Ovarian Cancer Post 2
Few Warning Signs
Like most cancers, the best weapon in battling ovarian cancer is early detection. In fact, if the cancer is diagnosed while still contained within the ovary, 95 percent of women will survive longer than five years with appropriate medical treatment. Unfortunately, only about 25 percent of women with ovarian cancer have their cancer detected while it’s still in such an early stage.
“Ovarian cancer is such an incredibly difficult disease to detect because it doesn’t have any early warning signs of it’s own,” said C.O. “Skip” Granai, M.D., director of the Program in Women’s Oncology at Women and Infants Hospital in Providence, R.I.
Because of this, women and their family physicians can easily mistake symptoms of ovarian cancer for symptoms of a variety of other no-big-deal health problems. Some women say they never experienced symptoms at all. Reported symptoms include: abdominal discomfort, pelvic pain or pressure, painless swelling in the abdomen, bloating, gas, constipation, diarrhea or other digestive problems, frequent urination, unusual vaginal bleeding, fatigue, nausea, loss of appetite, unexplained weight loss or gain, shortness of breath, fever and pain during intercourse.
“Epithelial ovarian cancer is relatively slow growing,” said Garold A. Bothby, M.D., director of Gynecological Oncology at M.D. Anderson Cancer Center in Houston and vice chairman of the department of OB/GYN at Arnold Palmer Hospital for Children and Women in Orlando, Fla. “And women don’t usually experience symptoms right away. But — and this is very important — when symptoms appear, they usually persist, progress and get worse over time.”
Early Detection Difficult
To complicate matters further, women and their physicians are pretty much flying blind when it comes to screening and early detection. “The bottom line is there are currently no good screenings for ovarian cancer and no good methods of detection,” Im said. “At this point, the best we can do is advise women to get a routine physical and a pelvic exam every year.”
During a pelvic exam, the physician feels the ovaries and uterus for size, shape and consistency. (The Pap test is not an early screening for ovarian cancer. It screens for cervical precancers and cancer.) For women at high risk for ovarian cancer, physicians may perform a CA-125 blood test. The CA-125 is a considered a helpful tool in monitoring whether cancer has returned in women previously treated for ovarian cancer, but it’s findings are often misleading and erroneous as an initial screening tool.
Physicians also may recommend a transvaginal sonogram for women at high risk. This is an ultrasound test performed with an instrument inserted into the vagina. It, too, is unproven as a reliable screening tool. “There are lots of dynamics in the ovaries,” Granai said. “The ovary is very busy all the time — even in post-menopausal women. And while the technology is good — it can literally show the eggs inside the ovaries — there is a lot of movement going on that gets picked up. For example, many women have perfectly normal cysts growing in their ovaries.
“As good as it is, the technology can’t yet tell the difference between what’s normal and what’s abnormal,” he said. “So, in many cases, what’s normal can look like early cancer and early cancer may look very much like a normal ovary.”