Early cancers of the ovaries often cause no symptoms. That’s why ovarian cancer is often referred to as “the silent killer.” Currently, there isn’t a definitive screening test for ovarian cancer. The two most common tests are transvaginal ultrasound (TVUS) and the CA-125 test. The ultrasound test allows a doctor to look for tumors in the uterus, fallopian tubes, and ovaries, but it cannot indicate whether a growth is cancerous. The CA-125 test assesses the levels of an ovarian cancer marker in the blood. The problem is that high levels of this antigen are also present in people with unrelated conditions. A pelvic exam can be useful because it can find some female cancers at an early stage, but most early ovarian tumors are difficult or impossible to feel.
Due to the limited availability of tests, about 75 percent of women with ovarian cancer receive their diagnosis when the disease is stage 3 or 4. “The majority of them can be treated with curative intent,” says Pam Khosla, M.D., section chief of hematology and oncology at Sinai Health System in Chicago. That includes debulking surgery, in which surgeons remove as much as they can of the visible tumors and cancerous tissue. Microscopic cancer cells and cancerous tissue that can’t be surgically removed are then treated with chemotherapy — typically, carboplatin and Taxol (paclitaxel).
Some doctors recommend surgery before the standard six cycles of chemotherapy, whereas others recommend three cycles, surgery, and then three more cycles. Surgery may be the first step if the tumor is causing pain or physical issues, such as bowel obstruction, or the physician is unsure whether cancer is causing the problems.
For more information about ovarian and other types of cancer, visit the American Cancer Society at cancer.org.