As I was talking to my patient the other day, she recalled how she had ignored her lower abdominal discomfort for several months and attributed it to changes in her diet. When she finally sought attention of her family doctor, multiple tests were performed including a pelvic exam and a CT scan which revealed presence of an ovarian cancer.
This is not an uncommon story. Since ovaries are hidden down in the pelvis, ovarian cancer can unfortunately go unnoticed for a long time without causing symptoms. Also, symptoms may be vague such as abdominal discomfort or distention, frequent urination, loss of appetite, nausea, unexplained weight loss or weight gain.
I often emphasize to my patients the importance of a yearly pelvic examination which can find an enlarged ovary. You should promptly notify your doctor if you are experiencing a new symptom that has been persistent for several days.
Ovarian cancer occurs more frequently in women older than 60. It is the ninth most common cancer (other than skin cancer) and the fifth leading cause of cancer death in women in the US. For unclear reasons, it is more common in Caucasian than African American women.
Ovarian cancer can be diagnosed by pelvic ultrasound or other scans such as a CT scan of the abdomen and pelvis. It may also be detected by a blood test called CA-125 which is a protein made by ovarian cancer cells. CA-125 is a tumor marker that may be elevated in women with ovarian cancer and it is a useful marker to monitor during and after treatments. However, CA-125 level is not a reliable test for diagnosis of ovarian cancer since it can be elevated in women without ovarian cancer and some women with ovarian cancer may have a normal CA-125 level.
Treatment of ovarian cancer involves surgery with removal of the affected ovary and usually includes removing the uterus, tubes, both ovaries and other sites of visible cancer spread within the abdomen. Studies have shown that women with ovarian cancer have better chances of survival and cure if the largest possible amount of cancer is surgically removed. This may be followed by chemotherapy treatments.
I am often asked if there is anything one can do to lower their risk of developing cancer. Many cancers are associated with risk factors which can be lowered by lifestyle changes. Risk of developing ovarian cancer is higher in women who are obese, who have never been pregnant, those on estrogen supplements, family history of breast or ovarian cancer and in women consuming diets rich in animal fats. Smoking increases risk of certain ovarian cancers.
A woman can lower her risk of developing ovarian cancer by smoking cessation, maintaining a healthy body weight through regular exercise as well cutting back on diets rich in animal fats and consuming more fruits and vegetables. While we cannot change our genetics, removing ovaries can be protective in women with a positive genetic test. Lastly, don’t delay scheduling your yearly pelvic examination since this can help with detection of ovarian as well as other cancers of the female genital tract.
Priya Rudolph, MD, PhD
Dr. Priya Rudolph, a graduate from Yale University is an experienced hematologist/oncologist with Georgia Cancer Specialists (www.gacancer.com). She has offices in Athens (ph 706-369-4478) and at the Cowles Clinic in Greensboro (Ph 706 454-0159). Georgia Cancer Specialists is a top 10 privately owned practice and is a national leader in advanced cancer treatment and research. Its physicians and staff offer many clinical trials and state of the art personalized care to each individual patient.