Ovarian Cancer Panel

Function

An Ovarian Cancer Panel typically consists of a combination of tumor markers, most commonly CA-125 (Cancer Antigen 125) and HE4 (Human Epidermal Protein 4). These markers are used in conjunction with clinical algorithms like the ROMA (Risk of Ovarian Malignancy Algorithm) score to estimate the likelihood of a pelvic mass being malignant. While CA-125 is the traditional marker, HE4 is less likely to be elevated in benign conditions, making the combination more specific than either test alone.

Why it is Ordered

This panel is not intended for screening the general population. It is specifically ordered for:

• Evaluating women who have a documented pelvic mass or ovarian cyst detected by imaging.
• Distinguishing between benign gynecological conditions (like endometriosis or fibroids) and ovarian cancer.
• Monitoring response to therapy in patients already diagnosed with ovarian cancer.
• Surveillance for recurrence in patients in remission.

Associated Conditions

The primary condition of concern is Epithelial Ovarian Cancer. Ovarian cancer is often called the 'silent killer' because symptoms are vague and it is frequently diagnosed at an advanced stage. Elevated markers in this panel, especially in post-menopausal women, significantly increase the suspicion of malignancy. However, it is important to note that CA-125 can also be elevated in non-cancerous conditions such as menstruation, pregnancy, pelvic inflammatory disease (PID), and cirrhosis. The inclusion of HE4 helps filter out some of these false positives, providing a clearer picture for the surgical oncologist.