About 22,530 women in the US will receive a new diagnosis of ovarian cancer this year, and more than half of those will be 63 and over. It is not a common cancer – ovarian cancer ranks fifth in cancer deaths among women – and the most difficult thing about this type of cancer is that there is currently no good or accepted screening or tests that will catch it early.
Symptoms Hard to Detect
Early detection is hard because many of the symptoms are common to women in mid-life, orcould easily be mistaken for various ailments and conditions. The most typical ovarian cancer symptoms include:
• Feeling full after eating only a few bites or loss of appetite
• Diarrhea, constipation, change in bowel habits
• Bloating, distension of the abdomen, clothes around the waist feel too tight
• Nausea, vomiting, heartburn, gas, indigestion
• Increased urinary frequency, need to urinate urgently, pressure on the bladder, leaking urine
• Vaginal discharge, bleeding, spotting, deep pain with intercourse
• Discomfort or pain in the abdomen, pelvic region, or lower back
As you can see, these are symptoms of many different things and at some point, most women will have these symptoms. However, it’s important to listen to your body, if symptoms are new and do not go away see your health care provider. If you’ve had any of these symptoms for 3 or more months and they can’t be explained by other conditions, do talk to a health care provider.
A physical exam, pelvic ultrasound, and some blood tests rule out ovarian cancer. Hoping to improve detection, researchers are looking into testing for the pattern of proteins in the blood (called proteomics) to find cancer cells earlier.
Risk Factors
Some risk factors for ovarian cancer are behavioral, which means habits (that’s on us), and some are inherited or genetic. But even having many risk factors does not mean that you will be at risk for ovarian cancer. Many women’s illness strikes those who have no known risk factors.
Here are factors that might increase a woman's chance of developing epithelial ovarian cancer:
Getting older – Half of all ovarian cancers are found in women 63 years of age or older.
Being overweight or obese – Those with a body mass index [BMI] of at least 30 may have a higher risk of developing ovarian cancer. Obesity may also affect the overall survival of a woman with ovarian cancer.
Late childbearing or never having a full-term pregnancy
Having a family history of ovarian cancer, breast cancer, or colorectal cancer
Ovarian cancer can run in families. Your ovarian cancer risk is increased if your mother, sister, or daughter has had ovarian cancer, and the more relatives, the more risk. A strong family history of breast cancer may be caused by an inherited mutation in the BRCA1 or BRCA2 genes and hereditary breast and ovarian cancer syndrome, which is linked to an increased risk of ovarian cancer.
The Role of Genetics
Researchers are studying what they call family cancer syndrome. As inherited gene mutations are found throughout a family, they find that some other types of cancer such as colorectal and breast cancer are linked to an increased risk of ovarian cancer. About 5 to 10% of ovarian cancers are a part of family cancer syndromes resulting from inherited changes (mutations) in certain genes.
You’ve probably heard of women getting tested for the BRCA1 and BRCA2 gene mutations that greatly increase their chances of getting breast cancer as well as ovarian, fallopian tube, and primary peritoneal cancers. The risk of some other cancers, such as pancreatic cancer and prostate cancer, are also increased with these gene mutations. Scientists continue to search for clues as to how genes become disrupted, and which are high-risk. My mom had the BRCA 1 mutation and did have breast cancer at age 32. I was tested and luckily was negative. However, if I was positive for BRCA1, I would have had both ovaries removed before menopause.
Precautionary mastectomies and hysterectomies by celebrities have made the news, and oncologists are studying how various preemptive surgeries, such as fallopian tube removal alone, or having both ovaries and fallopian tubes removed might prevent cancer from developing. Cells from very early fallopian tube cancers can become detached and then stick to the surface of the peritoneum or the ovaries growing out of control and becoming cancerous.
For reasons we don’t yet understand, these cancer cells may grow more rapidly in their new locations. A hysterectomy, while sparing the ovaries, appears to reduce the risk of getting ovarian cancer by about one-third.
Final Thoughts
Cancer is a scary subject, and women’s bodies have special vulnerabilities. As I often tell my patients, (and you) pay attention to your physical and emotional health. A nutritious diet, weight control, and lowering stress can improve your odds against all cancers. If you do have a family history of cancer, talk to your healthcare provider about any screenings or tests that can give you more information about your individual situation so you can make informed decisions.
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