Known as the silent killer because of its vague and easily misdiagnosed symptoms, ovarian cancer is often not detected until it’s at an advanced stage. That’s why it is important to know the facts about this gynecologic cancer. According to the American Cancer Society, an estimated 22,000 women will be diagnosed with ovarian cancer this year. It is predicted that it will cause more than 14,000 deaths in 2013, making it the fifth cause of cancer death in women. Ursula Matulonis, MD, director of the Gynecologic Oncology Program in the Susan F. Smith Center for Women’s Cancers at Dana-Farber Cancer Institute, says there are three things that every woman should know about ovarian cancer.
1. When to see your gynecologist
In the early stages, symptoms can be vague and similar to those of other, more common conditions, like digestive issues. However, there are warnings signs to be aware of, and they can increase over time. “Symptoms may be subtle but if a woman has several of them and they are consistent over time, she should see her gynecologist,” says Matulonis. If detected early and the cancer has not spread outside the ovary, the five-year survival rate is 93 percent. So, it’s important for a woman to know her body and any changes. The most common warning signs to look for include:
- Constant bloating or abdominal pain or pressure
- Persistent indigestion, gas, constipation
- Pelvic discomfort or pain
- Feeling full quickly
Other symptoms could include back pain, increased urination, menstrual changes and chronic fatigue.
2. No ovarian cancer screening test
Unlike mammograms for breast cancer, there is not a routine screening test for ovarian cancer. A Pap test, or Pap smear, is used to detect cervical cancer only. If there are persistent symptoms, a gynecologist might perform a physical pelvic examination to check the ovaries. However, this exam often does not catch the tumors until they are large in size and at advanced stage. Other examinations performed may include external and transvaginal ultrasounds, X-ray, and possibly a CA-125 blood test. “Protein gets shed from the cancer, and the CA-125 blood test can pick up that protein,” explains Matulonis. “However, this blood test is not used as a routine or annual screening test like a mammogram because in pre-menopausal women it is not always accurate and can fluctuate with such things as menstrual cycles and ovarian cysts.”
3. Know your family history
According to the National Cancer Institute, the number one risk factor for developing ovarian cancer is a family history. A woman's risk of the disease triples if her mother, daughter or sister has ovarian cancer. “Know your family history,” stresses Matulonis. “Who has had breast cancer? Who has had ovarian cancer? If there are either or both of these cancers in a family, that should be a red flag and that woman may want to consider genetic testing."
Genetic testing can detect if a woman has mutated versions of the BRCA1 and BRCA2 genes. The NCI says that 15 to 40 percent of women who have a BRCA1 or BRCA2 mutation will be diagnosed with ovarian cancer over the course of their lifetime. They also tend to get it earlier, before the age of 50.
Other risk factors include never having been pregnant and hormone replacement therapy. Matulonis points out that having a risk factor does not mean a woman will get ovarian cancer. Women who think they may be at risk of ovarian cancer should talk with their doctor.
Gynecologic Oncologic Program at Dana-Farber
Susan F. Smith Center for Women’s Cancers
Ovarian Cancer: Seven terms you should know
Research in advanced ovarian cancer shows promise