EARLY DETECTION OF MUCINOUS AND GRANULOSE CELL TUMORS:WHAT INHIBINS YOU COULD KILL YOU!

Granulosa cell and mucinous epithelial tumors are rare types of ovarian cancer. Inhibins are a family of growth factors comprised of several different species that are secreted in ovarian follicles and are also produced by granulosa cell tumors and mucinous epithelial carcinomas. Since physiological menopause or surgery reduces the circulating level of total inhibin, any inhibin production in women with mucinous or granulose tumors is indicative of disease progression.

Standard methods for detection of disease recurrence are typically based on imaging, with PET-CT having the highest sensitivity and specificity. However, imaging is costly and continued scanning can result in high radiation exposure. More importantly, by the time these tumors can be detected by standard imaging techniques, the disease is usually progressed to an advanced state.
Using serum inhibin levels as a way of detecting early disease progression provides the opportunity for early intervention and treatment prior to metastasis, and is cost effective, non-invasive and safe when used on a continual basis. In some published studies, the inhibin blood serum markers have detected up to 95% of granulosa cell and mucinous epithelial tumors with 95% specificity (true positive rate).

I like this approach because it provides a cheap, rapid, safe and non-invasive way of detecting early recurrence of these deadly cancers at a stage that is highly treatable!

Unfortunately, since these cancers are so rare, universal acceptance of inhibin based testing for detection of disease recurrence has not been implemented and currently, we are aware of only two provinces (Quebec and Saskatchewan) that are currently offering these life saving tests.

If you or someone you love has either granulosa cell or mucinous epithelial cancer, we urge you to contact your local health department and request that they adopt this test.

Link To Mayo Clinic Inhibin Testing For Granulosa Cell And Mucinous Tumors.


Comments

  1. Simple screening mhtdoes should be employed because the prognosis for stage 1 is excellent ranging from 87%-95% alive after five years. Stage 3c, the most common is a paltry 28%.This is not as simple as that. Anon, have you ever heard of lead-time bias? 5-year survival rate is not a measure of how effective early detection is. Early detection always increases 5-year survival rate regardless of whether it works. Say two people died in 2000 at the age of 30 from cancer. But in one case, the cancer was diagnosed in late stage in 1999, in another case it was diagnosed early in 1994. You wouldn’t say that the second person is better off, right? Yet, the latter person was alive for 6 years after diagnosis while the former only 1 year. This is called lead-time bias and if you are a physician, I am amazed that you don’t know this simple concept.The only measure of screening test effectiveness is the effect on mortality i.e. how many people out of say 10,000 die of the desease in screened vs non-screened group. Every cancer is different. Pap smears actually prevent cancer rather than simply detect it early which is a huge difference.Is Stage 1 cancer curable because it is detected early or because it is less aggressive (which is why it was detected early in the first place)? Will the new test actually reduce mortality from ovarian cancer or will it simply result in increase of incidence (because of overdiagnosis)? How big the effect on mortality will be? How large will be the extent of overdiagnosis? Only studies will help to answer these questions. As much as one may want to prevent death from ovarian cancer, one shouldn’t forget possible harm associated with screening the whole population until the information is available. Just look up screening for neuroblastoma in Japan as an example of a screening program that caused more harm than good.

    • Thank you for your thoughts on this. I do appreciate what you are saying but I am not sure I understand you completely. I agree with the OS as being the important guideline here but are you saying that early detection is only good if we can cure the cancer? Are you implying that two cancers are the same and will have the same genetic background, and therefore similar survival rates?

      I believe that the earlier you discover a disease, the better chance you have of controlling it and extending OS. I think an increase in incidence is a good thing, you are catching more of the disease. Since the progression of the disease is based on genetic features that if targeted, can be very effective…using a statistic that has an open ended variable such as the type of treatment a person gets, to decide whether early diagnosis is important or not, does not seem like proper patient stratification to me and not something that can be calculated.

      Thanks for your comments and thoughts, we need more people offering their opinions like yourself.

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