Ovarian Cancer, the “other” Female Cancer

By Dr. Sherry Ross

Ovarian Cancer, the “other” Female Cancer

In honor of Ovarian Cancer Month, I wanted to talk about a female cancer we don’t hear too much about even though it’s a common cancer occurring in women.   It might be this highly lethal cancer tends to be diagnosed in late-stages as a result of symptoms slow to occur.  There are more deaths from ovarian cancer than any other cancer of the female reproductive tract.  However, when this cancer can be found in its early stage treatment can improve the survival rate.

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

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

Major Risk Factors for Ovarian Cancer can be put into 2 groups:

  1. The more you ovulate the greater your risk:
    • Women who have never had children.
    • Women who never used birth control pills.
    • If you experience late menopause, after the age of 55 year you are at greater risk.
  1. Those women who have a family history:
    • Women with a Family history of breast, endometrial, ovarian or colon cancer and those who carry a mutation in the BRCA1 or BRCA2 genes
    • An Ashkenazi Jewish woman with a single family member with breast cancer before age 50 or with ovarian cancer.

This is the group that should be genetically counseled and tested for the Br Ca 1 and 2 genetic mutations that are associated with a genetic connection to ovarian and breast cancer.

Other risk factors include:

  • Women who are obese with a BMI > 30.
  • Women over the age of 55.
  • Infertility related to endometriosis (large studies show that 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 %. Your risk decreases with increasing number of pregnancies.
  • Use of Oral contraceptive pill is associated with a 40%. Increased duration of use is associated with decrease risk.
  • Breastfeeding reduces the risk of ovarian cancer by 20%.
  • Certain gynecological surgeries such as a tubal ligation can reduce the risk of ovarian can by 15%.
  • Dietary risks are mainly focused on reducing your risk of obesity. Keeping your BMI under 30 since we know obesity increases your risk of ovarian cancer. Following 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.

Screening options: There are no good screening tests for ovarian cancer since there is an association with a high rate of false positives.  The tools that are currently available for women who are high risk include transvaginal pelvic ultrasound and Ca 125 blood tests done every 6 months to one year along with pelvic examinations.

Who should be screened?  Those at 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.  If you do not have a family a history of ovarian cancer it is not recommended for women to have these screening tests.

Br Ca 1 and 2 positive should have a prophylactic oophorectomy once they are done with having children or by age 35 is the general recommendation for women with hereditary ovarian syndrome.

The important take home message is if you experience any of the symptoms associated with ovarian cancer talk to your health care provider.  Pay attention to your body and know what is normal for you.  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.

 

Posted in: Let's Talk Women's Health

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