This blog is written by our clinicians and aims to keep patients informed with up to date information on medical conditions.
Screening for certain female specific cancers may seem routine in the UK where we have regular breast screening for breast cancer and smear tests for cervical cancer, however there is one female cancer that we do not screen for, frequently labelled a silent killer – the ovarian cancer.
Ovarian cancer is rare, but is the 6th most common cancer in women in UK. Despite advances in medicine, survival rates from Ovarian Cancer have only seen modest improvements in the last 40 years, hence the emphasis on early diagnosis.
But with no formal screening programme in UK, what are your options?
The Symptoms of Ovarian Cancer
Ovarian cancer is considered to be ‘silent’ because its symptoms are often confused with those of more minor conditions.
Awareness of the following symptoms is incredibly important, especially if they are new and persistent:
- Abdominal swelling
- Digestive problems (including having more wind than usual, a loss of appetite and bloating)
- Abdominal/pelvic pain
- Feeling a frequent need to pass urine
- Irregular periods
Screening for Ovarian Cancer
For those at higher risk than average of ovarian cancer (for example women with a strong family history or personal history of breast and/or ovarian cancer), regular surveillance can be offered via scans and blood tests but for the majority of women who are deemed lower risk, there is no recommended screening.
Smear tests do not look for ovarian cancer, but the following can and should be done on an annual basis and as part of a Well-Woman Health Check:
1. Talking to and being examined by a doctor
- Providing a history of any symptoms, past medical history and family history is always important.
- Your doctor can then perform an abdominal examination and an internal pelvic one too. This will be to look for any abdominal or pelvic masses.
- A pelvic examination should be part of a woman’s regular health exam.
2. Blood tests
- CA125 is to date the best-known ovarian cancer marker, and is used for detecting disease, monitoring response to treatment and identifying disease recurrences.
However only approximately 85% of women with ovarian cancer have a raised CA125, and only 50% of women with early stages of ovarian cancer have the CA125 raised. CA125 may also be raised in benign conditions
- HE4 is another marker for ovarian cancer, that has been available privately for several years. HE4 is over expressed in ovarian cancer and other cancers and normal ovarian tissue has a minimal production of HE4. By combining HE4 with CA125 one gets an increased ability to identify ovarian cancers early.
- At RoC Private Clinic we utilize ROMA (Risk of Ovarian Malignancy Algorithm) test. This test assesses the CA-125 level and HE4 levels, together with a woman’s menopausal status and calculates a risk of ovarian cancer. The result will classify a woman as being at low or high risk of ovarian cancer.
3. Transvaginal ultrasound
- This is an incredibly important part of the assessment and will involve the sonographer scanning both ovaries as well as the rest of the pelvis.
- This test may not be able to identify whether an abnormality is cancerous or not but will highlight any masses or cysts