Ovarian Cancer
Ovarian cancer originates in the ovaries. The ovaries, located on each side of the uterus, are the pair of reproductive organs that produce eggs and are the main source of the primary female hormones, estrogen and progesterone. In 2008, it was estimated that 21,650 new cases of ovarian cancer would be diagnosed in the U.S. and 15,520 deaths would result. Ovarian cancer is the most lethal of the gynecologic malignancies.
Risk Factors
The risk of developing ovarian cancer increases with age, and most cases develop after a women
reaches menopause. The average age at which women develop ovarian cancer is 63. A subset of women
who are genetically predisposed to developing ovarian cancer may develop cancer at a younger age. The
following factors have been associated with developing ovarian cancer:
- Family history of ovarian, breast or colon cancer
- Personal history of breast cancer
- Ashkenazi Jewish origin
- Carrier of a genetic mutation that predisposes to ovarian cancer
- Obesity
- Never having children
Prevention
Being aware of one’s personal and family history may lead to genetic testing that may identify a mutation.
If a mutation is identified, the patient may elect to undergo prophylactic removal of the ovaries and
fallopian tubes. Women should receive regular pelvic examinations where a health care professional can
feel the ovaries for size, shape and consistency. A Pap test is not an accurate indicator for ovarian
cancer.
Recent studies have shown that women who use oral contraceptives for five or more years have a 50 percent lower risk of developing ovarian cancer than women who have never used oral contraceptives. However, the choice to use oral contraceptives should not be made solely for ovarian cancer prevention.
Symptoms
The most common symptoms of women with ovarian cancer are bloating, pelvic or abdominal pain,
difficulty eating or feeling full quickly and urinary symptoms such as urgency (always feeling like you have
to go) or frequency (having to go often).
Diagnosis
If a physician detects irregularities during a physical or pelvic exam or suspects that an ovarian cancer
may be present, then a transvaginal ultrasound or a blood test (CA-125) may be recommended.
True diagnosis of ovarian cancer is usually confirmed during time of surgery where tissue or fluid is obtained.
Treatment
Treatment for ovarian cancer usually involves advanced surgery and chemotherapy. If ovarian cancer is
found, then a salpingo-oophorectomy (removal of the tubes and ovaries), a hysterectomy, removal of the
omentum (a fatty area of tissue near the stomach and colon) and a lymph node dissection may be
performed. The goal of surgery is usually to remove as much of the tumor as possible. Chemotherapy is
frequently given after surgery and occasionally before surgery. Radiation therapy is rarely used. Survival is best when the specialized surgery.