Holistically funding ovarian cancer research — because survival shouldn’t come down to ‘luck’.
Are you aware that a cervical cancer smear (Pap test) does not detect ovarian cancer? That the cause of ovarian cancer is unknown? That clinical treatments for ovarian cancer have not advanced significantly in three decades, despite the disease recurring in 80% of cases?
Although it is important that these facts be widely known, ultimately awareness will not save lives — research will. But improving long-term survival rates is more complicated than funding one project or research area. The Ovarian Cancer Research Foundation (OCRF) recognises that a lack of prevention, early detection, treatment and recurrence management options exist simultaneously and impact women an girls every day. That's why the OCRF are funding four key areas of research.
What are these areas of research?
Early Detection focuses on developing accurate, non-invasive and accessible early detection programs to ensure diagnosis occurs in the early stages, making it more curable.
Finding New and Effective Treatments looks to identify targeted treatment options to deal with the complexities of the disease.
Managing Recurrence investigates how the disease can be monitored, and ultimately prevented from returning.
Prevention research digs into the origins and risk factors of the disease.
Saving Future Lives
According to the State of the Nation in Ovarian Cancer: Research Audit an early detection test could save the lives of 8000 Australian women over the next decade and 1.3 million globally. If detected early, in excess of 90% of those diagnosed are predicted to survive beyond 5 years, a vast improvement on the current 5-year survival rate in Australia of 48%.
An early detection test is required because the symptoms of ovarian cancer, such as bloating, weight loss or gain, mimic those of general ailments. Many women don’t experience symptoms at all until the cancer has spread. The body alone cannot alert us early enough.
The OCRF funds multiple approaches of early detection research with the hope of delivering early detection access to as many women and girls as possible. Research approaches include the multiplex Active Ratio test that looks for a measurable change to a protein that occurs early within cells, and development of novel exosomal biomarker panels that assess several biomarkers simultaneously.
An early detection test will save the lives of future generations of women and girls — but what about those experiencing ovarian cancer here and now?
"Currently, there is no effective test for early detection. We urgently need better ways to find this disease at an early stage. But until then, better treatments are our best defence,” says Associate Professor Stacey Edwards of the QIMR Berghofer Medical Research Institute.
"The good news is that there is a kind of research knowledge relay at play. Associate Professor Edwards explains, “there are many knowledge overlaps between early detection research and treatment research. For example, identification of new biomarkers associated with early detection could also be useful for understanding ovarian cancer progression and help guide treatment response.
Aware that treatment options are currently limited to chemotherapy, use of PARP inhibitors and surgery, Associate Professor Edwards is currently working on a treatment project funded by the OCRF. She hopes to identify new molecules that can be used in combination with PARP inhibitors so that a multi-pronged treatment approach can stop the cancer in its tracks and inhibit recurrence.
A recurrence rate of 80% is one factor that makes ovarian cancer the most lethal gynaecological disease. For most patients when ovarian cancer returns the current options simply stop working, so understanding how and why recurrence happens is essential.
Funded by the OCRF, Dr Maree Bilandzic and her team at the Hudson Institute of Medical Research last year identified the population of cells believed to be the key drivers of ovarian cancer metastasis and resistance — ‘leader cells’. Her team are working to identify drugs that can target these cells and help re-sensitise patients to treatment.
Is prevention the best cure?
Imagine if we could teach young girls to prevent ovarian cancer in the same way that we ensure that on hot days they wear a hat, stay in the shade and are slathered in sunscreen to ward off skin cancer.
When we think of prevention, we tend to think of light, habitual changes we can make to our lifestyles. But where ovarian cancer is concerned, prevention measures take the form of life-altering decisions.
Currently we know that those with BRCA 1 or BRCA 2 gene mutations can have a higher risk of developing ovarian cancer. But even if a woman discovers she has a BRCA gene mutation, what exactly are her prevention options?
Daniella Brasacchio is a research scientist at Monash University and a member of the OCRF’s Consumer Representative Panel. She also carries the BRCA 1 gene mutation.
Daniella discovered that she inherited this gene when ovarian cancer took her mother’s life. She found that she had an 80% higher risk of developing breast cancer and 50% higher risk of developing ovarian cancer. She commenced early detection screening for breast cancer, but no such screen exists to detect early-stage ovarian cancer. In order to have a family, Daniela lived with the anxiety of knowing she was considered high-risk for 12 years before, at age 39, she chose to have a hysterectomy and bilateral salpingo-oophorectomy.
Although she is grateful to have lessened her risk of developing ovarian cancer, this prevention measure has taken a toll on her life, in particular the surgery prompted premature menopause.
“I continue to be monitored for serious health associated risks with menopause including cardiovascular, cognitive and bone health. I have no natural breast tissue, no uterus, no ovaries. Yes, I feel less feminine. I am much more fortunate than my mother, and many others who have experienced or are experiencing ovarian cancer. Yet, more direct research is required for prevention because we deserve to have a choice.”
Understanding the root causes of and risk factors that contribute to ovarian cancer is important because when prevention means being informed and altering daily habits, rather than having to choose between the lesser of two evils, then prevention will be the best cure. The OCRF recognises this and is currently funding research that evaluates the role of hormones in the development of ovarian cancer, as well as collaborating on research that assesses lifestyle risk-factors.
Taking ‘luck’ out of the equation
According to Cancer Australia, a woman has a 1 in 87 chance of being diagnosed with ovarian cancer by age 85. If she is diagnosed, she has a 48% chance of being alive five years later.
Due in part to ovarian cancer research being historically underfunded, ‘luck’ sadly continues to play a role in determining if someone is within that 48% or not — whether someone was ‘lucky’ to be diagnosed early, ‘lucky’ to be diagnosed with a subtype that may be more treatable, ‘lucky’ that they are one of the few whose cancer doesn’t recur. But no one is ‘lucky’ when it comes to ovarian cancer so survival shouldn’t come down to chance.
This is why the OCRF is as committed as ever to its strategy and funding across all areas of the disease, as ultimately this holistic approach will bring us closer to freeing women and girls from the threat of ovarian cancer. With the collaboration of government, the community, corporate and philanthropic Australia, in 2022 the OCRF looks forward to supporting researchers who, every day, get closer to ensuring luck is no longer part of the equation.