Early Cancer Screening is Key to Survival
MADISON - No matter what kind of cancer, finding it early can be the key to surviving the disease. As researchers at the University of Wisconsin Paul P. Carbone Comprehensive Cancer Center work to develop groundbreaking tests for early detection of some of the most common cancers, they also stress that no test can work if patients don't come in to be screened.
"Significant advances in cancer detection have come in ovarian cancer," says David Kushner, MD, a UW Health gynecological oncologist.
Eighty percent of ovarian cancer cases are not diagnosed until the disease has reached an advanced stage. But according to Dr. Kushner, even ovarian cancer is treatable and curable in the early stages.
University of Wisconsin School of Medicine and Public Health researchers are at the forefront of a study of an early-detection blood test. Dr. Kushner says the test could be available within five years. Dr. Kushner also says public education about early ovarian cancer symptoms should give women a better chance of catching it early. He points to development of an ovarian cancer symptom checklist created just a few months ago by advocacy groups.
"It proved that the majority of women do have symptoms three to six months prior to getting diagnosed," says Dr. Kushner.
Breast Cancer: The Message is the Image
In breast cancer detection, UW Carbone Cancer Center researchers are studying improved imaging to spot the disease in its earliest stages.
"The mammogram is not a perfect test. On the other hand, it's the best test we have because it has reduced the mortality rate from breast cancer," says Jim Stewart, MD, UW Health oncologist.
A biopsy is typically the only way to diagnose breast cancer when mammograms and ultrasounds indicate suspicious areas. But researchers like Gale Sisney, MD and Elizabeth Burnside, MD, UW Health radiologists, are working on more precise, computer-assisted imaging. Researchers are developing an imaging method that would better distinguish between cancer and calcification, common calcium deposits that are usually noncancerous.
Dr. Sisney is also building a breast cancer device using magnetic resonance imaging or MRI that will help doctors perform biopsies.
"By 2010, the national goal will be to diagnose more than half of breast cancer cases while they're smaller than a dime," says Dr. Sisney.
Prostate Cancer: Know your PSA
One in six men will develop prostate cancer in their lifetime, according to the American Cancer Society (ACS). As a result, the ACS recommends men over 50 get annual rectal exams and blood tests. Right now the standard test for prostate cancer is the Prostate Specific Antigen, or PSA, blood test.
UW Health urologist David Jarrard, MD says the test can detect abnormalities, but it also can produce uncertain or false test results. Dr. Jarrard says if there's an elevated PSA, doctors may take the next step and do a "free to total" PSA test, a relatively new option. A combination of the two tests could determine if there should be a biopsy to confirm prostate cancer. Dr. Jarrard is currently researching a more advanced prostate cancer detection test that could be available over the next several years.
"Other, newer ways of detecting cancer are being developed at the UW Carbone Cancer Center using molecular abnormalities in normal prostate tissue to detect cancer," adds Dr. Jarrard.
Colon Cancer: The Difference is Virtual
"Better, Faster, Safer, Cheaper." That's the mantra of UW Health radiologist Perry Pickhardt, MD an international leader in the study of virtual colonoscopy.
Dr. Pickhardt's work confirmed that virtual colonoscopy, a non-invasive, 3-D colonoscopy that uses computed tomography scan technology (CT scans), is more accurate, safer and often cheaper than traditional colonoscopy.
Dr. Pickhardt predicts virtual colonoscopy will become a mainstream screening method in the next few months. But he says it will not replace colonoscopy. The advantage of the more traditional screening is the ability to remove pre-cancerous polyps at the same time as the screening procedure. But Dr. Pickhardt says virtual colonoscopy is a good option for people who have avoided screening because colonoscopy is invasive.
Dr. Pickhardt is the lead investigator on a clinical trial on the efficacy of using virtual colonoscopy to detect very small polyps. Patients will be tracked over time to find out more about how small polyps develop. He says the research could determine which polyps should be removed immediately and which are not likely to develop into cancer.
Primary Care Physicians Play Vital Role
UW Carbone Cancer Center doctors say screening by primary care physicians is often the most important single factor in early detection. A family medicine physician and educator in the UW School of Medicine and Public Health says as we learn more about diagnosing cancer, recommendations for screening are likely to change over time.
Jennifer Frank, MD, assistant professor of family medicine and physician at the Fox Valley Family Medicine Residency Program in Appleton, says the leading independent panel that creates general guidelines for cancer screening recommends routine screening for breast, cervical and colon cancer.
Dr. Frank says the future of cancer screening by family medicine physicians will focus on genetics and family history. She says blood tests are being developed to identify tumor markers which will help define who is and who is not at risk.
"What we really need is not fancier tests, but people getting the cancer screening they need," said Dr. Frank.
To learn more about screening and cancer care ask your primary-care physician, and visit www.uwhealth.org/cancer.
Date Published: 03/03/2008