Ovarian Cancer: What Women Must Know

Hand holding a turquoise ribbon that represents awareness of Ovarian Cancer

September is Ovarian Cancer Awareness Month and while ovarian cancer is not common, it does cause more deaths than any other female reproductive cancer. This is due to the difficulty surrounding ovarian cancer’s early detection, as most women who are ultimately diagnosed with the condition experience no symptoms or mild symptoms that they may easily dismiss. Unfortunately, many seek initial treatments when the disease has progressed into advanced stages, making treatment difficult and prognosis oftentimes poor.

Your Capital Women’s Care team is here to offer you important knowledge and insight into this silent women’s health predator to help you be more mindful of ovarian cancer’s warning signs and symptoms as well as be a vigilant advocate about your reproductive health so you have a long and healthy quality of life.

Ovarian Cancer Stats

  • Ovarian cancer is the fifth leading cause of cancer death in women in the U.S. There are nearly 22,000 new diagnoses each year, according to the National Cancer Institute (NCI.)
  • About 80% of ovarian cancers are discovered in the late stages, which tend to have worse outcomes, according to the American Cancer Society (ACS.)
  • Ovarian cancer kills around 14,000 women in the U.S. every year, according to the NCI.
  • There were 20,452 new cases of ovarian cancer reported within the U.S. in 2017.
  • For every 100,000 women, 10 new ovarian cancer cases were reported, with 7 dying as a direct result of the disease. 

What Is Ovarian Cancer?

Ovarian cancer affects the ovaries, two almond-sized organs that produce the female hormone estrogen and create and house a woman’s eggs for reproduction.

Abnormalities in estrogen production due to genetic mutations (especially in BRCA1 and BRCA2 genes and those associated with Lynch disease) can lead to cancerous tumor growth. There are a variety of tumor types relating to ovarian cancer. The most common is high-grade serous carcinoma, which comprises around 70% of diagnosed ovarian cancers.

The earlier the detection of ovarian cancer the better chance of recovery. Therefore, it is critical to know your risk factors and symptoms of ovarian cancer. 

Risk Factors of Ovarian Cancer

Several factors may increase a woman’s risk for ovarian cancer:

  • are of middle-age or older
  • have close family members (mother, sister, aunt, or grandmother) on either parent’s side diagnosed with ovarian cancer
  • have genetic mutation BRCA1 or BRCA2, or one associated with Lynch syndrome
  • have had breast, uterine or colorectal (colon) cancer
  • have Eastern European or Ashkenazi Jewish heritage
  • confirmed diagnosis of endometriosis
  • have never given birth
  • and/or have had difficulty becoming pregnant

Additionally, some studies suggest women taking estrogen alone (without progesterone) for 10+ years may face an increased ovarian cancer risk. 

Reduce Your Risk Factors

While there is no known way to prevent ovarian cancer, there are some things you can do associated with lowering ovarian cancer risk:

  • Using birth control pills for 5+ years
  • Having a tubal ligation, both ovaries removed or hysterectomy
  • Giving birth
  • Breastfeeding -- some studies suggest women who breastfeed for 1+ years may have a modestly reduced ovarian cancer risk. 

Ovarian Cancer Signs & Symptoms

It’s vital to your health to pay attention to your body and recognize what is normal for you. Contact your doctor to schedule an appointment should you experience any of the following: 

  • Vaginal bleeding -- particularly if you are past menopause -- or discharge from your vagina that is not normal for you
  • Pain, pressure or heavy feeling in pelvis
  • Lower abdominal or back pain, especially if inexplicable or worsening
  • Bloating, feeling full too quickly or difficulty eating
  • Weight change (either gain or loss)
  • Gas, nausea, vomiting and/or loss of appetite
  • Abnormal menstrual cycles
  • Changes in bathroom habits, including more/less frequent urination and/or constipation

If you have unusual vaginal bleeding, see your doctor immediately. If you have any other signs for 2+ weeks or longer and they aren’t considered normal for you, see your doctor. The symptoms may be caused by something other than ovarian cancer; however, the only way to determine symptoms’ cause is to schedule an initial exam and consultation with your doctor.

Ovarian Cancer Screening

There is no simple, reliable ovarian cancer screening for women who don’t have signs or symptoms.

The Pap test does not screen for ovarian cancer; it solely screens for cervical cancer only.

Diagnostic Tests

If you show high risk or have unexplained symptoms or signs of ovarian cancer, ask your doctor about these diagnostic tests, which may be used solely or in combination to determine presence of ovarian cancer:

  • rectovaginal pelvic exam
  • transvaginal ultrasound
  • laparoscopy or laparotomy
  • CA-125 blood test
  • physical exam
  • biopsy

It is important to note there are risks with ovarian cancer screening, including false-negative or false-positive results, plus infection, blood loss, bowel injury, or heart and blood vessel problems. Talk with your doctor to weigh risks and benefits carefully before moving forward with diagnostic tests. 

Should you receive confirmation diagnosis of ovarian cancer, ask your doctor for a referral to a gynecologic oncologist, a doctor specializing in woman’s reproductive cancers. Gynecologic oncologists perform surgery and prescribe and administer chemotherapy. Your doctor can work with you to create a treatment plan.

Survival Odds

Ovarian cancer can be cured, especially when detected early.  Early stage diagnosis of ovarian cancer has a good prognosis, with a 5-year survival rate of around 94%, according to the ACS.

There is chance of survival for those diagnosed with stage 3 or 4 ovarian cancer. According to the NCI, when all stages are grouped together, close to 50% of women diagnosed with ovarian cancer are still alive after 5 years. 

Because early detection plays a pivotal role in survival, the most important recommendation is to realize if you feel something is wrong, believe yourself and follow through with your doctor and voice your concerns.

Determining Ovarian Cancer Treatment

Choosing the right treatment plan can be difficult. Discuss treatment options available for your type and stage of cancer with an oncologist. They can explain the risks and benefits of treatments and their subsequent characteristic side effects.

Treatment for ovarian cancer involves a combination of surgery and chemotherapy best suited to your specific diagnosis.The type of ovarian cancer, the extent of the disease and factors like age and overall health determine treatment decisions.

Doctors remove cancerous tissue/tumor and depending upon cancer stage designation may or may not prescribe additional chemotherapy. Chemotherapy is given either orally and/or intravenously to shrink and/or kill residual cancer cells.

Different treatments may be provided by different specialists on your medical team:

  • Gynecologic oncologists treat cancers of a woman’s reproductive system through performing surgery and administering chemotherapy
  • Surgeons perform operations to remove tumor growths
  • Medical oncologists treat cancer with chemotherapy.

Ovarian Cancer Recurrence

There are multiple factors affecting ovarian cancer recurrence risk, including the stage at which original ovarian cancer diagnosis and treatment occurred.

The earlier the ovarian cancer is diagnosed and treated, the less likely it is to return.

According to the Ovarian Cancer Research Alliance (OCRA), the risk of ovarian cancer recurrence is:

  • 10% if ovarian cancer is diagnosed and treated in stage 1
  • 30% if diagnosed and treated in stage 2
  • 70-90% if diagnosed and treated in stage 3
  • 90-95% if diagnosed and treated in stage 4

Overall, about 70% of women diagnosed with ovarian cancer experience recurrence, with some experiencing multiple recurrences. 

Managing Advanced Stages

While ovarian cancer diagnosed in its earliest stage offers the best health prognosis, there are several treatment options that maximize quality of life for those diagnosed with advanced stage ovarian cancer.

Even certain late stage ovarian cancers can have good treatment outcomes, depending on a variety of factors. Doctors are seeing positive results in managing advanced stage ovarian cancer with:

  • Intraperitoneal chemotherapy (IP) directs a concentrated dose of drugs to the tumor site. Medication is also absorbed into the bloodstream and can attack cancer cells elsewhere in the body. This treatment seems to help some patients live longer; however, it can also cause more extreme side effects than IV medication, such as abdominal pain, nausea, and vomiting. 

Researchers are investigating the effectiveness of giving IP chemotherapy during surgery using heated drugs, known as heated intraperitoneal chemotherapy (HIPEC), or “hot” chemotherapy.

During HIPEC, surgeons remove all visible tumors, then pump chemotherapy medication, that has been heated to 103 degrees Fahrenheit through the abdominal cavity. Surgeons physically rock the patient while on the operating table to make sure the drug reaches all areas of the abdomen.

Some research has shown that HIPEC can extend some patients' lives. Women receiving HIPEC and surgery had an overall survival rate of about 1 year longer than those only undergoing surgery.

  • Targeted therapy attacks cancer by focusing on traits cancer cells need for survival. Instead of killing cancer cells outright like standard chemotherapy, targeted drugs interfere with these cells’ function, which can ultimately cause them to die.
  • Immunotherapy is a newer approach in treating ovarian cancer through stimulation of the patient’s immune system so it can better identify and attack cancer cells. Some studies have suggested combining immunotherapy medication with chemotherapy could offer survival benefits for women with ovarian cancer.
  • Clinical trials implement new treatment options to see if they are safe and effective.

Since there is no simple, reliable way to screen for any gynecologic cancer except cervical cancer, it’s especially important to recognize ovarian cancer warning signs and understand what you can do to reduce your risk:

  • Pay attention to your body. Know what is normal for you.
  • If you notice any changes in your body that aren’t normal for you and could be a potential sign of ovarian cancer, talk to your doctor.

Your Capital Women’s Care team is here for you and your family should you have questions or concerns regarding your personal reproductive health. Our goal is to optimize you and your family’s health and maximize your quality of life through our comprehensive, state-of-the-art healthcare and our caring and knowledgeable professional staff. 

Sources:

The sites listed below have more information about current clinical trials.

For more information about ovarian and other gynecologic cancers:

Centers for Disease Control and Prevention (CDC) – call 1-800-CDC-INFO or go to their website: www.cdc.gov/cancer/gynecologic

National Cancer Institute (NCI) – call 800-4-CANCER or visit their website at www.cancer.gov

 

Additional Sources:

https://medlineplus.gov/

https://www.cdc.gov/reproductivehealth/index.html

https://www.cdc.gov/reproductivehealth/womensrh/healthconcerns.html

https://search.womenshealth.gov/search?utf8=%E2%9C%93&affiliate=womenshealth&query=ovarian+cancer&commit=

https://search.womenshealth.gov/ovarian

www.everydayhealth.com/search/ovarian

https://www.everydayhealth.com/ovarian-cancer/guide/treatment/

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The providers of Capital Women's Care seek the highest quality medical and ethical standard in an environment that nurtures the spirit of caring for every woman.

 

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