Ovarian cancer

by Leen Jerjos, GCSOM, MBS 2019
Mentor: Jennifer Boardman, PhD

 Did you know that 22,000 women will be diagnosed with ovarian cancer in the United States this year alone? Yes, and 90% of these diagnoses will specifically be epithelial ovarian cancers (EOCs). EOCs originate in cells lining the fallopian tube or cells found on the surface of the female ovaries. An EOC diagnosis means these cells are multiplying too rapidly and have formed a tumor. Realistically speaking, because this type of cancer does not produce any symptoms in its early stages, most diagnoses are made after the tumor has formed and spread to other parts of the body. The cause of EOC is not fully known yet, although researchers have noted that some individuals have an increased risk for EOC due to genetic factors. Other potential risk factors include the number of lifetime ovulations, some environmental factors, cigarette smoking, and race.

EOC can be divided into two categories based on how aggressive the tumor is. Type I EOC is less aggressive, more stable, and is associated with better patient outcomes. Type II EOC, in contrast, is notorious for its highly aggressive behavior, meaning the tumor will not stay confined to the ovary very long, and will spread to another location in the patient’s body very quickly. Furthermore, type II EOC symptoms, if present, can be easily overlooked. Patients will experience abdominal bloating, indigestions, constipation, and heartburn, all of which can be attributed to a host of other illnesses. The lack of clear symptoms and the aggressiveness of the cancer results in 70% of cases of ovarian cancer being diagnosed at an advanced stage. These troubling statistics demonstrate why it is urgent that we develop new screening methods for people who are at an increased risk of EOC.

There are currently three known proteins present in our cells that behave differently in EOC cells. These proteins, therefore, can be used to provides information about the cancer, such as how aggressive it is (read: type I or type II). These proteins are referred to as biomarkers, and can be used to diagnose EOC at a much earlier stage compared to current methods. Current diagnostic approaches for EOC include the use of transvaginal ultrasonography, genetic testing, and ovarian tissue biopsies. Due to how invasive and costly they are, these procedures are only conducted on patients with known family history of EOC. If the new biomarkers were to be used as an alternative diagnostic approach, the physician would simply order bloodwork or a urine analysis test and check for the specific protein level.

The newest biomarker with diagnostic potential is another protein normally found in our healthy cells. In fact, this protein is involved in a chemical reaction that produces the active for of vitamin B6 that our body uses. Researchers found that EOC cells contained a higher concentration of this protein. This was a groundbreaking discovering as not only do we have a new biomarker that can be potentially used to diagnose EOC, but we may also have a potential treatment on our hands. Researchers found that increasing vitamin B6 concentrations in these cells can lower the concentration of this protein, due to a negative feedback loop. This phenomenon slowed down the rate of tumor growth, and although much is still to be done, this is beyond doubt a victory for cancer research.