Know the basics of symptoms, diagnosis, and treatment to help you battle ovarian cancer.
Ovarian cancer is a relatively rare form of cancer that begins in the ovaries. These small organs sit in a woman’s pelvis and house the eggs that, when fertilized, become embryos that can develop into a baby.
As occurs in virtually every other part of the body, the ovaries can sometimes give rise to cancer. The American Cancer Society estimates that about 22,530 women will receive a new diagnosis of ovarian cancer in 2019, and about 13,980 women will die of the disease. The Ovarian Cancer Research Alliance reports that ovarian cancer accounts for 2.5 percent of cancers in women, making it the 11th most common cancer among women. But it’s the fifth leading cause of cancer-related death among women and “the deadliest of gynecologic cancers.”
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Causes and Risk Factors of ovarian cancer
Dr. Stephanie V. Blank, director of gynecologic oncology at the Mount Sinai Health System in New York, states, “We don’t know exactly what causes it.” “There are various theories as to why women develop ovarian cancer,” but we don’t have enough information about the disease’s genesis to be certain of its causation.
However, “taking birth control pills and having a lot of pregnancies” are both linked to lower risk, she adds, “which makes some people think ovulation is part of the problem.” The monthly process of releasing an egg from the ovary into the fallopian tube, where it may or may not be fertilized by a sperm cell, is known as ovulation. It’s also thought that some ovarian cancer cases may be related to the body’s inflammatory reactions.
Risk factors include:
- Never having become pregnant after the age of 35, never having carried a child to term, or none of the above.
- A personal background of colorectal, breast, or ovarian cancer
- Applying fertility therapies.
- Hormone therapy following menopause
- Experiencing pain, heavy periods, and infertility due to endometriosis, a menstrual disease in which endometrial tissue grows outside of the uterus.
- Being too heavy or fat.
- Alcohol consumption and smoking
Signs and Symptoms
Ovarian cancer can be challenging to identify early, when it is most treatable, similar to other cancers that affect internal organs. According to the American Cancer Society, only 20% of ovarian cancers are discovered early on. About 94% of patients with ovarian cancer survive longer than five years after diagnosis when the disease is detected early.
But for most patients, this is not the case because ovarian cancer can be difficult to detect. “There’s not one sign or symptom that goes along with ovarian cancer,” Blank says, “so that makes it tricky. It’s not usually until the disease has spread beyond the ovaries that people develop any kind of symptoms. And even then, the symptoms are nonspecific—they’re the kind of thing that everybody has at some point in their lives, such as bloating or indigestion.”
The ACS reports that the most common symptoms of ovarian cancer include:
- Bloating.
- Pelvic or abdominal pain
- Trouble eating or feeling full quickly.
- Always feeling like you need to urinate or feeling an urgency to urinate
- Fatigue.
- Back pain.
- Upset stomach or constipation.
- Abdominal swelling accompanied by weight loss.
- Menstrual changes, such as heavier-than-normal or irregular bleeding.
While most women will experience at least a few of these symptoms at some point, the key with ovarian cancer is that these symptoms become persistent or change from a normal baseline. If you notice that you’re having these sorts of symptoms more often or they become more severe, see your doctor for evaluation. Many of these symptoms may be associated with other conditions unrelated to ovarian cancer.
Diagnosis
Because ovarian cancer occurs deep within the body and is not amenable to routine screening tests, it’s often diagnosed at later stages, once it has spread to other sites that may trigger more noticeable symptoms. If ovarian cancer is suspected, you’ll likely undergo a physical exam and imaging tests, such as an ultrasound or CT scan to look for tumors in the pelvic area. MRI scans, PET scans and colonoscopies may also be part of the work-up you’ll receive if your doctor suspects ovarian cancer.
Treatment
“A gynecologic oncologist, a medical professional specially trained in treating women with ovarian cancer, should be consulted if there is a suspicion of ovarian cancer,” advises Blank. Finding the right expert has been demonstrated to provide women with better results, she says.
Following your selection of the appropriate physician, you will need to make a number of decisions. The first is whether surgery will be included in the treatment plan, and if so, when it should be performed—prior to or following chemotherapy. “Surgery is the usual approach to (treatment), but it may not be the best course of action in some circumstances.”
Depending on the situation, surgery may be conducted as an open procedure, meaning that the surgeon will cut into the body, or you might have the option for a minimally invasive approach that requires less trauma and less recovery time. The ovaries will be removed, but your doctor may take other tissue as well. “It depends on a woman’s age. If a woman does not have a specific desire to keep her other organs, we generally remove the uterus, cervix, fallopian tubes and ovaries,” Blank says.
The key is for the surgeon to assess carefully where the disease may have spread and remove as much of it as possible. This is why some patients undergo chemotherapy first – to shrink the tumor and make it easier to remove entirely. For patients who are undergoing chemotherapy first, your doctor may reassess your condition after a few rounds to determine whether surgery has become a more viable option.
Radiation is not usually a front-line treatment, Blank says, but may be used as a palliative therapy if ovarian cancer recurs or comes back. “Ovarian cancer does tend to recur, but one thing that’s important to note is that the vast majority of patients will have a good response to front-line therapy,” Blank says. “But unfortunately, with time, a majority of people do experience a recurrence.”
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Disclaimer: The opinions and suggestions expressed in this article are solely those of the individual analysts. These are not the opinions of HNN. For more, please consult with your doctor.
