Ovarian cancer is cancer that starts in the ovaries. The ovaries are the female reproductive organs that produce eggs.
Hope for Women with Ovarian Cancer
Ovarian cancer used to be called a "silent killer" due to the subtle symptoms of the disease, 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.
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.
The risk for developing ovarian cancer appears to be affected by several factors, including:
- 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 may have an increased risk for ovarian cancer.
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.
- 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.
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
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
- Blood chemistry
- Blood tests
- Complete Blood Count
- Quantitative serum HCG (blood pregnancy test)
- Tumor Markers (CA125)
- Urinalysis (testing of the urine)
Imaging tests that may be done include:
- Abdominal computed tomography (CT) scan or magnetic resonance imaging (MRI) of abdomen
- Gastrointestinal (GI) series
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
Studies have shown that surgery performed by a specialist in gynecologic oncology results in a better outcome.
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 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.