Why Ovarian Cancer Is Called the Silent Killer

Many women don't have signs until it's too late

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Ovarian cancer is often called the "silent" killer because many times there are no symptoms until the disease has progressed to an advanced stage. One-third of American women will get some form of cancer in their lifetime and approximately 1 1/2 percent of those cases will be cancer involving one or both ovaries.

Early symptoms of ovarian cancer are often mild, making this disease difficult to detect.

Some early symptoms may include:

  • An unusual feeling of fullness or discomfort in the pelvic region
  • Unexplainable indigestion, gas or bloating that is not relieved with over-the-counter antacids
  • Pain during sexual intercourse
  • Abnormal bleeding
  • Swelling and pain of the abdomen

Most often these symptoms do not indicate ovarian cancer. However if you experience them, you should discuss them with your clinician.

Early detection of ovarian cancer offers a 90 percent cure rate. Sadly, a lack of symptoms from this silent disease means that about 75 percent of ovarian cancer cases will have spread to the abdomen by the time they are detected and, unfortunately, most patients die within five years.

Diagnosis

Symptomless ovarian cancer is most often detected during a woman's regular gynecological examination. Your physician will palpitate your ovaries during your pelvic and rectal exam for the presence of ovarian cysts or fibroid tumors.

If any abnormalities are noted, he will follow up with further testing which may include an ultrasound and chest X-ray. If further testing is required, a laparoscopy may be performed.

Methods for early screening of ovarian cancer include ultrasound in conjunction with a blood test. The blood test may detect a cancer protein called CA 125, which is sometimes detected in the blood of women with ovarian cancer.

These tests are useful in evaluating tumor growth, however neither of them has been proven as a reliable way to screen for ovarian cancer. Ultrasound can detect changes, but it does not give enough information alone to diagnose ovarian cancer.

The CA 125 blood test can return positive results when no cancer is present due to other conditions a woman may experience, including fibroid tumors, endometriosis, pelvic infection, pregnancy or other non-gynecological problems.

Treatment for Ovarian Cancer

The treatment for ovarian cancer varies according to a number of factors. For most women, the first treatment is also a diagnostic procedure which involves surgery to determine the extent to which the disease has spread. As a result of surgery, the cancer will be staged.

Stages range from I to IV, with I being the earliest and IV being the most advanced stage. Treatment of ovarian cancer is based on the stage and grade of the disease. A pathologist will determine the grade (how likely it is to spread) of the malignancy.

Hysterectomy with salpingo-oophorectomy (removal the fallopian tubes and one or both ovaries) will most often follow a diagnosis of ovarian cancer. Young women who still desire children and who have certain types of early ovarian cancer confined to one ovary may be able to have only the diseased ovary removed.

Chemotherapy or radiation will follow the hysterectomy based on individual cases.

Are You at Risk?

An immediate (mother, sister or daughter) family member who has had ovarian cancer increases your risk of developing this disease about three times, giving you a 5 to 7 percent risk of future ovarian cancer.

When the cause is genetic, ovarian cancer usually shows up a decade earlier in each successive generation. (If your mother had ovarian cancer in her 60s, you stand a good chance that this disease will develop in you in your 50s.)

Genetic counseling is a good idea for women with a family history of breast or ovarian cancers. Women with a family history may opt for oophorectomy, although this procedure does not offer absolute protection it does reduce risk by 75 to 90 percent.

Research has determined that women who use powders to dust their genital areas have a 60 percent higher risk of ovarian cancer. Feminine deodorant sprays can almost double your risk.

Women who use oral contraceptives for at least five years reduce their chance of developing ovarian cancer by half for the short-term following use and possibly for a lifetime. The longer you use the pill, the lower your risk.

Having two or three children can cut your risk by as much as 30 percent over women who never conceive or give birth. Having five or more children reduces the risk up to 50 percent, and breastfeeding your children can further reduce your risk.

Tubal ligation reduces a woman's risk up to 70 percent.

Remember, the best way to detect ovarian cancer is by regular pelvic examinations. See your gynecologist for a Pap smear (screens for cervical cancer only) and pelvic/rectal exam yearly or as your physician determines best for you.

Source:

Cancer of The Ovary. ACOG Education Pamphlet AP096. Accessed 08/26/09.

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