By Mack Barnes, MD
One of the most lethal forms of cancer that a woman can get is ovarian cancer. Unlike the mammogram for breast cancer or the Pap smear for cervical cancer, there are no screening tests for ovarian cancer. So a woman’s best defense against this disease is to learn about it, including how to reduce risk factors, recognize common symptoms and understand treatment options.
What is ovarian cancer?
Ovarian cancer is cancer that starts in the ovaries. The most common form of the disease, about 90 percent of cancers, is epithelial ovarian cancer. These tumors begin from cells that cover the outer surface of the ovary.
What are my risk factors for developing epithelial ovarian cancer?
Risk factors for developing ovarian cancer include the following:
- Age 55 or older
- Early onset (before age 12) of menstruation
- Having first child after age 30 or no children
- Menopause after age 50
- Prolonged use of fertility drugs
- Family history of ovarian cancer
- Personal history of breast cancer
How can I reduce my risk of developing epithelial ovarian cancer?
The risk of developing ovarian cancer can be reduced by oral contraceptives (birth control pills), tubal ligation or hysterectomy, having one or more children, prolonged (one year or more) breast feeding, a diet high in vegetables, and taking aspirin and acetaminophen.In rare circumstances an inherited predisposition can be identified associated with mutations in the BRCA gene. When found, preventive interventions can dramatically decrease lifetime risk.
What are the symptoms of ovarian cancer?
Symptoms of ovarian cancer are relatively common and can occur with other ailments. If their occurrence is unusual and persistent, you should check with your gynecologist. Common symptoms include bloating, abdominal or pelvic pain, trouble eating or feeling full quickly, and urinary problems.
How is ovarian cancer diagnosed?
Ovarian cancer can be diagnosed through regular health exams and by imaging methods, such as ultrasound, computed tomography, barium enema X-ray, magnetic resonance imaging, chest X-ray and positron emission tomography. Other tests also can be performed, including laparoscopy, colonoscopy or tissue sampling.
A blood test called CA-125 is often used to measure protein concentrations in the blood that may indicate the presence of ovarian cancer. In high risk individuals it is often monitored in a repeated manner over time in an effort to detect onset of ovarian cancer. A single CA-125 test or use in normal risk populations, however, is not recommended as the sole means of early detection due to a high rate of false positives.
How is ovarian cancer treated?
Treatment will depend on how far the cancer has spread and the patient’s general health. Surgery can be performed to remove the uterus, ovaries and fallopian tubes. Younger women who may wish to have children and have very early stages of the disease may have only the affected ovary removed. Chemotherapy can be used to reach all areas of the body, including cancers that may have spread beyond the ovaries.
Studies are currently underway to learn how to detect ovarian cancer in the early stages of the disease. Until a reliable screening test is developed, you should see your gynecologist if you suspect that you have ovarian cancer. Identifiable symptoms do exist; you just have to be looking for them.
Mack Barnes is a gynecological oncologist at Brookwood Baptist Women’s Medical Center.