I am a middle-aged woman. I recently went for a medical check-up, and I had my blood taken. A week later, the doctor called me back urgently to say that one of my tumour markers, CA-125, is raised. I am worried. What is this tumour marker?

CA-125 is a tumour marker that is used primarily in ovarian cancer screening.

But it isn’t a very specific marker. Many conditions can raise your CA-125 level, not just ovarian cancer. In fact, most women who have ovarian cancer do not have a raised CA-125.

Some other cancers can also give rise to a raised CA-125.

Non-cancerous conditions that can raise CA-125 include uterine fibroids, endometriosis, pregnancy and benign ovarian cysts.

The CA-125 test is mostly used to measure the activity of the tumour once a woman is actually diagnosed of having ovarian cancer, and its subsequent treatment.

If you actually have a pelvic mass and you are being investigated for it, a CA-125 of greater than 65 does mean cancer in 90% of cases.

What are the ovaries?

Ovaries are part of a woman’s reproductive organ. A woman has two of them, each located on either side of her uterus or womb.

Eggs or ova develop inside the ovaries and mature. One egg is released every menstrual cycle during the childbearing years. If this egg is not fertilised, then menstruation begins.

Ovarian cysts come from ovaries then?

Yes. Because your ovaries develop eggs and are so full of follicles, it is easy for a cyst to develop inside one of these follicles.

Ovarian cysts are sacs filled with fluid on or inside one of the ovaries. Many women have ovarian cysts at some point during their lives, and these usually go undetected.

Most of these ovarian cysts are harmless, and disappear within a few months.

Nevertheless, some ovarian cysts can rupture, and this becomes a medical emergency.

How do I know if I have an ovarian cyst?

Most of the time, you don’t. You usually won’t know unless you happen to go for an abdominal or pelvic ultrasound.

This is because most cysts don’t cause any symptoms unless they are very large.

A large ovarian cyst can cause some abdominal discomfort. If it is large and it presses against your bladder, then you may feel the need to urinate frequently.

Sometimes, you can experience pain in your pelvis, which may travel down to your lower back and thighs. Sometimes, this pain gets worse just before your period begins, or just before it ends.

Other women don’t even describe this as pain, merely a dull ache or discomfort in the abdomen.

Some women have pelvic pain during sexual intercourse or pain during bowel movements.

How would I know if I have an ovarian cyst that ruptures?

There will be severe pain and possibly internal bleeding. You will have to go to the emergency room immediately.

There is another condition called ovarian cyst torsion, where a large cyst may cause the ovary to move out of its normal location in the pelvis. This makes it easier to twist – a process called torsion.

If I have an ovarian cyst, what should I do?

You would have to go to a gynaecologist, who will then advise you on what treatment there is for you based on your age, the type of cyst and what you are experiencing.

Your doctor may just monitor the cyst, or give you birth control pills to reduce the chance of new cysts developing during your menstrual cycles.

The last option is surgery.

What about ovarian cancer? Can a cyst turn into cancer?

Most cysts are benign. But some cysts are diagnosed cancerous, or they turn cancerous.

Ovarian cancer is very difficult to detect until it has spread throughout the pelvis and abdomen. At this late stage, it is already very difficult to treat.

You hardly experience any symptoms when you have early ovarian cancer. If you do, you are more likely to think those symptoms – such as abdominal bloating or swelling, feeling full quickly after eating, constipation, weight loss, constipation – are due to indigestion.

Can ovarian cancer be treated?

Definitely. Early ovarian cancer is the easiest to treat, because the doctor can remove the affected ovary.

Late ovarian cancer would involve removing the ovaries, fallopian tubes, the womb and its surrounding lymph nodes, as well as chemotherapy.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, e-mail starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.