Know the signs, symptoms, and risk factors for ovarian cancer.
Ovarian cancer ranks as the fifth leading cause of cancer-related death in women, and is the top most deadly gynecologic cancer in the United States. Women have a 1 in 78 chance of developing ovarian cancer in their lifetime. We review the signs, symptoms, and risk factors for this devastating disease.
1. What is ovarian cancer?
Ovarian cancer is a malignant tumor that starts in the ovary or fallopian tube. There is a less common form of ovarian cancer called primary peritoneal cancer, which has similar symptoms and treatment options as the more common forms of ovarian cancer. Ovarian cancer often starts as a cyst or mass on the ovary that grows larger, invades nearby organs such as the fallopian tube, uterus, intestines, and even bladder, and can spread to other parts of the body. It is staged based on the degree of spread.
2. Why is ovarian cancer so deadly?
Ovarian cancer is deadly for two reasons. First, it is often diagnosed at a late stage, past the point where a cure is possible. Ovarian cancers often start small and grow slowly and gradually, and often go unnoticed for many months or even years. The symptoms of ovarian cancer often do not show up until the cancer has progressed to an advanced stage. Once the symptoms become noticeable, they are vague and are often misinterpreted as gas, irritable bowel syndrome, acid reflux, or normal signs of aging. For all these reasons, the diagnosis of ovarian cancer is often made late in the progression of the disease.
The second reason why ovarian cancer is so lethal, is that we do not have good screening tests for the cancer. Screening tests like mammograms and colonoscopies are very effective at saving lives because they can reliably catch cancer at an early stage, when there is still time to intervene and cure the cancer. There is no good screening test that consistently detects ovarian cancer at an early enough stage when a cure is possible.
3. What are signs and symptoms of ovarian cancer?
Some women experience pelvic pain or discomfort at the site of the tumor. Often this pain does not start until the tumor has grown fairly large or invaded nearby organs.
Gastrointestinal problems are another common sign of ovarian cancer. As the tumor starts to affect the small intestine and large intestine, one can notice new diarrhea, new constipation, bloating, abdominal pain, decreased appetite, and feeling full after eating only a small amount of food.
Some women notice weight loss in their face, arms, and legs, but increasing waist size. The bloating and increased waist size can be from excess fluid (or "ascites") that can form in the abdomen.
If the tumor is growing near the bladder, some women notice urinary urgency, frequency, bladder pain, or blood in the urine.
4. Do I have risk factors for ovarian cancer?
The most common risk factor for ovarian cancer is age (typically greater than 60 years old). Other risk factors include having no history of pregnancy or childbirth, no history of breastfeeding, severe endometriosis, BRCA genetic mutation, or Lynch syndrome.
Factors that can help lower your risk of ovarian cancer are hormonal birth control use for at least 3 years, breastfeeding, pregnancy, surgical removal of the ovaries, and history of tubal ligation surgery.
5. What comes next?
If you have any of the above signs of ovarian cancer, please see your doctor. Ask your doctor about imaging tests such as a pelvic ultrasound or a CT scan ("cat scan") of the abdomen and pelvis. There are certain blood tests called "tumor markers" that can determine if an ovarian mass or cyst is more likely to be cancerous. If you or your family members have history of breast cancer, ovarian cancer, breast cancer at age younger than 50 years old, or breast cancer in a male relative, you may qualify for genetic testing. The genetic testing would check your DNA to see if you have a genetic mutation that increases your risk of breast, ovarian, and other cancers.
If you are interested in learning more about topics in women's health, please visit www.thegentlegyn.com for more information.
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