Ovarian cancer is the 7th most common cancer in women and one of the most common gynecologic cancers, together with cervical and endometrial cancer.
September is known as Ovarian Cancer Awareness Month. Ovarian cancer is a type of cancer of the cells of the ovaries. It can occur in several different parts of the ovary, including the germ, stromal or epithelial cells. Germ cells are the cells that become eggs, stromal cells make up the substance of the ovary, and epithelial cells make up the outer layer of the ovary.
Ovarian cancer is the 7th most common cancer in women and one of the most common gynecologic cancers, together with cervical and endometrial cancer. In the United States alone, around 22 thousand new cases of ovarian cancer are diagnosed each year, out of which 14 thousand result in deaths.
In a recent interview, Dr. Linda Hendricks, a physician and managing partner at Central Georgia Cancer Care of Warner Robins and Macon, talked about ovarian cancer and its outlook. She stressed that while ovarian cancer is very treatable in early stages, it is rarely found early. Additionally, there are no straightforward symptoms, nor are there any effective, early screening tests approved for the disease. This is why awareness and keeping up with the most recent findings is vital.
Screening for ‘the silent killer’
Although ovarian cancer is rare in younger women, they should not be ruled out. A lot of women will go to their doctor complaining of persistent pelvic or abdominal pain, increased bloating, and feeling of fullness while eating. If certain factors add up, a doctor may recommend additional testing. However, most often, ovarian cancer is discovered by accident while looking for something else (possibly through a CAT scan). Having said that, going to the gynecologist at least once a year is important because it can also lead to uncovering ovarian cancer at an early stage.
A specific screening test is the CA125 test, which measures the amount of the protein CA 125 (cancer antigen 125) in the blood. In some cases, it may be used to monitor for early signs in those at a very high risk of the disease.
For women with a family history of ovarian cancer, recognizing that there are certain genetic factors and genetic mutations is something to keep in mind and something that should be checked. According to Dr. Hendricks, mutations in BRCA genes are responsible for the onset of ovarian cancer in over 50% of families with multiple cases of the disease and 13% of women around the world who have ovarian cancer are found to be BRCA1/BRCA2 positive.
If found, ovarian cancer is generally treated with a combination of surgery and chemotherapy.
Seeking a second, third…or sixth opinion
One woman’s journey with ovarian cancer is a mere example of why persistent symptoms should not be ignored.
In late 2011, Wendy, a 44-year-old woman from Sydney, Australia, had a swollen stomach the size of a bowling ball. “I looked like a woman pregnant with twins or triplets about to give birth to them. I was really, really huge” said the mother of two. Over the course of two months, Wendy went to different doctors a total of six times. Every time, she was told that she was either bloated, suffering from severe constipation or experiencing menstrual pain. “Emotionally I was quite frustrated because I knew something wrong with me inside because I looked so pregnant. No-one could tell me what was wrong with me. It was frustrating” said Wendy.
The real cause was not uncovered until she was admitted to the ER for severe pain and sent to see two other doctors. After a physical examination, she underwent a CT scan, which revealed a stage 4 ovarian cancer diagnosis. The cancer was massive, so much so that surgeons were unable to operate right away and Wendy had to have several rounds of chemotherapy first.
During her surgery, surgeons removed over 4 liters of fluid that had built up in her abdomen. “There was quite a lot of tumor in me. It took [my surgeon] from 2:30 in the afternoon and she didn’t finish until ten. It was horrific I was so scared and worried ... mainly for my children” said Wendy. Her surgeon, Dr. Sayer, said that she was shocked as to how so many medical experts missed the diagnosis. “She walked in this tiny little 55kg woman looking like she was carrying full term twins. It was not subtle at all. She was in trouble” she said.
According to Dr. Hendricks, the takeaway message is that early detection is crucial, but it is difficult. “The strongest known factor and indicator is family history. See your doctor, your gynecologist, regularly. A Pap smear is not a test for ovarian cancer. If ovarian cancer is in question, there are other things that can be looked at and used, even the fact most gynecologists can do in-office ultrasounds which could spot a tumor along with certain physical exams where a tumor could be felt” she said.
While ovarian cancer is not the most prevalent of cancers, it is certainly something to pay attention to. Having said that, women must remain vigilant of the signals their body gives them. Persistent symptoms (more than 12 days in a 30-day period) such as abdominal bloating, changes in appetite, and changes in bowel movements are just some of the warning signs that should be reported as soon as possible.