As mentioned above, diagnosis of ovarian cancer can only be picked up in an early stage if a woman is screened regularly for it. This test consists of the yearly pelvic exam and Pap test to feel for an enlarged ovary.
If the physician feels on bimanual examination that there is an enlarged ovary compared to the other, an ultrasound of the ovaries is ordered. Even in obese women this can be achieved with a vaginal ultrasound, which also eliminates the drinking of a lot of water before the test (the older equipment needed a full bladder as a marker).
This test will tell the physician whether there are solid elements or prominent papillary projections within an ovarian cyst such as would be the case with an early cystadenocarcinoma. Laparoscopy has no place in the work-up or the treatment of cancer of the ovary. Instead a careful staging procedure has to be combined with the surgical removal of the unruptured ovary to prevent the spread of the disease.
There is no reliable test yet to screen for ovarian cancer such as the PSA test for prostate cancer. However, in 50% of women with ovarian cancer the CA-125 (a cancer marker) is positive. In other ovarian cancer patients another tumor marker, called CEA (carcinoembryonic antigen), may be positive. In germ cell malignancies of the ovary the human chorionic gonadotropin, LDH and alpha-fetoprotein (AFP) often are positive. If all the tests are taken together, the pelvic exam, the pelvic ultrasound test and the biochemical ovarian cancer blood tests, about 95% of all ovarian cancers will be picked up.
Blood test being developed to screen for ovarian cancer
Newer research is pointing in the direction of a more specific and more reliable way to diagnose ovarian cancer by a simple blood test. This test is done on blood serum and certain proteins (proteomic patterns) that leach from the ovarian cancer into the blood are analyzed spectroscopically in the lab. This research article describes that these physicians are now testing this method in a prospective study. Once successful, it will be as good for screening ovarian cancer in women as the PSA test has been for screening prostate cancer in men.
1. V.T. DeVita et al. : Cancer- Principles & Practice of Oncology, Vol.1, 4th edition. J.B. Lippincott Co., Philadelphia, USA, 1993. Ovarian cancer chapter.
2. Cancer: Principles&Practice of Oncology. 5th edition, volume 1. Edited by Vincent T. DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Ovarian cancer chapter.
3. S Ginath et al. Int J Oncol 2001 Jun;18(6):1133-1144.
4. Y.-L. Hu et al. J Natl Cancer Inst 2001 May 16;93(10):762-767.
5. MKTuxen et al. Br J Cancer 2001 May;84(10):1301-1307.
6. U Wagner et al. Clin Cancer Res 2001 May;7(5):1154-1162.
7. Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
8. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc