I am very interested in ovarian clear cell cancer. As HGSC is far more prevalent in the United States, that is the focus of most research. Much of the research I encounter about OCCC is from Europe and Asia (more prevalent there). Clear cell is known to originate from lesions of ovarian endometriosis and it would seem that focusing on that condition would allow for early detection. A large percentage of women are found in an early stage OCCC as it is and has the characteristics of Type 1 cancer (grows locally, indolent behavior, etc.). When found early, the OS is high. It would seem with its unique genetic signature, its association with endometriosis, biomarkers, and so on, that early detection is possible and it could be avoided with the removal of endometriomas prior to menopause (although I've encountered women in their thirties with clear cell). Even the updated 2018 version of the NCCN for ovarian cancer references Japanese articles that state that fertility sparing surgery is an option for Stage 1A OCCC and that adjuvant chemotherapy is not necessary. Despite that, the NCCN continues to recommend the platinum based therapy which is not effective. I understand there is limited funding for the rare ovarian cancers (Gershenson, etc), but with its association with endometriosis perhaps funding would be available. I have tremendous confidence in the Mayo Clinic and their research. Thank you.

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