What’s your risk of ovarian cancer?

By Jennifer Arnhold, M.D.

As the fifth-leading cause of cancer deaths in women, ovarian cancer is an aggressive disease, and because of a lack of reliable screening, it often isn’t caught until later stages. This is why September is recognized as Ovarian Cancer Awareness Month.

Digital medical illustration: Perspective x-ray view of human ovum with tumor. Anatomically correct. Isolated on black.According to estimates from the American Cancer Society, about 22,440 women in the U.S. will be diagnosed with ovarian cancer in 2017, and about 14,080 will die from it.

Your lifetime risk of ovarian cancer without a gene mutation is about 1 in 75, and your lifetime chance of dying from it is about 1 in 100. Women with certain genetic mutations and a strong family history of breast and reproductive cancer are most at risk.

There is hope, however. Over the past 20 years, the diagnosis rate in women has been gradually declining. Prevention is the key to continuing this trend.

The exam

When a woman comes in for her annual physical or with ovarian concerns, her provider would take a thorough family history and possibly a pap smear (note that pap smears are not needed every year). A speculum exam to look at the vagina and cervix and a pelvic exam to feel the ovaries and uterus are also conducted.

If abnormal lumps on the ovaries are found, we order imaging such as a pelvic ultrasound or CT scan. A blood test that measures CA 125 might also be needed. CA 125 is a protein that collects in high concentration in tumor cells, especially ovarian cancer cells.

The blood test doesn’t provide a diagnosis, but if the numbers are elevated to a certain point, combined with abnormal imaging, it might lead us to believe that a tumor is cancerous.

Most of the time, tumors are benign, and that can be address and monitored. But if cancer is suspected, then patients are referred to a GYN oncologist.

If a woman who is done with childbearing undergoes a hysterectomy or other gynecological surgery, the recommendation is to remove the fallopian tubes at the same time. Fallopian tubes carry eggs from the ovaries to the uterus.

It is thought that the origin of ovarian cancer could be in the Fallopian tubes. Removing the tubes can significantly reduce your risk of ovarian cancer over your lifetime, and it doesn’t add any increased risk or complexity to the surgery.

Why is it so hard to detect?

Ovarian cancer begins as tiny fluid- or air-filled sacs on the ovary that can’t be picked up with imaging, and they’re impossible for a doctor to feel during a pelvic exam. The cancer also doesn’t show up in blood tests and doesn’t have obvious symptoms.Woman with menstrual pain is holding her aching belly - body pain concept.

These symptoms might include:

  • Changes in appetite
  • A feeling of early fullness
  • Changes in bowel or bladder habits
  • Generalized pain
  • Pelvic discomfort
  • Fatigue

Prevention is key.

Because there isn’t a reliable screening test for ovarian cancer, annual physicals with pelvic exams are extremely important.

You should also be aware of your body, paying attention to how you feel and noting any symptoms you might exhibit.

If you experience symptoms or have concerns, don’t wait to seek a professional assessment, and don’t be afraid to come in. It’s easy to rationalize pain as no big deal. The best way to know for sure is to see your doctor.

For more about ovarian cancer, click here.


photo of doctor Jennifer Arnhold

Dr. Jennifer Arnhold

About the Author: Jennifer Arnhold, M.D., lives in the Brainerd Lakes Area and enjoys spoiling her son, Ty, and poodle, Andy. She graduated from medical school in 2000 and performs gynecology and gynecological surgery at Tri-County Health Care in Wadena. You can also see her for outpatient appointments at Embrace Women’s Health Clinic in Baxter.


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