Ovarian Cancer Diagnosis, Prevention

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Prevention

There is no known way to prevent ovarian cancer. But these things may lower your chance of getting ovarian cancer:

Having used birth control pills for more than five years.
Having had a tubal ligation (getting your tubes tied), both ovaries removed, or hysterectomy (an operation in which the uterus, and sometimes the cervix, is removed).
Having given birth.

Early Detection

There is no simple and reliable way to test for ovarian cancer in women who do not have any signs or symptoms. The Pap test does not check for ovarian cancer. However, here are steps you can take:

Pay attention to your body, and know what is normal for you.
If you notice any changes in your body that are not normal for you and could be a sign of ovarian cancer, talk to your doctor about them and ask about possible causes, such as ovarian cancer.
Ask your doctor if you should have a test, such as a rectovaginal pelvic exam, a transvaginal ultrasound, or a CA-125 blood test if:
- You have any unexplained signs or symptoms of ovarian cancer. These tests sometimes help find or rule out ovarian cancer.
- You have had breast, uterine, or colorectal cancer; or a close relative has had ovarian cancer.

CA-125 Blood Test

This is a test to measure the level of CA-125 in the blood, as an indicator of ovarian cancer. The CA-125 level often increases when cancer of the ovaries is present, but other conditions can also cause increased levels, including pregnancy, menstruation and some non-ovarian cancers. The test does not distinguish between malignant and benign tumors and is best used with other cancer tumor markers.

Diagnosis

If you have a symptom that suggests ovarian cancer, your doctor must find out whether it is due to cancer or to some other cause. Your doctor may ask about your personal and family medical history.

You may have one or more of the following tests. Your doctor can explain more about each test:

Physical exam: Your doctor checks general signs of health. Your doctor may press on your abdomen to check for tumors or an abnormal buildup of fluid (ascites). A sample of fluid can be taken to look for ovarian cancer cells.

Pelvic exam: Your doctor feels the ovaries and nearby organs for lumps or other changes in their shape or size. A Pap test is part of a normal pelvic exam, but it is not used to collect ovarian cells. The Pap test detects cervical cancer. The Pap test is not used to diagnose ovarian cancer.

Blood tests: Your doctor may order blood tests. The lab may check the level of several substances, including CA-125. CA-125 is a substance found on the surface of ovarian cancer cells and on some normal tissues. A high CA-125 level could be a sign of cancer or other conditions. The CA-125 test is not used alone to diagnose ovarian cancer. This test is approved by the Food and Drug Administration for monitoring a woman's response to ovarian cancer treatment and for detecting its return after treatment.

Ultrasound: The ultrasound device uses sound waves that people cannot hear. The device aims sound waves at organs inside the pelvis. The waves bounce off the organs. A computer creates a picture from the echoes. The picture may show an ovarian tumor. For a better view of the ovaries, the device may be inserted into the vagina (transvaginal ultrasound).

Biopsy: A biopsy is the removal of tissue or fluid to look for cancer cells. Based on the results of the blood tests and ultrasound, your doctor may suggest surgery (a laparotomy) to remove tissue and fluid from the pelvis and abdomen. Surgery is usually needed to diagnose ovarian cancer. To learn more about surgery, see the "Treatment" section.

Although most women have a laparotomy for diagnosis, some women have a procedure known as laparoscopy. The doctor inserts a thin, lighted tube (a laparoscope) through a small incision in the abdomen. Laparoscopy may be used to remove a small, benign cyst or an early ovarian cancer. It may also be used to learn whether cancer has spread.

What should I do if my doctor says I have ovarian cancer?

If your doctor says that you have ovarian cancer, ask to be referred to a gynecologic oncologist - a doctor who has been trained to treat cancers like this. This doctor will work with you to create a treatment plan. Then seek a second opinion.