Ovarian cancer: detection and specialized treatment

What it is

Unlike breast or cervical cancer, there is no screening test proven to catch it early in women without symptoms. The ovaries sit deep in the pelvis, tumors can grow without clear discomfort, and the first symptoms — bloating, feeling full, digestive upset — are easily confused with common stomach or bowel problems.

Because of that combination — no screening test and vague symptoms — most cases are found once the disease has already spread. The best available tool is knowing the warning signs and not letting persistent symptoms slide: if something happens almost daily for more than two or three weeks, it should be checked.

Risk factors

• Age: most cases appear after menopause.
• Family history of ovarian, breast, or colon cancer.
• Inherited mutations in the BRCA1 and BRCA2 genes, and syndromes such as Lynch syndrome.
• Never having had children, or having a first pregnancy after age 35.
• Being overweight or obese.
• Estrogen hormone therapy after menopause.
• Endometriosis.
• Early first period and late menopause.

Long-term use of oral contraceptives, pregnancies, and breastfeeding are associated with lower risk; this is informational, not a recommendation: any decision is made in consultation.

Warning signs / common symptoms

• Bloating or swelling of the abdomen that does not go away.
• Feeling full quickly when eating, or difficulty eating.
• Persistent pelvic or abdominal pain.
• Needing to urinate urgently or more often than usual.
• Persistent tiredness, upset stomach, constipation, or back pain.
• Menstrual changes or bleeding after menopause.

Important: these symptoms are common and are almost always due to benign causes (colitis, gastritis, urinary tract infections). The difference lies in the persistence: if they occur almost daily for more than a few weeks, only a doctor can evaluate them. Come in for an evaluation.

How it is detected and diagnosed

• Everything starts with the consultation and gynecologic exam, where the doctor checks for growths or fluid in the abdomen.
• Pelvic or transvaginal ultrasound: the first imaging test to look at the ovaries.
• CA-125 blood test: a protein that is often elevated in this cancer; useful as support, although it also rises for benign reasons, so it is never interpreted on its own.
• CT scan and other imaging tests to determine how far the disease extends.
• Definitive confirmation comes from analyzing the tissue, almost always obtained during surgery; in selected cases, through a biopsy. The consultation, the tests, and the surgical evaluation are part of what the Unidad de Oncología Menonita offers.

Treatment options

The usual treatment combines surgery and medicines, and the unit offers:

• Cancer surgery: the foundation of treatment; it aims to remove the tumor and all affected tissue (debulking). In very selected, early cases fertility can be preserved; this is defined in consultation.
• Chemotherapy: almost always accompanies surgery, before or after, to eliminate any remaining cells.
• Targeted therapy: medicines such as PARP inhibitors, useful above all in patients with BRCA mutations, or antiangiogenic drugs in selected cases.
• Hormone therapy: an option in certain uncommon types of ovarian tumors.
• Palliative care: control of symptoms such as pain or fluid buildup, at any stage.

Being honest about other services: radiation therapy is rarely used in ovarian cancer, but if a case were to require it, or if a highly specialized procedure not available at the unit is needed, we refer and coordinate care with centers in Chihuahua City.

Early detection / prevention

• There is no recommended screening for women without symptoms and without elevated risk: the available tests (CA-125 and ultrasound) have not been shown to reduce mortality in the general population, according to the U.S. National Cancer Institute and the American Cancer Society.
• What does help: regular gynecologic checkups, prompt attention to persistent symptoms and, in women with a strong family history, a genetic risk evaluation (BRCA), which can open options for surveillance or preventive surgery.
• If there are several cases of ovarian or breast cancer in your family, mention it in consultation: that history changes the surveillance plan.

Frequently asked questions

Does a Pap test detect ovarian cancer? No. The Pap test only detects changes in the cervix. Evaluating the ovaries requires an exam, an ultrasound, and specific tests.

Does an elevated CA-125 mean I have cancer? Not necessarily. CA-125 also rises with endometriosis, fibroids, infections, and even menstruation. It is one piece of information, interpreted together with imaging studies and a medical evaluation.

Do ovarian cysts turn into cancer? The vast majority of cysts are benign, and many go away on their own. Some require monitoring or surgery; the doctor determines this based on their size, appearance, and your age. If a cyst is found, come in for an evaluation.

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