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Ovarian Cancer
Ovarian cancer is cancer that starts in the ovaries. The ovaries are the female reproductive organs that produce eggs. It is the
eight most common cancer among women, and it causes more deaths than any other type of female reproductive cancer. The
cause is unknown.
Risk Factors:
The more children a woman has and the earlier in life she gives birth, the
lower her risk for ovarian cancer. Certain genes (BRCA1 and BRCA2)
are responsible for a small number of ovarian cancer cases. Women with
a personal history of breast cancer or a family history of breast or ovarian cancer have an increased risk for ovarian cancer.
Hormone therapies and ovarian cancer:
•
Women who take estrogen replacement only (not with progesterone)
for 10 years or more seem to have a higher risk of ovarian cancer.
•
Birth control pills decrease the risk of ovarian cancer.
•
More recent studies suggest that fertility drugs do not increase the
risk for ovarian cancer.
Prevention:
Having regular pelvic examinations may decrease the overall risk.
Screening tests for ovarian cancer remains a very active research area. To date, there is no cost-effective screening test for
ovarian cancer. More than 50% of women with ovarian cancer are diagnosed in the late stages of the disease.
Recent research has shown that preventive surgery to remove the ovaries in women who have a mutation in the BRCA1 and
BRCA2 genes can dramatically reduce their risk of developing ovarian cancer.
Signs and Symptoms:
Ovarian cancer symptoms are often vague. Women and their doctors often blame the symptoms on other, more common
conditions. By the time the cancer is diagnosed, the tumor has often spread beyond the ovaries.
Early-stage ovarian cancer can cause symptoms, although these symptoms also occur with many other conditions. You
should see your doctor if you have the following symptoms on a daily basis for more than a few weeks:
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Bloating
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Difficulty eating or feeling full quickly
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Pelvic or abdominal pain
Other symptoms are also seen with ovarian cancer. However, these symptoms are also common in women who do not have
cancer:
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Abnormal menstrual cycles
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Vaginal bleeding
•
Digestive symptoms:
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Vague lower abdominal discomfort
o Constipation
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Weight gain or loss
o Increased gas
o Indigestion
o Lack of appetite
o Nausea and vomiting
•
Sense of pelvic heaviness
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Swollen abdomen or belly
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Unexplained back pain that worsens over time
Tests and Diagnostics:
A physical examination may reveal a swollen abdomen and fluid in the abdominal cavity (ascites). A pelvic examination
may reveal an ovarian or abdominal mass.
Lab tests that may be done include:
•
Alpha fetoprotein
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Blood chemistry
CA125 (may be done if ovarian cancer is strongly suspected or has been diagnosed, and to follow the cancer during or
•
after treatment)
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CBC
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Quantitative serum HCG (blood pregnancy test)
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Urinalysis
Imaging tests that may be done include:
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Abdominal CT scan or MRI of abdomen
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GI series
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Ultrasound
Pelvic laparoscopy or exploratory laparotomy may be done to evaluate symptoms and get a biopsy to help make the diagnosis.
No lab or imaging test has ever been shown to be able to diagnose ovarian cancer in its early stages (screening).
Treatment:
Surgery is part of the treatment for all stages of ovarian cancer. For earlier stages, it may be the only treatment. Surgery
involves:
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Removal of the uterus (total hysterectomy)
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Removal of both ovaries and fallopian tubes (bilateral salpingo-oophorectomy)
•
Partial or complete removal of the omentum, the fatty layer that covers and pads organs in the abdomen
•
Examination, biopsy, or removal of the lymph nodes and other tissues in the pelvis and abdomen
Chemotherapy is used after surgery to treat any remaining disease. Chemotherapy can also be used if the cancer comes back.
Chemotherapy may be given into the veins, or sometimes directly into the abdominal cavity (intra-peritoneal).
Radiation therapy is rarely used in ovarian cancer in the United States.
After surgery and chemotherapy, patients should have:
•
A physical exam (including pelvic exam) every 2 - 4 months for the first 2 years, followed by every 6 months for 3
years, and then annually
•
A CA-125 blood test at each visit if the level was initially high
•
Your doctor may also order a computed tomography (CT) scan of your chest, abdomen, and pelvic area and a chest
x-ray.
Call for an appointment with your health care provider if you have any of the symptoms listed above. Early diagnosis and
treatment of cancer greatly increases the chances of survival.
Sources: American Cancer Society, Cancer Prevention and Research Institute of Texas, Surgery at Cancer Treatment of America.
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