Is a yearly pelvic ultrasound sufficient to protect against uterine/ ovarian cancer?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I may be an outlier, but my doctor does a pelvic is every year. I am 38 and never did fertility treatments nor do I have PCOS. I don’t find it too uncomfortable and thought it was standard. He looks at ovaries and uterus. Always comments on how uterus looks good and ovaries are smaller than normal. We also do yearly Pap smear and breast exam…

This is weird and none of it is evidence based except the breast exam. I’m surprised your insurance will cover.

Yes, it covers it.

Probably bc he is coding it in a fraudulent way to get to covered. Routine ultrasounds yearly is bananas

[Anonymous]

Anonymous wrote:There’s also removing the Fallopian tubes to reduce ovarian cancer risk. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/salpingectomy

I asked about this since I have PCOS and history of complex cysts, I worry about ovarian cancer. my OB was supportive about tubal removal, I asked to have it done during my last birth (planned C). Insurance wouldn’t pay for it at the same time as a C-section bc of unspecified risks but would pay if I went back separately. So that is kind of disappointing.

Anyone out here had a salpingectomy for preventative reasons?

+1
I had an amazing ob (who has since retired). Due to family history that has led to anxiety about cancer, pcos & multiple ivfs, he agreed that removing my tubes w/ my final c-section would be wise. It was never mentioned to be an issue w/ insurance, and I ended up having an earlier than planned c-section so a different dr performed it. She had zero issue removing the tubes and insurance covered all of it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I may be an outlier, but my doctor does a pelvic is every year. I am 38 and never did fertility treatments nor do I have PCOS. I don’t find it too uncomfortable and thought it was standard. He looks at ovaries and uterus. Always comments on how uterus looks good and ovaries are smaller than normal. We also do yearly Pap smear and breast exam…

This is weird and none of it is evidence based except the breast exam. I’m surprised your insurance will cover.

Yes, it covers it.

Probably bc he is coding it in a fraudulent way to get to covered. Routine ultrasounds yearly is bananas

Not sure why you are insinuations this. I think you just don’t have very good insurance.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I may be an outlier, but my doctor does a pelvic is every year. I am 38 and never did fertility treatments nor do I have PCOS. I don’t find it too uncomfortable and thought it was standard. He looks at ovaries and uterus. Always comments on how uterus looks good and ovaries are smaller than normal. We also do yearly Pap smear and breast exam…

This is weird and none of it is evidence based except the breast exam. I’m surprised your insurance will cover.

Yes, it covers it.

Probably bc he is coding it in a fraudulent way to get to covered. Routine ultrasounds yearly is bananas

Not sure why you are insinuations this. I think you just don’t have very good insurance.

No. This whole thing is bananas. You are seeing an IVF specialist who gives you yearly ultrasounds that have nothing to do with infertility?

That is unethical and the doctor is 100 percent committing insurance fraud of some kind because no insurance would cover that. It’s not a matter of “good” insurance. I work for benefits in a large organization.

Health insurance is so messed up in this country. People doing this kind of crap and we’re all paying for it and then some people can’t even get basic healthcare.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I may be an outlier, but my doctor does a pelvic is every year. I am 38 and never did fertility treatments nor do I have PCOS. I don’t find it too uncomfortable and thought it was standard. He looks at ovaries and uterus. Always comments on how uterus looks good and ovaries are smaller than normal. We also do yearly Pap smear and breast exam…

This is weird and none of it is evidence based except the breast exam. I’m surprised your insurance will cover.

Yes, it covers it.

Probably bc he is coding it in a fraudulent way to get to covered. Routine ultrasounds yearly is bananas

Not sure why you are insinuations this. I think you just don’t have very good insurance.

No. This whole thing is bananas. You are seeing an IVF specialist who gives you yearly ultrasounds that have nothing to do with infertility?

That is unethical and the doctor is 100 percent committing insurance fraud of some kind because no insurance would cover that. It’s not a matter of “good” insurance. I work for benefits in a large organization.

Health insurance is so messed up in this country. People doing this kind of crap and we’re all paying for it and then some people can’t even get basic healthcare.

Yep. Your Dr is a scammer. He is ordering them bc he can bill for it and get paid for it. Easy cash in for him. This is NOT in your medical best interest. Unnecessary ultrasounds lead to other invasive procedures and false positives and do not reduce cancer risk. He is 100% ordering these for his benefit, not yours

[Anonymous]

In the part of Europe where I’m from, yearly pelvic ultrasounds for women over 40 are recommended/ commonplace. Ultrasounds are a low to no risk scan and can spot cancers early. They are not foolproof - but while uterine and ovarian cancers are not common enough in women under 60 to justify universal screening - they do happen and can be silent and deadly. There’s really no contraindication for having a yearly ultrasound especially if you’ve had ivf, pcos or tamoxifen. I’m surprised at posters who are annoyed at the suggestion.

[Anonymous]

Anonymous wrote:In the part of Europe where I’m from, yearly pelvic ultrasounds for women over 40 are recommended/ commonplace. Ultrasounds are a low to no risk scan and can spot cancers early. They are not foolproof - but while uterine and ovarian cancers are not common enough in women under 60 to justify universal screening - they do happen and can be silent and deadly. There’s really no contraindication for having a yearly ultrasound especially if you’ve had ivf, pcos or tamoxifen. I’m surprised at posters who are annoyed at the suggestion.

https://www.acog.org/practice-management/patient-safety-and-quality/partnerships/choosing-wisely

"In population studies, there is only fair evidence that screening of asymptomatic women with serum CA-125 level and/or transvaginal ultrasound can detect ovarian cancer at an earlier stage than it can be detected in the absence of screening. Because of the low prevalence of ovarian cancer and the invasive nature of the interventions required after a positive screening test, the potential harms of screening outweigh the potential benefits"

It is also noted that the majority of positive screenings from ultrasounds are false positives..

[Anonymous]

Anonymous wrote:My MIL just died from uterine cancer. Her pap smears were negative btw. The best prevention is a hysterectomy. I imagine an ultrasound may pick up nodules/masses. MIL regularly had her CA125 blood level tested after diagnosis. I guess this kind of test might be helpful too.

Just a point of clarification for readers - pap tests do not detect uterine cancer, they detect cervical. Im sorry about your MIL.

[Anonymous]

Anonymous wrote:

Anonymous wrote:In the part of Europe where I’m from, yearly pelvic ultrasounds for women over 40 are recommended/ commonplace. Ultrasounds are a low to no risk scan and can spot cancers early. They are not foolproof - but while uterine and ovarian cancers are not common enough in women under 60 to justify universal screening - they do happen and can be silent and deadly. There’s really no contraindication for having a yearly ultrasound especially if you’ve had ivf, pcos or tamoxifen. I’m surprised at posters who are annoyed at the suggestion.

https://www.acog.org/practice-management/patient-safety-and-quality/partnerships/choosing-wisely

"In population studies, there is only fair evidence that screening of asymptomatic women with serum CA-125 level and/or transvaginal ultrasound can detect ovarian cancer at an earlier stage than it can be detected in the absence of screening. Because of the low prevalence of ovarian cancer and the invasive nature of the interventions required after a positive screening test, the potential harms of screening outweigh the potential benefits"

It is also noted that the majority of positive screenings from ultrasounds are false positives..

I know more people who have died from ovarian or uterine cancer than any other cancer. Both asymptomatic till late stages. Idk why ppl assume these cancers are rare

[Anonymous]

Anonymous wrote:

Anonymous wrote:In the part of Europe where I’m from, yearly pelvic ultrasounds for women over 40 are recommended/ commonplace. Ultrasounds are a low to no risk scan and can spot cancers early. They are not foolproof - but while uterine and ovarian cancers are not common enough in women under 60 to justify universal screening - they do happen and can be silent and deadly. There’s really no contraindication for having a yearly ultrasound especially if you’ve had ivf, pcos or tamoxifen. I’m surprised at posters who are annoyed at the suggestion.

https://www.acog.org/practice-management/patient-safety-and-quality/partnerships/choosing-wisely

"In population studies, there is only fair evidence that screening of asymptomatic women with serum CA-125 level and/or transvaginal ultrasound can detect ovarian cancer at an earlier stage than it can be detected in the absence of screening. Because of the low prevalence of ovarian cancer and the invasive nature of the interventions required after a positive screening test, the potential harms of screening outweigh the potential benefits"

It is also noted that the majority of positive screenings from ultrasounds are false positives..

I understand that this is recommending against universal screening. But an individual woman may have individual risk factors that may cause the benefits to outweigh the risk of false positives. Plus, there is a big difference about when women’s cancers “can” be detected in the absence of screening and “when” they are actually detected. It is a fact that many doctors push women’s pain and other suggestive symptoms aside until things are too far along. All else being equal, I’d appreciate the extra heads up even if I got an ovarian cancer that would kill me. It would give me time to put things in place for my young children, ease the burden of my passing for my spouse, and let me take advantage of hospice services that would increase my QOL.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There’s also removing the Fallopian tubes to reduce ovarian cancer risk. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/salpingectomy

I asked about this since I have PCOS and history of complex cysts, I worry about ovarian cancer. my OB was supportive about tubal removal, I asked to have it done during my last birth (planned C). Insurance wouldn’t pay for it at the same time as a C-section bc of unspecified risks but would pay if I went back separately. So that is kind of disappointing.

Anyone out here had a salpingectomy for preventative reasons?

My SIL is BRCA positive and had her tubes removed preventatively in addition to a mastectomy. But then a few years later she had her ovaries out as well. I’m not close with her so I don’t know the reason why it was spaced out like that.

Probably because a mastectomy is a big surgery. Did she just have her tubes removed or did she have her ovaries removed? Ovary removal is also a big surgery in terms of outcome as it is pretty dramatic to immediately enter menopause.

There is some fairly strong research that many "ovarian" cancers actually originate in the fallopian tubes. Removing the ovaries before menopause can increase one's risk of heart disease and osteoporosis. So the current thinking is that in younger women at high risk of "ovarian" cancer, removing the tubes before menopause and waiting until after menopause to remove the ovaries could be the most effective approach--reducing the risk of cancer without increasing risk of other bad outcomes.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I’m curious why you think ovarian and uterine cancers are “quite common”? That wasn’t my understanding at all, and doing a quick google search says both of these are rare. Do you mean you’re at a higher risk because of the other cancer you had? Not trying to be difficult here, just trying to understand where you’re getting your stats from.

??
Ovarian cancer alone is 5th most common cancer

Not to mention, by the time you have real symptoms for most people you are already stage 3/4. Many doctors write off those symptoms as typical "female issues". Ultrasound yearly is a decent way to find any issues earlier than normal.

Why do you say this? What data do you have that suggests a yearly ultrasound improves outcomes?

Not PP but you do realize ovarian cancer is not a 100% death outcome? How can a yearly ultrasound not improve any chance of catching a mass earlier as compared to no ultrasound ever?

The data isn’t there, even for high-risk patients. Small lesions on the ovary are not easily seen on an ultrasound.

Because "early detection" of cancer isn't the panacea most of us think it is. For some cancers, it's likely that by detecting cancer early, you just know you have cancer for a longer period of time. It doesn't actually increase the odds of survival. (This is definitely NOT true for all types of cancer.)

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I’m curious why you think ovarian and uterine cancers are “quite common”? That wasn’t my understanding at all, and doing a quick google search says both of these are rare. Do you mean you’re at a higher risk because of the other cancer you had? Not trying to be difficult here, just trying to understand where you’re getting your stats from.

??
Ovarian cancer alone is 5th most common cancer

Not to mention, by the time you have real symptoms for most people you are already stage 3/4. Many doctors write off those symptoms as typical "female issues". Ultrasound yearly is a decent way to find any issues earlier than normal.

Why do you say this? What data do you have that suggests a yearly ultrasound improves outcomes?

Not PP but you do realize ovarian cancer is not a 100% death outcome? How can a yearly ultrasound not improve any chance of catching a mass earlier as compared to no ultrasound ever?

The data isn’t there, even for high-risk patients. Small lesions on the ovary are not easily seen on an ultrasound.

Because "early detection" of cancer isn't the panacea most of us think it is. For some cancers, it's likely that by detecting cancer early, you just know you have cancer for a longer period of time. It doesn't actually increase the odds of survival. (This is definitely NOT true for all types of cancer.)

LOL. Get the early screening.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I’m curious why you think ovarian and uterine cancers are “quite common”? That wasn’t my understanding at all, and doing a quick google search says both of these are rare. Do you mean you’re at a higher risk because of the other cancer you had? Not trying to be difficult here, just trying to understand where you’re getting your stats from.

??
Ovarian cancer alone is 5th most common cancer

Not to mention, by the time you have real symptoms for most people you are already stage 3/4. Many doctors write off those symptoms as typical "female issues". Ultrasound yearly is a decent way to find any issues earlier than normal.

Why do you say this? What data do you have that suggests a yearly ultrasound improves outcomes?

Not PP but you do realize ovarian cancer is not a 100% death outcome? How can a yearly ultrasound not improve any chance of catching a mass earlier as compared to no ultrasound ever?

The data isn’t there, even for high-risk patients. Small lesions on the ovary are not easily seen on an ultrasound.

Because "early detection" of cancer isn't the panacea most of us think it is. For some cancers, it's likely that by detecting cancer early, you just know you have cancer for a longer period of time. It doesn't actually increase the odds of survival. (This is definitely NOT true for all types of cancer.)

Op - 10000% agree with this.
To me a pelvic ultrasound makes sense because if you detect either uterine or ovarian cancer early, you can in fact remove the entire reproductive system. I am much less inclined to get lung or brain cts only to discover something you can do nothing about.
False positives are a concern with any screening, much like mammo

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:In the part of Europe where I’m from, yearly pelvic ultrasounds for women over 40 are recommended/ commonplace. Ultrasounds are a low to no risk scan and can spot cancers early. They are not foolproof - but while uterine and ovarian cancers are not common enough in women under 60 to justify universal screening - they do happen and can be silent and deadly. There’s really no contraindication for having a yearly ultrasound especially if you’ve had ivf, pcos or tamoxifen. I’m surprised at posters who are annoyed at the suggestion.

https://www.acog.org/practice-management/patient-safety-and-quality/partnerships/choosing-wisely

"In population studies, there is only fair evidence that screening of asymptomatic women with serum CA-125 level and/or transvaginal ultrasound can detect ovarian cancer at an earlier stage than it can be detected in the absence of screening. Because of the low prevalence of ovarian cancer and the invasive nature of the interventions required after a positive screening test, the potential harms of screening outweigh the potential benefits"

It is also noted that the majority of positive screenings from ultrasounds are false positives..

I know more people who have died from ovarian or uterine cancer than any other cancer. Both asymptomatic till late stages. Idk why ppl assume these cancers are rare

Then you know an odd group of people. Ovarian and uterine cancers kill a much lower number is people than, say, breast cancer, every year.