How is ovarian cancer screened?

Written by Liu Liang
Oncology
Updated on September 02, 2024
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The most commonly used screening method for ovarian cancer is the B-ultrasound examination of the adnexa uteri. The B-ultrasound can detect ovarian masses and tumors, and when these are found, the possibility of ovarian cancer should be considered, necessitating further examinations for confirmation. Another method involves the tumor marker CA125, which is relatively sensitive and specific for epithelial ovarian cancer. Therefore, for ovarian cancer screening, we can perform a blood test for CA125 in conjunction with a B-ultrasound of the adnexa uteri.

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Written by Liu Liang
Oncology
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How is ovarian cancer diagnosed?

Ovarian cancer is discovered through transvaginal ultrasound of the adnexa uteri revealing ovarian tumors, or through imaging studies such as abdominal CT scans or MRIs showing ovarian tumors, combined with tumor markers, particularly the ovarian epithelial cancer tumor marker CA125, which will be significantly elevated. Generally, with these findings, ovarian cancer can typically be clinically diagnosed. Confirmation, however, requires pathological diagnosis, which involves obtaining a biopsy of the tumor. This can be done through a puncture biopsy or through pathological examination after surgical excision to confirm ovarian cancer. Additionally, some patients with ovarian cancer present with substantial ascites at the time of discovery. If cancer cells are found in the abdominal fluid, combined with a significant increase in CA125 and imaging studies showing ovarian tumors, ovarian cancer can also be diagnosed.

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What are the early symptoms of ovarian cancer?

Patients with ovarian cancer often do not exhibit many symptoms in the early stages, and many do not have obvious symptoms initially. Some patients may experience pelvic pain due to tumor growth early on, primarily located in the bilateral pelvic area, with some experiencing pain that radiates to the perineal area. Some early-stage ovarian cancer patients may experience abnormalities in their menstrual cycle, primarily manifested as irregular menstruation, increased menstrual flow, and the presence of blood clots. Some patients may also experience abnormal vaginal bleeding outside of their menstrual period. In addition, some patients in the early stages may exhibit signs of abnormal hormone secretion. Aside from these, most early-stage ovarian cancer patients do not show obvious symptoms.

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Is ovarian cancer curable?

Early-stage ovarian cancer patients, meaning those without extensive ascites buildup, and without widespread implant metastasis in the pelvic and abdominal cavity, and without metastasis to distant organs like the liver and lungs. These very early-stage ovarian cancer patients can undergo radical surgery. Postoperative treatment decisions, such as whether postoperative adjuvant radiotherapy or chemotherapy is needed, are based on the postoperative pathological report, which looks for high-risk factors for recurrence such as vascular cancer emboli or neural invasion. Through these treatment approaches, very early-stage ovarian cancer patients can achieve a cure, but this is not absolute. It's not guaranteed that every early-stage ovarian cancer patient can be cured, as there are individual differences. Clinically, if there is no recurrence or metastasis within five years, it is considered a cure.

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What are the symptoms of ovarian cancer recurrence?

Symptoms of recurrent ovarian cancer include: First, vaginal bleeding, which is a manifestation of the tumor invading the uterus, cervix, or vagina. Second, abdominal bloating and pain, which indicate tumor spread to the abdominal cavity. Physical examination can reveal abdominal masses, ascites, and even intestinal obstruction. Third, there are symptoms such as stomach discomfort and indigestion related to the digestive tract. There might also be metastasis to the cervical lymph nodes, which can be palpated in the neck. Fourth, some late-stage patients may experience discomfort and heaviness in the lower abdomen, and even symptoms related to the urinary system such as frequent urination, urgent urination, and painful urination.

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Ovarian cancer requires the following examinations:

The examination for ovarian cancer begins with an abdominal ultrasound, which can clarify the tumor's size, shape, cystic or solid nature, location, and its relationship with neighboring organs. If necessary, CT scans and MRI can be conducted for a clearer view. Next are tumor markers, which are essential in the diagnosis of ovarian cancer. Additionally, CT scans of the lungs and head, or MRI, and a complete blood count of bone can help rule out distant metastasis. The most critical part is the pathological diagnosis, as the definitive diagnosis of tumors primarily relies on pathology. We can obtain a clear pathological diagnosis through laparoscopy or exploratory laparotomy.