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Real Doctors (Life Makers)  |  Clinical  |  Obstetrics & Gynecology  |  Question [Ovarian cancer] « previous next »
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dr_b.e.s.m
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Question [Ovarian cancer]
« on: /October/ 18, 2005, 01:03:06 AM »

36 yr old woman comes to you and is concern about her health and her chances of ovarian cancer.Her mother had ovarian cancer in past and was operated.Your advice

a- annual pelvic examination
b-annual CA-125 +/- USG
c- annual CT scan
d-annual USG +pelvic examination
e-annual PAP smear
« Last Edit: /October/ 29, 2005, 08:35:59 AM by dr_b.e.s.m » Logged


 
eman
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Re: Question [Ovarian cancer]
« Reply #1 on: /October/ 18, 2005, 10:30:33 AM »

 we study this topic in this year ,  unfortunate  the  natural  history  of  ov  carcinoma   is still unkown &the screening test are unreliable.about your Q the  answer may be  d  . CA 125 is not specific  &released in number of physiologic &pathologic conditions ,it raised in 60_70%    of epith ov cancers ,we study that the best method of screening is by combination of methods which is      PV exam +TVS +CA 125       Roll Eyes Roll Eyes
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dr_b.e.s.m
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Re: Question [Ovarian cancer]
« Reply #2 on: /October/ 29, 2005, 08:52:16 AM »

There is no standard screening test for ovarian cancer. And yes, this combination is the best available way for screening but I remember reading somewhere that it's indicated in patient with 2 or more first degree relatives with ovarian cancer. This woman has only one relative ( her mother) so this combination isn't indicated.

So I think that we don't need screening at all for ovarian cancer and all what we need is the Pap smear (Answer E) as screening for cervical cancer (she's above 18 years old).


I am not sure of the answer anyway , it's just a guess based on things I read. What do you think?
« Last Edit: /October/ 29, 2005, 08:54:08 AM by dr_b.e.s.m » Logged
 
eman
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Re: Question [Ovarian cancer]
« Reply #3 on: /October/ 29, 2005, 04:26:20 PM »

i do not agree with you dr b e s m ,bec pap not used in screening of ov cancer. wow faint
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dr_b.e.s.m
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Re: Question [Ovarian cancer]
« Reply #4 on: /October/ 30, 2005, 07:46:45 AM »

yes of course pap smear isn't a screening for ovarian cancer!!

I mean we don't need any screening for ovarian cancer at all (as it's only indicated for those with 2 or more first degree relatives history). ok?  then what shall we do for her? nothing but the ordinary pap smear as screening for cervical neoplasia ( as it's indicated for any woman above 18 years old ) .

It's a tricky question as it asks about your advice for this patient in general not only as regard ovarian cancer screening!!!  Cool

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cleo_md
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Re: Question [Ovarian cancer]
« Reply #5 on: /November/ 05, 2005, 11:27:00 AM »

that's a good question Dr B.E.S.M . It is indeed tricky

I got this quote for you

"No North American expert groups recommend routine screening for ovarian cancer. A National Institutes of Health Consensus Conference on Ovarian Cancer recommended taking a careful family history and performing an annual pelvic examination in all women; other screening procedures such as CA 125 testing and ultrasonography were recommended only for women with a presumed hereditary cancer syndrome "

Ref :
TI - NIH consensus conference. Ovarian cancer. Screening, treatment, and follow-up. NIH Consensus Development Panel on Ovarian Cancer.
SO - JAMA 1995 Feb 8;273(6):491-7.
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dr_b.e.s.m
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Re: Question [Ovarian cancer]
« Reply #6 on: /November/ 05, 2005, 02:19:25 PM »

 so we need U/S and CA 125 only in cases of hereditary ovarian cancer syndromes eg Lynch 2 and BRCA1 mutation. and the routine pelvic examination is done for all women. good points Smiley thank you

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dr_b.e.s.m
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Re: Question [Ovarian cancer]
« Reply #7 on: /November/ 05, 2005, 02:23:57 PM »

oops , I forgot Smiley Happy eid for you dr Cleo and to all muslems in USA? Embarrassed
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mednma
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Re: Question [Ovarian cancer]
« Reply #8 on: /January/ 16, 2006, 06:55:21 PM »

the screening test are unreliable.about your Q the? answer may be? d? . CA 125 is not specific? &released in number of physiologic &pathologic conditions

This statement is not quite true, Eman. Although, CA125 can be raised in other situations but, it is very reliable as a tumour marker. In fact, we ROUTINELY monitor ovarian cancer using CA-125 except in the few cases who dont have raised markers at all where we monitor the disease using abdominoplevic CT scans. This is the standard at the Leeds Teaching hospitals Gynae Cancer clinics. This also agrees with the Royal College guidleines and the guidelines of the National Institute for Clinical Excellence which we call the NICE guidelines.
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mednma
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Re: Question [Ovarian cancer]
« Reply #9 on: /January/ 16, 2006, 07:05:00 PM »

it's indicated in patient with 2 or more first degree relatives with ovarian cancer.

I am not sure of the answer anyway , it's just a guess based on things I read. What do you think?

This is true, 2 first degree relatives, you refer to clinical genetics for evaluation. They might downgrade her depending on the prescence or abscence of mutations.
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dr_b.e.s.m
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Re: Question [Ovarian cancer]
« Reply #10 on: /January/ 19, 2006, 02:07:55 PM »

Thanks a lot Dr Noha for the useful info.

We would like to read more posts sent by you on the website.
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