TO GET OUT FROM UNDERFOOT OF THE CLEANING LADY

Our peculiar digs, in Evanston, 1984

I spent this morning at my office, mainly to get out from under the feet of the cleaning lady.  There being no really private place to doze off in a WWU faculty office, I tried to do something useful.  I settled on a Google Scholar search.  Typing “ovarian cancer prevention” in the “all of these words” block, and asking for articles published in the past two year – I got 44,500 hits!  To put it otherwise – in less than two years 44,500 scholarly articles have emerged that dealt at least in part with the prevention of ovarian cancer.  I did it again, for the period 2010-2011, and got 48,500 hits!  Why, it seems permissible to ask, does ovarian cancer still exist?  My view is that most of these papers need never have been published, as they added little or nothing to the desired goal.  Let’s face it: given the way research funds are allocated, long publication lists are essential to tenure and promotion.  The current method of funding is whacky, and should be scrapped.  See my tirade on the subject published earlier:

http://ljb-quiltcutie.blogspot.com/2014/06/the-truth-in-small-doses-at-long-last_7.html

So, as the cleaning lady probably was still at it, I decided to actually read one of these 44,000 + articles.  I selected the one that had been cited most often, which happened to be a list of recommendations concocted by our old friends the USPSTF: the United States Preventative Services Task Force.  You have met them before: for instance, they are the group that raised the ire of urologists everywhere by recommending that the PSA test be abandoned for prostate cancer detection under most circumstances.  USPTF is a Federal-level, all volunteer group consisting of highly respected scientists and medical practitioners.  You have to take them seriously, but you needn't kowtow, if you know what I mean.

These guys report on their assessment of tests to use for detecting ovarian cancer early.  Specifically, they looked at the usefulness of BRCA testing for breast and ovarian cancer.  Their report ran to many, many pages, most of them of vanishingly small value and some completely redundant.  Frankly, I couldn’t keep awake long enough to swallow the whole thing at one gulp.  Here is what I think they recommend:

If you are worried, go to a genetics counselor and/or a primary care physician well trained in genetics, and have them analyze your family history.  If it appears on the basis of such analysis that your family DNA tree may contain a germline mutation in one of the BRCA genes, get tested (have a part of your genome sequenced.)  If the mutations are there, consider surgery.

If the analysis implies that no such mutations exist, stop worrying and get on with your life.

Yes, sure, there is more to it than that.  Here is the article.  I’ll bet you can’t read it all the way through without a nap.

http://annals.org/article.aspx?articleID=1791499&csrt=10772375032857733912