Ovarian cancer sneaks up on women because in its early stages, the symptoms aren’t intense and present vaguely, and there is no dependable screening test for the cancer. According to the National Ovarian Cancer Coalition, ovarian cancer is diagnosed in nearly 80% of women when the cancer is already in its later stages and prognosis is poor.1 The American Cancer Society notes that ovarian cancer is the deadliest of cancers affecting the female reproductive system and the fifth-leading cause of cancer deaths among women overall. Ovarian cancer will be diagnosed in an estimated 22,500 American women in 2019.2
September is set aside as National Ovarian Cancer Awareness Month to rally support, research and treatment for this tough-to-detect gynecological cancer. Standing unified in a countrywide awareness campaign, a number of cancer prevention and healthcare organizations join with everyday citizens and ovarian cancer patients and their families to fight for a cancer-free future.
What Is Ovarian Cancer?
The ovaries are a pair of almond-sized reproductive glands found on each side of a woman’s uterus in the pelvis. The ovaries’ job is to produce eggs for reproduction and the female hormones estrogen and progesterone. Ovarian cancer occurs when abnormal cells in an ovary grow out of control and crowd out normal cells. Eventually, these erratic cancer cells form a lump or tumor.
Ovarian cancer is categorized into three main cell types found within the ovary. Each cell type can develop its own tumor type and vary on how the cancer spreads. Epithelial ovarian cancer, which originates from the epithelium or surface of the ovary, is the most common.
Risk Factors for Ovarian Cancer
The American Cancer Society finds that a woman has a 1 in 78 chance of getting ovarian cancer during her life. The following are factors that increase the risk of ovarian cancer:
- Aging. The American Cancer Society notes that ovarian cancer is not typically found in women under age 40, and half of all ovarian cancers occur in females age 63 and older.
- Excess weight and obesity. Although the correlation between ovarian cancer and obesity is a bit fuzzy, being overweight puts people at a higher risk for developing a number of cancers.
- Late-age pregnancy or not having a full-term pregnancy. Women who have their first baby after age 35 or who have never carried a pregnancy to full term face a higher risk of ovarian cancer.
- Fertility treatments. Some research appears to show a higher rate of borderline ovarian tumors with the use of fertility drugs and in vitro fertilization.
- Hormone replacement therapy after menopause. Women who take estrogen alone after menopause and for typically five years or longer have an increased risk of developing ovarian cancer.
- Breast cancer survivor. Women who have had breast cancer incur a higher risk of also getting ovarian cancer, particularly if there is a strong family history of breast cancer.
- Carrier for BRCA1 and/or BRCA2 (BReast CAncer) genes. The Ovarian Cancer Research Alliance reports that 20% to 25% of women with ovarian cancer were born with a hereditary tendency to develop it. Up to 15% of all ovarian cancers are caused by an inherited genetic mutation in one of two genes: BRCA1 or BRCA2. Women of an Eastern European or Ashkenazi Jewish descent are at higher risk for carrying BRCA1 and BRCA2 mutations.3
- Family history of ovarian, breast or colorectal cancer. Women who have a grandmother, mother, sister or daughter who has or had ovarian cancer are at higher risk for getting cancer of the ovaries themselves. The increased risk can come from both the mother’s side and the father’s side of the family. A family history of breast or colorectal cancer elevates ovarian cancer risk, too, because of inherited changes in certain genes.
Oncology researchers do note a few factors that can help lower the risk of ovarian cancer including having a full-term baby before age 26, breastfeeding and taking oral contraceptives. Some studies also show that ovarian cancer risk lowers through other birth control forms including tubal ligation (tying of fallopian tubes), using intrauterine devices and undergoing a hysterectomy without removing the ovaries.4
Symptoms of Ovarian Cancer
The symptoms of ovarian cancer are subtle and are often mistaken for other common health problems. Most women do not seek medical help until later stages of the disease when they present with symptoms including:
- Pelvic or abdominal pain, cramping or constipation
- Feeling full quickly after eating or having little appetite
- Indigestion, upset stomach or nausea
- Frequent or urgent urination
- Lower back or pelvic pressure
- Increased abdominal swelling or girth
- Painful sexual intercourse
- Menstrual changes
- Unexplained exhaustion
- Weight loss
If any of these symptoms are new and unusual and present for more than two weeks, a woman should see her doctor, preferably a gynecologist.
Detecting and Diagnosing Ovarian Cancer
Catching cancer early is always the goal to allow for more treatment options. Currently, there is no consistently effective screening test for ovarian cancer. Regular women’s health exams are important to help rule out reproductive system cancers of any kind. A transvaginal ultrasound (TVUS) and the CA-125 blood test are ordered sometimes for women at highest risk for ovarian cancer, but both of these tests are not fully reliable for detecting cancer of the ovaries. Even women who have had their ovaries surgically removed still face a small risk of developing primary peritoneal cancer, since the peritoneum and ovaries form from the same tissues during embryonic development.
Treating Ovarian Cancer
Once ovarian cancer is diagnosed, doctors will try to determine the extent of the cancer through a process called staging. Ovarian cancer stages range from I through IV, with IV involving the greatest spread of the cancer. Staging helps doctors determine the best treatment options.
Surgery to remove the cancerous growth is the most common treatment for women with ovarian cancer. Chemotherapy that delivers chemicals to destroy or stop cancer cells from growing is also a best practice for ovarian cancer. Radiation is rarely used for treating ovarian cancer in the United States, but may be used to shrink tumors and destroy cancer cells that have spread to other parts of the body. Many women also choose a number of complementary therapies including acupuncture, herbal medicine, meditation and massage to boost their whole body approach to cancer treatment.
For more information about ovarian cancer, contact these cancer organizations and resource groups:
- American Cancer Society — cancer.org/cancer/ovarian-cancer; 1-800-227-2345.
- Centers for Disease Control and Prevention — cdc.gov/cancer/ovarian; 1-800-CDC-INFO (800-232-4636) | TTY: 888-232-6348.
- National Ovarian Cancer Coalition — ovarian.org; 888-OVARIAN (888-682-7426).
- Ovarian Cancer Research Alliance — ocrahope.org; 1-866-399-6262 (toll free) or 212-268-1002.
1 National Ovarian Cancer Coalition, September is Ovarian Cancer Awareness Month. Retrieved from http://ovarian.org/component/content/article/35-news/508-ovarian-cancer-awareness-month.
2 American Cancer Society, Key Statistics for Ovarian Cancer. Retrieved fromhttps://www.cancer.org/cancer/ovarian-cancer/about/key-statistics.html.
3 Ovarian Cancer Research Alliance, Risk Factors. Retrieved from https://ocrahope.org/patients/about-ovarian-cancer/risk-factors/.
4 Ovarian Cancer Research Alliance, Risk Factors. Retrieved from https://ocrahope.org/patients/about-ovarian-cancer/risk-factors/.
About the Author
An award-winning journalist who has documented stories in nearly 20 countries, Beth Lueders is an author, writer and speaker who frequently reports on diverse topics, including aging and health issues for both U.S. and international corporations.