Understanding Ovarian Cancer

September is Ovarian Cancer awareness month. Ovarian cancer ranks fifth in cancer deaths among women, accounting for more deaths than any other cancer of the female reproductive system. A woman’s risk of getting ovarian cancer during her lifetime is about 1 in 73. Her lifetime chance of dying from ovarian cancer is about 1 in 100.

About half of the women who are diagnosed with ovarian cancer are 63 years or older. It is more common in white women than African-American women. Fortunately, through earlier detection and more advanced treatments, the rate at which women are diagnosed with ovarian cancer has been slowly falling over the past 20 years. However, that’s no reason to relax. The American Cancer Society estimates that approximately 22,000 women will receive a new diagnosis of ovarian cancer in 2014, and more than 14,000 will die from this disease.

What is ovarian cancer?

Ovarian cancer begins in the ovaries. Women have two ovaries, one on each side of the uterus. The ovaries — each about the size of an almond — produce eggs (ova) as well as the hormones estrogen, progesterone and testosterone.

Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. At this late stage, ovarian cancer is difficult to treat and is often fatal. Like most illnesses, the earlier it’s detected, the better your chances for leading a normal and longer life.

It’s not clear what causes ovarian cancer. In general, cancer begins when healthy cells acquire a genetic mutation that turns normal cells into abnormal cells. Healthy cells grow and multiply at a set rate, eventually dying at a set time. Cancer cells grow and multiply out of control, and they don’t die when they should. As abnormal cells accumulate, they form a mass (tumor). Cancer cells invade nearby tissues and can break off from an initial tumor to spread elsewhere in the body (metastasize).

The type of cell where the cancer begins determines the type of ovarian cancer you have. Ovarian cancer types include:

  • Cancer that begins in the cells on the outside of the ovaries. Called epithelial tumors, these cancers begin in the thin layer of tissue that covers the outside of the ovaries. Most ovarian cancers are epithelial tumors.
  • Cancer that begins in the egg-producing cells. Called germ cell tumors, these ovarian cancers tend to occur in younger women.
  • Cancer that begins in the hormone-producing cells. These cancers, called stromal tumors, begin in the ovarian tissue that produces the hormones estrogen, progesterone and testosterone.

Physicians diagnose ovarian cancer through pelvic examinations, the use of ultrasound scanning or by taking small tissue samples. The type of ovarian cancer you have helps determine your prognosis and treatment options.

Know ovarian cancer signs and symptoms

Researchers are studying ways to improve ovarian cancer treatment and looking into ways to detect ovarian cancer at an earlier stage — when a cure is more likely. Symptoms of ovarian cancer, however, are not specific to the disease, and they often mimic those of many other more-common conditions, including digestive problems.

Signs and symptoms of ovarian cancer may include:

  • Abdominal pressure, fullness, swelling or bloating
  • Pelvic discomfort or pain
  • Persistent indigestion, gas or nausea
  • Changes in bowel habits, such as constipation
  • Changes in bladder habits, including a frequent need to urinate
  • Loss of appetite or quickly feeling full
  • Increased abdominal girth or clothes fitting tighter around your waist
  • A persistent lack of energy
  • Low back pain

Make an appointment with your doctor if you or someone you know has any signs or symptoms that worry you. If you have a family history of ovarian cancer or breast cancer, talk to your doctor about your risk of ovarian cancer. In some cases, your doctor may refer you to a genetic counselor to discuss testing for certain gene mutations that increase your risk of breast and ovarian cancers.

Certain factors may increase your risk of ovarian cancer. Having one or more of these risk factors doesn’t mean that you’re sure to develop ovarian cancer, but your risk may be higher than that of the average woman. These risk factors include:

  • Inherited gene mutations, which can often be determined through genetic testing. 
  • Family history of ovarian cancer. If women in your family have been diagnosed with ovarian cancer, you have an increased risk of the disease.
  • A previous cancer diagnosis. If you’ve been diagnosed with cancer of the breast, colon, rectum or uterus, your risk of ovarian cancer is increased.
  • Increasing age. Your risk of ovarian cancer increases as you age. Ovarian cancer most often develops after menopause, though it can occur at any age.
  • Never having been pregnant. Women who have never been pregnant have an increased risk of ovarian cancer.

Overall, the best advice is to talk with your physician about your risks and to determine appropriate testing. Again, early detection is critical to increased survival, so remain diligent and encourage other women at risk to do the same!

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