What is the DOVE project?
The DOVE project (Detecting OVarian cancer Earlier) is a clinical research study funded by the Canadian Institute of Health Research (CIHR) and the McGill University Health Centre Foundation. It is aimed at discovering a method of detecting ovarian cancer at an early stage. This cancer is referred to as a "silent killer" because in its early stages its symptoms are vague and non-specific. Therefore it mimics many common benign diseases and is therefore ignored by patients and doctors alike. Dr. Lucy Gilbert, chief of the division of gynecologic oncology at the McGill University Health Centre, along with a team of experts, is looking to change this and develop a "probability tool". This tool is intended to help patients and doctors decide when a particular set of seemingly innocuous symptoms, warrant urgent investigations to rule out ovarian cancer. Through the DOVE project, Dr Gilbert hopes to inform and educate the public and primary care doctors about the symptoms of ovarian cancer and the appropriate diagnostic investigations.
What is the importance of Ovarian Cancer?
Canadian women have a 1 in 65 lifetime risk of being diagnosed with ovarian cancer. It is the fourth leading cause of death from cancer Canadian women. Over 90% of ovarian cancers occur randomly in the low risk general population (i.e. even without a family history). If detected at an early stage i.e. stage I, over 90% of women can be cured. However, over 70% of women are diagnosed in stage III or IV, when despite extensive surgery and chemotherapy, over 50% will relapse within two years, and more than 80% will die of disease within 5 years.
What is the rationale of the DOVE study?
As stage I ovarian cancer (OC) is curable by surgery alone in over 90% of the cases, the key to saving lives is to increase the proportion of women diagnosed in stage I. In an attempt to do this, the American Cancer Society, the Society of Gynecological Oncologists and the Gynecological Cancer Society, issued a joint advisory in June 2007, urging women who have bloating, abdominal distension, abdominal/pelvic pain, urinary frequency and/or early satiety, to seek gynecological examination, transvaginal sonography (TVS), and assessment of CA125 (a tumour marker). However, these symptoms are very common and the vast majority of times are not associated with ovarian cancer. Furthermore, some women with OC have other symptoms. In addition, the tests for OC such as CA125 and TVS need to be performed and interpreted by experts to reduce over-diagnosis (false positive) or missing the disease (false negatives). In Quebec, there is yet another problem that many women do not have a family doctor or gynecologist and often experience lengthy delays for an initial consultation, with further delays for investigations.
The DOVE study is intended to overcome these difficulties by offering fast-track diagnostic testing to women with symptoms that have been found to be associated with ovarian cancer, in the context of a research study. This means that the all eligible symptomatic patients have access to the diagnostic assessments without delay. The results are interpreted by experts and the information is used to develop the probability tool that will accurately identify the particular cluster of symptoms that suggest that the probability of OC is high in a particular symptomatic woman. This probability tool will serve in future as a decision aid which doctors and patients can use in the future to decide on who needs urgent referral.
How can the DOVE project help me?
If you are a woman, living in Montreal, aged 50 years or more, and experience one of the symptoms below which have been identified as OCCASIONALLY being associated with ovarian cancer, you may be eligible to receive an ovarian cancer diagnostic testing at our center. You will be receiving Ca125 blood tests, a trans-vaginal sonography (TVS), and will also be assessed by experts who know how to interpret these tests. To find out if you are eligible, please complete the questionnaire below. If you have any of the symptoms mentioned below, please contact a member of the DOVE team and set up an appointment for an ovarian cancer diagnostic testing.
Women's Health Symptom Inventory
Please check off any of the symptoms that you may have experienced for more than 2 weeks but less than 1 year:
- Feeling full or stuffed after eating even only a few bites, or food feels stuck, or loss of appetite.
- Nausea, vomiting , heartburn, gas, burping, indigestion.
- Diarrhoea, constipation, bowel or rectum feels full, change in bowel habits, constant urge to have a bowel movement, painful or burning bowel movements, rectal pain, painful defecation.
- Need to urinate more often or need to urinate urgently, pressure on the bladder, or leaking urine, burning sensation when urinating, need to urinate but nothing there, can’t empty bladder completely, feeling full after urinating.
- Bloating, distension, enlargement or thickening of abdomen or stomach area, or clothes around the waist feel too tight, or notice an abdominal mass.
- Vaginal discharge, bleeding, spotting, or deep pain on intercourse.
- Weight-loss not due to dieting.
- Discomfort or pain in abdomen, or pelvic region, or lower back.
If you are over 50 years old and have any of the above group of symptoms, please call us at 1-866-716-3267 to schedule an appointment for ovarian cancer diagnostic testing of your symptom(s).