Not that long ago, most people considered a cancer diagnosis to be a death sentence. This is no longer the case for most cancer patients. Since 1990, cancer death rates have declined significantly for most types of cancer. Advancements in medical technology and ever-increasing knowledge have vastly improved early detection, a key component of successful treatment. This is especially true of ovarian cancer, which has a 94 percent survival rate when detected early. Compare that to the 47 percent survival rate overall, and you see the importance of early detection.
How Is Ovarian Cancer Detected?
Many women think they can rely on a yearly pap and pelvic exam to detect most “female” cancers. While that’s true of vaginal and cervical cancer, it is not true for cancer of the ovaries. Pelvic exams rarely lead to an early diagnosis of ovarian cancer. That doesn’t mean you shouldn’t get these vital screenings! It just means that you can’t rely on them to detect everything. The tests doctors rely on the most are the transvaginal ultrasound (TVUS) and CA-125 blood test. These screenings are typically only performed for women who display symptoms of ovarian cancer or who are considered high risk.
Screening Tests for Ovarian Cancer
The TVUS is pretty much what it sounds like. Your doctor inserts the ultrasound wand into your vagina, which emits sound waves that create a picture of the reproductive system. In addition to your ovaries, this includes the uterus and fallopian tubes. While the TVUS is effective for finding tumors and cysts, it cannot diagnose whether these growths are cancerous.
CA-125 is a blood test that measures a protein called, you guessed it, CA-125. However, this test alone cannot determine cancer. It is merely an indicator, as many women who have ovarian cancer also have heightened CA-125 levels. The catch is that not all women who have ovarian cancer have high levels of the CA-125 protein. And, many women have elevated CA-125 counts without having ovarian cancer. In fact, it’s more commonly an indicator that the patient has another condition, such as pelvic inflammatory disease or endometriosis.
Unfortunately, despite researchers working hard to find a more reliable method to screen for ovarian cancer, the TVUS and CA-125 are currently our best options. Typically, these tests are only administered if the patient displays signs or symptoms of ovarian cancer, or if she is considered high risk for the disease. This is because these screenings have not been shown to reduce a woman’s chances of dying from ovarian cancer if she does not fit one of these demographics.
What Are the Signs and Symptoms of Ovarian Cancer?
The most common signs of ovarian cancer are:
- Difficulty eating or feeling overly full
- Issues with urination, such as feeling the urge to urinate when you don’t actually need to, or having to urinate often
- Pain in the abdominal or pelvic area
These symptoms do not always – or even usually – indicate ovarian cancer. They may be the result of a noncancerous cyst or condition, as well as other types of cancer. However, if they reoccur multiples times in a month or become more severe, talk to your doctor.
Other, less common ovarian cancer symptoms include:
- Abdominal swelling accompanied by weight loss
- Extreme fatigue
- Heavy or irregular periods
- Pain during intercourse
- Upset stomach
Again, even if you have all of these symptoms, that does not mean you have ovarian cancer (or any other type of cancer). But, you should schedule an appointment with your doctor.
What Should You Expect When You See Your Doctor?
When you talk to your doctor about your symptoms, he or she will likely perform a physical exam. Typically, this includes a pelvic exam, which may reveal abnormalities in the ovary that indicate the need for further testing. Your doctor will also look for ascites, which is fluid in the abdomen, a common side effect of cysts and tumors.
If the physical exam or medical history you describe indicate the possibility of cancer, your doctor should order further testing or a consultation with a specialist (or both). Typically, this means a gynecologic oncologist, which is a doctor who specializes in cancers of the female reproductive system.
Diagnosing Ovarian Cancer
Although transvaginal ultrasound and CA-125 tests are considered the most reliable for early detection of ovarian cancer, your doctor may order other tests, depending on your symptoms. These include:
- Colonoscopy: This test determines whether the cancer has spread to the colon or rectum.
- CT scan: Rotates around your body to produce detailed images. CT scans don’t reveal small tumors, but may detect larger ones, as well as whether tumors have spread to nearby areas or other organs.
- Laparoscopy: For this test, the doctor makes a small incision and inserts a thin tube that takes pictures of the lower abdomen. Your doctor may also perform biopsies during a laparoscopic procedure.
- PET scan: Cancer loves sugar. For this test, the patient ingests radioactive glucose. The cancer essentially gobbles up the sugar, causing those cells to glow in the scanner. Combined with the CT scan, this test helps detect spreading cancer cells. Insurance rarely covers PET scans used to detect ovarian cancer, though.
- Biopsy: A biopsy is the only way to determine whether a growth is cancerous. It involves removing a small section of the growth (or the entire tumor) and examining it with a microscope.
Does Medicare Cover Ovarian Cancer Testing?
Original Medicare covers a pap smear every 24 months and every 12 months for women at high risk for vaginal or cervical cancer. However, if you have symptoms between these covered screenings, do not hesitate to make an appointment with your physician. If you have Medicare Advantage, your plan may cover more aggressive testing.
If you have questions about your Medicare plan options, call us toll-free at 844-655-4347 to speak to a licensed agent.