ovarian cancer targets one in seventy women

Every year there are about 22,000 new cases of ovary cancer diagnosed in the United States and about 15,000 related deaths.

Statistically 1 in every 70 women will develop the disease at some time in her life, with half of those cases occurring after the age of 65.

Symptoms

Symptoms

Current research indicates that ovarian cancer is NOT a silent disease. It is a disease that can often be confused with other more common conditions such as ulcers, diverticular disease, endometriosis, ovarian cysts, and inflammatory diseases. Nearly 95 percent of women will experience one or more of the following 4 problems:

  • Pelvic or abdominal pain.
  • An increase in the size of the abdomen or persistent bloating.
  • The need to urinate more frequently or urgently.
  • Feeling fully quickly even after a light meal.

 

The following are also signs which should be noted if they are not usual for you:

  • Excess gas and indigestion
  • Unexplained weight gain or loss
  • Irregular periods and menstrual cycles
  • Vaginal bleeding that is not part of a menstrual cycle
  • Painful intercourse
  • Back Pain which seems to worsen over time
  • Nausea, vomiting or indigestion
  • Changes in bowel habits: diarrhea or constipation
  • Excessive fatigue which may be mistaken as Chronic Fatigue Syndrome
  • A vague feeling of discomfort in the pelvic region
  • Excessive hair growth
Diagnosis

Diagnosis

Your gynecoloical oncologist will take a full medical history; carry out another physical examination and Pap smear test to rule out other female cancers. The rest of the diagnostic procedure (work-up) will depend on the woman’s age, symptoms and condition of health. Tests may include:

  • CA125 tumor marker blood test
  • Bhcg, CEA, inhibin A and B, Alphafetal protein, and LDH
  • Chest X-rays
  • Ultrasound of abdomen or pelvis
  • Colonoscopy or barium enema to rule out colon cancer
  • Mammogram to rule out breast cancer
  • CT or PET-CT scans
Treatment

Treatment

The main ovarian cancer treatment options are surgery, and systemic chemotherapy. Radiation therapy is rarely used.

Surgery is usually the first choice, and, according to the stage of the disease, chemotherapy may also be offered.

Rarely, if the cancer is quite advanced at presentation or if the patient is too medically frail to undergo surgery first, chemotherapy will be given before surgery to shrink the tumors. This is called neoadjuvant chemotherapy.

Click here to read the article: “Advanced ovarian cancer: what should be the standard of care?” by Barbara A. Goff  in the Journal of Gynecological Oncology, January 8, 2013.

Surgery

In general, an open laparotomy is performed to determine the size and extent of the tumor. If there are any signs of fluid collection, a sample will be sent to the lab for testing.

In general, surgery will involve a complete hysterectomy, along with removal of both ovaries and fallopian tubes which will make a women menopausal if she was not previously.

Possibly the pelvic and aortic lymph nodes will also be removed. Cell samples may also be ‘washed’ from the abdominal and pelvic areas. A fat pad called the omentum will be removed to test for signs of cancer spread. In most cases, surgery will be followed by chemotherapy.

If ovarian cancer is more extensive, it may require tissues from surrounding organs to be removed, such as parts of the urinary and gastrointestinal tract. Removing as much of the cancerous tissue as possible improves the woman’s long-term ovarian cancer survival rate. This initial surgical attempt to remove as much visible tumor as possible is called a debulking surgery.

In special cases, if the woman is young and wants to retain her childbearing abilities this may be possible if cancer is limited to one ovary. The uterus and other organs may be left intact if the case allows this.