By the time a physician diagnoses ovarian cancer, about 60 percent of women have an advanced stage of the disease because the symptoms often mimic other conditions.
Possible signs of ovarian cancer (which are similar to many other conditions):
• Increased abdominal size or clothes fitting tighter around your waist.
• Increased or urgent need to urinate.
• Pelvic pain.
• Nausea and gas.
• Constipation or diarrhea.
• Abnormal bleeding.
• Unusual fatigue.
• Unexplained weight loss or gain.
• Shortness of breath.
• Enlarged lymph nodes in the groin.
Certain factors are associated with an increased risk of getting ovarian cancer:
Women have an increased risk if they have had breast, intestinal or rectal cancer. Women with two immediate family members who have had ovarian cancer (mother and sister or two sisters) have nearly a 50 percent chance of developing ovarian cancer.
Women who have a first-degree relative (mother or sister) and one or more second-degree relatives (aunt, cousin or grandmother) with ovarian cancer are still considered to be high risk, but their risk is less than if they have two immediate family members with the illness.
Risk may increase in women who have had issues with infertility or with polycystic ovarian syndrome. Risk decreases with the use of birth control pills, and is lower in women who have given birth or who have breast-fed infants.
Women often ask about routine screening for ovarian cancer. How can they identify it early? How can they prevent it? Unfortunately, specific tests have not been developed that allow for consistent early detection of ovarian cancer. A blood test called CA-125 (a cancer marker) is often used to monitor someone diagnosed with ovarian cancer, but does not provide reliable results for early detection or screening.
Another screening technique that women often ask about is pelvic ultrasound.
Pelvic ultrasound can detect some changes, but it is not routinely used to screen for ovarian cancer. Ovarian cancer can be very fast growing, and ultrasound may not identify a very early ovarian cancer.
However, if a woman is at high risk for ovarian cancer, having a pelvic ultrasound and a blood test for CA-125 may be a logical option for screening. Some authorities believe that among high-risk women (those with a strong family history of either ovarian or breast cancer), getting both a pelvic ultrasound and CA-125 screening five years before the earliest age of onset in their relatives should be encouraged. Some believe that women should have a baseline pelvic ultrasound and a blood CA-125 measurement, followed by
yearly CA-125 measurements and an ultrasound every two years. If the CA-125 rises significantly from one year to the next, an ultrasound should be performed more frequently.
Early diagnosis is best, but is problematic because the symptoms don’t present themselves until the disease is fairly advanced. An advanced disease is unlikely to be cured, and no screening tool currently exists that is sensitive, reliable or cost effective. Thus, it is important to become aware of bodily changes and report anything that persists longer than a couple of weeks.
Marcia Hanks is a certified nurse-midwife and advanced practice registered nurse at St. Patrick Hospital and Health Sciences Center. Questions for our clinicians? Please send them to info@saintpatrick.org.
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