Vanderbilt-Ingram Cancer Center Researchers Launch Ovarian Cancer Study: Urine Test for Early Detection is Goal

September 10, 2007

Gautam Rao, M.D.Researchers at Vanderbilt-Ingram Cancer Center have launched a pilot study to determine if a simple urine test could detect ovarian cancer, the leading cause of death from gynecologic malignancy in the United States. Currently there is no simple, reliable early screening test for ovarian cancer, which usually is found in late stages when it is considered incurable.

Gautam Rao, M.D., assistant professor in the Division of Gynecologic Oncology, is investigating high levels of prostaglandins in ovarian tumors and believes that a major urinary metabolite of some prostaglandins may indicate the presence of ovarian cancer.

“We believe this metabolite of prostaglandin is elevated in the urine of women with ovarian cancer,” said Rao. “If we can confirm these high levels in urine match the same markers found in ovarian tumors, this could be the first step in the development of a reliable urine test for women.”

Such a test could save lives. According to the National Cancer Institute, approximately 22,430 women are diagnosed with new cases of ovarian cancer each year, and 15,280 women will die of the disease. Most cases of ovarian cancer are diagnosed in late stages when the cancer often has spread beyond the ovary. The disease is detected at late stages because symptoms such as abdominal pain, swelling, pelvic pain and gastrointestinal distress can be subtle and often are confused with other health problems. Most cases are detected by transvaginal ultrasound or laparoscopic surgery.

Rao and his colleagues at Vanderbilt-Ingram are enrolling women with known or suspected ovarian cancer in this pilot study. Patients are asked to collect urine specimens during a 24-hour span prior to initial surgery and before they have received any clinical treatment for cancer. Levels of PGE-M, a metabolite of prostaglandin E2 (PGE2), will be measured in the urine, and COX-1 and COX-2, which are cyclic endoperoxidases, will be measured in the tumor. A portion of ovarian tumor will be sampled by the Vanderbilt-Ingram Tumor Bank Human Acquisition and Pathology Shared Resource after surgical removal and the markers will be compared to those found in the urine.

“If we find the strong correlation we suspect, this biomarker could be used for screening purposes and to measure response to cancer treatment, especially therapy aimed at decreased prostaglandin production, such as aspirin or other nonsteroidal anti-inflammatory drugs,” said Rao.

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