Ovarian Cancer

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Using Imaging To Understand Your Ovarian Cancer

Dr. Bobbie Rimel Cedars-Sinai Medical Center

Imaging is a key option for ovarian cancer patients who’ve been diagnosed with what appears to be an obvious late stage cancer — as opposed to an early stage cancer — to determine the cancer’s stage without requiring surgery.

Before doctors take further action to determine what stage a woman is at, they will likely do a pelvic exam to feel for lumps or changes in and around the ovaries, particularly if she has been experiencing discomfort, bloating or if she has risk factors for ovarian cancer.

“Staging is primarily done surgically in ovarian cancer but may be avoided in a patient that already has sort of obvious what we call stage four or highly metastatic disease,” says Dr. BJ Rimel, gynecologic oncologist at Cedar-Sinai Medical Center.

For those women, she says, surgery may not be the appropriate option. Instead, imaging tests can be performed.

Some of the imaging tests use include CT scans, MRIs or ultrasound imaging tests to screen for ovarian cancer.

A CT scan is an imaging study performed in an imaging center, according to Rimel. A CT scan looks for tumors in the uterus, ovary or abdomen.

To perform a CT scan, an IV is required to administer contrast dye for the woman. Contrast dye helps to differentiate between types of tissue. The entire process of performing a CT scan takes only a few minutes. The woman is asked to lie down in a device that looks like a donut. The table on which the woman lies down on for the procedure will move in and out of the donut as the CT scan progresses. The contrast dye will help determine what tissue is receiving blood flow versus what tissue is not.

Doctors are able to detect certain differences between tissues with more blood vessels versus what has fewer blood vessels with a CT scan.

An MRI on the other hand, uses magnets to create an image, which creates contrast as well. The metal dye can be given to a woman intravenously. The advantage to giving a woman an MRI as opposed to a CT scan is that with an MRI, more subtle findings are possible, according to Rimel. Additionally, there are some circumstances under which a woman would be unable to receive the contrast dye required for a CT scan—due to something such as kidney failure—and then, an MRI would be the appropriate option.

A third imaging test option would be to do a transabdominal ultrasound. A transabdominal ultrasound allows doctors to look at the abdomen for masses in the abdomen, uterus and ovaries. To complete this test, a patient will lie on an examination bed and an ultrasound probe will be used on the abdomen, Rimel says.

While a transabdominal ultrasound is an option, it is not as commonly performed as a transvaginal ultrasound for pelvic cancers like ovarian cancer.

This is because, according to Rimel, a transvaginal ultrasound is more sensitive way of looking at the ovaries and uterus. The reason it is more sensitive is that it allows doctors to see more of the ovaries and uterus. The distance between the ultrasound probe and what they are looking to examine is shorter when performing a transvaginal ultrasound because the vagina is closer.

As a result of this, the transvaginal ultrasound is more commonly used when investigating for ovarian cancer.

Screening for cancer and running further tests to determine to what stage the cancer has progressed can be a different process depending on what kind of cancer the patient has. SurvivorNet has more about different types of screening such as screening for breast cancer and screening for colon cancer.

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Dr. Bobbie J. Rimel is an OB/GYN and Oncologist at Cedars-Sinai Medical Center. Read More