A MESSAGE FROM THE MANAGER:   CA-125 and Ovarian Cancer

Most of us, at one time or another, have received the e-mail about a woman diagnosed with ovarian cancer begging you to forward information to your family and friends about the importance of obtaining a CA-125 screen during your annual exam and insisting that you ‘not take no for an answer’ when your physician advises against it.  I recently received this e-mail, forwarded to me by a cousin, and lucky enough for me, I am privy to more reliable information and thought I would share what I know with you.

 

A CA-125 is what’s known as a ‘tumor marker’.  It is a blood test used to monitor the effectiveness of a treatment in someone who has already been diagnosed with ovarian cancer or suspicious ovarian mass.  Most of the time, it can be unreliable because other conditions cause CA-125 levels to rise and create false positives; these conditions include menstruation, pregnancy, endometriosis, pelvic and abdominal infections, fibroid tumors, and liver disease, just to name a few.  

 

The CA-125 is not an ideal screening tool because only 80-90% of women with a known malignancy in its later stages test positive for the cancer antigen.  This means that there are a large number of false negatives. A woman can test negative for a CA-125, but still have ovarian cancer.  There are multiple forms of ovarian cancer and interestingly enough, a CA-125 is only able to test for one form.

 

Because of this threat of false negatives and positives, a CA-125 is not considered an accurate diagnostic test and is not recommended by ACOG (American College of Obstetrics and Gynecology) to diagnose ovarian cancer.

 

Ovarian cancer is not common. Women have a 1 in 58 chance of getting ovarian cancer in their lifetime.  The chances of incurable ovarian cancer are 1 in 98.

 

Ovarian cancer is not preventable; however, it is important to know the risk factors commonly associated with it.  They are as follows:

 

·         Age- Most ovarian cancers develop after menopause.  Half of all ovarian cancers are found in women over the age of 63.

·         Obesity- A study done by the American Cancer Society determined that an overweight woman’s risk of developing ovarian cancer was 50% higher than women of an ideal weight.

·         Menstrual history- Women who began menstruating before 12 years of age or someone who became menopausal after the age of 50 are at a slightly increased risk.

·        Fertility drugs- Long term use of fertility drugs may cause an increased risk.

·        Family history- Ovarian cancer is more commonly found in women whose close blood relatives have or had the disease.  The relatives can be from either the mother or father’s side of the family.

·        Breast cancer- Women with a history of breast cancer are also at a higher risk of ovarian cancer.

·         Talcum powder- There is a slight increase risk associated with women who have used talcum powder (this does not include cornstarch products) on their genital area.

·         Use of Hormone Replacement Therapy-   This can be a little tricky!   There are a few studies which suggest that long term use of HRT (more than 10 yrs) can possibly increase the risk, but most of these findings are for women who used estrogen alone, without progesterone.  It is very important you discuss the benefits of taking HRT before you make a decision to stop based on your ovarian cancer risk since most studies do not suggest an increased risk.

·         Birth control pills- These can greatly reduce the risk of ovarian cancer in women who have taken them for several years.

·         Pregnancy and Breastfeeding-   Having one or more children and breastfeeding for a year or more can reduce your risk.

·         Diet- A diet high in vegetables is beneficial for reducing ovarian cancer development.

 

Ultimately, the best way for early detection of ovarian cancer is to schedule your annual pelvic exams and be aware of the symptoms.  These symptoms may include:

 

·        Abdominal swelling

·        Unusual vaginal bleeding

·        Pelvic pain or pressure

·        Unusual back or leg pain

·        Abnormal gas, bloating, stomach pain, or indigestion

·        Constipation or diarrhea

 

In order to get an appropriate diagnosis, your physician will need to order an ultrasound, CT scan, MRI, Barium enema scans, and possibly a laparoscopic procedure to biopsy the tumor, which is the only certain way of making this diagnosis. A CA-125 alone cannot diagnose cancer.

 

So, before you get all caught up with these hysterical internet scares and immediately distrust your physician’s advice, take time to speak to your physician about your concerns and possibly obtain a second opinion if you still aren’t sure.

 

Your health and peace of mind certainly should never depend on an over-circulated e-mail.

 

Always,

Laura

 

 

 

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