Taming the Silent Killer

Ovarian cancer, the fifth most diagnosed, is called the “silent killer.” Vague symptoms make this cancer difficult to detect, allowing it to invade other tissues. With an almost 60-percent death rate, women need to understand the symptoms so they may seek treatment early.I lost an ovary and fallopian tube to a large tumour nine years ago. I had symptoms for months but nothing really “worth” visiting the doctor about - until one afternoon I developed severe pain and ended up in the operating room of my local hospital.

Symptoms of ovarian cancer can mimic many common illnesses. According to the Canadian Cancer Society, the symptoms of the early stages of ovarian cancer include a mild discomfort in the lower part of the abdomen, a sense of incomplete evacuation of stool, a frequent urge to urinate, gas, indigestion, feeling full after a light meal, low back pain, and vaginal discharge. More advanced ovarian cancer symptoms may cause a buildup of fluid in the abdomen, making clothes fit tightly even though you have not gained weight, pain during intercourse, abnormal bleeding, diarrhea or constipation, abdominal pain, nausea and vomiting, and fatigue. If you have a combination of these symptoms for more than three weeks you should have your doctor do some tests to rule out ovarian cancer.

The tests are simple: a transvaginal ultrasound, a CA-125 blood test, and a pelvic exam. Many doctors, however, are not doing a CA-125 blood test because they believe it is not reliable. This is incorrect and the National Ovarian Cancer Association recommends it be done in conjunction with the other tests on women with the above symptoms. Using the test, which determines the level of an antigen in the blood that is known to be a tumour marker, in 1983 Harvard University found elevated levels CA-125 in 80 percent of women with Stages III and IV ovarian cancer. In women with Stage I cancer, the blood test is not as reliable, with only 40 to 50 percent of those tested showing elevated levels. A false positive can also result in women with endometriosis, uterine fibroids, and a number of other conditions. But it is the best test we have when combined with a transvaginal ultrasound and a pelvic exam, and it is covered under provincial medical plans. Laparoscopic surgery is still the only definitive method to detect ovarian cancer.

As a form of prevention, our doctors recommend birth control pills to stop ovulation. To lower the risk of developing ovarian cancer, studies show that a vegetarian diet with good protein sources, along with vitamins A, C, E, and selenium and zinc, combined with the plant nutrients indole-3-carbinol and d-glucarate are good prevention strategies. Prevention the key but we must diagnose this cancer in its early stages so that more women survive.

According to Statistics Canada, one-third of Canadian women have not had a pelvic exam and PAP test in the last three years. If we want to diagnose ovarian cancers in the early stages, women need to have proper gynecological exams every year and if you have one elevated CA-125 then you should have this test annually, as well.