Ovarian Cancer: Not so silent?

Ovarian cancer is often considered a silent cancer until advanced stages.

According to the American Cancer Society, approximately 21,550 new cases of ovarian cancer were diagnosed last year and 14,600 women died of the disease. In fact, ovarian cancer is the most common cause of death from all gynecological cancers in the United States. Ovarian cancer is often considered a silent cancer until advanced stages.

Recent research suggests however that early signs of ovarian cancer are often present but go unrecognized. A symptom complex that includes early satiety, bloating, abdominal and/or pelvic pain, and urinary changes frequently precedes a diagnosis of ovarian cancer. These symptoms are present whether women are diagnosed with early or late-stage cancer.

Traditionally, transvaginal sonography and serum CA-125 have been used to evaluate women suspected of having ovarian cancer. Unfortunately, this combination results in a relatively high false-positive rate suggesting the presence of ovarian cancer in many women who ultimately are shown to have non-cancerous findings. A new test, HE4, currently approved by the FDA for monitoring the recurrence and the progression of ovarian cancer, may hold promise for diagnosis. This test appears to be as sensitive as CA-125 in detection of ovarian cancer, but detects fewer non-cancerous tumors. Early studies suggest the use of transvaginal sonography, CA-125, with the addition of HE4 resulted in lower false-positive rates.

Routine screening using transvaginal sonography and CA-125 are not recommended unless a woman is experiencing persistent symptoms that include one or more of the following; increasing abdominal girth, bloating, fatigue, abdominal pain, indigestion, impaired eating, recent onset of urinary incontinence, or unexplained weight loss. Women at high risk, including those with BRCA 1 or BRCAP 2 mutations or a significant family history of ovarian cancer, should undergo ovarian cancer screening starting at age 35, or 5 to 10 years earlier than the youngest age of ovarian cancer diagnosis in the family.