A study to evaluate the use of CA125 in ovarian cancer follow-up: A change in practice led by patient preference

Palmer, Cheryl; Pratt, J.; Basu, Bristi; Earl, Helena

doi:10.1016/j.ygyno.2005.11.046

Cited by 11 publications

(8 citation statements)

References 26 publications

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“…Discounting is another effect of the same mediation process, but it is likely to make symptoms more bearable, and so work in favour of the same therapeutic goals. Reassurance and legitimation are both subjective benefits of testing, and may partially explain why patients say they want the tests (Palmer, Pratt, Basu & Earl, 2006).…”

Section: Figurementioning

confidence: 99%

Cancergazing? CA125 and post-treatment surveillance in advanced ovarian cancer

Jordens

Morrell

Harnett

et al. 2010

Social Science & Medicine

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Post-treatment surveillance of advanced ovarian cancer involves regular testing of asymptomatic patients using the CA125 test. This practice is based on a rationale that is not supported by evidence from clinical trials. This paper aims to stimulate critical reflection concerning the effect of investigative tests on clinical decisions and interactions, and the experience of illness, particularly in the context of advanced malignant disease. Drawing on the idea of the "medical gaze", and building on previous health communication research, we present an analysis of in-depth interviews and psychometric tests collected in a prospective study of 20 Australian women with advanced ovarian cancer conducted between 2006 and 2009. We describe the demands placed on patients by the use of the CA125 test, some hazards it creates for decision-making, and some of the test's subjective benefits. It is widely believed that the CA125 test generates anxiety among patients, and the proposed solution is to educate women more about the test. We found no evidence that anxiety was a problem requiring a response over and above existing services. We conclude that the current debate is simplistic and limited. Focussing on patient anxiety does not account for other important effects of post-treatment surveillance, and educating patients about the test is unlikely to mitigate anxiety because testing is part of a wider process by which patients become aware of a disease that -once it has relapsed -will certainly kill them in the near future.

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Section: Figurementioning

confidence: 99%

Cancergazing? CA125 and post-treatment surveillance in advanced ovarian cancer

Jordens

Morrell

Harnett

et al. 2010

Social Science & Medicine

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“…This phenomenon has also been frequently noted in anecdotal reports and empirical studies of ovarian cancer survivors, with the CA125 biomarker coming to play a prominent role in many women's experiences of cancer survivorship (for example, Hamilton, 1999; Guppy and Rustin, 2002; Howell et al , 2003; Palmer et al , 2006; Parker et al , 2006; Chitale, 2009). According to Hamilton (1999, p. 339):

Many women begin to identify their CA125 levels as the evidence of disease status ….

…”

Section: ‘Measured Vulnerability': Commonalities In Experience Acrossmentioning

confidence: 67%

Biomarkers, the molecular gaze and the transformation of cancer survivorship

Bell

2013

BioSocieties

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Over the past two decades, molecular technologies have transformed the landscape of cancer diagnosis, treatment and disease surveillance. However, although the effects of these technologies in the areas of primary and secondary cancer prevention have been the focus of growing study, their role in tertiary prevention remains largely unexamined. Treating this topic as a problematic to be conceptually explored rather than empirically demonstrated, this article focuses on the molecularisation of tertiary prevention, especially the growing use of molecular biomarkers to monitor disease recurrence. Taking a semiotic approach, I speculate on the potential meanings of molecular biomarkers for people living with and beyond cancer and suggest the meanings of these technologies may differ in important ways for those on both sides of the risk divide: that is, those ‘at risk' for cancer and those living with realised risk. Although molecular biomarkers may intensify a sense of ‘measured vulnerability', by indexing cancer's presence they may also prove reassuring. Moreover, as an invisible but ostensibly ‘transparent' sign, in some contexts they appear to enable cancer survivors to challenge biomedical decision making. In the light of recent oncological debates about the value of these biomarkers in tertiary prevention, I conclude by suggesting that signs can never be reduced to their ‘objective' biomedical denotation in spite of professional attempts to expunge meaning and value from care.

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“…Twelve full-text studies constituted the evidence base for t he present g u ideline : one rct of c a125 i n fol low-up 15 ; five retrospective cohort studies on methods of detection [16][17][18][19][20] ; two pilot studies 21,22 ; and four qualitative or observational studies of psychosocial concerns, health care provider and patient preferences or satisfaction, and patterns of care [23][24][25][26] . Eleven of those studies fell within the scope of our guideline; one study about sexual symptomatology was out-of-scope 22 …”

Section: Resultsmentioning

confidence: 99%