Women's Health

What OB-GYNs Wish Their Patients Knew about Ovarian Cancer

What OB-GYNs Wish Their Patients Knew about Ovarian Cancer

There are numerous things OB-GYN providers want their patients to know about ovarian cancer.

For instance, that it is somewhat rare, but deadly. It ranks 5th in cancer deaths among women. Due primarily to the diagnostic issues noted below, about 70% of women are unfortunately in the most advanced Stage IV of ovarian cancer when diagnosed. The five-year survival rate for Stage IV is 17%.

He/she wants you to know that how often a woman has released eggs for fertilization seems to be a factor in ovarian cancer risk. Women in greatest danger appear to be those having fewer ovulation cycles by never having children, never using birth control pills, who started their periods at an early age, and entered menopause after age 55.

Your physician will want you to be aware that for a smaller percentage of women (about 10%), genetic factors are at play. Gene mutations of BCRA1 and/or BRCA2 cause a hereditary form of the disease.

Your OB-GYN is hopeful you are aware of new gene-specific drugs to treat BRCA1/2 that are classified as PARP Inhibitors. These drugs are formulated to specifically target BRCA1/2 genes. PARP enzymes help repair damaged DNA inside cells. By blocking the PARP pathway, these drugs make it very hard for tumor cells with a mutated BRCA gene to repair their damaged DNA. This process often leads to death of the BRCA1/2 cells.

And, also that research has shown how a family history of colon cancer could put you at increased risk for both ovarian and uterine cancer.

It would be important to him/her that you understand in identifying and responding to the response needs of those at high risk due to BRCA1/2.

He/she is hopeful you are aware of ways you can be pro-active in reducing your risk factors for the development of ovarian cancer. For example, remaining physically active seems to lessen the risks.

He/she would want you to know that studies have shown women with a diet high in fatty foods have a 29% higher risk of ovarian cancer than those with the lowest fat intake. Also, that a diet high in meat and fat will increase your cancer risk up to 50% while a diet high in fruits and vegetables did not have a negative impact on cancer risk percentages.

Additionally, he/she wants you to be aware that sugary drinks increase your risks while green tea, garlic, and Brazil nuts do not.

And that, according to the American Institute of Cancer Research, specific vegetables that may help decrease the risk of ovarian cancer include asparagus, carrots, tomatoes, cauliflower, broccoli, and rinsed sauerkraut. Also, that risk-decreasing fruits include blueberries, kiwi, and red grapes.

As to diagnosing ovarian cancer, your physician needs you to understand the symptoms are vague and often not severe enough for a woman to seek medical help. That symptoms tend to be gastro-intestinal, such as: feeling full after eating small amounts, being bloated, or constipated, feeling pelvic pressure, or transient stomach cramps. Urinary symptoms of urgency and frequency have also been reported.

He/she would warn you that most women either ignore these symptoms or self-medicate with over-the-counter preparations for relief of gas, constipation, or discomfort, and perhaps even grab some cranberry juice from the market for her urinary symptoms.

Your physician feels you have the right to know that some women with ovarian cancer were originally misdiagnosed and treated for other conditions, such as Irritable Bowel Syndrome.

And, your doctor wants you to be aware that the five-year relative survival rate for all types of ovarian cancer is 45%. However, that the survival rate rises to 92 percent if the cancer is caught in stage IA or IB, before it spreads beyond the ovary.

He/she would be proud to share with you that the overall cancer death rate has declined to 23 percent since its peak in 1991. Also, that right now, America’s biopharmaceutical companies are working on more than 800 cancer medicines.

Your doctor would want you informed that there isn’t an established screening for ovarian cancer (such as the pap smear for cervical cancer.) Plus, the original suspicion of ovarian cancer is often triggered when a pelvic mass is discovered during an internal gynecological exam.

Your OB-GYN physician would want you aware that available research funds are primarily spent on developing treatments, with little left for preventive measures. But that your involvement with clinical trials might help you live longer.

Your doctor would also want you to be aware that change is on the horizon in cancer diagnosis: A new test has been developed to find genetic markers of ovarian and endometrial cancer in the cervical fluid collected during a routine PAP test. The research is in its early stages, but the outcome looks very promising.

What OB-GYN specialists want their patients to know about ovarian cancer could be condensed into a purse-sized booklet and be briefly discussed at each appointment:

  • An early diagnosis is crucial for a good outcome
  • Diet and exercise lower risk of ovarian cancer
  • Physical symptoms of ovarian cancer are vague but have a pattern
  • For new symptoms, including those described earlier in this article, see your physician, especially if they last longer than a week
  • Yearly pelvic exams are strongly recommended.
  • The risk factors for developing ovarian cancer include genetic factors
  • If a palpable pelvic mass is determined during the internal exam, a transvaginal ultrasound test would be indicated
  • For those patients with a family history of multiple cases of breast or ovarian cancer, genetic counseling and testing will be offered
  • If the screening blood test shows the presence of the mutated genes BRCA1 and/or BRCA2, which markedly increases a woman’s risk for ovarian cancer, treatment options will be discussed, including surgical prophylactic measures
  • If BRCA1/2 is present, the advisability of genetic testing for sisters or daughters will be stressed
  • Your doctor wants you to receive the best treatment possible
  • If diagnosed with ovarian cancer, your OB-GYN provider is more than willing to transfer your case to an ovarian cancer specialist, such as a gynecological oncologist

Your doctor wants you to be a part of this decision. It is suggested you share with your physician that you prefer a medical center that treats your type of ovarian cancer and has hopefully published research on that type.

Your OB-GYN would want you to experience a seamless transfer of care from him/her to the oncology specialist. To help make this happen, that doctor will designate the office nurse to guide you through the preparation for that appointment by:

  • Notifying you of any pre-appointment restrictions, such as not eating solid food on the day before your appointment
  • Getting your signed release to transfer medical history to the new provider
  • Guiding you in writing down your symptoms, including any that may seem unrelated to the reason why you scheduled the appointment
  • Transferring your key medical information, to include other conditions and current medications, vitamins or supplements; often via fax
  • Directing you in writing down key personal information, including any major changes or stressors in your life, which will be needed for your new file
  • Assisting you in jotting down questions to ask your new doctor
  • It will be suggested that you ask a relative or friend to accompany you, to help you remember what the doctor says. The appointment will be stressful enough so having a second set of ears is a bonus

Your OB-GYN will want you to know that he/she will remain in contact with your new specialist regarding your care. He/she will also want you to know that he cares about you and your treatment progress even though you are no longer receiving medical services from him/her.