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Unveiling the Silent Threat: Understanding Ovarian Cancer

Ovarian cancer, often dubbed the “silent killer,” presents a formidable challenge in the realm of women’s health. With symptoms often subtle or absent in the early stages, timely detection of ovarian cancer remains a critical issue. However, advancements in medical technology, particularly in the field of ultrasound imaging, are reshaping the landscape of ovarian cancer diagnosis.  

In this blog post, we’ll explore the role of ultrasound in detecting ovarian cancer, its benefits, and the evolving landscape of early detection. 

Ovarian cancer  

Ovarian cancer is the fifth most common cause of cancer-related deaths among women, with a high mortality rate primarily due to late-stage diagnosis. This cancer originates in the ovaries, the reproductive organs responsible for producing eggs and hormones. Ovarian cancer most commonly occurs in women over the age of 50. Unfortunately, symptoms such as abdominal bloating, pelvic pain, and changes in bowel habits often mimic less severe conditions, leading to delayed diagnosis. Additionally, ovarian cancer symptoms are not always obvious, so ovarian cancer is often diagnosed late. However, if diagnosed early, it can be more treatable.  

The scan assesses important aspects of ovarian health, including: 

  • The size of the ovaries 
  • The texture of the ovaries 
  • Whether there are any cysts on the ovaries 

Diagnosing Ovarian Cancer 

However, ovarian cancer is not solely diagnosed by an ultrasound scan. Doctors facilitate something known as Risk of malignancy index (RMI) to decide whether an abnormality seen on the scan is cancer or not. This score considers: 

  • The ultrasound scans 
  • CA 125 blood levels 
  • Your menopausal status 

At Fusion Healthcare, we offer a serum CA125 blood test which evaluates the levels of this marker in the blood. 

Women with a high RMI score are referred to a specialist Multidisciplinary team (MDT) who will decide further tests and next steps. 

If your healthcare provider does not think cancer is likely, then they may recommend another ultrasound after a few months to assess whether anything has changed about the ovaries. 

Ultrasound for ovarian cancer 

Ultrasound imaging has emerged as a powerful tool in the detection and management of ovarian cancer. Unlike traditional X-ray imaging, ultrasound uses high-frequency sound waves to create detailed images of internal organs, including the ovaries. Transvaginal ultrasound (TVUS) and transabdominal ultrasound (TAUS) are two common techniques used to visualize the ovaries and surrounding structures. 

Despite not diagnosing cancer on its own, ultrasound scans still provide highly valuable information to clinicians regarding ovarian health and possess many benefits. 

Diagnosing Ovarian Cancer 

  1. Ultrasound can detect masses on the ovaries at an early stage, allowing for timely intervention. 
  1. Ultrasound do not use any radiation and instead use high frequency sound waves, this is beneficial when imaging reproductive organs. 
  1. Ultrasound scans provide high resolution images which enable healthcare providers to accurately address characteristics of the ovaries or ovarian tumours.  
  1. Ultrasound scans allow for effective monitoring of the progression of ovarian cancer during treatment and follow-up. This provides valuable information about the management of ovarian cancer and can help personalize treatment plans. 

On of the drawbacks of Ultrasound is that sometimes it is difficult to distinguish between ovarian tumours and benign masses on ultrasound, as a result this can lead to false positives and misdiagnosis. This further emphasizes the importance of the RMI. Your healthcare provider will carefully assess you test results to ensure you are referred appropriately should it be necessary. 

What to expect during the procedure 

Two scans are usually performed for a thorough evaluation of the pelvic region and organs: A pelvic ultrasound scan and a transvaginal ultrasound scan. Therefore, there is minimal preparation that must be taken to ensure the best quality images. 

In preparation for the scan you may be asked to drink a lot of water so that your bladder is full for the first scan, this allows clinicians to have a better look at the organs.  

You may also be asked to change into a gown for easier access. 

During the scan: 

  • Preparation: These scans are performed with the patient lying down. The transabdominal scan of the pelvis (over the tummy) is performed first, with a gel applied over the abdomen. The transvaginal scan is performed second. Before the transvaginal scan is performed patients are told to use the toilet so the scan is performed on an empty bladder. For the TV scan, a slender probe is inserted into the vagina to give a clearer look at the anatomy. 
  • Ultrasound scanning: The transducer probe emits high frequency sound waves which bounce of structures and create real time images on the monitor.  
  • Image interpretation: Images taken during the scan are interpreted by sonographers or doctors to evaluates any findings. The information attained is crucial in diagnosis and deciding next steps. 

The entire procedure is usually painless; however, some find the transvaginal ultrasound scan to cause some discomfort. The entire process usually takes around 30 minutes to complete. 

Ultrasound scans a valuable tool in the diagnosis, management, and follow-up of ovarian cancer. In combination with a serum CA125 blood test, ovarian cancer can be detected early allowing for viable treatment and management options.