“How can I possibly have ovarian cancer? I’ve always kept up with my gynecological care and never had an abnormal Pap smear. Shouldn’t this have been found sooner?”
Dr. Catie Watson hears this frustration from a lot of patients surprised by an ovarian cancer diagnosis. “Unfortunately, there’s not a good early detection screen for ovarian cancer,” laments the Roper St. Francis Healthcare gynecologic oncologist, explaining that a Pap smear is only designed to detect cervical cancers, not ovarian cancer.
Ovarian cancer also exhibits only vague symptoms and, in 80 percent of cases, reaches advanced stages before it’s even discovered. “This type of cancer is aggressive, often spreading in a matter of weeks or months,” says the doctor. Patients may experience a change in appetite, bloating, abdominal or pelvic discomfort—all things you could chalk up to simply being female.
So how do you battle a hard-hitting disease that can’t be easily detected or avoided? You call in the cancer cavalry.
On Your Side
As a gynecologic oncologist, Dr. Watson confronts precancers, cancers, and other abnormalities of the female reproductive tract. Prior to joining the Roper St. Francis Healthcare team, this steady achiever completed residencies at the University of Tennessee Health Sciences Center and Duke University Medical Center and received a fellowship from MD Anderson Cancer Center. Hers is the sort of in-depth experience and knowledge that patients need when faced with such a fickle foe.
Fighting Back
Without a reliable screen, most ovarian cancers get discovered incidentally during an ultrasound or CT scan for some other medical reason. When a gynecologist or primary care physician spies a potentially troublesome pelvic spot, they refer the patient to a gynecological oncologist, like Dr. Watson, who then biopsies the cells to determine whether or not cancer is present.
“Ovarian cancer is a basket term for a huge spectrum of pathologies that primarily affect women in their post-menopausal years,” notes the doctor. As with most cancers, the disease gets ranked from stage 1 (limited to the ovaries) to stage 4 (spread throughout the body). To treat a cancerous mass, doctors lean on a combination of observation, surgery, and chemotherapy. “When I can help a patient get to the point of maintenance therapy or being disease free, that’s a good moment,” muses Dr. Watson.
The Good News
While the five-year survival rate for ovarian cancer still hovers at 50 percent, this number has improved over the last two decades thanks to the development of targeted drugs and better identification of at-risk patients through BRCA testing. (According to the Centers for Disease Control, about 10 percent of ovarian cancers result from inherited gene mutations.)
Dr. Watson encourages any woman with first- or second-degree relatives that have had ovarian cancer, as well as anyone with a personal history of epithelial cancer, to talk to their healthcare provider about getting the BRCA test. This simple blood test determines if there’s a mutation of the genes that put you at risk for developing ovarian cancer. If so, the doctor and patient can discuss removing her ovaries at the appropriate time, usually after her childbearing years.
“When it comes to ovarian cancer, the absence of a good screen and clearcut symptoms means early detection isn’t a great option,” sums up Dr. Watson. “So, the best plan of attack is to identify at-risk patients.”