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Ovarian Cancer
General Information Understanding Ovarian Cancer Who's at Risk Recognizing Symptoms Detection Treatment Prevention More Information Ovarian Cancer is the fourth leading cause of cancer death for women. Detection, prevention, and treatment are extremely difficult because of vague symptoms and an unidentified cause. Ovarian cancer is the seventh most common cancer for women and one of the deadliest. All women are at risk for this disease. According to the American Cancer Society, 22,200 new cases of ovarian cancer will be diagnosed in 2005 and 16,210 will die from this disease. Often referred to as the “Silent Killer,” ovarian cancer often goes unnoticed until the later stages of the disease. According the American Cancer Society, only about 25% of ovarian cancer cases are detected in the early stages of the disease. 9 out of 10 women who are treated for early ovarian cancer will live longer than 5 years after the cancer is discovered. Ovarian cancer originates within a woman’s reproductive ovaries. Cancer that spreads to these reproductive organs from other tissue or organs is not ovarian cancer. Ovarian cancer in the form of tumors can develop within any of the three types of tissue that exists in an ovary:
90% ovarian cancer originates within the epithelial cells that cover the ovaries. Not all tumors are cancerous, however, some are benign. Benign tumors do not spread beyond the ovaries and can be easily treated. Malignant tumors are cancerous and can spread to other parts of the body. Because ovarian cancer originates within the female reproductive organs, the ovaries, all women are at risk for developing the disease. However, there is evidence that supports other risk factors that make a woman more susceptible to the disease. While these risk factors do not ensure ovarian cancer, they are still important to be aware of.
*The American Cancer Society and the Ovarian Cancer National Alliance provided information for “Who’s At Risk?” Greatly problematic to the fight against ovarian cancer is the, or lack of, definitive symptoms that coincide with ovarian cancer. The symptoms are vague and not typically alarming. These symptoms can be misdiagnosed for a number of reproductive, gastrointestinal or other benign conditions. A recent study by Barbara Goff, M.D. at the University of Washington School of Medicine located in Seattle found that 90% of women had one or more of the following persistent symptoms. Symptoms include:
Problematic to the detection of ovarian cancer is that these symptoms mimic many other conditions. Women who unknowingly have ovarian cancer often have little reason to suspect that these symptoms could be related to cancer. These symptoms are not definitive to produce a diagnosis of ovarian cancer, however, it is extremely important to pay attention to your body. If these symptoms persist for more than two weeks and over the counter treatments do not alleviate symptoms, contact your OB/GYN. Ovarian cancer proves to be extremely difficult to detect because the ovaries reside deep within the woman’s body and are difficult for doctors to feel. Simple pelvic exams, while important for reproductive health, are generally not enough for detecting this cancer. Ovarian cancer remains a threat because a reliable method for detection does not exist. Some detection methods include the vaginal-rectal pelvic exam, the transvaginal ultrasound, and the CA-125 blood test. Aside from the vaginal-rectal pelvic exam, these detection methods are not annual or semi-annual screening procedures. These methods are used only if there is reason to suspect ovarian cancer to already exist. This is another example of why detecting ovarian cancer is so difficult. Ovarian cancer is generally already developed beyond the early stages of the disease when these tests can be performed. Vaginal-rectal pelvic exams should be performed annually, according to experts. This exam pays special attention to the ovaries, uterus, bladder and rectum. A doctor will insert two lubricated fingers into the vagina to feel the reproductive organs and check for abnormalities. He/she will also insert a lubricated finger into the rectum to feel for lumps and abnormalities. This is generally accompanied by a Pap test (smear). During a transvaginal ultrasound, high energy sound waves are bounced off internal tissue and organs to create an image (sonogram) of the ovaries. CA-125 Blood tests remain very controversial because of its lack of reliability. CA-125 is a blood test that measures for an elevated level of a protein in blood that can indicate the presence of a tumor. According to the Ovarian Cancer National Alliance, women with early stages of ovarian cancer will have an increased production of this protein by 50% of its normal level; for advanced stages of ovarian cancer, the production is as high as 80% of its normal level. However, elevated levels of this protein also exist in women who are or may be pregnant, those who are ovulating, or women with other types of cancer or benign conditions. The CA-125 blood test is not as reliable in pre-menopausal women as it is in post-menopausal women. If a doctor suspects ovarian cancer because of abnormalities or the presence of precancerous cells, he/she may suggest more definitive detection methods to determine the problem, such as a CT scan, an MRI or a biopsy. A CT scan or an MRI takes pictures of parts of the body in great detail that assists doctors to get a clear view of the affected organs. A biopsy takes a sample of tissue through a small incision made into the abdomen (called a laparotomy) which will be viewed under a microscope by a pathologist to check for signs of cancer in the cells. Once diagnosed, a doctor can explain the options for treatment. Treatment for ovarian cancer is dependent on several factors such as the stage of the disease, the overall health of the patient, and personal considerations of the patient. The three treatment options include surgery, chemotherapy, and radiation therapy. All treatments have some risks and side-effects so it is important to discuss these options with your doctor. Surgery is dependent on the progression of the disease, the overall health of the woman, and her plans for the future (i.e. if she hopes to have children). Depending on the stage of the disease, a surgeon may remove one or both of the ovaries and may, if the disease has spread to other reproductive organs (uterus and fallopian tubes), suggest removing those affected organs. It is important to note that the five year survival rate is vastly improved when surgery is performed by a gynecologic oncologist, an OB/GYN who specializes in the treatment of female reproductive cancer. For more information on gynecologic oncologists, talk to your doctor or visit the Society for Gynecologic Oncologists' website. Chemotherapy includes the use of drugs to kill cancer cells. Chemotherapy is performed in cycles and includes rest periods. The drugs are either given intravenously (through the veins) or by mouth. Chemotherapy drugs can also be given directly into the abdomen. Chemotherapy, while attacking cancer cells, also damage normal cells which causes side effects. The amount and level of side effects depends on the type of drugs used, the amount of drugs used and the duration of drugs used. Side effects generally end when treatment concludes. In Radiation Therapy, high energy x-rays are used to kill or shrink cancer cells. Radiation therapy is rarely used to treat ovarian cancer in this country, however. There are no definitive risk factors for ovarian cancer. Likewise, there is no guaranteed way to prevent the development of this disease. However, studies have shown that there may be a few ways to lower susceptibility to ovarian cancer. Women who take birth control pills for several years may reduce their risk for ovarian cancer. Having the fallopian tubes “tied” may reduce the risk of ovarian cancer. Having the uterus removed (hysterectomy) may also reduce the risk. Having these procedures completed should be done for a legitimate medical reason, however, not just to reduce the risk of ovarian cancer. Having children, plus breast-feeding them for a year or longer may reduce the risk of ovarian cancer. A healthy diet is believed to decrease the risk of ovarian cancer. Women should increase their intake of vegetables and reduce their intake of red meats high in fat. Your doctor is a great source of information and it is very important that you feel comfortable talking to your doctor about all your health issues, including ovarian and other reproductive cancers.
The Ovarian Cancer National Alliance provides a place for the newly diagnosed and their families, survivors, and others with an interest in ovarian cancer to seek information and support. To receive more information about the Ovarian Cancer National Alliance, call (202) 331-1332. The Wisconsin Ovarian Cancer Alliance is a partner of the Ovarian Cancer National Alliance and strives to promote education, advocacy, and support to overcome ovarian cancer. The American Cancer Society is a great resource for any individual interested in learning more about all types of cancer. The American Cancer Society provides information and support to patients, survivors, families, doctors and everyday individuals. The information shared is easy to understand and is extremely thorough. Other links include: Society for Gynecologic Oncologists Johanna’s Law: The Gynecologic Education and Awareness Act |
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