Ovarian Cancer, the “Other” Female Cancer

Let's talk about it: September is National Ovarian Cancer Month.

This highly lethal cancer causes more deaths than any other cancer of the female reproductive tract. Ovarian cancer is a common cancer in women and perhaps the reason we don't talk about it as much is that it tends to be diagnosed in the late stages since the symptoms are slow to occur. When ovarian cancer is found in its early stage however treatment can improve the survival rate.

Major risk factors for ovarian cancer

  • The more you ovulate the greater your risk, which means at highest risk are:
    • Women who have never had children.
    • Women who never used birth control pills.
    • Women who experience late menopause, after the age of 55 years.
  • Family history and genetic factors:
    • Women with a family history of breast, endometrial, ovarian or colon cancer.
    • Women who carry a mutation in the BRCA1 or BRCA2 genes.
    • Ashkenazi Jewish woman with a single family member with breast cancer before age 50 or with ovarian cancer. This group should be offered genetic counseling and testing for the BRCA 1 and 2 genetic mutations.

Other risk factors for ovarian cancer:

  • Obesity
  • Age greater than 55 years.
  • Infertility related to endometriosis (Large studies however show fertility treatments do not increase your risk of ovarian cancer).

Protective factors that help reduce your risk of ovarian cancer include:

  • Pregnancy reduces the odds of ovarian cancer by 25 to 50 percent. Your risk decreases with each additional pregnancy.
  • Use of the oral contraceptive pill is associated with a 40 percent decrease. Increased duration of use is associated with decreased risk.
  • Breastfeeding reduces the risk of ovarian cancer by 20 percent.
  • Certain gynecological surgeries such as a tubal ligation can reduce the risk of ovarian cancer by 15 percent.
  • Dietary changes to reduce your risk of obesity. Follow the rules of healthy living which include a well-balanced diet with reduced high-fat dairy, limiting alcohol consumption to 3 to 4 a week and exercising regularly.

Symptoms tend to occur in the late stages of the disease and include:

  • Unexplained vaginal bleeding
  • Pelvic or abdominal pain
  • Abdominal bloating
  • Poor appetite
  • Unexplained weight loss
  • Lower back pain
  • Frequent urination or urinary incontinence
  • Constipation

Ovarian Cancer Screening

Woman at high risk high risk such as those with a family history or test positive for Br Ca 1 and 2 mutations, Ashkenazi women with a single family member with breast cancer before age 50 or with ovarian cancer should be screened regularly with transvaginal pelvic ultrasound and Ca 125 blood tests done every 6 months to one year along with pelvic examinations. Because of a high rate of false positives, it is not recommended that women without a family a history of ovarian cancer have these screening tests.

BRCA1 and 2 positive women should have a prophylactic oophorectomy (removal of the ovaries) once they are done with having children or by age 35.

What Can You Do?

The important take home message is to pay attention to your body and know what is normal for you. If you experience any of the symptoms associated with ovarian cancer talk to your health care provider. Don’t ever be afraid to call your health care provider to discuss unusual symptoms. Early detection can save your life when dealing with this aggressive female cancer.

Society of Gynecologic Oncologists sponsors the Women's Cancer Network at www.wcn.org.

When a hereditary ovarian cancer syndrome is suspected, the National Cancer Institute Cancer Information Service (1-800-4-CANCER) can supply information.

 This post has been reproduced with the permission of Dr. SherryTM


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