Ovarian CancerDr Asha S Vijay
Ovarian cancer screening isn’t as simple as getting an ultrasound. Characterizing ovarian masses and distinguishing between benign and malignant pathology is essential to decrease unnecessary anxiety and enable decisions regarding optimal treatment. Benign pathology may be best treated conservatively or in a general gynecology unit using a minimal access approach. Conversely, suspected malignant masses should be referred to specialized units for further management. Thus prior knowledge of the nature of ovarian masses is essential not only for the patient but to organize clinical services in terms of planning, costs, and overall management.
Transvaginal ultrasonography (TVS) is the most commonly employed imaging modality for assessing adnexal masses, and several prediction models have been created to maximize its predictive capability. In many countries, the risk of malignancy index (RMI), which combines ultrasound features, serum CA125 levels, and the menopausal status of the patients, is still used to characterize ovarian pathology. Unfortunately, both of these are flawed in screening the general population.
These findings suggest that with adequate training and knowledge of the standard features associated with particular pathologies, ultrasound examiners should be able to reliably diagnose and differentiate between certain specific types of adnexal pathology. It is important to remember that when evaluating women with an adnexal mass, ultrasound characteristics need to be correlated with the clinical history and signs and symptoms before arriving at a diagnosis.
Ovarian cancer is one of those diseases you probably assume you’re being screened for when you go to your well-woman exams, but that’s not the case. Ovarian cancer screening isn’t recommended for women at average risk for the condition, but that’s not something that most people know.
There are no recommended screening tests for ovarian cancer in people who don’t have symptoms and don’t have an increased risk of developing the condition.
Ovarian cancer is a scary disease—it affects about 20,000 women in the U.S. each year, according to the Centers for Disease Control and Prevention (CDC). Unfortunately, only about 20 percent of cases are caught in the early stages. So it makes sense that we would all want to know how to get screened for this condition to treat it as early as possible.
The manual pelvic exams may be helpful, although ovarian cancers would be challenging to feel with this test. When you do a pelvic exam, you’re inserting a finger into the vagina, pushing down from above, and it’s very inaccurate as you are just squeezing together the uterus and ovaries. It’s hard to detect a smaller mass.
While a transvaginal ultrasound can help find a mass on a woman’s ovary, it can’t tell whether that mass is cancerous or benign. When transvaginal ultrasounds are used for screening, most of the masses found are not cancerous.
As you can see, knowing the signs and symptoms of ovarian cancer is incredibly important.
The symptoms of ovarian cancer can be subtle. Still, the most common ones include bloating, pelvic or stomach pain, trouble eating or feeling full quickly, and having urinary symptoms like urinating often. This is tricky because other benign diseases can also cause these symptoms. But when they’re caused by ovarian cancer, they’re usually persistent and a change from your usual.
So, who usual be tested for ovarian cancer?
If you’re at a higher risk of ovarian cancer, that’s a different story. Women at higher risk generally include inherited gene mutations like BRCA1& BRCA2. Your risk may also be increased if you have a family history of ovarian cancer if you have e had estrogen hormone replacement therapy (especially over a long period and in large doses), and if you started your period at an early age or started menopause at a later age. In general, if a woman has a genetic predisposition to ovarian cancer, it is reasonable to consider screening. If you have any of the risk factors for ovarian cancer, talk to your doctor about your screening options.