"If some of my relatives had only known what was happening to other women in the family, they could have gotten help earlier and perhaps saved their lives," said Rojas, who is 32. Besides her mother, who first had breast cancer and later cervical and colon cancer, other relatives with genetically related cancers include her grandmother, two sisters, an aunt and a cousin.
Rojas learned about UT Southwestern's ovarian cancer research through the Susan G. Komen Breast Cancer Foundation, where she works as an auditor, a job she believes helps in her effort to "get the word out to educate women about cancer."
The portion of the study in Dallas is headed by Dr. John O. Schorge, assistant professor of obstetrics and gynecology, and Dr. Gail Tomlinson, associate professor of pediatrics and director of the Familial Cancer Registry at UT Southwestern. Sponsored by the National Cancer Institute and the Cancer Genetics Network, the study is being offered in two other Texas cities, San Antonio and Houston and in a total of 16 medical centers across the country. It is aimed at determining whether a blood test, called CA125 (cancer 125), will work as a predictor of ovarian cancer in women who are at increased risk because of their family history of breast and/or ovarian cancer.
Participants fill out a questionnaire on their family history and will give blood tests at three-month intervals. Preliminary research suggests that checking CA125 levels over time may uncover a trend toward the development of cancer. If CA125 levels go up, then participants may undergo ultrasound of the ovaries.
"By following the patients for two years, we hope to detect the presence of ovarian cancer before it begins to grow," Schorge said.
He said participants in the study, who must not be pregnant nor become pregnant during the two-year period, must meet one of the following criteria:
·Have at least two first- (parent, child or sibling) or second-degree (grandparent, aunt or cousin) relatives who have had ovarian or breast cancer.
·Be of Ashkenazi ethnicity, which carries a high risk for hereditary women's cancers, and has one first-degree relative with breast or ovarian cancer or has had breast cancer herself. ·Have a first- or second-degree relative of a known carrier of a BRCA1 or BRCA2 cancer-gene mutation.
·Have a 20 percent risk of cancer based on assessment of her family history by researchers, or she carries a BRCA mutation.
"Women are given Pap tests looking for signs of cervical cancer as a part of their regular health care," Schorge said. "Yet for ovarian cancer there is no test, in spite of the fact that it accounts for more deaths than all other gynecologic cancers combined. In addition, ovarian cancer is the most difficult of the women's cancers to detect because there are no symptoms or warning signs. Yet there is a whole population of women at increased risk for developing ovarian cancer because of family members with breast- or ovarian-cancer histories."
This pattern certainly fits the Rojas family. Rojas was a teen-ager when her mother was diagnosed with cervical cancer. But this time she knew what was going on. "I had been only 5 years old when my mother had a double mastectomy when we were living in Juarez. It was 'hush, hush' around the house, and nothing was ever said about the cause of her illness. It took me many years to learn about not only my mother's cancers but also those of other women in the family."
Rojas, who is still trying to get her female relatives to be tested, said, "Women must learn not to be afraid to ask for help. They're not the only ones in the world with this problem, it's everybody's problem." Cancer researchers estimate in 2001 that 23,400 women will be newly diagnosed with ovarian cancer in the United States.
For more information about the study, call Sharon Haynes, manager of the outpatient clinic at UT Southwestern's General Clinical Research Clinic, at 214-648-7853.
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