“By the time there are symptoms it has already spread…”
There have been many stories in the news recently about ovarian cancer, and “new guidelines for early detection”. But are these guidelines really “new”, and will they truly make a significant difference in improving survivability for women with ovarian cancer? What about prevention?
Let’s shed some light on this dark subject:
These “new” recommendations are not really “new”, just less vague and mostly involve awareness – paying attention to your body’s signals, not “pooh-poohing” them, discussing them with your GYN or PCP and making sure that he or she follows up with an appropriate evaluation.
Here are some things to look out for:
- Intermittent abdominal bloating
- Intermittent lower abdominal cramps or wavelike/sharp pains
- Loss of appetite or feeling full with minimal food intake
If you ever experience these–pay attention. These may all be signs of early ovarian cancer.
Although all of these “body sensations” could be secondary to bowel issues such as constipation or irritable colon, they are among the signs that ovarian cancer exhibits as it swells and expands the ovary and spreads to nearby bowel.
There is currently no specific “Yes/No” simple blood detection tests for ovarian cancer, but they are on the horizon. Through a technique called “proteinomics”, a specific antigen, a blood protein secreted specifically by ovarian cancer cells, may be identified. Although presently clinically available, results are not yet reliable enough for general use. However, it is something to watch for within the next few years.
The problem with all ovarian cancer blood tests is not necessarily the sensitivity, but the specificity. For a test to be useful, it can’t have too many “false positives”. Unfortunately, this is a problem with presently available tests.
Ovarian cancer grows within the ovary, erupts through the surface capsule, and expands mostly by local extension. The idea is to catch it before it spreads.
That said -YES- there is something you can do now for early detection.
You can choose to have an ultrasound- specifically, an Endovaginal Ultrasound (EVUS). When performed by a careful technician skilled at looking at, and into ovaries, they can detect a carcinoma in its “seed” stage, as small as one half to one inch, before it has a chance to grow and spread. This ultrasound is best done by your gynecologist in his or her office. If your gynecologist is not skilled in this way, a good technician in an ultrasound center may perform the test.
Unfortunately, ovarian cancer can grow and spread rapidly (within months), unlike cervical cancer or breast cancer, which grows very slowly over years before metastasizing.
What do I recommend?
- For women with no risk factor: Yearly EVUS with specific attention to the ovaries.
- For woman with minimal risk factors (such as a history of long-term infertility therapies, women with one first generation or two or three second generation relatives with breast or colon cancer): Yearly EVUS plus yearly CA-125.
- For women with moderate risk factors (such as one first-generation relative with ovarian cancer, significant family history or breast cancer and/or colon cancer): EVUS twice yearly and once-yearly CA-125.
- For women with significant risk factors (such as two or more first generation relatives with ovarian cancer, especially with additional family history of breast and/or colon cancer): EVUS every three to four months plus CA-125 twice yearly. For this group of women genetic testing and very possibly prophylactic removal of ovaries may be preferable.
This is a reasonable and “state of the art” way for early detection of ovarian cancer.
(Brest, colon and ovarian cancers have some interrelationship. History of one of these diseases conveys a somewhat increased risk for the others.)
I give the same advice for prevention of ovarian cancer as for breast and colon cancers
- A healthy diet – Multiple small meals with emphasis on complex carbohydrates and protein and avoidance of excess animal fats, simple carbs, and rich foods) is both intuitive and important.
- Stress Reduction – It is, after all, your immune system that is in large part responsible, along with genetics, for the genesis of illness, and certainly responsible for the body’s response and ability to heal. Keep your immune system strong through stress reduction including “mindfulness, regular exercise and a consistently healthy diet!”