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The Silent Killer: Ovarian Cancer

Ovarian cancer is a disease in which malignant or cancerous cells are found in the ovaries. An ovary is one of two small, almond-shaped organs located on each side of the uterus that store eggs or germ cells and produce female hormones estrogen and progesterone.

What is the general outlook for women diagnosed with ovarian cancer?
In women age 35 to 74, ovarian cancer is the fifth leading cause of cancer-related deaths. An estimated one woman in 71 will develop ovarian cancer during her lifetime. The American Cancer Society estimates that there will be over 22,000 new cases of ovarian cancer diagnosed this year and that more than 15,000 women will die from ovarian cancer this year.

When one is diagnosed and treated in the earliest stages, the five-year survival rate is over 90 percent. Due to ovarian cancer’s non-specific symptoms and lack of early detection tests, only 19 percent of all cases are found at this early stage. If caught in stage III or higher, the survival rate can be as low as 30.6 percent. Due to the nature of the disease, each woman diagnosed with ovarian cancer has a different profile and it is impossible to provide a general prognosis.

Symptoms

Ovarian cancer is difficult to detect, especially, in the early stages. This is partly due to the fact that these two small, almond shaped organs are deep within the abdominal cavity, one on each side of the uterus. These are some of the potential signs and symptoms of ovarian cancer:

  • Bloating Pelvic or abdominal pain
  • Trouble eating or feeling full quickly
  • Feeling the need to urinate urgently or often

Other symptoms of ovarian cancer can include:

  • Fatigue
  • Upset stomach or heartburn
  • Back pain
  • Pain during sex
  • Constipation or menstrual changes

If symptoms persist for more than two weeks, see your physician.

Persistence of Symptoms

When the symptoms are persistent, when they do not resolve with normal interventions (like diet change, exercise, laxatives, rest) it is imperative for a woman to see her doctor. Persistence of symptoms is key. Because these signs and symptoms of ovarian cancer have been described as vague or silent, only around 19 percent of ovarian cancer is found in the early stages. Symptoms typically occur in advanced stages when tumor growth creates pressure on the bladder and rectum, and fluid begins to form.

A rectovaginal pelvic examination is when the doctor simultaneously inserts one finger in the rectum and one in the vagina. It is helpful to take a mild laxative or enema before the pelvic exam.

Have a comprehensive family history taken by a physician knowledgeable in the risks associated with ovarian cancer. 5 percent to 10 percent of ovarian cancer has a familial link.

Every woman should undergo a regular rectal and vaginal pelvic examination. If an irregularity of the ovary is found, alternatives to evaluation include transvaginal sonography and/or tumor markers. The most common tumor marker is a blood test called the CA-125.

Diagnosis and Tests

Unfortunately, most women with ovarian cancer are diagnosed with advanced-stage disease (Stage III). This is because the symptoms of ovarian cancer (particularly in the early stages) often are not acute or intense, and present vaguely. In most cases, ovarian cancer is not detected during routine pelvic exams, unless the doctor notes that the ovary is enlarged. The sooner ovarian cancer is found and treated, the better a woman’s chance for recovery. It is important to know that early stage symptoms are not silent, so women should be extra alert and watch out for early symptoms.

Potential symptoms of ovarian cancer include:

  • Bloating
  • Pelvic or abdominal pain
  • Trouble eating or feeling full quickly
  • Feeling the need to urinate urgently or often

Other symptoms of ovarian cancer can include:

  • Fatigue
  • Upset stomach or heartburn
  • Back pain
  • Pain during sex
  • Constipation
  • Menstrual changes

Did You Know?

The Pap test does not detect ovarian cancer. It determines cancer of the cervix.
Screening Tests Although there is no consistently reliable screening test to detect ovarian cancer, the following tests are available and should be offered to women, especially those at high risk for ovarian cancer.

Pelvic Exam: Women age 18 and above should have a mandatory annual vaginal exam. Women age 35 and above should receive an annual rectovaginal exam (physician inserts fingers in the rectum and vagina simultaneously to feel for abnormal swelling and to detect tenderness).

Transvaginal Sonography: This ultrasound, performed with a small instrument placed in the vagina, is appropriate especially for women at high risk for ovarian cancer or for those with an abnormal pelvic exam.

CA-125 Test: This blood test determines if the level of CA-125, a protein produced by ovarian cancer cells, has increased in the blood of a woman at high risk for ovarian cancer or with an abnormal pelvic examination.

While CA-125 is an important test, it unfortunately is not always accurate. Some non-cancerous diseases of the ovaries also increase the CA-125 levels, and some ovarian cancers may not produce enough CA-125 levels to cause a positive test.

Positive Tests

If any of these tests are positive, a woman should consult with a gynecologic oncologist who may conduct a CT scan and X-Rays and study the results. However, the only way to more accurately confirm ovarian cancer is with a biopsy, a procedure in which the doctor takes a sample of the tumor and examines it under a microscope.

Research into new ovarian cancer screening tests is ongoing and new diagnostic tests may be on the horizon. NOCC monitors the latest scientific developments, so please come back and visit our site for updates.

Treatment

After your diagnosis, your doctor will develop your customized treatment plan. Women should always discuss their treatment options with a physician, because the best and most appropriate treatment will be different based on the stage of disease, the woman’s age and the overall condition of her health.

There are three main treatment types for ovarian cancer:
1) Surgery—Surgery to remove the cancerous growth is the most common method of diagnosis and therapy for ovarian cancer. It is best performed by a qualified gynecologic oncologist.

2) Chemotherapy—Chemotherapy is the treatment of cancer using chemicals (medications) that travel through the bloodstream to destroy cancer cells or stop them from growing both in and outside the ovaries. Chemotherapy is used in the majority of cases as a follow-up therapy to surgery.

3) Radiation Therapy—Radiation therapy uses high-energy X-rays to kill cancer cells and shrink tumors (only rarely used in the treatment of ovarian cancer in the United States).

Complementary Therapies

Some women with ovarian cancer turn toward the whole-body approach of complementary therapy to enhance their fight against the disease, as well as to relieve stress and minimize side effects such as fatigue, pain and nausea.

Complementary therapies are diverse practices and products that are used in conjunction with conventional medicine. Many women have tried and benefited from the following complementary therapies. You might want to speak with other women with cancer or your health-care team to see which therapies they found most helpful or might work best for you and your lifestyle.

Acupuncture An ancient Chinese method of healing in which small sterilized needles are inserted into the body’s energy centers to promote healing.
Aromatherapy The use of essential oils from flowers, herbs and trees to promote health and well being.

Herbal Medicine Use of remedies using plant parts to treat symptoms and illnesses. (Consult your health-care professional prior to using herbal medicine).

Massage Manipulating the body’s muscle and connective tissue through rubbing, kneading and patting to promote relaxation and well being.
Meditation Conscious relaxation and focused breathing to relax the mind and body.

Qi Gong A type of Chinese medicine that combines movement, meditation and breathing to enhance the flow of qi (an ancient term given to what is believed to be vital energy) in the body, improve blood circulation and enhance immune function.

Stress Reduction Use of stress reduction methods such as exercise, meditation, etc. which have been found to be beneficial in reducing cancer progression and recurrence.

Yoga, Tai Chi Postures, movements and breathing exercises to strengthen and heal the body, mind and spirit.

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