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About 20% of ovarian cancers are found at an early stage. When ovarian
cancer is found early at a localized stage, about 94% of patients live
longer than 5 years after diagnosis. Several large studies are in
progress to learn the best ways to find ovarian cancer in its earliest
stage.
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.
Revised: 01/19/2008
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