Ovarian cancer develops in about one of every 70 women in the United States, accounting for approximately 20,500 new cases and 12,000 deaths every year. Because symptoms of early stage disease are not obvious, it frequently goes undetected, particularly in women who do not receive regular medical checkups. However, if diagnosed and treated early, the survival rate is around 90 percent.
What is ovarian cancer?
Ovarian cancer is cancer of the ovaries, the female reproductive organs located on either side of the uterus. Cancer occurs when the healthy cells that make up the organ’s tissue stop growing in an orderly way. Rapid growth causes a build-up of cells into a mass called a tumor. Tumors can be benign (not cancerous) or malignant (cancerous).
Most ovarian tumors, especially in young women, are not life threatening. In fact, about 90 percent of the ovarian growths found in women younger than 30 are benign fluid-filled cysts. Sometimes these cysts appear and disappear during the monthly cycle and require no treatment at all. Ovarian growths that do not dissolve on their own, however, must be removed for further study. This is to prevent the cancerous cells from infecting other organs.
The symptoms of ovarian cancer
The symptoms can be subtle. Some women experience bloating and discomfort, or swelling in the lower abdomen. You may lose your appetite, and feel full or nauseous, even when you have not eaten very much. There may be gas, indigestion and weight loss. If the tumor is a rather large one, you may become constipated or urinate more often than usual. This is because the tumor may be putting pressure on the bowel or bladder.
How is ovarian cancer detected
Because the symptoms just described can be caused by disorders other than cancer, a thorough pelvic exam is important. Your doctor will perform a digital exam of the vagina, rectum and lower abdomen, feeling for anything unusual. If a mass is present, further testing is indicated.
How to diagnose ovarian cancer
Although a Pap smear is useful in detecting cancer of the cervix (the opening of the uterus), it will not detect ovarian cancer. During a pelvic exam, you should have both a Pap smear and a physical exam.
There are several ways for your doctor to take a closer look if a growth is discovered. You may be given an ultrasound test which uses sound waves to produce a sonogram, or a picture, of the ovaries. Several diagnostic tests involve the use of X-rays. In a CAT scan, for example, computer pictures of cross sections of the ovaries are created using X-ray images. In the intravenous pyelogram (IVP), the patient is given a dye to highlight the kidneys, ureter and bladder for X-ray. The lower GI series is an examination of the lower bowel using a barium enema to highlight the area for Xray.
The tests help identify the presence and location of a tumor. But to know whether or not a growth is cancerous requires examination of the tissue under a microscope.
If cancer is suspected, the tissue is sampled after removing the entire ovary. Removing only a sample is too risky, because cutting into the abnormal cells can cause the disease to spread. Once the ovary is removed, a tissue sample can safely be taken for microscopic examination. If cancer is found, the surgeon will probably recommend removal of the second ovary as well as the uterus and fallopian tubes. At the same time, samples of surrounding tissue will be taken to determine whether the disease has spread.
How to treat ovarian cancer
Surgery is almost always the first step in treating ovarian cancer. If additional treatment is prescribed, several options are available. In chemotherapy, a combination of drugs is injected into the bloodstream to kill the cancer cells. Radiation therapy directs high-energy rays to the diseased area to stop growth of cancer cells. In another procedure called intraperitoneal radiation, the patient’s abdomen and pelvis are bathed with a radioactive liquid using a thin tube. A new treatment called biological therapy strengthens the body’s immune system by introducing natural and laboratory-produced substances into the bloodstream.
Reactions to the treatment are very individual, but most women experience natural feelings of fear, depression and anger. You may want to talk to other women who have had ovarian cancer and your doctor can offer suggestions to help you cope with the physical side effects of cancer therapy.
Removal of the ovaries causes menopause to begin, if it has not already occurred. Symptoms normally experienced with menopause may be more pronounced after ovarian surgery; however, reducing symptoms by estrogen replacement is not advised for cancer patients.
Although reactions to chemotherapy vary, side effects may include nausea, appetite loss, vomiting, hair loss, kidney failure and a lowered resistance to infection. During radiation therapy, women feel a loss of energy, and sometimes experience nausea, vomiting, diarrhea, urinary discomfort and vaginal dryness. Reactions can be minimized through diet and adequate rest. The good news is that these side effects generally disappear once the treatments stop.
Can ovarian cancer be prevented?
The causes and prevention of this cancer have not yet been discovered. We do know, though, that some women are more likely than others to develop the disease. For example, women who have had breast cancer or whose family members have had ovarian cancer are considered to be at greater risk. If there is a history of ovarian cancer in your family (mother, grandmother, maternal aunt or sister), you should see your doctor to set up a screening program.
On the other hand, certain hormones produced during pregnancy appear to protect against the disease. Women who have had multiple pregnancies or who take oral contraceptives are less likely to develop ovarian cancer.
Early detection is important. Women should have thorough annual checkups, particularly after age 40. Also, new medical breakthroughs may occur at any time. Ovarian cancer is the subject of extensive research as scientists try to learn why it is caused, and how to better detect and treat it.