When should you go for an ovarian cancer screening?

Dr Swati Gaikwad Obstetrics and Gynaecology, Motherhood hospital, Kharadi, Pune tells us some critical things about this gynaecological cancer.

Ovarian cancer is a cancerous growth that arises anywhere in the ovary. It is thought to be the fifth most common cause of cancer deaths in women in India. It is also considered to be one of the most ferocious gynecologic cancers with a high death rate. The age-specific incidence rate for this cancer showed an increased risk after 35 years with a peak in between 55-64 years. Here Dr Swati Gaikwad Obstetrics and Gynaecology, Motherhood hospital, Kharadi, Pune tells us some critical things about this gynaecological cancer.

When is a woman most susceptible to this cancer

The early stages of ovarian cancer show few or no symptoms at all. Also if the symptoms manifest they are so vague in nature which we often brush off as trivial health issues like a pain in lower abdomen, heaviness in abdomen, indigestion, frequent urination, change in bowel habits, pain during sexual intercourse. As cancer progresses one may also experience nausea, weight loss, loss of appetite, breathlessness. The appearance of any one of these symptoms more than 12 times in a month for less than a year warrants a thorough check-up to diagnose ovarian cancer.

What are the risk factors that one should watch out for

There is multiple risk factors have been implicated in the causation of ovarian cancer. Early menarche, late menopause, nulliparity, failed infertility treatment, obesity, endometriosis, menopausal HRT, BRCA 1 and BRCA 2 mutation, LYNCH syndrome is associated with increased risk of developing ovarian cancer while multiparity, lactation, hysterectomy, tubal ligation, OC pill use have shown to have a protective role against this cancer.

Many people mistakenly believe that cancer is largely a hereditary disease but remember around five to ten per cent are due to gene mutation and rest 90 -95 per cent of cancers are due to the lifestyle choices you make food choices and sedentary life. That's why prevention and awareness have become vital tools to fight cancer and they start with knowing how to nourish your body and how to develop healthy habits with lasting benefits.

How ovarian cancer is diagnosed?

A complete personal and family history, pelvic examination gives clinical suspicion of adnexal mash which can be further evaluated with a blood test and imaging study.

Blood tests: Checking for elevated levels of tumour markers like Serum CA125, CEA, AFP, LDH levels and LDH isoenzymes, HCG. These parameters are useful as a tumour marker for the specific histological type of an ovarian tumour; CA125 for non-mucinous epithelial carcinoma, CEA for a mucinous tumour and Krukenberg a tumour, AFP for yolk sac tumour, LDH and LDH isoenzymes for dysgerminoma and HCG for another solid germ cell tumours. In addition, preoperative diagnosis of histological types of ovarian tumours may be possible by combining these tumour markers.

Imaging tests: Trans-vaginal ultrasound, MRI, or a CT scan might be used.

Laparoscopy: A laparoscope is a thin viewing tube with a camera at the end, is inserted through a small incision in the lower abdomen. This will allow the doctor to see the ovaries and, if necessary, to take a tissue sample (BIOPSY) to examine for the presence of cancer cells.

Colonoscopy: If there is constipation or bleeding from the rectum, a colonoscopy may be needed to examine the large intestine or colon.

Abdominal fluid aspiration: If the patient's abdomen is swollen, there may be a build-up of fluid, which can be examined by using a fine needle to remove some fluid through the abdomen.

Once the clinical diagnosis is made surgery or other therapies are suggested accordingly.