New Hope for Ovarian Cancer Screening

Ovarian cancer is the fourth leading cause of cancer deaths in American women, killing about 14,000 of them each year.

However, in 1987, researchers at the University of Kentucky began using ultrasound to detect the disease. While more study still needs to be done, this technique does offer hope for detecting the disease early. Dr. John van Nagell of the University of Kentucky Chandler Medical Center spoke with The Early Show about ovarian cancer and his screening program.

Most ovarian cancers are malignancies (life-threatening tumors) that develop in one or both ovaries. A major problem with this disease is that there are no signs of early detection. Often the disease first becomes evident at an advanced stage, when it is very difficult or impossible to cure. Neither pelvic exams nor a blood test can accurately determine whether a woman might have early ovarian cancer.

Van Nagell says ovarian cancer is difficult to diagnose because it can take a while before the cancer mass is large enough to cause symptoms by interfering with pelvic organs or spreading into the abdominal cavity. Since the symptoms are vague and often resemble those of common benign conditions, such as menstrual disorders and intestinal illnesses, they are often ignored.

Transvaginal ultrasound is the method van Nagell and his fellow researchers have been using to screen for ovarian cancer. Although the group has screened 15,000 women, van Nagell says they still need to conduct more before they can determine whether transvaginal ultrasound definitely reduces a woman's risk of dying from ovarian cancer.

So far, we've determined the survival rate of ovarian cancer patients whose disease was detected by annual screening was 90 percent, or nearly twice as high as those without screening," van Nagell says. He expects the method will become available for women with increased risk for ovarian cancer within the next five years.

Van Nagell says that it is believed that the more years that a woman ovulates during her lifetime, the higher her risk for ovarian cancer. For example, women who ovulate less because of pregnancies, birth control pills, or breast feeding seem less likely to develop ovarian cancer, possibly because they do not have the recurring tiny injuries that occur in the ovaries' outer layer as the egg passes through during ovulation. Some doctors think that recurring cell division involved in the healing of these wounds induces some cells to grow at uncontrolled rates and to become cancerous. Women with a family history of ovarian cancer are also at a higher risk for the disease.

Symptoms of ovarian cancer include bloating, pain, pressure or discomfort, van Nagell says. As the tumor grows, the most common first symptoms are caused by fluid build-up within the abdominal cavity. If the cancer spreads to the diaphragm, fluid may collect around and under the lungs, causing shortness of breath. Pressure on the stomach can also cause loss of appeite or a feeling of fullness, even after a very light meal.

Some women describe their symptoms as feeling about four months pregnant. When the tumor presses on organs near the ovaries, such as the bowel of bladder, the woman may experience gas, nausea, vomiting, diarrhea, constipation, or frequent urination.
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