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Family Health Magazine - WOMEN'S HEALTH

Ovarian Cancer
What women must know to get help early

Until very recently, finding and treating early cancer of the ovaries seemed next to hopeless. Only a third of cases were diagnosed before the cancer spread. Thankfully, this is changing. We know much more about early symptoms and better understand who is at risk. More dependable screening is now available, with improvements still to come. With earlier detection, treatment is more effective. More women are now expected to survive ovarian cancer.

Subtle symptoms

Ovarian cancer has long been thought of as a silent killer. It was almost always diagnosed very late. By the time it was found, cancer had already spread through the abdomen. Symptoms came from outside the ovaries. New studies now show that women with ovarian cancer do have symptoms that may be present very early.

In June 2007, as a result of these studies, most of the major North American cancer societies dealing with ovarian cancer gave the following recommendations.

Women who experience one or more of these six symptoms, continuously or severely, for three weeks, should visit their doctor:

• pain in the pelvic area or abdomen
  
• bloating of the abdomen
  
• urinary frequency (needing to pass urine more often than normal)
  
• urinary urgency (needing to pass urine more urgently than normal)
  
• feeling full
  
• difficulty eating

However, it is important to keep this in perspective. Every woman has these same symptoms at various times in her life. The key difference is that in this case, they are a change from the usual, and last for three weeks.

Other common conditions that cause the same symptoms are urinary tract (bladder) infection, irritable bowel syndrome, food sensitivity, and menstrual symptoms.

Knowing for certain

If a woman has symptoms associated with ovarian cancer, her doctor can do a number of tests. These generally include a urine test to check for infection, a pelvic exam to feel the ovaries, an ultrasound, and a CA125 blood test.

Thankfully, ovarian cancer remains quite rare. In most cases, the tests will be reassuring. A woman can feel at peace knowing she does not have ovarian cancer. She and her doctor can then search for another explanation.

The important message is that these symptoms should not be ignored. The tests are easy to do. If they do reveal the possibility of ovarian cancer, checking out the symptoms may save her life.
Ovarian cancer is still very rare in most women. Over the course of a woman’s life, she has only a two per cent risk of developing this disease. In fact, most cases are in women who have risk factors that can be identified. Women without risk factors have an even lower chance of developing it.

If there are no symptoms

One of the biggest questions in dealing with ovarian cancer is whether all women should be checked for it. Screening means that women who are completely free of symptoms are regularly tested using a simple and inexpensive blood or physical test. Unfortunately, screening for ovarian cancer is not as simple as we might like.

A good example of the hype around screening is in an email that has been circulating for a few years. It asks whether your doctor is ‘neglecting to order an important medical test.’ The email’s most popular version describes a woman’s close call with ovarian cancer, and the test that could have prevented her ordeal. That test is CA125. Unfortunately, CA125 is not great at screening for ovarian cancer. Not only is this e-mail alarming, it offers women false hope.

CA125 is a marker for ovarian cancer. However, it also flags just about anything that irritates the pelvic organs or the lower abdomen. A CA125 test will react to abdominal and chest infections, menstruation, pregnancy, endometriosis, benign tumours of the ovaries, and liver disease. So a single or even yearly CA125 is not a good way to find ovarian cancer early for most women. Of all women who have elevated CA125, only three out of a hundred actually have ovarian cancer. Researchers are feverishly trying to find a more reliable screening tool.

However, CA125 can monitor cell activity in the ovaries once the CA125 level has been lowered by cancer treatment. In this case, a rising level may suggest return of the cancer. Until a better test is found, it is also used to screen women at very high risk.

Other screening tests that may be used for women at high risk include regular ultrasound and pelvic examinations. Some authorities recommend that these women should be tested every six months, as the cancer can develop in them very quickly.

The bottom line

No specific test exists to regularly screen for ovarian cancer. Thankfully, it is still rare for most women.

The ray of hope, however, is that we now know a set of symptoms that women themselves may notice. If concerned, they can get early diagnosis (or reassurance), and treatment where necessary. Successfully treating ovarian cancer is now much more likely.

We also understand much more about who is at high risk, and can monitor these women much more closely. A woman is at high risk if she has a strong family history of breast, ovarian, or colorectal (lower bowel) cancer, or is known to have the BRCA-1 or -2 gene mutations. If ovarian cancer occurs in these women, a custom designed screening program can detect it early.

Remember that it is important to monitor your own body. Seek medical care if something changes.

FAMILY HEALTH is written with the assistance of

FAMILY HEALTH is written with the assistance of

While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2019, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 0S1    [WH_FHb08]