After the initial impact of an ovarian cancer diagnosis sets in, the first few questions that come to mind usually include “How long will I live?”; “How do I get rid of it?”; and “Who’s going to be the best doctor to treat my specific cancer?”
With ovarian cancer in particular, the answer to that last question can dramatically affect the first two. Seeing the right type of doctor can make a difference in your outcomes and long-term survival.
Read MoreSo when is it time to visit a gynecologic oncologist? The earlier the better. When detected early enough, ovarian cancer is curable in over 90 percent of cases, which is part of the reason why Dr. Karlan says that a gynecologic oncologist should be the one to give you an ovarian cancer diagnosis. If a gynecologist finds a mass during a transvaginal ultrasound or early workup that looks like it might be cancer, that could mean it's time to start thinking about finding an expert. Before recommending one, though, they might choose to conduct one of a number of blood tests, called “ovarian cancer triage tests,” which look for signs that the mass is ovarian cancer, as opposed to a non-cancerous mass, cyst, or benign tumor.
Most of these tests look for elevated amounts of the protein CA 125, which can be a sign of ovarian cancer. (This is not always the case, though; elevated CA 125 levels can also occur in conditions like pregnancy, menstruation, endometriosis, and uterine fibroids). More comprehensive blood panels like OVA1 or the ROMA (Risk of Ovarian Malignancy Algorithm) test look for CA 125 alongside other less-specific tumor markers. These tumor markers can signal inflammation typical of ovarian cancer, and testing for them can give gynecologists an indication that it's time to recommend seeing a specialist.
Once you make an appointment with a gynecologic oncologist, the next steps usually include staging your ovarian cancer, which means determining how much it has spread beyond the ovaries, if at all. Ovarian cancer stages include:
- Stage I, in which the cancer cells are confined to the ovaries alone
- Stage II, in which the cancer cells have spread beyond the ovaries to the nearby fallopian tubes, uterus, or side walls of the pelvis
- Stage III, in which the cancer cells have spread beyond the ovaries and pelvis and into the upper abdomen, the diaphragm, the surface of the liver, or the layer of fat that protects your abdomen, called the omentum
- Stage IV, in which the cancer cells have spread beyond the peritoneal cavity (the abdomen) to other organs like the lungs and the inside of the liver.
After staging your cancer and considering available treatment options like chemotherapy, surgery, targeted therapies, and clinical trials, your gynecologic oncologist will build out a treatment plan specific to your cancer.
That way, Dr. Karlan says, "you can get the right treatment, the first time, by an expert who does this on a daily basis."
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