Ovarian Cancer is of major concern in my patients as in all women. I think women fear cancer more than any other disease. As a matter of fact, a friend of mine called me last night. She was very tearful and concerned. Her mother-in-law was told by a gynecologist that she had ovarian cancer. I sometimes find my colleagues very frustrating. I believe in telling women and their family all of the information. In other words, when I see a patient that might have ovarian cancer, I will be open an honest that this might be the diagnosis that we are dealing with for her. However, there is no way to definitively diagnose ovarian cancer without a biopsy and/or a lot more information. This statement made by the gynecologist from another state rippled through the nation to every person that loves this woman. When she called me last night, I told her that there is a lot more information that needs to be obtained. In other words, the jury is still out.

I want to talk a little bit about Ovarian Cancer. The good news is that this type of cancer is relatively rare with only 4% of women being affected. Most of the women are greater than 50 years of age. The problem with ovarian cancer is that it reveals itself rather late in the course. The symptoms of the disease are really generic. The first symptom that is usually unnoticed is bloating. Everything causes bloating, right? You can indigestion, constipation, or painful periods that cause bloating.  Some women will experience nausea, vomiting, or gas that just does not go away even when the diet is changed. This does not mean that any of these symptoms are consistent with ovarian cancer. It just means that if these symptoms persist, it is best to go the gynecologist or your family doctor to be evaluated.

As gynecologists, we have been handicapped by the insurance companies because they do not want to pay for the necessary tests. That is the easy way out for them. In fact, many women will not have the test if it is not covered by insurance. In this case, the test is not done and the diagnosis is delayed. This is the real problem. 

An article published online in The Lancet Oncology, proves that both ultrasound and a simple blood test called a CA125 combined have a high degree of sensitivity and specificity. This is much better than a transvaginal ultrasound alone. A CA125 is a blood test that shows the presence of an ovarian cancer antigen. When the CA125 is elevated, it means that there is a level of suspicion of an ovarian or peritoneal cancer (lining of the abdomen and pelvis).  However, there are known ovarian cancers that do not cause an increase in the CA125 level. Also, there are other disease etiologies that can cause a rise in CA125. Among these conditions are endometriosis, fibroids, inflammation of the abdomen, pregnancy, or ovarian cysts. Because other conditions will cause a rise in CA125, many doctors do not order the test out of fear that insurance companies won't pay for it and it will increase the hysteria among women.

However, I am a strong proponent of using the tools that are currently available. I am pleased that there is a well-respected journal that is publishing in March that a CA125 in combination with ultrasound is quite possibly the best way to go to rule out an ovarian malignancy. If you have any of these symptoms, or if you just don't feel right, make sure you are evaluated.  Earlier diagnosis is by far the best way to go. Early treatment in ovarian cancer has helped to save the lives of several of my patients with early ovarian cancer.

To your Health,

Dr. Michelle Haendiges