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Ovarian cancer screening could be detrimental

December 28, 2009 12:00:00 AM PST
Every year, more than 20,000 women find out they have ovarian cancer. But unlike other cancers, doctors say yearly screening for ovarian cancer may do more harm than good.Amy Brannock is a musician, an artist and a two-time ovarian cancer survivor.

"I actually went to the emergency room thinking I had appendicitis, and that was when they did a CT scan and found a tumor," said Amy.

She had a hysterectomy and chemo. Finally, the standard blood test for ovarian cancer, the CA-125, determined she beat it.

"So, I thought, 'OK, we've got it treated. I'm good to go,'" she said.

For three years, Amy went on with her life thinking she was cancer-free. But all along, the test was lying.

"Amy's CA-125 has been normal just like any normal person," said gynecologic oncologist Dr. Daniel Clarke-Pearson.

It wasn't until she felt a lump in her neck that her doctors realized the cancer was back with a vengeance.

Typically doctors preach about yearly cancer screening, but according to his study in the New England Journal of Medicine, Clarke-Pearson says the average woman should not be tested for ovarian cancer.

"I say don't get tested because it leads to a lot of unnecessary surgery, and on one hand, the testing could lead to a false sense of security," said Clarke-Pearson.

According to the study, the standard blood test misses up to 50 percent of early ovarian cancers. Abnormal ultrasound readings are also incorrect up to 90 percent of the time.

"That's what's so insidious about this particular cancer. It's so sneaky," said Amy.

Amy's cancer is incurable, but with regular treatment, dhe's striving for many more years of music and memories.

Symptoms of ovarian cancer are often vague, but they include pelvic or stomach pain, bloating, feeling full soon after eating and urgent urinary frequency.

Doctors say there is a small section of the population who should be screened. This includes women with a family history of breast or ovarian cancer and those with mutations in the BRCA-one and BRCA -two genes.

According to the American Cancer Society, about 21,550 new cases of ovarian cancer are diagnosed each year. More than 14,000 women die from the cancer each year. Ovarian cancer is the ninth most common cancer in women (not counting skin cancer). It ranks as the fifth cause of cancer death in women. A woman's risk of getting invasive ovarian cancer in her lifetime is about 1 in 71.

Symptoms of ovarian cancer may be vague and may mimic those of other conditions. For instance, many cases of ovarian cancer are mistaken for digestive or bladder disorders. Experts say the key is to notice persistent or worsening signs and symptoms. With digestive disorders, symptoms tend to come and go. With ovarian cancer, symptoms are typically constant and gradually worsen. Recent research suggests a woman with ovarian cancer is more likely to experience symptoms such as: Abdominal pressure, fullness, swelling or bloating, pelvic discomfort or pain and urinary urgency

Doctors typically do not recommend screening for ovarian cancer for most healthy women. Several screening tests are commercially available, but according to the Mayo Clinic and leading experts, none has been proven to lead to an early diagnosis that improves outcome.

These tests may also lead to false-positives, which may subject women to unnecessary procedures.

Some common tests include:

Pelvic Exam: A doctor will examine the patient's vagina, uterus, rectum and pelvis, including the ovaries, for masses or growths.

Ultrasound: This method uses high-frequency sound waves to produce images of the inside of the body. However, if a mass is found, ultrasound can't reliably distinguish a cancerous growth from a non-cancerous growth.

CA-125: This is a protein that your body makes in response to many different conditions. Many women with ovarian cancer have high levels of CA 125 in their blood. However, other conditions may cause elevated levels. Many women with early-stage ovarian cancer may have normal CA-125 levels. Because of this, the CA-125 test isn't used for routine screening in women who are not at high risk for ovarian cancer.


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