Ovarian cancers are often found when they are already advanced and hard to treat.

Researchers have long believed this was because women first experienced symptoms when ovarian cancer was already well-established. Symptoms can also be hard to identify as they’re vague and similar to other conditions.

But a new study shows promising signs ovarian cancer can be detected in its early stages. The study targeted women with four specific symptoms – bloating, abdominal pain, needing to pee frequently, and feeling full quickly – and put them on a fast track to see a specialist.

As a result, even the most aggressive forms of ovarian cancer could be detected in their early stages.

So what did the study find? And what could it mean for detecting – and treating – ovarian cancer more quickly?

Why is ovarian cancer hard to detect early?

Ovarian cancer cannot be detected via cervical cancer screening (which used to be called a pap smear) and pelvic exams aren’t useful as a screening test.

Current Australian guidelines recommend women get tested for ovarian cancer if they have symptoms for more than a month. But many of the symptoms – such as tiredness, constipation and changes in menstruation – are vague and overlap with other common illnesses.

This makes early detection a challenge. But it is crucial – a woman’s chances of surviving ovarian cancer are associated with how advanced the cancer is when she is diagnosed.

If the cancer is still confined to the original site with no spread, the five-year survival rate is 92%. But over half of women diagnosed with ovarian cancer first present when the cancer has already metastatised, meaning it has spread to other parts of the body.

If the cancer has spread to nearby lymph nodes, the survival rate is reduced to 72%. If the cancer has already metastasised and spread to distant sites at the time of diagnosis, the rate is only 31%.

There are mixed findings on whether detecting ovarian cancer earlier leads to better survival rates. For example, a trial in the UK that screened more than 200,000 women failed to reduce deaths.

That study screened the general public, rather than relying on self-reported symptoms. The new study suggests asking women to look for specific symptoms can lead to earlier diagnosis, meaning treatment can start more quickly.

What did the new study look at?

Between June 2015 and July 2022, the researchers recruited 2,596 women aged between 16 and 90 from 24 hospitals across the UK.

They were asked to monitor for these four symptoms:

• persistent abdominal distension (women often refer to this as bloating)
• feeling full shortly after starting to eat and/or loss of appetite
• pelvic or abdominal pain (which can feel like indigestion)
• needing to urinate urgently or more often.

Women who reported at least one of four symptoms persistently or frequently were put on a fast-track pathway. That means they were sent to see a gynaecologist within two weeks. The fast track pathway has been used in the UK since 2011, but is not specifically part of Australia’s guidelines.

Some 1,741 participants were put on this fast track. First, they did a blood test that measured the cancer antigen 125 (CA125). If a woman’s CA125 level was abnormal, she was sent to do a internal vaginal ultrasound.

What did they find?

The study indicates this process is better at detecting ovarian cancer than general screening of people who don’t have symptoms. Some 12% of women on the fast-track pathway were diagnosed with some kind of ovarian cancer.

A total of 6.8% of fast-tracked patients were diagnosed with high-grade serous ovarian cancer. It is the most aggressive form of cancer and responsible for 90% of ovarian cancer deaths.

Out of those women with the most aggressive form, one in four were diagnosed when the cancer was still in its early stages. That is important because it allowed treatment of the most lethal cancer before it had spread significantly through the body.

There were some promising signs in treating those with this aggressive form. The majority (95%) had surgery and three quarters (77%) had chemotherapy. Complete cytoreduction – meaning all of the cancer appears to have been removed – was achieved in six women out of ten (61%).

It’s a promising sign that there may be ways to “catch” and target ovarian cancer before it is well-established in the body.

What does this mean for detection?

The study’s findings suggest this method of early testing and referral for the symptoms leads to earlier detection of ovarian cancer. This may also improve outcomes, although the study did not track survival rates.

It also points to the importance of public awareness about symptoms.

Clinicians should be able to recognise all of the ways ovarian cancer can present, including vague symptoms like general fatigue.

But empowering members of the general public to recognise a narrower set of four symptoms can help trigger testing, detection and treatment of ovarian cancer earlier than we thought.

This could also save GPs advising every woman who has general tiredness or constipation to undergo an ovarian cancer test, making testing and treatment more targeted and efficient.

Many women remain unaware of the symptoms of ovarian cancer. This study shows recognising them may help early detection and treatment.

Jenny Doust, Clinical Professorial Research Fellow, Australian Women and Girls’ Health Research Centre, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Humans have long been searching for a “magic elixir” to make us smarter, and improve our focus and memory. This includes traditional Chinese medicine used thousands of years ago to improve cognitive function.

Now we have nootropics, also known as smart drugs, brain boosters or cognitive enhancers.

You can buy these gummies, chewing gums, pills and skin patches online, or from supermarkets, pharmacies or petrol stations. You don’t need a prescription or to consult a health professional.

But do nootropics actually boost your brain? Here’s what the science says.

What are nootropics and how do they work?

Romanian psychologist and chemist Cornelius E. Giurgea coined the term nootropics in the early 1970s to describe compounds that may boost memory and learning. The term comes from the Greek words nӧos (thinking) and tropein (guide).

Nootropics may work in the brain by improving transmission of signals between nerve cells, maintaining the health of nerve cells, and helping in energy production. Some nootropics have antioxidant properties and may reduce damage to nerve cells in the brain caused by the accumulation of free radicals.

But how safe and effective are they? Let’s look at four of the most widely used nootropics.

1. Caffeine

You might be surprised to know caffeine is a nootropic. No wonder so many of us start our day with a coffee. It stimulates our nervous system.

Caffeine is rapidly absorbed into the blood and distributed in nearly all human tissues. This includes the brain where it increases our alertness, reaction time and mood, and we feel as if we have more energy.

For caffeine to have these effects, you need to consume 32-300 milligrams in a single dose. That’s equivalent to around two espressos (for the 300mg dose). So, why the wide range? Genetic variations in a particular gene (the CYP1A2 gene) can affect how fast you metabolise caffeine. So this can explain why some people need more caffeine than others to recognise any neurostimulant effect.

Unfortunately too much caffeine can lead to anxiety-like symptoms and panic attacks, sleep disturbances, hallucinations, gut disturbances and heart problems.

So it’s recommended adults drink no more than 400mg caffeine a day, the equivalent of up to three espressos.

2. L-theanine

L-theanine comes as a supplement, chewing gum or in a beverage. It’s also the most common amino acid in green tea.

Consuming L-theanine as a supplement may increase production of alpha waves in the brain. These are associated with increased alertness and perception of calmness.

However, it’s effect on cognitive functioning is still unclear. Various studies including those comparing a single dose with a daily dose for several weeks, and in different populations, show different outcomes.

But taking L-theanine with caffeine as a supplement improved cognitive performance and alertness in one study. Young adults who consumed L-theanine (97mg) plus caffeine (40mg) could more accurately switch between tasks after a single dose, and said they were more alert.

Another study of people who took L-theanine with caffeine at similar doses to the study above found improvements in several cognitive outcomes, including being less susceptible to distraction.

Although pure L-theanine is well tolerated, there are still relatively few human trials to show it works or is safe over a prolonged period of time. Larger and longer studies examining the optimal dose are also needed.

3. Ashwaghanda

Ashwaghanda is a plant extract commonly used in Indian Ayurvedic medicine for improving memory and cognitive function.

In one study, 225-400mg daily for 30 days improved cognitive performance in healthy males. There were significant improvements in cognitive flexibility (the ability to switch tasks), visual memory (recalling an image), reaction time (response to a stimulus) and executive functioning (recognising rules and categories, and managing rapid decision making).

There are similar effects in older adults with mild cognitive impairment.

But we should be cautious about results from studies using Ashwaghanda supplements; the studies are relatively small and only treated participants for a short time.

4. Creatine

Creatine is an organic compound involved in how the body generates energy and is used as a sports supplement. But it also has cognitive effects.

In a review of available evidence, healthy adults aged 66-76 who took creatine supplements had improved short-term memory.

Long-term supplementation may also have benefits. In another study, people with fatigue after COVID took 4g a day of creatine for six months and reported they were better able to concentrate, and were less fatigued. Creatine may reduce brain inflammation and oxidative stress, to improve cognitive performance and reduce fatigue.

Side effects of creatine supplements in studies are rarely reported. But they include weight gain, gastrointestinal upset and changes in the liver and kidneys.

Where to now?

There is good evidence for brain boosting effects of caffeine and creatine. But the jury is still out on the efficacy, optimal dose and safety of most other nootropics.

So until we have more evidence, consult your health professional before taking a nootropic.

But drinking your daily coffee isn’t likely to do much harm. Thank goodness, because for some of us, it is a magic elixir.

Nenad Naumovski, Professor in Food Science and Human Nutrition, University of Canberra; Amanda Bulman, PhD candidate studying the effects of nutrients on sleep, University of Canberra, and Andrew McKune, Professor, Exercise Science, University of Canberra

This article is republished from The Conversation under a Creative Commons license. Read the original article.