The ovaries are located within the pelvis and produce eggs and hormones. Ovarian cancer occurs when ovarian cells grow abnormally and the body does not get rid of them. While there are many types of ovarian cancers, most are either ovarian epithelial carcinomas (cancer that begins in the cells on the surface of the ovary) or malignant germ cell tumors (cancer that begins in egg cells).
In the United States in 2012, there will be an estimated 22,280 new cases of ovarian cancer and 15,500 women will die from the disease. Ovarian cancer is the fifth most common cause of cancer among women and causes more deaths than any other gynecologic cancer.
Q: What are the symptoms of ovarian cancer?
A: Ovarian cancer is dangerous because it is insidious. Three out of four patients with ovarian cancer are diagnosed when the cancer already has spread beyond the ovaries. Nevertheless, when asked, almost all ovarian cancer patients recall having some symptoms before they were diagnosed. These symptoms are usually vague, and they are often mistaken for other common digestive or gynecologic conditions.
The most common symptoms of ovarian cancer are:
• Bloating or swelling of the abdomen
• Feeling full quickly when eating
• Feeling "heavy" in the pelvis and/or having pressure with urgency to urinate
If these symptoms persist for more than one or two weeks, women should see their doctor. When ovarian cancer is caught before it has spread outside the ovaries, 90 percent of women will survive five years. When ovarian cancer is diagnosed after the disease has spread outside the ovaries, however, the chance of five-year survival drops to less than 25 percent.
Q: Why do women get ovarian cancer?
A: It is not yet completely understood why ovarian cancer occurs. It can run in the family, but that is uncommon. Only one out of 10 cases of ovarian cancer is familial. Women of Ashkenazi Jewish descent are at higher risk of carrying mutated genes (genetic blueprints that get passed from parents to offspring) related to ovarian cancer. However, these genes also exist in women of other ethnic backgrounds. Women with family members who have breast or ovarian cancer under 45 are also at greater risk of having a genetic predisposition for ovarian and breast cancer.
Please check with your doctor if you suspect ovarian cancer runs in your family, as there are tests for these genetic disorders. If you have a genetic risk for ovarian cancer, there are preventive measures that could help you.
While it is impossible to identify who might develop ovarian cancer, there are certain groups of women who might be at higher risk for it: women who start menses early (before age 12) or who are older when they enter menopause (after age 52). The risk seems to be higher in women who ovulate without interruption.
Women who have not had children are at higher risk, and the risk decreases with each pregnancy. Breast-feeding may reduce the chance of ovarian cancer. Taking birth-control pills for five years (before menopause) reduces the chance of developing ovarian cancer by 50 percent. Smoking does not appear to elevate one's risk for most types of ovarian cancer, and there is no specific diet that has been definitively proven to cause or prevent it.
Q: What should you do when you suspect that you have ovarian cancer?
A: You need to see a doctor as soon as possible. Once you are examined, your doctor will determine if you need additional imaging or laboratory tests. If ovarian cancer is suspected, it is best that a physician who is specially trained in dealing with gynecological cancers treats you. Studies have shown that women who undergo surgery performed by a gynecologic oncologist for ovarian cancer survive more than twice as long, on average, than women whose ovarian cancer is removed by a general gynecologist or general surgeon. Surgery, followed by chemotherapy, is the mainstay treatment of ovarian cancer.
The take-home message: Ovarian cancer is an insidious disease and thus often presents at an advanced stage. If you think ovarian cancer might run in your family, see a doctor, because testing and preventive measures may be available. Early recognition and appropriate treatment of ovarian cancer can help prolong your survival.
Nguyen is a gynecologic oncologist with Sutter Gould Medical Foundation.
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Bee Healthy is a column written by a variety of Sutter Gould health care providers on topics that will range from how to pack healthy school lunches to coping with holiday stress, from cancer awareness to superfoods.
