According to the American Cancer Society (opens in new tab), over 22,000 women will receive a new diagnosis of ovarian cancer this year. It’s one of the most common types of cancer in women and causes more deaths than any other cancer of the female reproductive system.
Ovarian cancer occurs when cells near and on the ovaries rapidly grow out of control. This cellular overgrowth often creates in the affected area. On occasion, tumors may be benign, which means you may be less likely to develop cancer. In other cases, tumors can be fatal spreading rapidly to other areas of the body. It can also cause other types of cancer and health complications such as GI and urinary issues.
Ovarian cancer is passed down genetically from generation to generation. While there are several different causes, it is predisposed (thanks to genetics) and will often develop in women after they’ve reached menopause.
If you can, talk to your family members about your family history of ovarian cancer. This will help you understand your level of risk.
The most common causes of ovarian cancer include:
Age: Ovarian cancer typically develops in women age 65 and older, after they’ve reached menopause. (although younger women can develop it as well).
Family history: Women with a family history of ovarian cancer on either their father’s or mother’s side are at higher risk.
Genetics: Genetic abnormalities such as BRCA1 and BRCA2 are proven to cause ovarian cancer. These mutations are often associated with conditions like Lynch syndrome, Peutz-Jeghers syndrome, nevoid basal cell carcinoma, and Li-Fraumeni and Ataxia-Telangiectasia. If you’re from an Eastern European or Ashkenazi Jewish background, then you may also have a greater genetic chance of developing ovarian cancer.
Medical history: If you have a history of breast, uterine, or colorectal cancer, then you may be more susceptible to ovarian cancer. Conditions like endometriosis are also a contributing factor.
Reproductive history: Women who’ve never had a baby may have a greater chance of developing ovarian cancer.
Diagnosing ovarian cancer is tricky. Since there’s no routine screening for it like breast, colon, or cervical cancer, testing is typically conducted after a patient shows signs or symptoms. This is why it’s important to pay attention to your body and regularly check in with your doctor so you can keep track of any changes.
Common symptoms of ovarian cancer include:
Unusual vaginal bleeding, particularly for women who are postmenopausal.
Pain or pressure in pelvic area.
Abdominal or back pain.
Bloating.
Feeling full too quickly, difficulty eating, or change in appetite.
Change in bathroom habits such as more frequent urination or constipation.
Your annual well-woman exam (opens in new tab) is a good time to talk with your OBGYN about your overall gynecological health and discuss any changes you may have noticed throughout the year. During this visit, your doctor will conduct a routine breast examination to check for breast cancer and a pap smear to check for cervical cancer. Based on your health history and condition, your doctor will decide if you need additional care or testing to determine if you have ovarian cancer.
“Even a car gets an annual check! As a woman, it is important to see your gynecologist for your annual well-woman exam. A pap smear is not the only reason for the visit,” says Dr. Agarwala.
If you notice something’s off between well-woman exams, be sure to book an appointment with your gynecologist or primary care doctor (opens in new tab) so you can talk through your symptoms.
How is ovarian cancer is diagnosed?
If your doctor thinks you may have ovarian cancer based on your symptoms, they’ll perform one or more of the following procedures to make a diagnosis:
A complete pelvic exam to check for the physical presence of growths. These exams are conducted during your annual well-woman exam with your gynecologist. Your doctor may give you a more thorough exam if you show symptoms of ovarian cancer.
A transvaginal pelvic ultrasound to detect the presence of tumors on or around your ovaries. A probe is inserted into the vagina to capture live intrauterine video, the same type of imaging used on women who are pregnant.
A CA-125 blood test to detect the presence of certain proteins that indicate a potential diagnosis of ovarian cancer.
A CT scan or PET scan, advanced imaging services that take photos of your body to view hard-to-see areas. These can detect inflammation, swelling, growths, and other abnormalities.
A biopsy, the most definitive way to determine a cancer diagnosis. Samples of tissue are taken from the affected area, and then examined. Biopsies are typically done after multiple tests show positive results for ovarian cancer.
What are your treatment options?
If you’re diagnosed with ovarian cancer, there are a few common types of treatments. Based on your condition, your doctor will determine which of these treatments will work best for you.
Treating ovarian cancer is a collaborative effort. You’ll see a few different types of doctors, include a gynecological oncologist, surgeon, and medical oncologist. Here are the most common types of treatments for ovarian cancer.
Chemotherapy
Chemotherapy is the most popular form of cancer treatment where drugs are used to kill cancer cells or slow their growth. Chemo is administered orally or through an IV as an intravenous infusion. Chemo drugs travel to all areas of your body, making it an effective treatment for cancer that has spread to other areas.
Surgical removal
Surgical removal of the affected area may be done if chemotherapy or less invasive treatments are unsuccessful. Your doctor may recommend surgery as a first line of defense based on your diagnosis.
Dr Agarwala says, “If you have a mountain to shoot at, you will need 1000 bullets. If you have a small hill, then you will only need a few bullets. Reducing the mountain of the cancerous mass will make the attack on the cancerous cells more successful, especially when done in tandem with chemotherapy.”
Women who have a genetic predisposition to ovarian cancer may choose to have elective preventive surgical removal of at-risk areas. Tubal ligation, hysterectomy, or ovary removal are common preventive procedures. The most serious form of ovarian cancer begins in the fallopian tubes. High-risk patients may have them removed at the first signs of ovarian cancer.
Radiation
Radiation is a common treatment for other types of cancers, but is rarely used to treat ovarian cancer. In instances where tumors may be hard to reach or have not been removed, your doctor may recommend it.
Targeted therapy
Targeted therapy is a newer form of treatment that uses drugs or other substances to kill cancer cells with less damage to your regular cells. This treatment is particularly effective for those who have BRCA1 and BRCA2 mutations.
Immunotherapy
Immunotherapy is a newer approach to cancer treatment where immune-boosting tumor vaccines are administered to the abdominal cavity. These can help reduce fluid build up when cancer is present.
Experimental treatments and drugs
Experimental treatments and new cancer-fighting drugs are constantly being developed. If your body is resistant to any of the treatments above, your doctor may recommend a new medication or procedure. Many of these treatments are still being tested, but in some instances, may improve your condition.
How can you reduce your risk of ovarian cancer?
Most risk factors of ovarian cancer are genetic, which means your lifestyle choices won’t increase your risk of getting it. However, there are some thing you can do to reduce your risk. Here are some to consider.
Take birth control: Use of oral contraceptives for five years or longer has been proven to reduce risk of ovarian cancer around 50% (opens in new tab). Your health insurance plan covers many types of preventive birth control, including the pill, free of charge.
Stay active: Maintaining a lower BMI (opens in new tab) can reduce your risk of ovarian cancer. Set some fitness goals to stay in shape, and see if your insurance company or workplace has a rewards program for your activity.
Start a family: Giving birth calibrates your hormones, which can reduce your risk of developing ovarian cancer.
Breastfeed: If you’re a new mama, breastfeeding for a year or more can help prevent ovarian cancer. Talk to your insurance company about your breast pump and lactation counseling benefits.
Whether you have a family history of ovarian cancer or not, be sure to maintain a close relationship with your primary care doctor and OB-GYN in sickness and in health so you can get the care you need whenever something comes up.
