Ovarian Cancer
Risk Factors, Symptoms, and Diagnosis
Ovarian cancer used to be called a “silent killer” and the disease that whispers. Today, we know there are symptoms. While there is still no proven effective screen to find ovarian cancer early when it is easier to treat – knowing your family history, paying attention to persistent symptoms, and bringing them to your doctor’s attention could save your life.
The good news is that ovarian cancer is comparatively rare, representing 1% of all new cancer cases in the United States. However, ovarian cancer is most often diagnosed at later stages, when the cancer has spread and is more challenging to treat.
There are around 20,000 new cases of ovarian cancer diagnosed each year. Ovarian cancer is most frequently diagnosed between the ages of 55-64, and approximately 75% of ovarian cancer is diagnosed at advanced stages.
Screening
There is no reliable way to screen for ovarian cancer in individuals who do not have any symptoms. The Pap smear, for example, cannot detect ovarian cancer; it is an effective screen only for cervical cancer. Most people are diagnosed at later stages of ovarian cancer because the symptoms are often not obvious, and there is no reliable screening test for ovarian cancer. However, earlier detection can mean a higher chance of survival. That’s why it is essential to understand your risk, know your body, and be aware of the symptoms of ovarian cancer.
Specific tests and exams can also be performed for individuals at higher risk for ovarian cancer or for those who have suspicious symptoms.
Signs and Symptoms
- Bloating
- Pelvic or abdominal pain
- Difficulty eating or feeling full quickly
- Urinary symptoms (urgency or frequency)
- Fatigue
- Indigestion
- Back pain
- Constipation
- Pain with intercourse
- Menstrual irregularities
What should I do if these symptoms continue?
These symptoms are general and certainly may indicate conditions other than cancer. If you experience one or more of these symptoms almost daily for two weeks or more and the symptoms are new and not typical for you, see your gynecologist or primary care physician. You know your body better than anyone. Stay calm and err on the side of caution.
Risk Factors
All people with ovaries of every age and ethnicity carry some risk of developing ovarian cancer. However, not all risks are weighted equally. A risk factor is anything that increases a person’s chance of developing a specific illness. Having one or more risk factors associated with a disease does not mean you will develop that disease. Having no risk factors for a disease does not mean you will not get that disease. Discussing risk factors with your doctor may help you make informed lifestyle choices, including preventative measures appropriate to the severity of your risk.
The risk factors for ovarian cancer include:
- Age – the risk of developing ovarian cancer increases with age. Roughly half of people diagnosed with ovarian cancer are age 63 or older. Ovarian cancer is rare in people under 40, but it can happen.
- Family History – having close family members on either your mother’s or father’s side who have had ovarian cancer.
- Inherited Risk – up to 25% of ovarian cancers are linked to a genetic mutation (change) passed down from either the mother or father that raises a person’s risk. These include BRCA1 and BRCA2 and Lynch syndrome, which may increase a person’s risk of ovarian, uterine, colorectal, breast, and several other cancers.
- Endometriosis – a history of this condition (when tissue similar to the lining of the uterus grows elsewhere in the body) may increase the risk of certain types of ovarian cancer, including ovarian clear cell carcinoma (OCCC) and endometrioid carcinoma.
- Menstrual and Reproductive History – ovarian cancer risk may be increased due to:
- Early menstruation (before age 12)
- Menopause after age 50
- Not giving birth to a child
- Having children later
- Unexplained infertility (the medical inability to have a child)
- Never taking birth control pills
- Hormone Replacement Therapy (HRT) – Some studies suggest that post-menopausal HRT may increase the risk of ovarian cancer.
Diagnosis
If your healthcare provider suspects you may have ovarian cancer, they’ll ask about your symptoms and perform a pelvic exam. They’ll check for unusual growths or enlarged organs during the exam.
Your healthcare provider may recommend additional tests, including:
Imaging tests can show the location, size, and shape of an ovarian tumor and whether the cancer has spread beyond the ovaries.
An ultrasound is often the first imaging test used to look for ovarian cancer. The two types of ultrasounds your healthcare provider may use are a transabdominal ultrasound and a transvaginal ultrasound. A transabdominal ultrasound is used to examine organs in the pelvis, and a transvaginal ultrasound is used to examine the uterus, ovaries, tubes, cervix, and pelvic area. During a transvaginal ultrasound, your healthcare provider will insert a probe into your vagina, which may help them see your ovaries more clearly.
Other imaging tests your healthcare provider may use include MRI, CT, and PET scans.
Blood tests alone cannot diagnose ovarian cancer, but abnormal results may indicate health problems.
The cancer antigen-125 (CA-125) test is the most common tumor marker test for ovarian cancer. High levels of CA-125 in your blood can be a sign of cancer, but the levels can also be normal even when cancer is present or raised due to health problems that aren’t cancer. Because of this, blood tests must be used along with other tests to help diagnose ovarian cancer.
Want more information on CA-125? Check out our webinar In a Nutshell: CA-125 and Ovarian Cancer.
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