A Conversation with Dr. Laura Williams
Ovarian Cancer Questions – Music City Moms
Question: I am taking Arimidex (I have one more year) and as a result of this my belly is enlarged somewhat. In my quarterly checkups with my oncologists should I ask for the blood test to check on ovarian cancer?
Answer: The combination of a CA-125 test and a pelvic ultrasound would help your oncologist determine if you had any abnormal growth in the ovary.
Question: Dr. Williams, I go faithfully every year to my OB/GYN for a checkup. I am 51 years old, going through menopause but am in good health otherwise. I take Prometrium and Estradiol for my hot flashes, and I've been on medication now for about four years. Do I need to be worried about ovarian cancer since I do see my doctor regularly every year?
Answer: Unfortunately, ovarian cancer is not usually diagnosed on the basis of a routine exam. However, if you have no unusual family history of ovarian cancer, your chances of developing the disease are small.
Question: I have had a pain on the right side of my abdomen since last week. At first I thought it was just ovulating, but the pain hasn't gone away. In addition, I have had a combination of all symptoms (gas, pain and swelling in the belly, diarrhea, constipation and upset stomach) since last Friday (for the last five days). Do you feel that I should be concerned?
Answer: Ovarian cancer is not usually associated with pain but more likely with abdominal swelling, the feeling of fullness, and bloating. However, there are many reasons that you might have right lower quadrant pain and the symptoms you mentioned. Your doctor may help you sort this out.
Question: If a woman has the following symptoms – gas, pain and swelling in the belly, diarrhea, constipation or upset stomach – should she ask her doctor to test for ovarian cancer?
Answer: If her doctor has made no other diagnosis to account for her symptoms, then a test for ovarian cancer would be appropriate.
Question: What are the general symptoms of ovarian cancer? Is it hereditary?
Answer: Less than 10 percent of ovarian cancer cases are hereditary, i.e., associated with genetic abnormalities in the BRCA genes. The symptoms of ovarian cancer are non-specific and include: abdominal swelling, bloating, the feeling of fullness and occasional constipation or diarrhea.
Question: How do you test for ovarian cancer when your OB/GYN is reluctant to? At what age should you be more concerned about it?
Answer: The peak incidence of ovarian cancer is age 60. Unfortunately, for patients who have not gone through menopause, the CA-125 test is often inaccurate and can lead to operations for benign gynecologic conditions. That is probably why your gynecologist is reluctant to perform the test. If you have classic symptoms of ovarian cancer, suggest that your gynecologist perform an ultrasound or a CT-scan and a CA-125 test.
Question: How big a problem is ovarian cancer in the U.S.? Is the problem getting better or worse? Is there any progress being made on detection and accuracy? Is there a trustworthy Web site you can go to look up information on ovarian cancer?
Answer: The Gynecologic Cancer Foundation Web site,
www.thegcf.org, offers useful information for patients and caregivers. Approximately 23,000 to 25,000 new cases of ovarian cancer are diagnosed in the U.S. each year. The incidence has increased slightly over the past two decades, and there has been some improvement in survival with the use of aggressive surgery and chemotherapy techniques. The National Cancer Institute and privately funded research groups are investigating new treatment modalities across the country.
Question: If these are common symptoms, then how do I know if or when I should see a doctor? Or if it's just "normal" bodily functions. Thanks!
Answer: If you notice a change in your bodily functions that persist, you should seek help from your doctor.
Question: I get regular gynecology checkups. Is there anything else I need to do? I am a 30-year-old woman with a history of smoking (3 months smoke free).
Answer: No. There are no effective screening tests for ovarian cancer. Annual gynecologic checkups are important for many other reasons, such as for the detection of abnormal Pap smears.
Question: Can ovarian cancer be related to pain in the left side and an enlarged uterus?
Answer: Usually not. However, if there’s any question regarding a growth in the left side of your pelvis, a pelvic ultrasound and CA-125 test can be performed.
Question: How do I ask my doctor to check for ovarian cancer? I've heard that the regular/annual Pap smear does not look for these diseases. Why aren't they included in the regular Pap smear?
Answer: If you have typical symptoms of ovarian cancer, you can ask your doctor to perform an ultrasound and a CA-125 test. A Pap smear typically analyzes cells that come from the surface of the cervix. Ovarian cancer cells remain within the abdominal cavity and are unlikely to travel down the fallopian tubes into the uterus and into and out of the cervix to be detected by a Pap smear.
Janey's mom since 2006, Elliott's mom since 2007, Richard's wife since 2003. And editor of this Nashville incarnation of momslikeme.com.