Over 90 Percent of What Planned Parenthood Does, Part 16: Blood Tests to Screen for Ovarian Cancer

repro systemWelcome to the latest installment of “Over 90 Percent of What Planned Parenthood Does,” a series on Planned Parenthood Advocates of Arizona’s blog that highlights Planned Parenthood’s diverse array of services — the ones Jon Kyl never knew about.

September is Ovarian Cancer Awareness Month.

Ovarian cancer can strike anyone with ovaries, although it is most common in people who are more than 55 years old. It starts when certain mutations in ovarian cells start to proliferate, resulting in tumor growth. (Some types of ovarian cancer can originate in the fallopian tubes, but most ovarian cancers arise from the cells that cover the surface of the ovary.) If a cancerous cell breaks away, it might set up camp elsewhere in the body, resulting in the cancer’s spread. It can be a serious condition, affecting around one out of 71 ovary-wielding individuals.

What causes ovarian cancer?

If you learned about the reproductive system in school, you probably remember that ovulation involves the release of an egg from an ovary. What your teacher probably didn’t tell you is that the process of ovulation is actually rather violent. An egg does not exit the ovary through a preexisting “doorway” and shuttle down the fallopian tube to make its way to the uterus. Nope, when an egg is “released,” it actually bursts through the ovary itself.

OH YEAHUnfortunately, during ovulation, the egg perforates the ovary, creating a lot of tissue damage. The ovary needs to repair itself, sort of like how bricklayers will need to be hired to fix that mess left by the Kool Aid man. Because ovarian cells are so often replicating themselves during the repair process, there are more chances for an error to occur. Cells that divide frequently, like ovarian cells, are more prone to becoming cancerous.

Think of it this way: If there is a small chance that a bricklayer will make a mistake when building one brick wall, there is an even larger chance that the bricklayer will make a mistake when building brick walls on a monthly basis. The same principle holds for the rapidly dividing cells in the ovary — each time tissue is damaged and repaired, there is a chance that a mutation could occur, possibly leading to cancer.

This is also why estrogen- and progestin-containing hormonal birth control, which suppresses ovulation, decreases the risk for ovarian cancer — the less you ovulate, the less tissue damage is being done to your ovaries, and the less frequently your ovaries need to repair themselves. According to Planned Parenthood, taking ovulation-suppressing hormonal birth control pills continuously for five to 10 years can protect you from ovarian cancer for up to 20 years after you have stopped using it. According to the National Cancer Institute, ovarian cancer risk decreases by 10 to 12 percent after one year of oral contraceptive use, and by approximately 50 percent after five years of use.

Am I at risk for ovarian cancer?

Although there are no “gold-standard” screening methods for ovarian cancer, regular physical or pelvic exams might help a health care provider detect signs of it, such as tenderness or swelling in the area of the ovaries. But ovarian cancer is difficult to detect early, when it would be the easiest to treat. Anyone with ovaries can get it, but a few factors increase risk:

  • age (it is most common in people older than 55)
  • genetics (a family history of ovarian or breast cancer)
  • having had breast, uterus, colon, or rectum cancer
  • never having been pregnant
  • never using birth control pills

Some people with a family history of ovarian cancer opt to have their ovaries removed — if the ovaries aren’t there, they can’t become cancerous. If you read Angelina Jolie’s provocative op-ed earlier this year, you might remember that she chose to have her breasts surgically removed after learning she has a genetic mutation that gave her an 87 percent chance of developing breast cancer and a 50 percent chance of developing ovarian cancer. She implied that she might have her ovaries surgically removed in the future, in order to eliminate her risk for ovarian cancer. The test that detected her genetic mutation was very expensive, but for those who can afford it and have a family history of breast or ovarian cancer, it might be used to inform health decisions.

How does a provider screen for ovarian cancer? 

If you are at risk for ovarian cancer, you might want to monitor your ovarian health with a blood test, which assesses the level of a protein called CA125 in your blood. This protein is produced by ovarian cells, and a very high level of CA125 might be indicative of a tumorous growth. Planned Parenthood Arizona can perform this blood test, but if there are signs of possible cancer, we would refer you to a specialist to perform a biopsy and any further treatment that is needed.

Symptoms of ovarian cancer can include bloating, nausea, or fatigue, which are so common in everyday life that they might not raise any red flags. Other symptoms, like severe abdominal pain, might land you in an emergency department. Abdominal pain could be indicative of many things, ranging from indigestion to appendicitis to, yes, cancer. In the case of ovarian problems, an ultrasound might find a mass around an ovary. This could be a benign (noncancerous) cyst, which can be removed surgically. Another possibility is that you could have a cancerous tumor on your ovary. At this stage, the most effective treatments are surgery, radiation, and chemotherapy. (Having one ovary removed won’t impact fertility, as long as your remaining ovary is functional.)

Although there are currently no good tests for ovarian cancer, it can sometimes be caught early. Planned Parenthood Arizona offers physical and pelvic exams, and also performs blood tests that might detect signs of ovarian cancer. You can schedule an appointment at your local Planned Parenthood health center. For more information about ovarian cancer, visit Planned Parenthood’s website or read the National Cancer Institute’s online booklet.