by NUHA IDRIS
Ovarian cancer is a malignant tumour in one or both ovaries. It is a common cancer that affects Australian women.
Early-stage ovarian cancer rarely causes any symptoms. However, advanced-stage ovarian cancer can cause nonspecific symptoms that could be mistaken for other conditions. Such symptoms could include discomfort in the pelvis area, changes in bowel habits (constipation or diarrhoea) and menstrual irregularities.
Early detection of signs and symptoms of ovarian cancer can prevent further complications that are harder to treat in late-stage ovarian cancer. The disease is more likely, in early stages, to be confined to the ovaries rather than break away to other areas of the body.
While there is a tremendous amount of research underway, there is currently no early detection test for ovarian cancer. At the moment, doctors combine the CA-125 blood test with a transvaginal ultrasound in high-risk populations.
CA-125 (cancer antigen 125) is a protein that is potentially found in ovarian cancer tumours. Doctors monitor for this to indicate if ovarian cancer is present. However, sometimes a person may have normal CA-125 levels even if they have ovarian cancer. A CA-125 blood test could also produce false positives for other conditions like endometriosis, fibroids or pregnancy. As such, the CA-125 blood test is not accurate enough for ovarian cancer screening because other noncancerous disorders and conditions could elevate CA-125 as well.
Another possible screening tool for ovarian cancer is the transvaginal ultrasound. An ultrasound examination is high-frequency soundwaves that produce an image of your organs. A transvaginal ultrasound examines the female pelvis, looking for abnormalities in areas like the uterus, cervix, endometrium, fallopian tubes, bladder, pelvic cavity and, of course, ovaries. It is a useful procedure for assessing ovaries, particularly those in postmenopause. Premenopausal ovaries are much more active, which can make the procedure unreliable in younger women. It can also be difficult differentiating cancer from endometriosis with this procedure as well as the CA-125 blood test.
For those with average risk (i.e. women with no symptoms, no inherited genetic syndromes, no family history, etc.), transvaginal ultrasound and the CA-125 blood test is not recommended as it leads to unnecessary procedures without improved outcomes.However, for women at higher risk, it may be beneficial to utilise these procedures, along with genetic testing, but it is still not proven that they help in improving outcomes with ovarian cancer.
For women with certain risk factors, it is more beneficial to screen for ovarian cancer. The main risk factor for ovarian cancer is age.There is increasing risk for women over 50 with an average age of diagnosis at 64 years of age. Another important factor is family history as hereditary factors account for approximately 20% of ovarian cancers. If you have these two main risk factors, it is important to speak to your healthcare provider about potentially screening for ovarian cancer. If you are also experiencing the symptoms of ovarian cancer listed previously, it is also advisable to speak to your healthcare provider for further information and screening.
Unfortunately, at this stage, there is no tried and true screening method for ovarian cancer. The CA-125 blood test and transvaginal ultrasound are not accurate in determining if a person has ovarian cancer. As such, it is not recommended that women at lower risk undergo these procedures as routine screening. However, for women at higher risk (such as those with family history of ovarian cancer and women who are older), it is recommended that you speak to your healthcare provider.