How Is Ovarian Cancer Diagnosed? Everything You Need To Know

Ovarian cancer stands to be the third most common cause of cancer in Indian women. It is also the second most commonly occurring gynaecological cancers in the country today, as per reports. By the present year, 2020, India is supposed to have over 36,000 new ovarian cancer cases while around a lakh case would be prevalent. The cancer constitutes to be 6% of all cancer cases in India.

There are multiple types of ovarian cancer. The most common ones are those which develop on the ovarian surface lining. This usually affects post-menopausal women. A female reproductive system contains two ovaries, one on each side of the uterus.

The exact cause of ovarian cancer is not known; however, some of the common risk factors associated with the disease include post-menopausal status, genetic predisposition, hormonal replacement therapy, overweight and smoking.

Early detection is critical for curing ovarian cancer. Treatment and cure will be highly effective when the cancer is still confined to the ovary. The disease is largely asymptomatic in its early stages. Consequently, patients do not seek any medical advice which makes the condition worse. Diagnoses is the first step to confirm or rule out the disease.

Unlike breast and cervical cancer, there is no standardised mass level screening technique associated with ovarian cancer. Only through a laparoscopic biopsy the epithelial precursor lesion STIC can be detected early, which cannot be applied at a mass level. More useful methods include trans vaginal USG (specially in post-menopausal women) and serial and annual USG evaluation. Another effective method can be to genetically screen the BRCA gene, which has a significant role in the disease process of hereditary ovarian cancer.

Also read: Ovarian Cancer: Causes, Symptoms, Prevention And Treatment

There are several tests used in the cases of ovarian cancer. The CA125 is the most common tested biomarker for ovarian cancer, especially for post-menopausal women. It is highly important to know the disease stage at the time of presentation, as it is crucial for evaluating the diagnostic utility of this test. The test is not sufficient as a diagnostic marker to differentiate between benign and malignant tumours. However, a new found test which is the combination of human epididymis secretory protein 4 (HE4) is considered as more competent (sensitive) in cancer detection.

Another method is to use imaging or radiology in full blown cases of cancerous ovary. The disease stage and viability of surgical resection is determined by computed tomography (CT) scan of the abdomen and pelvis with oral and intravenous contrast, and chest imaging. However, the most reliable method is to conduct a biopsy which includes cutting a small piece or surgical removal of tumour from suspected tissue and getting it examined for malignancy. A microscopic examination reveals the final diagnosis of ovarian cancer and its type.

In early stages when the tumor is operable, surgical resection of the tumor is the treatment of choice. However in advanced cases where the tumor has spread, chemotherapy is the preferred treatment modality.

Also read: Ovarian Cancer Is Deadly, But New Tests, Treatments Start To Emerge

Ovarian cancer hasn't received equivalent focus in comparison with breast and cervical cancers. The biggest challenge of the top three women cancers which include breast, cervical, and ovarian cancers is the stigma associated with it. Owing to numerous social pressures and stigmas associated with check-up of breasts and gynaecology, women don't come forward for diagnosis and worse delay treatment on being diagnosed. Consequently, they are significantly under-reported and under-investigated. It therefore becomes imperative that much awareness is imparted about the second most common gynaecological malignancy in Indian women.

(Dr. Prabal Deb, Director Lab Operations & Chief Histopathologist, SRL Diagnostics)

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