Ways to find ovarian cancer early

Regular women’s health exams

During a pelvic exam, the health care professional feels the ovaries and uterus for size, shape, and consistency. Although a pelvic exam is recommended because it can find some reproductive system cancers at an early stage, most early ovarian tumors are difficult or impossible for even the most skilled examiner to feel. Pelvic exams may, however, help identify other cancers or gynecologic conditions. Women should discuss the need for these exams with their doctor.

Although the Pap test is effective in detecting cervical cancer early, it is not a test for ovarian cancer. Rarely ovarian cancers are detected through Pap tests, but usually these are at an advanced stage.

See a doctor if you have symptoms

Early cancers of the ovaries tend to cause symptoms that are more commonly caused by other things. These symptoms include abdominal swelling or bloating (due to a mass or accumulation of fluid), pelvic pressure or abdominal pain, difficulty eating or feeling full quickly, and/or urinary symptoms (having to go urgently or often). Most of these symptoms can also be caused by other less serious conditions, but when the symptoms are caused by ovarian cancer they tend to be more severe and are a change from how a woman usually feels.

By the time ovarian cancer is considered as a possible cause of these symptoms, it may have already spread beyond the ovaries. Also, some types of ovarian cancer can rapidly spread to the surface of nearby organs. Still, prompt attention to symptoms may improve the odds of early diagnosis and successful treatment. If you have symptoms similar to those of ovarian cancer almost daily for more than a few weeks, and they can't be explained by other more common conditions, report them to your health care professional -- preferably a gynecologist -- right away.

Screening tests for ovarian cancer

Screening tests and exams are used to detect a disease, such as cancer, in people who do not have any symptoms. Perhaps the best example of this is the mammogram, which can often detect breast cancer in its earliest stage, even before a doctor can feel the cancer. Although there has been a lot of research to develop a screening test for ovarian cancer, there hasn’t been much success so far. There are 2 tests that are used most commonly to screen for ovarian cancer. These tests, transvaginal sonography and CA-125, are often offered to women who are at high risk of developing epithelial ovarian cancer, such as those with a very strong family history.

Transvaginal sonography is an ultrasound test that places a small instrument in the vagina. It can help find a mass in the ovary, but it can't actually tell which masses are cancers and which are not.

CA-125 is a protein in the blood that is higher in many women with ovarian cancer. The problem with this test is that conditions other than cancer can also cause high levels of CA-125. In addition, someone with ovarian cancer can still have a normal CA-125 level. When a CA-125 level is abnormal, many doctors will repeat the test (to make sure the result is correct). The doctor may also consider ordering a transvaginal ultrasound test, or even taking samples of fluid from the abdomen or tissue from the ovaries to find out if a cancer is really present.

In studies of women at average risk of ovarian cancer, these screening tests did not lower the number of deaths caused by ovarian cancer. For this reason, transvaginal sonography and the CA-125 blood test are not recommended for ovarian cancer screening of women without known strong risk factors., These tests are often done in women at high risk, but it is not known how helpful they are. Ways to improve ovarian cancer screening tests are being researched. Hopefully, further improvements will make these tests effective enough to lower the ovarian cancer death rate.

There are no recommended screening tests for germ cell tumors or stromal tumors. Some germ cell cancers release certain protein markers such as human chorionic gonadotropin (HCG) and alpha-fetoprotein (AFP) into the blood. After these tumors have been treated by surgery and chemotherapy, blood tests for these markers can be used to see if treatment is working and to determine if the cancer may be coming back.

Researchers continue to look for new tests to help diagnose ovarian cancer early.