Stephen C. Rubin, MD, Professor and Chief of the Division of Gynecologic Oncology, University of Pennsylvania Health System, responds:

Some patients with ovarian cancers, even when advanced, will not have an elevation in CA-125 at the time of diagnosis. For these patients, regular physical examinations along with imaging scans from time to time are very important in their follow-up care. Most physicians will check a CA-125 regularly, as well. Fortunately, it would be very unusual for ovarian cancer to recur after ten years. You should see your physician to have your current symptoms evaluated.