OVARIAN SCREENING

Ovarian cancer is not a particularly common disease.

However, unfortunately, as a rule it does not cause symptoms in its early stages. As a result women often present to the doctor quite late on, which makes treatment more difficult. Consequently, there has been a great deal of interest in the development of a test that could detect early ovarian cancer in apparently healthy women who have yet to show any signs of the disease. Examining asymptomatic women in this context is a form of screening.

Diagnosis of ovarian cancer

Possible tests for this include a blood test called CA 125 and vaginal ultrasonography. Irrespective of the test used, the problem with ovarian cancer screening is that there is currently no information to tell us whether early detection of ovarian cancer alters the final outcome from the disease. Logic may suggest that this is likely – but it has yet to be proven. In the absence of this information it is not generally advised that the general population with no risk factors from the disease undergo screening.

Risk factors associated with ovarian cancer

Probably the most potent risk factor for the development of ovarian cancer is a family history of the disease. There are also some suggestions that some fertility drug treatment may play a role. For women at increased risk of the disease it is thought reasonable to offer screening. For women with a strong family history of cancer it is often useful to consult with a clinical geneticist to accurately evaluate the level of risk.

At OMNI we can organise a consultation with a consultant clinical geneticist for an evaluation of risk. We use vaginal ultrasonography to visualise the ovaries and screen for ovarian disease. Ultrasound will detect the majority of early stage ovarian cancers, however other types of benign cysts will also be visualised. We can also take blood to measure the level of the tumour marker CA 125 which can also be helpful in some cases.

If an ovarian cyst is found on ultrasonography this does not necessarily mean there is a serious problem. Often such cysts can be monitored and may not require intervention. Should a persistent ovarian cyst be detected at screening which has features suggesting it may be an early cancer, then surgery with an accredited surgeon trained in Gynaecological Oncology would be advised.

OMNI Ultrasound & Gynaecological Care

Condous performs Advanced Endosurgery procedures for women needing intervention for pelvic masses, adnexal pathology, severe endometriosis or hysterectomy. He also runs ‘Hands on’ Live Sheep Laparoscopic Workshops for gynaecologists at Camden Veterinarian School.
Having completed an undergraduate degree with the University of Adelaide, he left Australia in 1993 and moved to London where he completed his training in Obstetrics and Gynaecology. From 2001 to 2003 Condous worked as a Senior Research Fellow at St George’s Hospital, London. At St George’s he set up the Acute Gynaecology Unit, the first in the United Kingdom. It was also during this time that he developed an interest in Early Pregnancy and especially the management of pregnancies of unknown location (PULs). Condous has developed many mathematical models for the prediction of outcome of PULs which have been featured in numerous peer review journals. In 2005, he returned to Australia where he completed his Laparoscopic Fellowship at the Centre for Advanced Reproductive Endosurgery, Royal North Shore, Sydney.

Condous was appointed as a Consultant Gynaecologist and Senior Lecturer at Nepean Hospital in 2006 and soon was made Associate Professor. In 2010, he was made Departmental Head of Obstetrics and Gynaecology at Nepean Hospital. He obtained the MRCOG in 1999 and was made FRANZCOG in 2005. In 2009, he was awarded his Doctorate in Medicine (MD), University of London, for his thesis entitled: “The management of pregnancies of unknown location and the development of new mathematical models to predict outcome”.

Condous has edited three books including the “Handbook of Early Pregnancy Care”, published over 100 papers in international journals and is internationally renowned for his work in Early Pregnancy. He is the Associate Editor for Gynaecologic Obstetric Investigation, which is a European based journal, as well as the Australasian Journal of Ultrasound in Medicine (AJUM). He is on the organising committee and is an invited speaker at the International Society of Ultrasound in Obstetrics and Gynaecology (ISUOG) Scientific meeting in Sydney 2013. His current research interests relate to the management of ectopic pregnancy, 1st trimester growth, PULs and miscarriage and the use of transvaginal ultrasound (in particular sonovaginography, to predict posterior compartment deep infiltrating rectovaginal endometriosis).Condous is also actively involved with post-graduate education including the annual running of the Early Pregnancy and Gynaecological Ultrasound Interactive Courses for Sonologists, Radiologists, Sonographers and Gynaecologists in Australia.