Facts and Information
Symptoms do exist:
Bloating, pelvic or abdominal pain, difficulty eating, feeling full quickly, and frequent or urgent urinating are shown to be more common in women with ovarian cancer. These are vague symptoms and often mistaken for gastrointestinal problems. But if they persist for several days, get checked out by your gynecologist. "You can explain away these symptoms to yourself. But the only way to be sure it's nothing is to go get a pelvic exam," says J. Rebecca Liu, M.D., a gynecologic oncologist at the U-M Comprehensive Cancer Center.
There is no screening test for ovarian cancer, like a Pap smear or mammogram. The CA125 blood test measures the amount of a certain protein that's often elevated with ovarian cancer. But the test is not foolproof. "There are a lot of benign conditions that can cause higher levels of CA125," Liu says. Early detection is a key area of research. U-M researchers are looking for markers in the blood that indicate ovarian cancer, an approach that could in time lead to a blood test to screen for ovarian cancer.
All women need yearly pelvic exams. Maybe your doctor says you don't need a Pap smear every year, but Pap tests just check for cervical abnormalities. A pelvic exam is not the same thing. In particular, older women should not discontinue their yearly gynecology visit as ovarian cancer is more likely to occur in women older than 60. "A pelvic exam is key because it's the best screening we have right now," Liu says.
Survival rates are significantly better when ovarian cancer is diagnosed in an early stage. With stage I ovarian cancer, the earliest stage, 95% of women are alive five years after diagnosis. Only 30% of women with stage III or IV ovarian cancer survive five years. Some 70% of women have advanced disease when they are diagnosed.
Ovarian cancer is difficult to treat because it's often resistant to current treatments. It may respond to chemotherapy drugs initially, but when it recurs -- which it usually does -- the cells will no longer be killed by that drug. Researchers are focusing on new molecularly targeted therapies that hone in on and destroy the cancer cells, and they hope this will overcome the resistance.
It's most common in older white women. Most patients are older than 60 and post-menopausal. Women who have not had children are at higher risk. Women who have taken birth control for a number of years lower their risk.
A small number of ovarian cancers are hereditary. It's linked to the same genes that are linked to breast cancer, BRCA1 and BRCA2. If ovarian cancer runs in your family, particularly on your mother's side, and if family members were diagnosed at a young age, you might consider genetic testing.
The best person to treat ovarian cancer is a gynecologic oncologist. These specialists are skilled in the comprehensive management of female reproductive cancers, including surgery and chemotherapy. Studies have shown gynecologic oncologists are two to three times more likely to provide surgical care consistent with national guidelines. Women with ovarian cancer treated by gynecologic oncologists have 10% to 25% better survival rates than women treated by general oncologists or gynecologists. While your regular gynecologist can perform diagnostic tests, if you are diagnosed with ovarian cancer, you should see a gynecologic oncologist.
Source: Ovarian cancer: The not-so-silent killer
What is Ovarian Cancer?
Ovarian cancer is a growth of abnormal malignant cells that begins in the ovaries. Ovarian cancer is the seventh most common cancer among women.
There are three types of ovarian cancer:
- Epithelial ovarian cancer is the most common and accounts for 85% to 89% of ovarian cancers. It forms on the surface
of the ovary in the epithelial cells.
- Germ cell cancer is an uncommon form of ovarian cancer, accounting for only about 5% of ovarian cancers. Germ cell cancers
start in the cells that form the eggs in the ovaries. This cancer is usually found in adolescent girls and young women, and usually affects
only one ovary
- Equally rare, stromal cell cancer starts in the cells that produce female hormones and hold the ovarian tissues together.
Source: Gynecologic Cancer Foundation - 
Understanding
Ovarian Cancer [pdf].
News
U-M News
Cancer stem cells recruit normal stem cells to fuel ovarian cancer, U-M study finds
Study pries into ovarian cancer's deadly secrets
Researchers identify ovarian cancer biomarkers
Ginger causes ovarian cancer cells to die, U-M researchers find
National News (American Cancer Society)
Risk Factors
A risk factor is something that may increase the chance of developing a disease. But risk factors don't tell us everything. Having a risk factor, or even several risk factors, does not mean that you will get the disease. And many people who get the disease may not have had any known risk factors.
The following risk factors may increase the risk of ovarian cancer:
Age
The risk of developing ovarian cancer gets higher with age. Ovarian cancer is rare in women younger than 40. Most ovarian cancers develop after
menopause. Half of all ovarian cancers are found in women over the age of 63.
Obesity
Various studies have looked at the relationship of obesity and ovarian cancer. Overall, it seems that obese women (those with a body mass
index of at least 30) have a higher risk of developing ovarian cancer.
Reproductive history
A woman who has had children has a lower risk of ovarian cancer than women who have no children. The risk goes down with each pregnancy. Breast
feeding may lower the risk even further. Using oral contraceptives (also known as birth control pills or "the pill') significantly lowers the
risk of ovarian cancer if taken for longer than 5 years.
Gynecologic surgery
Tubal ligation (having your "tubes tied") may reduce the chance of developing ovarian cancer by up to 67%. A hysterectomy (removing the uterus
without removing the ovaries) also seems to reduce the risk of getting ovarian cancer by about one-third.
Fertility drugs
In some studies, researchers have found that using the fertility drug clomiphene citrate (ClomidŽ) for longer than one year may increase the risk
for developing ovarian tumors. The risk seemed to be highest in women who did not get pregnant while on this drug. If you are taking fertility
drugs, you should discuss the potential risks with your doctor. However, women who are infertile may be at higher risk (compared to fertile women)
even if they don't use fertility drugs. This may be in part because they haven't had children or used birth control pills (which are protective).
More research to clarify these relationships is now underway.
Androgens
Androgens are male hormones. Danazol, a drug that increases androgen levels, was linked to an increased risk of ovarian cancer in a small study.
In a larger study, this link was not confirmed, but women who took androgens were found to have a higher risk of ovarian cancer. Further studies
of the role of androgens in ovarian cancer are planned.
Estrogen therapy and hormone therapy
Some recent studies suggest women using estrogens after menopause have an increased risk of developing ovarian cancer. The risk seems to be higher
in women taking estrogen alone (without progesterone) for many years (at least 5 or 10). The increased risk is less certain for women taking both
estrogen and progesterone.
Family history of ovarian cancer, breast cancer, or colorectal cancer
Ovarian cancer can run in families. Your ovarian cancer risk is increased if your mother, sister, or daughter has (or has had) ovarian cancer. The
risk also gets higher the more relatives you have with ovarian cancer. Increased risk for ovarian cancer does not have to come from your mother's
side of the family -- it can also come from your father's side. Up to 10% of ovarian cancers result from an inherited tendency to develop the
disease. Genetic counseling, genetic testing, and strategies for preventing ovarian cancer in women with an increased familial risk.
Personal history of breast cancer
If you have had breast cancer, you may also have an increased risk of developing ovarian cancer. There are several reasons for this. Some of the
reproductive risk factors for ovarian cancer may also affect breast cancer risk. The risk of ovarian cancer after breast cancer is highest in
those women with a family history of breast cancer. A strong family history of breast cancer may be caused by an inherited mutation in the BRCA1
or BRCA2 genes. These mutations can also cause ovarian cancer.
Source: American Cancer Society
What are the risk factors for ovarian cancer?
Symptoms
See a doctor if you have symptoms.
Early cancers of the ovaries tend to cause symptoms that are more commonly caused by other things.
Symptoms include:
- Abdominal swelling or bloating (due to a mass or accumulation of fluid)
- Pelvic pressure or abdominal pain
- Difficulty eating or feeling full quickly
- Urinary symptoms (having to go urgently or often)
Most of these symptoms can also be caused by other less serious conditions. These symptoms can be more severe when they are caused by ovarian cancer, but that isn't always true. What is most important is that they are a change from how a woman usually feels.
Source: American Cancer Sociey:
Ovarian Cancer
Screening
For women at average risk, there is no standard or routine screening test for ovarian cancer.
Source: National Cancer Institute Ovarian Cancer Screening.
There are 2 tests that may be used to screen women who are known to be at high risk. These tests, transvaginal sonography and CA-125, are often offered to women with a very strong family history or with certain inherited genetic syndromes.
Source: American Cancer Society Ovarian Cancer: Early
Detection, Diganosis and Staging Topics.
Take Action
U-M Clinical Studies
Learn about clinical studies at the University of Michigan by visiting UMClinicalStudies.org
Clinicaltrials.gov
Ovarian Cancer Prevention Research
Resources
University of Michgan
National Resources
American Cancer Society
Toll-free number: 1-800-227-2345
Gilda Radner Familial Ovarian Cancer Registry
Toll-free number: 1-800-OVARIAN (1-800-682-7426)
Gynecologic Cancer Foundation
Toll-free number: 1-800-444-4441
National Cancer Institute
Toll-free number: 1-800-4-CANCER
National Ovarian Cancer CoalitionToll-free number: 1-888-682-7426 (1-888-OVARIAN)
