Ovarian Cancer Tests

When a woman is diagnosed with cancer, she needs to consider her family’s history of cancer. Some cancers are inherited; however, most are spontaneous. If there is a concern with a family pattern of cancer, then a thorough family history should be taken. Sometimes this leads to formal genetic counseling with blood testing for specific gene mutations. If you have a specific gene mutation putting you at risk for breast or ovarian cancer, then surveillance testing or procedures are different from those with a spontaneous cancer. Therefore, start with telling your oncologist your family history. I'm not sure what is standard, but my gynecologist is going to give me internal ultrasounds to check my ovaries yearly until I'm 40 years old. Then when I turn 40, the plan right now is to have my ovaries removed. Unless anything funny looks like it's going on, then they get pulled then. I should note I'm 32 right now, so that may change.
My breast specialist thought this plan was fine so we're running with it.

Unfortunately there is no easy and reliable way to diagnose ovarian cancer early. When the cancer is far enough along to start causing symptoms of pelvic pressure, urinary frequency, feeling full after eating small quantities of food, and tummy enlargement from fluid in the abdomen and pelvis, it is almost always at least Stage lll and easily seen with a sonogram or CAT scan or MRI. The symptoms of early ovarian cancer are subtle and often misconstrued as bowel problems. They are sometimes called the ovarian cancer "whisper" because they aren't easily heard. Burping or excess flatulence more than half the time, should prompt a visit to be checked. Most gynecologists will perform a pelvic exam. I would suggest a transvaginal sonogram (TVU) to look for cysts and fluid. If there is fluid in the pelvis that can be sampled with a needle, the diagnosis can be made from finding ovarian cancer cells in the fluid. Usually the TVU is diagnostic at that point anyway and sampling the fluid is just confirming the diagnosis. Sadly, the TVU may not show anything worrisome in the earliest stages of ovarian cancer. Often patients with and without symptoms ask for a CA 125 blood test or the newer OVA1 test to look for cancer. These tests are not good for screening because of the high false positive rate. In my experience they often come back high when there is no obvious abnormality. Then what? The patient undergoes surgery because they get nervous. Hopefully the answer to the dilemma of diagnosing ovarian cancer is right around corner. Unfortunately there is no easy and reliable way to diagnose ovarian cancer early. When the cancer is far enough along to start causing symptoms of pelvic pressure, urinary frequency, feeling full after eating small quantities of food, and tummy enlargement from fluid in the abdomen and pelvis, it is almost always at least Stage lll and easily seen with a sonogram or CAT scan or MRI. The symptoms of early ovarian cancer are subtle and often misconstrued as bowel problems. They are sometimes called the ovarian cancer "whisper" because they aren't easily heard. Burping or excess flatulence more than half the time, should prompt a visit to be checked. Most gynecologists will perform a pelvic exam. I would suggest a transvaginal sonogram (TVU) to look for cysts and fluid. If there is fluid in the pelvis that can be sampled with a needle, the diagnosis can be made from finding ovarian cancer cells in the fluid. Usually the TVU is diagnostic at that point anyway and sampling the fluid is just confirming the diagnosis. Sadly, the TVU may not show anything worrisome in the earliest stages of ovarian cancer. Often patients with and without symptoms ask for a CA 125 blood test or the newer OVA1 test to look for cancer. These tests are not good for screening because of the high false positive rate. In my experience they often come back high when there is no obvious abnormality. Then what? The patient undergoes surgery because they get nervous. Hopefully the answer to the dilemma of diagnosing ovarian cancer is right around corner.