Ovarian cancer is one of the deadliest of cancers because most cases are diagnosed late, after the disease has spread. In 2007, it is estimated that about 22,000 cases of ovarian cancer will be diagnosed and 15,000 deaths will occur in the U.S. alone.
One of the legacies of ovarian cancer is the contribution that birth control pills (BCP’s) and synthetic hormone replacement therapy (HRT) play. At one time, women were told by doctors that BCP’s and HRT were statistically helpful in actually lowering the incidence of ovarian cancer.
But as the Women’s Health Initiative (WHI) results from a few years ago told us, the opposite was true. Ovarian cancer goes up with the addition of HRT for sure, and in my opinion, the same is true for BCP’s.
These are the same BCP’s and HRT that are responsible for not only causing an increased susceptibility to ovarian cancer but also has caused an epidemic of migraine headaches, PMS (PMDD), depression, blood clots, strokes, fibroids, ovarian cysts and the other cancers of the breast and uterus, too.
The problems of menopause are made worse with previous exposure to these drugs, as well.
Recently, new guidelines on symptoms of ovarian cancer were announced to aid clinicians and women alike in helping to diagnose ovarian cancer at an earlier stage. Previously, the only real test for determining ovarian cancer was the CA-125 blood test. This is a tumor marker that is only elevated in 50% of patients with early ovarian cancer, however.
As a result, the CA-125 is not the most effective screening tool for this disease. So the Gynecologic Cancer Foundation (GCF) announced several symptoms that, if present for a few weeks, should be considered an early warning sign for ovarian cancer.
These symptoms are:
Pelvic or abdominal pain
Feeling full quickly
Urinary frequency (or the urge to urinate)
As you can see these are fairly vague and ill-defined symptoms. They are also very common and all of us will have some of these symptoms at some point. Many people have these symptoms for years, which are more likely attributed to a condition called Irritable Bowel Syndrome (IBS).
Dr. Barbara Goff, professor and director of gynecologic oncology at the University of Washington in Seattle says, “What’s different about the symptoms of ovarian cancer is that they are new symptoms, not symptoms you have had all your life; they occur regularly, either daily or every other day; and they persist more than several weeks.”
I applaud the GCF for publicizing the symptoms list for ovarian cancer and hope the awareness helps women and clinicians in catching this deadly disease early. My recommendation would be to screen every woman with a CA-125 blood test anyway, even if only 50% of early cases are caught. It is still 50% more than if we did not do it.
However, I would recommend a screening ultrasound or if you want to incorporate this into a body wide screen, a “Lifescan” test. This is a hyperfast CT scan of the neck, chest, abdomen and pelvis. It is strictly a screening test and insurance never pays for it.
But it looks at important structures such as the thyroid, lungs, heart and coronary vessels (it does a great heart disease profile), liver, pancreas, bowel, kidneys, ovaries and uterus. It only takes about 15 minutes with minimal radiation exposure.
All of these screening tests you can do at any age. Just get a baseline and keep testing every couple of years with the CA-125 and every 5-7 years with the Lifescan. Don’t forget the mammograms.
Finally, a baseline colonoscopy is recommended as well. You can catch colon cancer 20 years early with this procedure.
My colleagues would say that most of these recommendations are a waste of money and resources. Since much of it is not reimbursed by insurance, then it becomes simply your decision and your resources. I personally do these screening tests for me and my family. Shouldn’t you?
Of course the most effcient method of avoiding significant problems like cancers of the breast, ovaries, and uterus, along with migraine headaches, PMS (PMDD), depression, uterine fibroids, ovarian cysts and blood clots is to stop taking birth control pills and synthetic hormones.
Instead, we use bio-identical or natural hormones to supplement a woman’s hormone imbalance, if any. These are absolutely safe and curative in many of the above mentioned conditions.
Andrew Jones, M.D.
Medical Director, Women’s Health Institute of Texas