Ovarian Cancer

Ovarian Cancer is the second most common gynecologic cancer and is most common in women aged 40 to 65. Risk factors include early menstruation with late menopause, obesity, and a family history of ovarian, breast or colon cancer. Other risk factors may include using either the fertility drug Clomid or hormone replacement therapy. The American Cancer Society estimates 21,550 new cases of ovarian cancer and 14,600 deaths due to ovarian cancer in 2009 (ACS). Pregnancy, breastfeeding, birth control pills, ovarian removal, and tubal ligation/hysterectomy may offer some protection against ovarian cancer.

Only about 20% of ovarian cancers are found in the early stages and early detection is the best survival tool. Symptoms may include stomach or abdominal swelling/bloating, pelvic pressure, a rapid feeling of fullness after eating, urinary urgency and/or urinary frequency. Other women have complained of symptoms like persistent indigestion, a change in bowel habits, painful intercourse and lower back pain. The problem is that many of these symptoms can also be caused by such things as PMS, irritable bowel syndrome, urinary disorders or other diseases. The key is if these symptoms are persistent, last beyond a few weeks and worsen over time. If this occurs a woman should see her gynecologist for testing.

Ultrasound is usually the first modality used for the diagnosis of ovarian cancer and can determine the presence or absence of a mass with 97% accuracy (GLOWM). CT is often used to determine tumor size, location and degree of metastasis to adjacent lymph nodes or organs. Blood tests are used to determine levels of CA-125, a blood protein often found at higher levels in women with ovarian cancer. During surgery many tissue samples are taken in the abdomen and pelvis to determine cancer staging. Staging ranges from stage I (confined to ovaries) to Stage IV (spread to distant organs such as liver or lungs). Five year survival rates vary from 80% for Stage I to 18% for Stage IV. Treatment consists of surgery, chemotherapy and radiation.

This image shows a bilateral stage IB Ovarian cancer in a 47 year old. Despite the large masses (see O) the cancer is still confined to the ovaries.

Image:

http://www.glowm.com/resources/glowm/graphics/figures/v4/0540/034f.jpg Accessed February 15, 2010.

References:

ACS. American Cancer Society. Overview: What is Ovarian Cancer? Accessed February 15, 2010 at http://www.cancer.org/docroot/CRI/CRI_2_1x.asp?rnav=criov&dt=33

GLOWM. The Global Library of Women’s Medicine. Ovarian Cancer. Accessed February 15, 2010 at http://www.glowm.com/?p=glowm.cml/section_view&articleid=265&SESSID=haaj72nm2tvd91b1f18m3chhk5

MayoClinic.com. Ovarian Cancer. Accessed February 15, 2010 at http://www.mayoclinic.com/health/ovarian-cancer/DS00293/DSECTION=symptoms

National Cancer Institute. Ovarian Cancer. Accessed February 15, 2010 at http://www.cancer.gov/cancertopics/types/ovarian