Ovarian Cancer

Statistics

Ovarian cancer is a type of cancer that develops in the ovaries. It is the seventh most common cancer in women worldwide, and it is the fifth most common cancer for women in the United States and the United Kingdom.1,2,3 Statistically, white women are the most likely to develop ovarian cancer, while black women are the least likely. The cancer likelihood of other races falls somewhere in between. Ovarian cancer is almost twice as common in industrialized countries as it is in less developed countries. Among European nations, Latvia has the highest incidence of ovarian cancer while Portugal has the lowest.1 Ovarian cancer is most common in older women, with 65 being the median age of diagnosis.2

Ovarian cancer is often called a “silent killer” because it is asymptomatic in its early stages, and even its later-stage symptoms are vague and easily attributed to other conditions.

Symptoms

Ovarian cancer may produce the following symptoms:

  • Bloating
  • Loss of appetite or quickly feeling full
  • Urinary symptoms, such as urgency or frequency
  • Pelvic or abdominal pain
  • Fatigue
  • Back pain
  • Upset stomach
  • Pain during sex
  • Constipation
  • Menstrual changes
  • Abdominal swelling coupled with weight loss
  • Ovarian cysts

While each of these symptoms could indicate a number of different conditions, they tend to be more persistent when a female has ovarian cancer. They also tend to represent a change from the afflicted individual's normal condition.4 For example, a woman who already experiences persistent bloating might find her bloating more intense or frequent than usual.

Risk Factors

The following are risk factors for the development of ovarian cancer:

  • Early onset of menstruation (before age 12)
  • Late menopause (after age 55)
  • Obesity
  • Prolonged hormone replacement therapy
  • Old age
  • Family history of the disease2

Prevention

While women with a family history of the disease can seek out testing for the presence of cancer-causing genes, there is currently no effective way of screening early ovarian cancer.2 There are a few interesting ways, however, that women can reduce their risk. Keeping a low-fat diet is perhaps the most straightforward method, although having children can also reduce the risk. Breastfeeding children can reduce the risk of ovarian cancer even further.5 Taking hormonal contraceptives (such as the birth control pill) for at least five years can decrease the risk by about 60%.2

Detection

For mid-to-late stage ovarian cancer, there are a number of ways to detect the presence and progress of the malignant mass. A doctor may perform a standard pelvic exam on a suspected cancer patient, although such exams should be part of every woman's regular health checkups. To perform the exam, the doctor must place one or two fingers inside of the female's vagina and place another finger on her abdomen in order to feel the shape, size, and position of her ovaries. For a more advanced version of this test, the doctor may instead insert an ultrasound probe, which uses echoing sound waves to construct a digital image of the woman's pelvic interior.6 The doctor may also construct a digital image using either a CT (Computed Tomography) scan or an MRI (Magnetic Resonance Imaging) machine. Both of these machines are used to scan the woman's body from the outside, and therefore do not require vaginal insertion. There is also a blood test that can detect levels of CA-125, a protein commonly found in cancerous cells. This test is not particularly accurate, however, given the fact that high CA-125 levels can also be caused by uterine fibroids, liver disease, inflamed fallopian tubes, and other types of cancer. Therefore, the blood test is often coupled with at least one of the methods described above.

Treatment

Treatment for ovarian cancer generally involves surgery to remove as much of the tumorous tissue as possible, as well as chemotherapy, hormone therapy, or radiation therapy to eliminate remaining cancer cells.7 

Once detected, most instances of ovarian cancer have spread too far throughout the body for any treatment to be effective. About half of women diagnosed with ovarian cancer survive beyond five years.2

 

If exams indicate that the woman has localized or early ovarian cancer (meaning that the cancer is contained within the pelvic area), the surgeon will probably remove the fallopian tubes, ovaries, and the uterus. This method is the most likely effective in preventing recurrence of ovarian cancer. In addition, the doctor will take samples from other areas of the body as part of a staging procedure. If a woman strongly desires to remain fertile, it may be possible to retain the uterus, one of the ovaries, and the unaffected fallopian tube. When ovarian cancer is advanced or widespread, however, more extensive surgery is necessary, and a woman would most likely undergo radical debunking. This procedure requires a partial removal of the uterus, ovaries, fallopian tubes, possibly the rectum, and part of the large colon. Occasionally, segments of the small intestine or the diaphragm must be removed.8

Sexual Difficulties

Survivors of ovarian cancer may encounter sexual difficulties during the disease and after. The physical and psychological stress of fighting cancer may inhibit a woman's libido, and the changes in her appearance (such as hair and weight loss) may harm her self-esteem. Decreases in estrogen, temporary or permanent, may decrease the vagina's natural lubrication and cause the vaginal walls to thin out, in which case the cancer patient may want to consider using an artificial lubricant. There are many support groups for ovarian cancer and other types of cancer. The best thing a cancer patient can do is communicate her needs with her partner and her support network, and remember that it is possible to return to an active, fulfilling sex life if they so desire.9

References

  1. "Ovarian Cancer Incidence Statistics." Cancer Research UK. Cancer Research UK, 23 Apr. 2014. Web. 19 May 2014.
  2. LeVay, Simon, Janice I. Baldwin, and John D. Baldwin. Discovering Human Sexuality. 2nd ed. Sunderland, MA: Sinauer Associates, 2012. Print.
  3. "Ovarian Cancer." World Cancer Research Fund. World Cancer Research Fund International. Web. 19 May 2014.
  4. "How Is Ovarian Cancer Diagnosed?" American Cancer Society. American Cancer Society, 6 Feb. 2014. Web. 19 May 2014.
  5. "What Are the Risk Factors for Ovarian Cancer?" American Cancer Society. American Cancer Society, 6 Feb. 2014. Web. 19 May 2014.
  6. "Detection." Ovarian Cancer National Alliance. Ovarian Cancer National Alliance, Web. 03 June 2014.
  7. "How Is Ovarian Cancer Treated?" American Cancer Society. American Cancer Society, 6 Feb. 2014. Web. 19 May 2014.
  8. "Surgery for Ovarian Cancer." American Cancer Society. American Cancer Society. Web. 06 Feb. 2014.
  9. "Sexual Side Effects." NOCC: National Ovarian Cancer Coalition. National Ovarian Cancer Coalition. Web. 19 May 2014.

Last Updated 26 June 2014.

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