What is ovarian cancer?
Cancer is a disease where cells in a part of the body multiply uncontrollably. Cancers are named after that part of the body where they initially develop. If the cancer cells develop in the ovaries for instance, then the cancer is called ovarian cancer, even if the cancer spreads to other tissues or organs.
The ovaries are almond-shaped organs on each side of a woman’s uterus (the organ that holds the unborn baby). Ovarian cancer happens to belong to a group of diseases that includes two other organs aside from the ovaries - the fallopian tubes (two tube-like organs connected to each ovary, that allow eggs to travel from the ovaries to the uterus) and the peritoneum (the membrane-like tissue that covers the organs, including the ovaries, in the abdominal cavity).
What are the signs and symptoms of ovarian cancer?
Ovarian cancer is considered a covert killer. In its early stages, ovarian cancer rarely exhibits obvious symptoms and even when it progresses, symptoms are subtle and vague and may be mistaken for other conditions. According to Dr. Usha Menon and others, 58% of women when diagnosed with ovarian cancer, are already in either stage III or stage IV, which are associated with poor survival. Five-year survival for stage III is only 27% and for stage IV, only 13%. Because of this, it is considered as the deadliest of cancers involving women’s reproductive system.
According to the CDC and MSKCC, ovarian cancer may cause the following signs and symptoms:
· Abdominal pain or pain in the pelvis or back pain
· Bloating or swelling of the abdomen.
· Change in menstrual period.
· Constipation or diarrhea signaling a change in bowel habits.
· Difficulty eating or feeling full easily.
· Frequent and urgent need to urinate.
· Vaginal bleeding in between periods or when you are past menopause.
· Any abnormal vaginal discharge.
· Gain or loss of weight
If you have experienced any or a combination of the above, every day or almost every day, for more than two weeks, it’s recommended to see your doctor and specifically inquire if you have ovarian cancer. Early diagnosis means early treatment that can increase survival. The key is to recognize experiences different from what is normal to you and if it affects you for over two weeks.
What are the risk factors for ovarian cancer?
The risk factors are age, which is the most common, followed by genetics.
Ovarian cancer is said to be the second most common cancer involving women’s reproductive organs in the United States and there is a 1 in 70 chance of being diagnosed with this cancer. Two-thirds of ovarian cancers are diagnosed in women between the ages 50-75 years with about 62 years as the average age of diagnosis. Only 5 percent are diagnosed in women under the age of 30.
If you have a blood relative such as a mother, grandmother or sister who had ovarian cancer, your risk is increased as cancer may run in your family. Around 5-10 percent of women diagnosed with ovarian cancer inherited the risk for the disease which is attributed to genetics.
To be specific, the following increases your risk of having ovarian cancer:
1. You have close family members with ovarian or breast cancer.
2. You had breast cancer prior to the age of 40.
3. You were diagnosed with breast cancer before the age of 50 and have one or more blood relatives who had breast or ovarian cancer at any age.
4. You had breast cancer before age 50 and have Ashkenazi Jewish heritage.
5. You have a blood relative diagnosed with breast cancer before age 50 or ovarian cancer at any age and have Ashkenazi Jewish heritage.
6. If you had early menstruation or late menopause
7. If you had endometriosis, a condition where the lining of the uterus grows outside it.
8. Possibly postmenopausal hormone therapy
You are considered high risk if there are mutations or changes in your genes related to BRCA1 or BRCA2 (genes related to breast cancer) or a gene related to colon cancer (HNPCC) or Lynch Syndrome. This can only be known if you undergo genetic testing.
If you have one or more of the above factors, the CDC’s recommendation is for you to speak to a doctor about your risk.
How does one get ahead from ovarian cancer, the covert killer?
Apart from understanding the enemy, minimizing your risk level and assuming preventive measures increases one’s chances of survival.
Lowering one’s risk level includes:
1. Following a healthy lifestyle – healthy eating, staying active and maintaining one’s target weight.
2. Know your risk level by asking questions (ex. inquire about close family members who had ovarian cancer) which can help make informed decisions on what to do to protect oneself and one’s family.
3. Number of full-term pregnancies – the more one had full term pregnancies, the lower one’s risk.
4. Birth control pills – the longer the time of taking the pills, the higher the protection from ovarian cancer. Unfortunately, some contraceptives such as the oral kind have risks, so seek the advice of your doctor if it’s a good option for you.
5. Tubal Ligation -This procedure involves tying one’s fallopian tubes which can lower the risk of ovarian cancer, however, Memorial Sloane Kettering Cancer Center experts in New York City strongly advice that the procedure shall be used to prevent pregnancies and not lowering ovarian cancer risk.
Preventive Measures for Women
There is no drug or vaccine that prevents ovarian cancer. Surgery is the most common preventive measure against ovarian cancer.
1. Removal of ovaries and fallopian tubes through surgery – usually women at high risk decide this option to prevent ovarian cancer.
2. Removal of the fallopian tubes – According to the CDC, 90% of ovarian tumors develop from the cells that line the surface of the ovaries and most arise from the end of the fallopian tubes, making this the most common form of ovarian cancer. According to two specialists from MSKCC, 80% of ovarian cancers happen in patients with no family history or genetic risk and are not even identified as high risk. The same specialists talk about opportunistic salpingectomy, a term used for removal of the fallopian tubes at the time of other surgeries in one’s abdomen or pelvic area. It is said to be a highly effective preventive measure for those with an average risk of ovarian cancer, and additionally, it is a simple surgery. For more information about this, click on this link: https://www.mskcc.org/videos/can-we-prevent-ovarian-cancer
3. Genetic counselors may provide preventive strategies for those at high risk. Click on this link for more information.https://www.mskcc.org/cancer-care/risk-assessment-screening/genetic-counseling-and-testing/hereditary-cancer-genes-and-hereditary-cancer-syndromes/brca1-and-brca2-genes
Note:
CDC – Centers for Disease Control and Prevention
MSKCC – Memorial Sloan Kettering Cancer Center
HNPCC - Hereditary Polyposis Colorectal Cancer
References :
1. UKTOCS: What’s next for ovarian cancer screening?
2. Ovarian cancer population screening and mortality after long-term follow-up in the UK Collaborative Trial of Ovarian Cancer Screening: a randomized controlled trial: Prof. Usha Menon et al ; Lancet 2021 ; 379 :3182-93 or
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