Thankfully, none of the women in my family have had ovarian cancer. However, when my mother was in her late 30s, she saw a gynecologist after she developed a sudden, sharp pain in her side and missed her period. He examined her and ran some blood tests. Initially, they thought she might be pregnant or even have an ectopic pregnancy because the blood test revealed an elevated level of the "pregnancy hormone" HCG (Human Chorionic Gonadotropin). But pregnancy was not the diagnosis. An ultrasound revealed that my mother had a benign growth on one of her ovaries called a teratoma. Surgery was immediately performed and my mother was left with one "good" ovary that was closely followed by her gynecologist. She spent Thanksgiving that year giving me "orders" over the phone from the Naval Hospital and we had dinner for 15, thankful that she did not have ovarian cancer.
I will never forget the story behind my mother's ovarian "tumor" and I share this information with my gynecologist and other doctors who take a family history, even though a teratoma is not a cancer (because it grows but never spreads). This history, along with the history of breast cancer in my family, has led me to have a trans-vaginal ultrasound once a year to make sure no growths are developing on my ovaries. While the test itself is not painful, it is time consuming. A wand is inserted vaginally and the ultrasound waves penetrate the pelvic tissues so that the radiologist can see the ovaries clearly. This offers much more accurate results compared to an external ultrasound. Ovarian cancers are tricky to find since the ovaries sit deep inside the pelvis and they are difficult to see or feel. They produce symptoms similar to everyday indigestion (abdominal pain, bloating and feeling full) until they are very large and have possibly spread throughout the body. When it comes to this disease, surveillance does not prevent cancer, but catching it early is crucial to improving a woman's odds of survival.
The exciting news in relation to early detection, however, has come in the form of a blood test that screens for a protein called CA-125 (Cancer Antigen 125), which is commonly found on cancer cells in the ovary. A new study from the University College London has found that, with regular blood screenings for this protein, 86 percent of ovarian cancers can be found earlier than they might be detected through ultrasound. For women at high risk, this can be a very valuable test. Estimates reported on cancer.gov indicate that there will be over 21,000 new cases of ovarian cancer in 2015. An even more startling statistic is that 14,000 are expected to die of ovarian cancer each year. What does this mean? It means that we are not doing a great job at diagnosing this disease at an early stage (before it has spread) since only 20 percent of these cancers are found at an early enough stage to cure patients long term. Compared to breast cancer, where a whopping 90 percent of cancers are detected early, there's a lot of room for improving early detection by figuring out who is at risk (women with a family history of ovarian and breast cancer as well as other genetically transmitted cancer syndromes) and then following these women closely with a blood test to catch this disease when the CA-125 just starts to rise. Screening tests may not be appropriate for women of average risk but, for those in the high-risk category, it is important to consult with health care experts familiar with the most current screening standards.
Elizabeth Chabner Thompson, MD, MPH, is a radiation oncologist and founder of BFFL Co (Best Friends for Life), which provides a wide range of products for patients undergoing various surgical procedures or cancer treatments. One such product is the Axillapilla® post-surgery pillow featured on the Katie Couric Show. This heart-shaped pillow provides support and stability for a patient recovering from surgery, especially cardiac surgery.