Ovarian cancer used to be called a silent killer because the subtle symptoms of the disease kept it from being detected early, and because few active chemotherapy drugs were available to combat the disease. With the emergence of gynecologic oncology as a specialty, this story began to change in the following ways:
- As a subspecialty, gynecologic oncologists focused their efforts on the needs and issues of women with cancer.
- Physicians categorized the signs and symptoms of cancer affecting women, and raised public awareness.
- Research funding was targeted and directed toward improving the outcome of women with gender-specific cancers, and slowly the prognosis of these women improved.
Our team of gynecologic oncologists continues to work toward the goals of providing comprehensive cancer care for the women diagnosed with gynecologic cancer. Their expertise in the management of these diseases allows patients access to new, state of the art treatments that are designed for their individual needs. In this way, ovarian cancer has been transformed from a "killer" to a chronic disease with options for management.
Ovarian cancer is one of the most common cancers among women, and it causes more deaths than any other type of female reproductive cancer. The cause is unknown, but the risk for developing ovarian cancer appears to be affected by several factors, including:
- Children: The more children a woman has and the earlier in life she gives birth, the lower her risk for ovarian cancer.
- Genetics: Certain genes (BRCA1 and BRCA2) are responsible for a small number of ovarian cancer cases.
- Personal or Family History: Women with a personal history of breast cancer or a family history of breast or ovarian cancer may have an increased risk for ovarian cancer.
- Age: Older women are at the highest risk. The majority of deaths from ovarian cancer occur in women ages 55 and older. About 25 percent of ovarian cancer deaths occur in women between 35 and 54 years of age.
- Hormone therapies and ovarian cancer:
- Birth control pills decrease the risk of ovarian cancer.
- More recent studies that are suggest that fertility drugs do not increase the risk for ovarian cancer.
Symptoms of Ovarian Cancer
Ovarian cancer symptoms are often vague. Women and their doctors frequently 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:
- Difficulty eating or feeling full quickly
- Pelvic or abdominal pain
Other symptoms can occur with ovarian cancer. However, these symptoms are also common in women who do not have cancer:
- Abnormal menstrual cycles
- Digestive symptoms
- Increased gas
- Lack of appetite
- Nausea and vomiting
- Sense of pelvic heaviness
- Swollen abdomen or belly
- Unexplained back pain that worsens over time
- Vaginal bleeding
- Vague lower abdominal discomfort
- Weight gain or loss
Other symptoms that can occur with this disease:
- Excessive hair growth
- Increased urinary frequency or urgency
Diagnosis of ovarian cancer
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. Various lab and imaging tests will be done to establish an accurate diagnosis.
- Surgery is part of the treatment for all stages of ovarian cancer. For earlier stages, it may be the only treatment necessary. Surgery involves:
- Removal of the cervix and uterus (total hysterectomy)
- Removal of both ovaries and fallopian tubes (called a bilateral salpingo-oophorectomy)
- Removal of the omentum, the fatty layer that covers and pads organs in the abdomen; biopsy; or removal of the lymph nodes and other tissues in the pelvis and abdomen
- Removal of the bulk of tumor in the abdomen and pelvis
- Chemotherapy is used after surgery to treat any remaining cancer cells or disease and 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 to treat ovarian cancer in the United States.
After surgery and chemotherapy, patients should have:
- A physical exam (including pelvic exam) every two to four months for the first two years, followed by every six months for three years, and then annually.
- A CA-125 blood test when needed 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.