The statistics are distressing: Each year, of the 20,000 women diagnosed with ovarian cancer, 14,000 will die from the disease. The disease is known as a silent killer because it is so hard to diagnose. “When women notice the symptoms of ovarian cancer, it is usually stage III or stage IV at that point, which makes the prognosis grim,” says Elizabeth Killebrew, M.D., a gynecologist at Piedmont Fayette Hospital.
A study published in the Journal of the American Medical Association looked at more than 78,000 women to determine whether screening tests for ovarian cancer proved beneficial in preventing ovarian cancer-related deaths. “Researchers took a group of women who were screened with ultrasounds and CA-125 tests,” says Dr. Killebrew. “These were low-risk women who did not have ovarian cancer in their families. When they looked at that group over a 10-year trial, there was no difference between the screened group and the unscreened group in terms of mortality rates.”
A CA-125 is a blood test that examines the level of the protein CA-125 in the blood. Dr. Killebrew is not surprised by the outcome of this study. “We have known for a long time that the CA-125 test has so many false positives. It turns positive with fibroids, endometriosis and inflammation,” she explains.
Screening for high-risk patients
Despite the challenges that ovarian cancer screening presents, Dr. Killebrew would still recommend screening for high-risk women. “Ultrasounds, if you look at studies, are actually a better test. When I have a patient who comes in, is very concerned and feels like she has had gastrointestinal upset for the last two months, I do an ultrasound,” she says. “Then I know the size, look and shape of her ovaries, and I have a better chance of knowing if it is something serious early on.”
Dr. Killebrew’s take-home message for women who are concerned about ovarian cancer: “You need to go to the doctor regularly, pay attention to your body, and read and understand the latest information on ovarian cancer, because we don’t have a very good test. We can only evaluate, examine and talk to you,” she says. “Finally, don’t assume that because you don’t have periods that you do not need to visit your gynecologist. You probably need to go more regularly at that point.”
While screenings for ovarian cancer are still under scrutiny, the best thing you can do is communicate with your doctor. If you have a family history of ovarian cancer or are concerned about your health, schedule regular appointments with your gynecologist and talk to him or her about your screening options. For more information on ovarian cancer, visit Piedmont Cancer Services.
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