DENISE: Hello there I'm Denise Richardson for howdini.com. Ovarian cancer has been called the silent killer because by the time it's discovered, it's often already advanced. But doctors now believe that there are some symptoms and warning signs to help detect it earlier. Here to help us recognize the signs of ovarian cancer is gynecologist Dr. Jennifer Wu. Dr. Wu thank you for being with us. How many women are getting ovarian cancer every year?
DR. WU: In 2002, there were 23,000 cases diagnosed. So overall numbers are small, but the mortality is very high because usually the cancer is at an advanced stage at diagnosis.
DENISE: I recently had a girlfriend who was recently diagnosed with ovarian cancer. One of the symptoms that she said she had was bloating. And you know in retrospect over the last couple of years if she had known that was a symptom she would have gone to the doctor. What are the other symptoms?
DR. WU: Some of the other symptoms of ovarian cancer include abdominal pain, increase in abdominal girth, bloating, distention, sometimes urinary symptoms, frequency of urination.
DENISE: Can they be the kind of symptoms that can appear to be something else?
DR. WU: Unfortunately these are very common symptoms. If you ask patients, have you ever had bloating, most patients will say oh yes at one point or another. I think to try to determine the difference whether it's an ongoing problem and persistant. For more than a month. Oftentimes patients will go to a primary care doctor, not necessarily to their gynecologist and they need to be a little bit specfic about how long they've been having the symptoms. The doctor will generally do a medical exam and order a sonogram if there's anything suspicious with it.
DENISE: So is that the only testing, the medical exam, the sonogram, what other testing is involved?
DR. WU: There's also a blood test called the CA-125. It's a good test for patients who are perimenopausal or menopausal. CA-125 can be falsely elevated in younger patients by things like ovulation which occurs every month. So it's a more specific test for older patients. And that can help us to determine whether this could be an ovarian cancer problem or not. Unfortunately it doesn't detect early ovarian cancer, so we're still looking for the ideal test to detect early ovarian cancer.
DENISE: Are those tests always conclusive?
DR. WU: Unfortunately physical exams, sonograms, CA-125, these are not conclusive. The only way to be conclusive is to do a surgical exicison and then study the specimen in pathology.
DENISE: Who is predisposed to ovarian cancer?
DR. WU: Certain patients who have a family history. There's something called BRCA 1 and 2 and these are genetic markers that can show that a patient is more predisposed to ovarian cancer. Patients with family history, patients with a personal history of breast cancer.
DENISE: And what's the prognosis? What's the treatment for ovarian cancer?
DR. WU: The treatment for ovarian cancer is surgical excision often in conjunction with chemotherapy. If ovarian cancer is caught in the early stage, stage 1, cure rates are great, 90 to 95 percent. But unfortunately most ovarian cancer is caught at an advanced stage and five years survival is something as low as 20 percent.
DENISE: What is an early stage?
DR. WU: So staging with ovarian cancer is related to where the cancer is. Early cancer, or stage 1, means that the cancer is just confined to the ovary. In advanced stages, the cancer has spread to adjacent organs and things like that, like the intestines, the liver, the lungs. So it becomes very difficult to treat cancers once they've spread beyond the ovary and spread to other body parts.
DENISE: Chemotherapy is not helpful in that circumstance.
DR. WU: Patients are usually treated with surgical excision and chemotherapy, but usually it doesn't get all of the cells, so then patients will experience a relapse, the ovarian cancer comes back. Then they may need additional chemotherapy.
DENISE: When a woman goes to her gynecologist and maybe she doesn't have a family history of ovarian cancer, she's simply scared of the possibility given the statistics out here, what should she do?
DR. WU: Unfortunately we don't have a great screening test in terms of sonograms or blood tests or anything like that, that could be used for the widespread population that could be used to prevent ovarian cancer. We're still working on that. But, I think that patients that try to take care of themselves and go for annual checkups, we have a better chance of finding ovarian cancer early in them.
DENISE: Dr. Wu thank you very much for being with us. I'm Denise Richardson for howdini.com.