Ovarian cancer is the 5th most common cancer in women. It is feared by all women because   it is usually not discovered until it is in the advanced stages. A lot has been written about a       “simple” blood test measuring a tumor marker called a Ca 125 that can be used as a screening test for ovarian cancer, however this test is not considered to be a good screening test. The reasons are several. There are reasons for the Ca 125 level to be elevated (>35) other than ovarian cancer. Also the Ca 125 level is not elevated in all cases of ovarian cancer. There is no recommended interval as to when the test should be performed. The Ca 125 is useful in following a person with ovarian cancer to determine if chemotherapy is working, and this is the proper use of this tumor marker.

How then should a person be screened for ovarian cancer? The answer to this remains an annual pelvic exam by a qualified physician. Any ovarian enlargement, especially in a postmenopausal woman, should be evaluated thoroughly. Pelvic ultrasound, CT scan or laparoscopy could be used in this evaluation.

An annual office visit to a gynecologist should be part of any preventative health plan in all women in the reproductive age group or older. Even if a woman does not need a PAP test either due to low risk status or previous hysterectomy, she still needs an annual pelvic exam if she has not had her ovaries removed, as this remains the best screening test available for ovarian cancer.

 

 

Author:         James S. Holtman, M.D.

               see biography at AOGMD.COM