The Silent Killer: Identifying and Understanding Ovarian Cancer
Currently, there is no screening test reliable enough to detect early ovarian cancer. There were more than 20,000 new cases of ovarian cancer and 15,000 related deaths in the United States in 2008.
The symptoms of ovarian cancer include:
- Pelvic or abdominal pain
- Difficulty eating (or feeling full quickly)
- Urinary symptoms such as urgency or frequency
Women with ovarian cancer report that these symptoms are present for more than a few weeks and are a change from their normal health.
Although the exact cause of ovarian cancer is not known, several risk factors are associated with an increased chance of developing the disease. These include:
- A family history of breast and/or ovarian cancer
- A personal history of breast, uterine, or colon cancer
- Carrying a mutation in the genes called BRCA1 or BRCA2
- Being 55 years or older
- Infertility and/or not having been pregnant
- Having endometriosis
- Having estrogen hormone therapy for 10 or more years
It is important to note that most women who have risk factors do not get ovarian cancer. Also, having a risk factor does not necessarily mean a woman will develop ovarian cancer.
Diagnosis, Staging, and Treatment
Ovarian cancer is most often diagnosed through a physical exam, pelvic imaging, and a blood test called CA-125. Once ovarian cancer is suspected, surgery is performed to confirm and treat the cancer.
The stage of the cancer is defined by how far it has spread at diagnosis. The stage of the cancer often determines how well the woman will do in recovery.
- Stage I cancer has not spread outside the ovary.
- Stage II cancer is confined to the pelvis.
- Stage III cancer has spread within the abdominal cavity.
- Stage IV cancer has spread to distant sites within the body.
The treatment of ovarian cancer depends on the stage at diagnosis. The usual treatment consists of surgery to remove the ovaries and any cancer that has spread outside the ovaries. The goal is to remove all the cancer. Following surgery, most women receive chemotherapy to treat any remaining cancer.
Stage I and II ovarian cancers, when treated with surgery and chemotherapy, have a cure rate approaching 95 percent. More than 75 percent of women are diagnosed at Stage III or IV, however, when the cure rate is less than 25 percent.
Finding a Gynecologic Oncologist
Women with ovarian cancer should seek out a gynecologic oncologist—a physician with specialty training in comprehensive care of female reproductive cancers. Gynecologic oncologists are better at removing cancer during the initial surgery and four times more likely to accurately determine the stage of the cancer during the surgical procedure; most importantly, they provide care that results in a 10 to 25 percent increase in survival for women with ovarian cancer.
Patricia L. Judson, MD, is an associate professor at the University of Minnesota. She specializes in obstetrics, gynecology, and women’s health and has a subspecialty in gynecologic oncology. She is the gynecologic oncology fellowship director at the University of Minnesota and the director of gynecologic oncology at North Memorial Medical Center in Robbinsdale, Minnesota. Dr. Judson’s research interests include clinical trials in all gynecologic cancers, with an emphasis on complementary and alternative medicine. She is the principal investigator for the Gynecologic Oncology Group and the Sime Research Fellow for the Center for Spirituality & Healing.
In each issue of Women, the Gynecologic Oncology Group (GOG)—a national nonprofit organization dedicated to promoting excellence in the quality and the integrity of clinical and basic scientific research in the field of gynecologic malignancies—offers answers to important questions concerning gynecologic oncology. For more information visit www.gog.org.