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Ovarian cancer: We need a test
By Katie Van Kessel M.D.
As an obstetrician and gynecologist, I regularly order Pap smears for my patients to screen for cervical cancer and mammograms to screen for breast cancer. However, I can’t order a simple test that will screen for ovarian cancer, and that is troubling.
Ovarian cancer affects almost 200,000 women worldwide and about 18,000 women in the U.S. Seven in 10 women die within five years of being diagnosed with ovarian cancer and approximately 14,230 women will die in the United States from ovarian cancer in 2013. In Washington state alone, a woman dies every day of the disease, yet ovarian cancer is highly curable if found in its earliest stage.
Over 90 percent of patients who are diagnosed early have a greater chance for survival. However, only 15 percent of ovarian cancer patients are diagnosed early. So what can women do?
It is very important to know your family history. Is someone in your family a BRCA1 or BRCA2 genetic mutation carrier? (You might remember this is the genetic mutation Angelina Jolie was aware she carries.) Are there stories of your great-grandma passing from “tummy troubles”? Do you have a family history of ovarian cancer? Do you have multiple blood relatives who have had breast cancer? If you answered yes to any of these questions, you might choose to see a genetic counselor.
Additionally, individuals of Ashkenazi Jewish ancestry are 10 times more likely to carry a BRCA gene mutation than the general population. Women carrying mutations in BRCA1 or BRCA2 have up to an 80 percent risk of developing breast cancer and up to a 45 percent risk of developing ovarian cancer. Jewish men can also pass on these mutations to their children.
If – based on family history or ethnic background – you are at high risk of ovarian cancer, a CA-125 test, coupled with a trans-vaginal ultrasound, can be a reliable indicator if you first establish your individual baseline. A new study (which was funded in part by the Marsha Rivkin Center for Ovarian Cancer Research), conducted by Dr. Karen Lu, professor of gynecologic oncology at the M.D. Anderson Cancer Center in Houston, shows promise for using the combination of a CA-125 blood test and a trans-vaginal ultrasound to track any changes over time. According to Dr. Lu, the “new study "is a ray of excitement.” However she cautions that the “important message is that this shouldn't change clinical practice right now. We don't have enough data."
The Rivkin Center provides a critical source of funding, both national and international, for translational research and early detection screening. Dr. Saul Rivkin founded the Marsha Rivkin Center for Ovarian Cancer Research in 1996 in honor of his wife, Marsha, who passed away from ovarian cancer, and his five daughters. The Rivkin Center is a partnership with Swedish Medical Center and the Fred Hutchinson Cancer Research Center. It is the mission of the Rivkin Center to save lives and reduce suffering through improved treatment, early detection and prevention of ovarian cancer.
Awareness and advocacy is necessary so that more women become aware of potential symptoms. As September is National Ovarian Cancer Awareness Month, I want to make sure as many people as possible see the signs and symptoms of ovarian cancer. They may seem like fairly common indicators, however it is important to be aware of them and share them with the women in your life:
Abdominal bloating, discomfort or pain
- Lack of appetite
- Frequent urination
- Lack of energy
- Vaginal bleeding
- Nausea or diarrhea
These symptoms may be caused by ovarian cancer or by other less serious conditions. It is important to check with a doctor, preferably a gynecologist, if these symptoms are new and persist for 2-3 weeks, especially if you experience several at one time. A Pap smear is NOT a test for ovarian cancer.
I became involved with the Rivkin Center because I saw the devastating effects of ovarian cancer in my own family. In 2008, my mother-in-law passed away from ovarian cancer after being diagnosed with stage III in 2001. As a physician, even as an OBGYN, I was powerless to help her. And that steeled my resolve to do something for others by helping to raise money for vital research and sharing the signs and symptoms in any way I can, because we need a reliable test for all women.
Katie Van Kessel, M.D., is an OBGYN physician at Overlake Hospital Medical Center and on the board of the Rivkin Center for Ovarian Cancer Research.