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Preventative Measures

Program: In what way does being female increase your cancer risk? A look at gynecologic cancers
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Andrew Schorr:

Prove otherwise is what Gina was saying. We're going to come back to Gina in a minute. Want to mention about ovarian cancer too. I want to ask you about that. I always think--you know, I was watching Saturday Night Live last night, I always think of Gilda Radner, who died of that. And of course Gilda's Club is a great friend of Patient Power. Typically it's found late, and most often it is fatal. You want to catch it early. You don't really have a test for that now. What could a woman do to try to limit her risk or have earlier detection? We've got pap smears for cervical cancer, but what do we have for ovarian, or where are you headed?

Dr. Gray:

It's a difficult area. Ovarian cancer, as you mentioned, does traditionally get diagnosed late because we have no good screening method and patients traditionally present late. However, another colleague of ours, Dr. Barbara Goff, did an excellent study several years ago looking at patient's symptoms where they took patients who were presenting to just a general clinic for a variety of--female patients, a variety of symptoms and then patients who were presenting with a pelvic mass or kind of a preoperative condition and found that patients who ultimately ended up having ovarian cancer their symptoms of abdominal pain, pelvic pain, urinary frequency and what we call bloating were much more frequent than those who presented and didn't have ovarian cancer, and they were much more severe. So it wasn't just that if you have a pain here and there, but if you have pain every day or bloating every day for a period of several weeks, then that should be something that you should really investigate and bring to your practitioner's attention.

Andrew Schorr:

So, Dr. Greer, what could come out of Barbara Goff's research--and she was on the show a couple weeks ago talking about the HPV vaccine, so folks you should listen to that--could be ultimately maybe guidelines that say if a patient is complaining of this or that you need--you, the grassroots physician out there in heartland America, need to consider early signs of ovarian cancer, right?

Dr. Greer:

That's correct. I think that the symptom complex that Dr. Goff has described is an important part of listening to your body and then making proactive action to try and have it evaluated, which would include an examination, a pelvic exam and possibly a blood test for CA-125 and also maybe even a computerized tomography of the abdomen to see if there's anything wrong.

There's been a lot of interest in doing screening with CA-125. It's probably--it has not be been a useful tool for screening because one percent of the population have elevated CA-125, and some ovarian cancers don't express CA-125. But it's one of the few noninvasive tests that we have that can possibly identify somebody as at risk.

One other cautionary note about CA-125 is that women that are premenopausal that have conditions like endometriosis that we talked about or uterine fibroids or leiomyomata and other gyn conditions can also elevate CA-125, so it's somewhat of a nonspecific test.

Andrew Schorr:

Okay. We're going to take a break. I want you to think about what's going on here because I've often said that we're blessed in Seattle with some excellent, excellent physicians. We have two University of Washington, Seattle Care Alliance not just physicians but researchers. Gina said, I'm going there because I want to get the benefit of the latest thinking, and then something as serious as endometrial cancer or ovarian cancer, I think you'd do well to do that. We're going to talk about that as we continue on Patient Power.

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