Information About Ovarian Cancer

Ovarian Cancer Update

Researchers continue to learn more and more about ovarian cancer, but it is still a complex disease to understand and treat. There is no reliable screening test, which makes it hard to detect the disease early. When caught early, ovarian cancer can be effectively treated and the less likely the cancer is to return. However, because most women are diagnosed in later stages, recurrence is more likely, but it is hard to predict who will recur.

The Foundation for Women’s Cancer estimates that about 15% of women will survive more than 10 years after being diagnosed with an advanced-stage ovarian cancer. These women may or may not develop recurrence.

There are more and more new treatment options available for women with early stage or recurrent ovarian cancer. One new treatment is immunotherapy, which helps the body’s own immune system recognize and attack ovarian cancer cells as they grow.

Some kinds of ovarian cancer are passed down through genes. Scientists hope that studying this kind of ovarian cancer will lead to better treatments. They are also looking at how lifestyle, diet, and medicine can lower a woman’s risk of getting ovarian cancer.

Common Questions About Ovarian Cancer

1. What is ovarian cancer?

Ovarian cancer is the growth of abnormal malignant cells that begins in the ovaries (women’s reproductive glands that produce eggs) or in the fallopian tubes.

Most ovarian cancers begin either in the cells on the surface of the ovary or in the egg cells. Some begin in the fallopian tubes or in an endometriosis, a non-cancerous gynecologic condition. Cancer that spreads to the ovaries from another site in the body is not considered ovarian cancer. Scientists are still learning about how and why ovarian cancer starts.

There are three types of ovarian cancer: epithelial ovarian cancer, germ cell cancer and stromal cell cancer. The most common type is epithelial ovarian cancer and it accounts for 85 percent to 89 percent of ovarian cancers, according to the Foundation for Women’s Cancer.

2. What is my risk of ovarian cancer?

A few factors affect a woman’s risk of ovarian cancer:

    -Age: Ovarian cancer is most common in women older than 55. Young women can get ovarian cancer, but this is rare. All women can get ovarian cancer.
    -Childbirth: Not giving birth to a child raises a woman’s risk.
    -Family history: Women with a family member who had ovarian, breast, or colon cancer have a higher risk. But 90% of women who get ovarian cancer do not have a family history of the disease.
    -Genes: The most significant risk factor for ovarian cancer is an inherited genetic mutation in the genes BRCA1 or BRCA2. These genes are responsible for about 10 to 15 percent of all ovarian cancers. About 20 to 25 percent of women diagnosed with ovarian cancer have a hereditary tendency to develop the disease.
    -HRT: Long term use of post-menopausal hormone therapy (HRT).

To assess your personal risk, the Ovarian Cancer Research Fund Alliance has an ovarian cancer risk questionnaire.

3. How can I lower my risk of ovarian cancer?

There are some actions you can take that lower your risk for ovarian cancer.

    -Have one or more children: Your risk drops more if you have a child before age 30
    -Breastfeed: your risk drops more if you breastfeed for over a year
    -Use birth control pills: your risk drops 50% if you take them for 5 years or more
    -Have your tubes tied (tubal ligation surgery)
    -Remove the ovaries and fallopian tubes (salpingo-oophorectomy)
    -Remove the uterus (hysterectomy)

4. Is there a test to screen for ovarian cancer?

No, there are no tests that can screen for ovarian cancer. PAP smears, mammograms or colonoscopies cannot detect ovarian cancer.

5. What are the symptoms of ovarian cancer?

The most common symptoms of ovarian cancer are:

    -Bloating
    -Pain in the lower belly
    -Feeling full quickly or having trouble eating
    -Having to pee more often or more urgently

Other symptoms may include:

    -Back pain
    -Fatigue
    -Trouble digesting
    -Trouble with bowel movements
    -Pain during sex
    -Changes in your period

6. What should I do if these symptoms continue?

Many women have similar symptoms and it does not come from ovarian cancer. If you have any of these symptoms almost daily for more than two weeks and they are not normal for you, see a gynecologist and report all your symptoms. Know your body and know what is “normal” for you.

7. What can I expect when I go to see my healthcare provider?

If you have one or more of these symptoms for more than 2-3 weeks, tell your healthcare provider. A physical (pelvic/rectal) exam is necessary to palpate (feel) any abnormalities on the ovaries or surrounding area. If the exam is normal, it is reasonable to wait 2-3 weeks to see if symptoms resolve. If they do not, than a transvaginal or pelvic ultrasound should be performed.

If the physical exam is abnormal, your healthcare provider might suggest further tests like a CT scan or MRI and a CA-125 blood marker test. CA-125 is high in approximately 80 percent of women with advanced stage epithelial ovarian cancer, but elevations can occur for reasons other than ovarian cancer. For more information on the CA-125 blood test, click here.

All women should see a gynecologist for a routine exam every year from when they turn 18. It does not matter whether or not the woman has had sex.

8. Who should I see if my healthcare provider thinks I might have ovarian cancer?

You should see a gynecologic oncologist, a highly trained doctor who specializes in diagnosing and treating cancer in the female reproductive system. The five-year survival rate for a patient whose surgeon was a gynecologic oncologist is significantly increased.

For help finding a gynecologic oncologist, visit the Foundation for Women’s Cancer.

9. How can I know for sure if I have ovarian cancer?

Surgery is the only way to confirm a diagnosis of ovarian cancer. The goal of surgery is to remove all visible tumors and signs of cancer and to follow with chemotherapy.

10. What are the treatments for ovarian cancer?

The treatment for ovarian cancer often includes surgery, which should be performed by a gynecologic oncologist, and chemotherapy, which may be given through a vein or directly into the abdomen. There are many clinical trials and research studies being done to find more treatments.

11. Someone close to me in my family has ovarian cancer. Does that mean I will get it too?

If you are worried about your risk, you can speak to a genetic counselor. This person is a healthcare professional who can look at your personal and family history and help you learn about your risk. For help finding a genetic counselor, visit FORCE: Facing Our Risk of Cancer Empowered.

12. If I have ovarian cancer, do I need to have genetic counseling?

All women with ovarian cancer should have genetic counseling. Speak to your healthcare provider for more information. Another good resource is FORCE.

The Society of Gynecologic Oncology recommends that all women with high grade-epithelial ovarian cancer, regardless of family history, receive genetic testing to determine if they carry mutations in the BRCA1 or BRCA2 genes. If you test positive for these genetic mutations, you may have additional treatment options.

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