October 6, 2008

Early Detection Improves Chances of Surviving Ovarian Cancer


As ovarian cancer awareness month comes to a close, it's critical to keep in mind all year the importance of early detection.

Ovarian cancer is the leading cause of death from gynecologic cancers in the United States and is the fifth leading cause of cancer death among U.S. women. A woman's lifetime risk of ovarian cancer is 1 in 67.

The American Cancer Society estimates that 21,650 women will be diagnosed with ovarian cancer in the U.S. in 2008 and about 15,520 women will die from the disease. It is an insidious disease that can strike without warning or cause.

The symptoms of ovarian cancer are often vague, making it difficult to diagnose. But there are tests which can detect ovarian cancer when patients are at high risk or have early symptoms.

In spite of this, patients are usually diagnosed in advanced stages and only 45 percent survive longer than five years. Only 19 percent of cases are caught before the cancer has spread beyond the ovary to the pelvic region. However, when ovarian cancer is detected and treated early on, the five-year survival rate is greater than 92 percent.

Until we have better early detection tools, all women should be educated about the disease. Listen to your body. Do not ignore signs and symptoms which include:

Vague but persistent and unexplained gastrointestinal complaints such as gas, nausea and indigestion;

Abdominal bloating, pelvic and/or abdominal pain, and/or feeling of fullness;

Unexplained change in bowel habits (constipation or diarrhea);

Unexplained weight gain or loss;

Frequency and/or urgency of urination;

Unusual fatigue;

Shortness of breath;

New and unexplained abnormal postmenopausal vaginal bleeding.

The risk for ovarian cancer increases with age, with the highest occurrence in women over 50 years old. A family or personal history of ovarian, breast, endometrial or colon cancer can also increase risk. Other risks include uninterrupted ovulation (having no pregnancies; infertility, low parity) and the presence of gene mutations, especially BRCA1 or BRCA 2.

There are a number of preventive and risk reduction measures. The use of oral contraceptives for more than five years can reduce your risk by approximately 50 percent. Multiple pregnancies, having the first full-term pregnancy before the age of 25 and breast feeding can also reduce risk.

Additionally, hysterectomy/tubal ligation substantially reduce the risk of ovarian cancer, as does the removal of the ovaries and fallopian tubes (oopherectomy).

If you are concerned about your risk of ovarian cancer or have symptoms, speak to your gynecologist and have an examination.

Ovarian cancer is diagnosed through a pelvic examination that allows the ovaries to be examined from many sides. Every woman should undergo a rectal and vaginal pelvic examination at her annual check up with her gynecologist.

A transvaginal ultrasound uses sound waves to create a picture of the ovaries, and can often reveal if there are masses or irregularities on the surface of the ovaries. It cannot determine if you have cancer but it can show characteristics that give different levels of suspicion.

Also, blood tests measure the level of a substance in the blood that may increase when a cancerous tumor is present.

It's important to note that none of these tests is definitive when used on their own and are most effective when used in combination with each other. The only way to confirm the presence of ovarian cancer suspected by the above tests is through surgical biopsy of the tumor tissue.

To find more information and help about ovarian cancer, contact the Ovarian Cancer Research Fund at (800) 873-9569 or www.tulsaworld.com/ovarian.

Dr. Regina Lewis is director of Oklahoma State University Women's Health Center.

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