Elevate Your Health Colorado Gilda Radner, We Haven't Forgotten You...

As much as women hate to come in and get a pap smear, we need to be grateful for those darn things.  A pap smear can detect precancerous cells on the cervix, so they can be treated or removed before they become cancerous.  Women used to die of cervical cancer, now it's quite unusual.  

Even mammograms can detect small breast cancers, when they are still curable.  Unfortunately, though, there is no such effective screening test for ovarian cancer.  Usually, ovarian cancer does not show symptoms until it is advanced, and much more difficult to treat or cure.

Both exams that could potentially detect ovarian cancer are flawed as screening tests -- they have high false negative and high false positive rates.  For example, a pelvic ultrasound may show a mass or cyst on a woman’s ovary, but the mass or cyst may be nothing clinically significant -- that’s a “false positive.”  The woman may even undergo surgery to remove the mass or cyst, only to find out it's not cancer and never needed to come out.  And what if the woman suffers a complication of this surgery?  Fortunately, most ovarian findings on ultrasound are not cancerous, so that would be a lot of women getting what is basically unnecessary surgery.

What about the CA 125 blood test that many have heard of?  Also flawed -- it can be “positive” when there is nothing wrong and “negative” when there is in fact cancer present -- hence the false positives and false negatives.  What if a woman has a positive CA 125 but her ovaries look normal on ultrasound?  Then she has to have surgery to investigate further and in fact, maybe the CA 125 was positive because she was on her period, or has fibroids or endometriosis, not cancer.

It seems like it should be simple to find ovarian cancer, but it's not.   Even on a pelvic exam, the provider may or may not be able to feel a mass that could be cancer, until it gets so big the woman starts to have symptoms anyway.

So, what are we supposed to do???  Mainly, be aware of your body.  If you have new pelvic pain, bloating, decreased appetite, change in bowel habits, or anything new like that, let your provider know.  Sure, we all have a meal that doesn’t agree with us from time to time, but if the symptoms persist for more than a few days or a week, and catch your attention, take it seriously.  Women can get so busy taking care of everyone else, we need to make sure if something is not feeling right, we take the time to stop, and take care of ourselves.

Hopefully, there will be a new screening test for ovarian cancer coming soon.  There is a lot of research going on and potential answers in the pipeline.  One thing is for sure, a reliable and easy screening test for ovarian cancer, like a pap smear, will be a breakthrough for women’s preventive care.