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Researchers at the University of
Kentucky Medical Center in Lexington have been investigating a procedure called
transvaginal ultrasound that may be effective in detecting ovarian cancer at an early stage. Because there are currently no
reliable tests to screen for ovarian cancer, most tumors are detected in late stages when
the chances of survival are generally low. According to Dr. Beth Karlan, director of
gynecologic oncology at Cedar Sinai Medical Center in Los Angeles, the transvaginal
ultrasound provides a clearer picture of the ovaries than conventional abdominal
ultrasound.
In a study of 14,469 women with no symptoms of ovarian cancer, researchers detected 17 ovarian
cancers (of 180 tumors found) with transvaginal ultrasound. Women who had abnormal
findings on the first screening underwent additional tests over a period of four to six
weeks to make sure the abnormality was not a transient cyst. Those who had persistent
abnormalities were then required to undergo a series of blood and ultrasound tests to
determine whether there was a need for surgery. After surgery, researchers determined that
11 of the cancers were Stage I (early stage), three were Stage II, and three were Stage
III (late stage). Although the total number of ovarian cancers detected was relatively
small, the majority of tumors were detected at an early stage, when they are most likely
to respond positively to treatment.
To perform a transvaginal ultrasound,
gynecologists insert an ultrasound probe, slightly larger than a tampon, into the vagina.
According to Dr. Karlan, the transvaginal ultrasound is anatomically closer to the ovaries
in many women than abdominal ultrasound and allows physicians to more accurately see what
the ovaries look like. Abdominal ultrasound requires the ultrasound waves to pass through
the abdomen, causing the image to be less clear. In general, the closer the ultrasound
probe is to the area being imaged, the clearer the image will turn out. Women in the study
reported that transvaginal ultrasound was also more comfortable than conventional
abdominal ultrasound that requires a distended bladder.
Though the study does not definitively
confirm that transvaginal ultrasound reduces the risk of dying from ovarian cancer,
researchers believe the exam may help reduce the number of late-stage diagnoses. It is
estimated that nearly 15,000 women die from the disease each year, 70% of whom are not
diagnosed until the cancer has spread beyond the ovaries.
Early detection of ovarian cancer is
the key to survival. Some symptoms of ovarian cancer include:
- Pelvic or abdominal pain or discomfort
- Vague, but persistent, gastrointestinal
upsets such as gas, nausea and indigestion
- Frequency and/or urgency of urination in
the absence of an infection
- Unexplained changes in bowel habits
- Unexplained weight gain or weight loss,
particularly weight gain in the abdominal region
- Pelvic and/or abdominal swelling,
bloating, and/or feeling of fullness
- Pain during intercourse
- Ongoing fatigue
- Abnormal post-menopausal bleeding
If diagnosed and treated before the
cancer has spread outside the ovary, the five-year survival rate is 95%. However, only 25%
of all ovarian cancers are presently detected at this early stage.
Additional Resources and References
Updated: July 23, 2001
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