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Gynecologic Cancer Awareness Month: Ovarian Cancer

Ovarian cancer is a sneaky cancer and thus represents a formidable adversary. This cancer originates in the ovaries but also includes cancers originating from the fallopian tubes and peritoneum.

The fallopian tubes are a pair of tubes along which eggs travel from the ovaries to the uterus. The peritoneum is a membrane that makes up the inside and surface lining of hollow organs.

According to the American Cancer Society, ovarian cancer is the leading cause of death from gynecological cancer and the fifth most common cause of cancer-related deaths in females in the U.S. An estimated 19,710 cases are expected to be diagnosed in 2023 with 13,270 expected deaths from this cancer.

Risk factors

Risk factors for ovarian cancer remain elusive, but some have been identified — a family history of ovarian or breast cancer, specific gene mutations (BRCA1 and BRCA2), age, obesity, and history of infertility or never being pregnant. Hormone replacement therapy or pelvic inflammatory disease also are known to increase ovarian cancer risk.

Symptoms

Due to the location of the ovaries, symptoms of ovarian cancer can be very subtle. Recognizing them is crucial for early intervention. Symptoms may include abdominal bloating, pelvic pain, changes in bowel habits, frequent urination, and unexplained weight loss or getting full quickly. Given the vague nature of these symptoms, they can be easily overlooked or attributed to other conditions. Heightened awareness is essential.

Screening for ovarian cancer in the average woman without any symptoms is currently not recommended, as it has not resulted in improvement in ovarian cancer-related deaths. Blood tests, one of which is called CA 125, and a sonogram of the ovary can be done for detection when necessary.

Prevention strategies include surgery to remove the ovaries and fallopian tubes but are recommended only for those women with BRCA1 or BRCA2 mutations. These women are considered at risk of developing ovarian, breast or other cancers. Surgery to prevent ovarian cancer can result in the detection of very early-stage ovarian cancer in some women.

Staging and treatment

Ovarian cancer progresses through stages and is classified as stages I to IV. Fallopian tube and peritoneal cancers are staged the same way. Treatment approaches vary based on the stage and individual patient factors.

  • Surgery is a cornerstone, aiming to remove the tumor and affected tissue.
  • Most women other than ones with stage 1 cancer require chemotherapy. Sometimes chemotherapy may be given before surgery to shrink the cancerous cells.
  • Other options for the treatment include targeted therapy, and immunotherapy that are employed to target cancer cells and prevent recurrence.

Clinical trials offer cutting-edge options, showcasing the evolving landscape of ovarian cancer treatment.

Support networks and coping mechanisms are vital for patients and caregivers navigating the ovarian cancer journey.

Ovarian cancer and fertility

Ovarian cancer treatments can affect fertility, prompting discussions about preserving reproductive options before embarking on therapy. Fertility preservation methods such as egg freezing provide hope for building families after treatment. Surgical techniques can be modified for those wishing to preserve fertility and those with very early-stage cancer.

When to call your doctor

If you have symptoms of abdominal bloating, discomfort, unexplained weight loss or other concerning symptoms you should consult with a health care provider promptly.

You can also discuss genetic testing if you have family members diagnosed with ovarian or breast cancer at a young age or have multiple family members with breast or ovarian cancer.

It is important to eat a healthy diet, exercise regularly and quit smoking to protect your health.

Learn more about ovarian cancer care at Northside.

Additional References:
  • Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022 Jan;72(1):7-33. doi: 10.3322/caac.21708. Epub 2022 Jan 12.
  • Jelovac D, Armstrong DK. Recent progress in the diagnosis and treatment of ovarian cancer. CA Cancer J Clin. 2011 May-Jun;61(3):183-203. doi: 10.3322/caac.20113. Epub 2011 Apr 26.
  • Goff BA, Mandel LS, Drescher CW, et al. Development of an ovarian cancer symptom index: possibilities for earlier detection. Cancer. 2007 Jan 15;109(2):221-7. doi: 10.1002/cncr.22371.
  • Machetti C, De Felice F, Perniola G, et al. Screening program in ovarian cancer: A logical step in clinical management? A meta-analysis. Curr Probl Cancer. 2018 Mar-Apr;42(2):235-240. doi: 10.1016/j.currproblcancer.2017.12.005. Epub 2018 Jan 5.
  • Eleje GU, Eke AC, Ezebialu IU, et al. Risk-reducing bilateral salpingo-oophorectomy in women with BRCA1 or BRCA2 mutations. Cochrane Database Syst Rev. 2018 Aug 24;8(8):CD012464. doi: 10.1002/14651858.CD012464.pub2.
 

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Dr. Kumud Rangaraj

Specialties: Oncology, Hematology

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Dr. Rangaraj is a board-certified hematologist and medical oncologist specialist. Her clinical interests include breast, gynecological, lung, gastrointestinal, and head and neck cancers, as well as blood cancer and hematologic disorders. 

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