A New Way to Catch Hidden Ovarian Cancer Early

By Elizabeth Chabner Thompson, MD, MPH

Published May 29, 2015

When my mother was in her late thirties, she saw her gynecologist after she had missed her period and developed a sudden, sharp pain in her side.

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, instead of a baby, 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 fifteen, thankful that she did not have ovarian cancer.

Ultrasound Screening for 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 transvaginal 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 my pelvic tissues so that the radiologist can see the ovaries clearly. A transvaginal ultrasound offers much more accurate results compared to an external ultrasound.

Ovarian cancers are tricky to find because the ovaries sit deep inside the pelvis and they are difficult to see or feel. Until they are very large and have possibly spread throughout the body, ovarian cancers produce symptoms similar to everyday indigestion: abdominal pain, bloating, and feeling full.

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.

A Blood Test That Detects Ovarian Cancer

And there is exciting news about improving early detection, in the form of research on an existing blood test that screens for a protein called CA-125 (cancer antigen 125). This protein is commonly found on cancer cells in the ovary. A new study from researchers at the University College, London, has found that with regular yearly blood screenings for this protein, 86 percent of ovarian cancers can be found earlier than they might be detcted through ultrasound.

For women at high risk of ovarian cancer, this can be a very valuable test.

Estimates by the National Cancer Institute indicate that there will be over 21,000 new cases of ovarian cancer in 2015. An even more startling statistic is that 14,000 women are expected to die of ovarian cancer each year.

What this means is 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 early enough to cure patients in the 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 of ovarian cancer. Women with a family history of ovarian and breast cancer, as well as other genetically transmitted cancer syndromes, are at risk. Following these women closely with a blood test can catch this disease when the tell-tale protein 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 healthcare experts familiar with the most current screening standards.

Elizabeth Chabner Thompson, MD, MPH, is a radiation oncologist and founder of BFFL Co