How can medical imaging help diagnose ovarian cancer?
Ovarian cancer is the fifth most common cause of cancer death for women, according to the Canadian Cancer Society’s Canadian Cancer Statistics 2017. While its mortality rate has fallen over the past 30 years, it can be challenging to detect and diagnose because many of its symptoms are similar to those caused by less serious problems.
Women’s reproductive glands, the ovaries are about the size of an almond and located in the abdomen above the pelvis – one on each side of the uterus. They produce eggs and the female hormones estrogen and progesterone.
It’s often difficult to diagnose ovarian cancer in its early stages, because symptoms associated with ovarian cancer are often vague and non-specific, and can be experienced by women without ovarian cancer. The most common symptoms include:
- Abdominal pressure, fullness, swelling, or bloating.
- Pain or discomfort in pelvic or abdominal areas.
- Urgent or frequent need to urinate.
If you experience these symptoms daily, for more than a few weeks, it’s important to discuss them with your health care practitioner.
Other symptoms could include persistent indigestion, gas, or nausea; unexplained changes in bowel habits, including diarrhea or constipation; loss of appetite; unexplained weight loss or gain; low back pain and dyspareunia (painful sexual intercourse).
HOW IS OVARIAN CANCER DIAGNOSED?
After discussing your symptoms with you, your doctor may request blood tests or medical imaging to investigate the cause for your symptoms.
When imaging is requested, it’s often used to determine if a mass is present in the ovaries. It could include a pelvic ultrasound, and possibly a transvaginal ultrasound in which a narrow probe is inserted into the vagina. MRI or CT imaging may also be ordered for a more detailed look at an indeterminate or complex mass.
If a mass is found, a surgical biopsy would be needed in order to confirm cancer, as well as the type and stage of cancer.
WHAT ARE THE RISK FACTORS FOR OVARIAN CANCER?
According to the American Cancer Society, the strongest risk factor for ovarian cancer is a family history of breast or ovarian cancer. The risk is increased by about fourfold among women with a first-degree relative (parent, sibling, or child) with a history of ovarian cancer and by about 70% among women with a first-degree relative with a history of breast cancer.
As well, almost 40% of ovarian cancer cases in women with a family history are due to mutations in the cancer susceptibility genes BRCA1 and BRCA2. If it’s determined you have this combination of risk factors, you may be referred for genetic counseling and evaluation.
Other known risk factors include never having delivered a child, beginning menstruation before age 12, starting menopause after age 55, or using estrogen alone as postmenopausal hormone therapy. Obesity may also be associated with increased risk of developing ovarian cancer.
On the other hand, pregnancy and long-term use of oral contraceptives can help reduce the risk of developing ovarian cancer.
Please note, that a risk factor is something that increases the risk of developing cancer, but most cancers are the result of many risk factors. Cancer can also develop in people without risk factors, so it’s important to speak to your health care practitioner about any concerns.
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