Ovarian Cancer Awareness, 9/27/10, Dr. Laura Williams & Dr. - NewsChannel5.com | Nashville News, Weather & Sports

Ovarian Cancer Awareness, 9/27/10, Dr. Laura Williams & Dr. John Wheelock


Laura Williams, MD: gynecologic oncologist
John Wheelock, MD: gynecologic oncologist
TOPIC: Ovarian Cancer Awareness
Monday, September 27, 2010

News notes via www.webmd.com

What is ovarian cancer?

Ovarian cancer happens when cells that are not normal grow in one or both of your ovaries. This topic is about epithelial ovarian cancer, the most common type.

This cancer is often cured when it is caught early. But most of the time, the cancer has already spread by the time it is found.

It is frightening to hear that you or someone you love may have ovarian cancer. It may help to talk with your doctor or join a support group to deal with your feelings.

What causes ovarian cancer?

Experts do not know exactly what causes ovarian cancer. But they do know that DNA changes play a role in many cancers.

Some women are more likely than others to get this rare cancer. Women who are past menopause or who have never been pregnant are more likely to get ovarian cancer.

What are the symptoms?

In some cases, ovarian cancer may not cause early symptoms. But most women do have symptoms, even in early-stage ovarian cancer. These symptoms include recent, frequent bloating; pain in the belly or pelvis; difficulty eating or feeling full quickly; or urinary problems, such as an urgent need to urinate or urinating more often than usual.

Other symptoms that women with ovarian cancer may have include fatigue, indigestion, back pain, pain with intercourse, constipation, and changes in their menstrual cycles. But these symptoms are also common in women who don't have ovarian cancer.

How is ovarian cancer diagnosed?

Sometimes the doctor may feel a lump in or on an ovary during a routine pelvic exam. Often a lump may be seen during an ultrasound. Most lumps are not cancer.

The only way to know for sure that a woman has ovarian cancer is with biopsies taken during surgery. The doctor makes a cut (incision) in the belly so that he or she can look inside. The doctor will remove bits of any tumors that are found and send them to a lab to confirm that they contain cancer.

There is a blood test called CA-125 (cancer antigen 125) that is sometimes done to look for cancer in women at high risk. So far, there is not enough proof to show that this test works to find ovarian cancer early in most women. Too much CA-125 in the blood can be caused by many things, such as the menstrual cycle, endometriosis, and uterine fibroids, as well as many types of cancer.

How is it treated?

Surgery is the main treatment. The doctor will remove any tumors that he or she can see. This usually means taking out one or both ovaries. It may also mean taking out the fallopian tubes and uterus. After surgery, most women have several months of chemotherapy, which means taking drugs that kill cancer cells.

This cancer often comes back after treatment. So you will need regular checkups for the rest of your life. If your cancer does come back, treatment may help you feel better and live longer.

Ovarian cancer is very serious, but many women do survive it. It depends on your age and overall health, how far the cancer has spread, and how much cancer is left behind during surgery.

It may help to talk to other women who are going through the same thing. People who take part in support groups usually feel better, sleep better, and feel more like eating. Your doctor or your local branch of the American Cancer Society can help you find a support group. You can also look on the Internet to find support sites where women with this cancer can talk to each other.

What are your chances of getting ovarian cancer?

This cancer most often affects women who are past menopause. Women are more likely to get ovarian cancer if others in their family have had it. They are more likely to get it if they have had breast cancer.

You may also be more likely to get this cancer if:

What Increases Your Risk

Risk factors for ovarian cancer include:

  • A family history. Between 10% and 20% of women with ovarian cancer have a close female relative who had ovarian or breast cancer.1 Women with a family history may develop ovarian cancer at an earlier age, such as in their 40s, rather than at the more typical age of postmenopausal women in their 50s. Women who have BRCA1 or BRCA2 gene mutations have between a 16% and 60% chance of developing ovarian cancer during their lifetimes.6
  • Increasing age. Ovarian cancer most often affects postmenopausal women.
  • Never having a baby.
  • Starting menstrual cycles before age 12 and going through menopause at an older age. The more menstrual cycles you have, the more risk you have for ovarian cancer.
  • Being unable to become pregnant (infertility). Women who do not use birth control and are sexually active but who are unable to become pregnant may have a higher chance for ovarian cancer.
  • Use of estrogen or hormone replacement therapy. Some studies have shown that some women who use these hormones have a slightly increased risk of developing ovarian cancer, and other studies have shown no increased risk.7, 8, 9 In general, experts advise women considering hormone replacement therapy for symptoms of menopause to take the smallest dose possible to control symptoms, and to take the medicine for the shortest time that they can.
  • Women who are of Ashkenazi Jewish ancestry (Jews whose ancestors came from Eastern Europe) may have an increased risk because of changes to the BRCA1 or BRCA2 genes. Women with this ancestry have higher rates of these gene changes.
  • Polycystic ovary syndrome (PCOS). Elevated levels of male hormones (androgens) commonly found in PCOS may increase your risk for ovarian cancer.10
  • A history of breast cancer. Women with a personal history of breast cancer or a family history of breast cancer have a higher risk for ovarian cancer.

When To Call a Doctor

In some cases, ovarian cancer may not cause early symptoms. But most women do have symptoms, even in the early stages. These symptoms may be caused by other problems. But if you have one or more of the following symptoms, and it occurs almost daily for more than 2 or 3 weeks, talk to your doctor:

  • Recent, frequent bloating.
  • Pain in your belly or pelvis.
  • Difficulty eating or feeling full quickly.
  • Urinary problems, such as feeling an urgent need to urinate or urinating more often than usual.

These symptoms may be common for some women, and they may not mean that you have ovarian cancer. But the early symptoms of ovarian cancer follow a specific pattern:

  • They start suddenly.
  • They feel different than your normal digestive or menstrual problems.
  • They happen almost every day and don't go away.

The symptoms may not seem bad enough for a woman to seek medical care. But getting medical care right away may help find ovarian cancer at an early stage. A woman has a better chance of successful treatment when ovarian cancer is found early.

Watchful Waiting

Watchful waiting is a period of time during which you and your doctor observe your condition or symptoms without using medical treatment. Watchful waiting is not appropriate if you have symptoms that do not go away. If you are concerned about your symptoms and you have a higher risk for ovarian cancer, call and make an appointment with your doctor.

Who To See

Health professionals who can evaluate your symptoms and your risk for ovarian cancer include:

Doctors who manage your cancer treatment include:

  • Gynecologic oncologist. Your long-term outcome (prognosis) is improved if you are under the care of an experienced gynecologic oncologist. His or her expertise can help determine the best treatment choices at the time of the initial surgery.4
  • Medical oncologist (often called an "oncologist").


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