Ovarian cancer is the leading cause of death from gynecologic cancers in the United States and is the fifth leading cause of cancer death among U.S. women. The American Cancer Society estimates that 21,550 women will be diagnosed with ovarian cancer in the U.S. in 2009 and about 14,600 women will die from the disease. It is an insidious disease that can strike without warning or cause.
The symptoms of ovarian cancer are often vague and subtle, making it difficult to diagnose. There is no effective screening test for ovarian cancer but there are test which can detect ovarian cancer when patients are at high risk or have early symptoms. In spite of this, patients are usually diagnosed in advanced stages and only 45% survive longer than five years. Only 19% of cases are caught before the cancer has spread beyond the ovary to the pelvic region. However, when ovarian cancer is detected and treated early on, the five-year survival rate is greater than 92%.
Until we have better early detection tools, all women should be educated about the disease so they can achieve early diagnosis and successful treatment.
A woman's lifetime risk of ovarian cancer is 1 in 67.
Listen to your body. Do not ignore the symptoms.
Signs & Symptoms
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Vague but persistent and unexplained gastrointestinal complaints such as gas, nausea, and indigestion
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Abdominal bloating, pelvic and/or abdominal pain, and/or feeling of fullness
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Frequency and/or urgency of urination
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Unexplained change in bowel habits (constipation or diarrhea)
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Unexplained weight gain or loss
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Unusual fatigue
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Shortness of breath
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New and unexplained abnormal postmenopausal bleeding
Risk Factors
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Increasing age, with highest occurrence in women over 50
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Family or personal history of ovarian, breast, endometrial, or colon cancer
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Uninterrupted ovulation (having no pregnancies, infertility, low parity)
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Presence of gene mutations, especially BRCA1 or BRCA2
Prevention and Risk Reduction
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Use of oral contraceptives for more than five years can reduce your risk by approximately 50%
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Multiple pregnancies, having first full-term pregnancy before the age of 25
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Breast feeding
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Hysterectomy/Tubal ligation substantially reduces risk
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Removal of the ovaries and fallopian tubes (oophorectomy) dramatically reduces the risk of ovarian cancer. Primary peritoneal cancer, which is microscopically almost identical to ovarian cancer, can still occur but is infrequent.
Questions to Ask
What do I do if I am concerned about my risk of ovarian cancer or have symptoms that persist and are unusual for me?
Speak to your gynecologist for more information and have an examination. Be sure to discuss the possibility of ovarian cancer with your doctor.
How is ovarian cancer diagnosed?
A vaginal-rectal pelvic examination (also called a bimanual exam) This exam allows the ovaries to be examined from many sides. Every woman should undergo a rectal and vaginal pelvic examination at her annual check-up with her gynecologist. Transvaginal Ultrasound This test uses sound waves to create a picture of the ovaries, and can often reveal if there are masses or irregularities on the surface of the ovaries. It cannot determine if you have cancer, but it can show characteristics that give different levels of suspicion.
CA125 blood test This test measures the level of a substance in the blood that may increase when a cancerous tumor is present; this protein is produced by ovarian cancer cells and is elevated in more than 80% of women with advanced ovarian cancers and 50% of those with early-stage cancers. Because CA125 misses half of early cancers and can be elevated by benign conditions, the National Cancer Institute (NCI) does not endorse using it to screen women at ordinary risk or in the general population.
It is very important to note that none of these tests are definitive when used on their own. They are most effective when used in combination with each other. The only way to confirm the presence of ovarian cancer suspected by the above tests is through a surgical biopsy of the tumor tissue.
The PAP test is used to detect cervical cancer, NOT ovarian cancer.
If tests suggest the possibility of ovarian cancer, seek a referral to a gynecologist or oncologist:
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A gynecologic oncologist is a professional who specializes in treating women with reproductive tract cancers.
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Gynecologic oncologists are initially trained as obstetrician/gynecologists and then undergo three to four years of specialized education in all of the effective forms of treatment for gynecologic cancers (surgery, radiation, chemotherapy and experimental treatments) as well as the biology and pathology of gynecologic cancers.
Why is it so important to be treated by a gynecologic oncologist?
The importance of being treated by a gynecologic oncologist cannot be stressed enough. According to numerous medical studies, there are significant survival advantages for women who are treated, managed, and operated on by a gynecologic oncologist.
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Gynecologic oncologists are 5 times more likely to completely remove ovarian tumors during surgery
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80% of ovarian cancer patients receive inadequate surgical debulking and staging from non-gynecologic oncology surgeons
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Survival rate and outcomes vastly improve with gynecologic oncologists
How can I find a gynecologic oncologist in my area?
Call The Gynecologic Cancer Foundation toll-free hotline at 1-800-444-4441 or visit them online at www.wcn.org
How is ovarian cancer usually treated?
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Surgery, debulking, and surgical staging (removal of ovarian tumors)
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Chemotherapy
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Radiation therapy when appropriate
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Treatment for recurrent ovarian cancer needs to be determined by a gynecologic oncologist
Where can I get more information and help?
Gynecologic Cancer Foundation
800/444-4441 www.thegcf.org or www.wcn.org
Cancer Care Phone Support
800/813-4673 www.cancercare.org
Ovarian Cancer National Alliance (OCNA)
202/331-1332 www.ovariancancer.org
National Ovarian Cancer Coalition (NOCC)
888/OVARIAN www.ovarian.org
Wellness Community
888/793-WELL www.thewellnesscommunity.org
All of the above information was supplied by The Ovarian Cancer Research Fund.
Revised March 2009
Source: American Cancer Society, Gynecologic Cancer Foundation, National Cancer Institute, National Institute of Health, and National Ovarian Cancer Coalition.
