Ovarian Cancer - Symptoms and Statistics

Ovarian cancer is the fifth most common cancer among women, and it causes more deaths than any other type of female reproductive cancer, yet the cause is unknown. Each year more than 21,000 women are diagnosed with ovarian cancer and about 15,000 die of the disease. The mortality rates for ovarian cancer have not improved in thirty years. Women have ovaries, one on each side of the uterus, which are about the size of an almond, and they produce eggs in addition to the hormones; estrogen, progesterone and testosterone. As ovaries are located in the middle of the abdomen symptoms in the early stages of this disease are not very pronounced.

• Cancer that begins in the cells on the outside of the ovaries, which is the most common.
• Cancer that begins in the egg-producing cells, which are called germ cell tumors, tends to occur in younger women.
• Cancer found in the hormone-producing cells, which are called stromal tumors, and actually begins in the ovarian tissue that produces the hormones.

Some of the symptoms of ovarian cancer:

• Bloated feeling
• Pelvic or abdominal pain
• Trouble eating or feeling full quickly
• Feeling the need to urinate urgently or often

Other ovarian cancer symptoms

• Fatigue
• Upset stomach or heartburn
• Back pain
• Pain during sex
• Constipation or menstrual changes

Obviously many of these symptoms could be caused for other reasons, but if these symptoms don’t resolve with some simple treatment then it is time to see you doctor. If you have a family history of ovarian or breast cancer, definitely talk to your doctor about your possible risk of ovarian cancer. There are genetic blood tests available that may help determine your risk.

Inherited gene mutation - This is the BRAC1 and BRAC2 blood tests that are used for women in families that have had multiple cases of cancer. There is also a test for colorectal cancer called HNPCC which actually covers the lining of the uterus, colon and the stomach.

Family History of Ovarian Cancer – If you have family members that have been diagnosed with ovarian cancer you are at an increased risk.

A Previous Cancer Diagnosis – Your risk of ovarian cancer is higher if you have been diagnosed with cancer of the breast, colon, rectum or uterus.

Increasing Age – While ovarian cancer typically develops after menopause, it can happen at any age.

Undesired infertility. 

Never Having Been Pregnant – This puts you at an increased risk.

Hormone Replacement Therapy for Menopause – Some studies show you at higher risk but the studies are not consistent.

The facts are all women are at risk to some degree and symptoms are very vague at first but do increase over time. As with any cancer early detection increases survival rates. A PAP test will not reveal ovarian cancer.

There is no specific screening test for ovarian cancer. The following tests are the path to detection.

Pap Exam: Every woman over the age of 18 ought to have and annual vaginal exam and women over the age of 35 should have an annual rectovaginal exam.

Transvaginal Sonography: This is an ultrasound test with a small instrument placed in the vagina which is done for women that have a high risk for ovarian cancer or one that had an abnormal pelvic exam.

CA-125 Test: This is a blood test that determines if the level of CA-125, a protein produced by ovarian cancer cells has increased in the blood of a woman at high risk or with an abnormal pelvic exam. This is an important test but it is not always 100% accurate, as there are some other diseases that can cause this increase in the blood.

If any if these tests are positive a woman should consult with a gynecologic oncologist who will probably do a CAT scan and X-rays. While these tests are helpful the only sure way to diagnosis ovarian cancer is with a biopsy. Sometimes if the surgeon is doing a biopsy and finds cancer he will immediately begin surgery to remove one or both ovaries along with the fallopian tube.

The results of the surgery are used to stage the ovarian cancer. A CAT scan, an MRI or a PET scan may be used to determine whether the cancer has spread in the abdomen. Staging is the next step which will determine the prognosis of the patient and treatment options.

• Stage I. Ovarian cancer is confined to one or both ovaries.
• Stage II. Ovarian cancer has spread to other locations in the pelvis, such as the uterus or fallopian tubes.
• Stage III. Ovarian cancer has spread beyond the pelvis or to the lymph nodes within the abdomen.
• Stage IV. Ovarian cancer has spread to organs beyond the abdomen, such as the liver or the lungs.

Quite often if a woman has ovarian cancer then they will have a total hysterectomy.

Other treatments include radiation which may be external or internal. Internal radiation uses a radioactive substance sealed in needles, seeds, wires or catheters that are placed directly into or near the cancer. Again the method used depends on the stage of the cancer. 

This also holds true for chemotherapy.

Biological therapy is a treatment that uses the patient’s immune system to fight cancer by using substances made by the body or in a laboratory to boost, direct or restore the body’s natural defense against cancer.  This is also known as biotherapy or immunotherapy.

Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. 

There are numerous clinical trials being held all the time, so a patient may want to choose that as a treatment option.

Obviously we need much more research on ovarian cancer to have a specific test available for diagnosis.  Secondly, we need to let women know what the symptoms are for ovarian cancer.  Ovarian cancer is more deadly than breast cancer, but women have not been adequately educated as to the symptoms as compared to breast cancer. As in all cancers early detection is the key to survival.

The copyright to this article is owned by Pamela Oglesby. Permission to republish this article in print or online must be granted by the author in writing.