June 2021

Ovarian Cancer

Last fortnight, I had the pleasure of visiting the University of New South Wales, and in particular the Gynaecological Cancer Research Group there. I was hosted by Associate Professor Caroline Ford, who runs the group. This research group looks at gynaecological cancer, which encompasses all cancers of the female reproductive system, although the current focus of their research is on endometrial cancer and ovarian cancer. Members here would be aware that ovarian cancer is a devastating disease that is still frequently diagnosed too late. The current survival rate for ovarian cancer is only 43 per cent over five years. Every day in Australia, four women are diagnosed with ovarian cancer and three women die of ovarian cancer. That's 1,500 new cases and 1,000 deaths every single year in Australia.

A few decades ago, if you were diagnosed with ovarian cancer, it was nearly a death sentence. Today, the survival rate is better—43 per cent after five years—but it's still incredibly bad compared to other forms of cancer. The primary treatment still remains major surgery to remove ovaries, fallopian tubes and the uterus. At the moment, presentation usually occurs with a physical manifestation—usually bloating of the abdominal area and discomfort. But, by the time women present with those symptoms, the cancer is already quite far advanced. The hope of this research group is that, if we can find a way to detect ovarian cancer at an early stage, the survival rates could improve quite dramatically.

This research group at the University of New South Wales has identified a set of DNA regions that are specifically changed in blood from patients who are suffering from ovarian cancer but are unchanged in the blood of people who have only benign conditions. The centre is currently developing a large biobank of blood samples from diverse groups of women in order to refine these ovarian-cancer-specific DNA regions more specifically and then design highly sensitive laboratory tests to detect them accurately in the blood. The hope is that, by doing so, they will allow for early detection of ovarian cancer and hence earlier intervention and hence higher survival rates

Unlike with other cancers, which can be diagnosed by effective screening at an early stage—for example, cervical cancer through cervical cancer screening tests or breast cancer through mammography—an early detection test for ovarian cancer does not currently exist. But, like other cancerous tumours, ovarian cancer tumours shed DNA into the bloodstream, and the DNA is different to healthy DNA because it has mutations inherent to the cancer. But at the moment the DNA is quite difficult to detect because it's in fragments. In addition, every patient tends to have different mutations, reflective of their own particular form of cancer, making it challenging to identify a common thread behind the disease.

When I was at the University of New South Wales, I met and spoke with Dr Kristina Warton, who's leading some of this research, in addition to Associate Professor Caroline Ford. What she's noticed is that methylation of some of these DNA fragments is a change that happens consistently across different types of ovarian cancer. She's now using a cutting-edge scientific technique—PCR, polymerase chain reactions, for those who are familiar with it—to amplify this circulating tumour DNA to detect methylation and develop this eventually into a blood test. As Dr Kristina Warton told me, if we can develop an effective test for ovarian cancer, it's almost as good as a cure, because if you catch ovarian cancer early enough you can address it and cure it through surgery. Cervical cancer is a good example, because, in countries where health systems have been able to widely apply the Pap smear test, cervical cancer rates have really plummeted. This is really all about diagnosis, and early diagnosis leads to better prognosis.

All this stuff is, of course, expensive, and there's always a lot of competition for medical research dollars in Australia, as there is around the world. Last year, on World Ovarian Cancer Day, the government announced $16.2 million for eight research projects. Some of that funding from the Medical Research Future Fund is going to this ovarian cancer research at the University of New South Wales.

I also want to commend two individuals who reside within my own electorate: brother and sister Marc Freeman and Camilla Freeman-Topper, who tragically lost their own mother to ovarian cancer 27 years ago. Marc and Camilla—who are part of the eponymous fashion brand Camilla and Marc—recently launched the 'Ovaries. Talk About Them' campaign to raise awareness and money. They've been selling hoodies and unisex T-shirts online. To date, this campaign has raised $225,000, kickstarting the development of an early detection test in this research and enabling the group to employ two scientists to focus solely on this work. So I commend the work of Camilla and Marc and the professors at the University of New South Wales.