Each year, ovarian cancer is diagnosed in nearly a quarter of a million women worldwide and is the fifth leading cause of cancer-related death among women. Increasing awareness and recognizing the signs, symptoms, and risk factors of ovarian cancer are important, so women can take the steps to detect it at a stage when the chance of a cure may be higher.
Ovarian cancer consists of a group of cancers that originate from the various tissues within the ovary. Many types of tumors that start in the ovaries are benign (noncancerous) and never spread beyond the ovary. Women with these types of tumors can be treated with a full or partial removal of the ovary. Other types of tumors are cancerous (or malignant) and can spread to other parts of the body and require a more extensive evaluation and treatment program. There are three types of ovarian cancers: epithelial, generally in ages over fifty and the most common; germ cell, generally in ages under twenty-five; and stromal cell, in all ages and the least common.
Epithelial ovarian cancer rises from the ovarian surface and spreads rapidly throughout the abdominal cavity. The lifetime risk for women diagnosed with this type is about one in seventy. It is typically seen in women over the age of fifty who are postmenopausal, but does not exclude women who are still menstruating. In most cases, ovarian cancer does not reveal early signs or symptoms, and the majority of women who are diagnosed with epithelial ovarian cancer are already at an advanced stage (stage III or IV).
Unfortunately, there is currently no effective early screening strategy for this type of cancer, but there are persistent symptoms that women should be aware of, including: prolonged abdominal bloating and/or pain; unexplained nausea and vomiting; and difficulty eating. One important factor to consider is family history. Although the majority of cases occur at random, the BRCA1 and BRCA2 mutations are associated with 10 to 15 percent of ovarian cancer cases. Since these genes are linked to both breast and ovarian cancer, women who have had breast cancer have an increased risk of ovarian cancer. If the patient has had a family member with ovarian cancer, genetic screening should be scheduled as early as possible to identify predisposing factors. A gynecologic oncologist should perform these screenings and discuss options and next steps if the mutations are present.
The good news is that ovarian cancer is highly treatable and very responsive to surgery and chemotherapy. A GYN oncologist, a specialist in treating women’s reproductive cancers, should treat these patients and will diagnose and oversee the cytoreductive surgical procedure, followed by chemotherapy. During this type of surgery, doctors attempt to remove all visible tumors. Improved outcomes, in terms of survival and disease-free intervals, have been documented when gynecologic oncologists oversee the primary surgical removal of the tumor followed by preventive chemotherapy.
Currently there is no way of preventing ovarian cancer. However, several measures have been found to reduce a woman’s risk of developing the disease. Women who had a significant number of pregnancies, women who breastfed, and women who took oral birth control (for five year or more years at any time in their lives) had significantly lowered their risk of ovarian cancer.
It is important to empower women with the knowledge to take charge of their health and be good advocates for themselves.