Ovarian cancer Flashcards
Which cancer marker will be raised in Ovarian cancer?
CA-125.
However, this is not specific to ovarian cancer. it is also raised in inflammation, infection and infarction.
When to test for Ovarian cancer?
Carry out tests in those 50 years old or older, with the following symptoms occurring at 12 or more times per month:
- persistent abdominal distension (often referred to as “bloating”)
- early satiety and/or loss of appetite
- pelvic or abdominal pain
- increased urinary urgency and/or frequency
Also carry out tests when a women aged 50 or more experience symptoms suggesting Irritable Bowel Syndrome (IBS) within the last 12 months, because IBS seldom presents for the first time in women of this age.
What is done to test for Ovarian cancer?
CA-125 levels is tested. If >35IU/ml or greater, arrange an ultrasound scan of abdomen and pelvis
If USS, CA125 and clinical status suggests ovarian cancer, what is the next step?
CT scan of pelvis and abdomen. Include the thorax if clinically indicated
What is done for definitive diagnosis of ovarian cancer?
Tissue biopsy:
use percutaneous image-guided biopsy if feasible.
If not, consider laparoscopic biopsy.
What signs and symptoms are seen in more advanced ovarian cancers? Complications
Pleural effusions
Ascites
Malignant bowel obstruction
Thromboembolic phenomenon
Kidney problems - hydronephrosis secondary to ureteric obstruction
Inflammatory myopathies - dermatomyositis
How is the staging and determination of extent of spread of ovarian cancer determined?
It is determined with surgery.
CA-125, transvaginal USS findings and age can be useful in what aspects?
CA-125, transvaginal ultrasound findings and age can be useful in differentiating benign ovarian cysts and ovarian malignancy.
Which type of ovarian cancer is most common?
Ovarian cancer of epithelial origin - especially serous > mucinous - forms 90% of cases.
