinical Trial Ongoing
A clinical trial for lymphoma, breast, and head and neck cancer patients opened in March 2019 to test the vaccine with checkpoint blockade. The in-situ vaccine is also being tested in the laboratory in liver and ovarian cancers.
“Literally hundreds of immunotherapy trials are accruing thousands of patients each year to understand how to better whip T cells into shape and to get immune soldiers to do their job harder,” said Brody. “Clinical oncologists are frustrated that the majority of patients don’t respond to PD-1 blockers. We may be able to potentiate PD-1 blockade with this in-situ vaccine.”
In a 2018 review of in-situ vaccination, Mee Rie Sheen, PhD, of Harvard Medical School in Boston, and Steven Fiering, PhD, of the Geisel School of Medicine at Dartmouth in Hanover, New Hampshire, noted that local administration of immunostimulatory reagents into a recognized tumor by in-situ vaccination can generate systemic antitumor immunity to fight metastatic disease. “Conventional vaccines contain antigens and immune adjuvants. With in-situ vaccination, the tumor itself supplies the antigen, and the treatment only applies immune adjuvant directly to the tumor,” the authors stated.
They explained that current immunotherapy often fails to eliminate cancer because of local immunosuppression mediated by tumors. In-situ vaccination, in effect, “changes the tumor microenvironment from immunosuppressive to immunostimulatory, stimulates presentation of tumor antigens by antigen‐presenting cells to T cells, and generates systemic antitumor immunity that promotes antigen‐specific effector T‐cell attack of both treated and importantly, untreated metastatic tumors.”
Sheen and Fiering concurred with Brody about the advantages of in-situ vaccination — i.e., that it:
  • Is simple and cost‐effective
  • Has minimal systemic side effects
  • Is a feasible and flexible adjuvant delivery system
  • Exploits all tumor antigens in the tumor to avoid the need to identify antigens
  • Utilizes all antigens in the tumor to minimize immune escape
  • Has potential synergy when combined with other therapies
This article was published by MedPage Today.