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Difficult to Detect

Sep 22, 2015 09:17PM ● Published by Kevin

Don’t let cancer sneak up on you. Each year, ovarian cancer is diagnosed in nearly a quarter of a million women worldwide. According to the American Cancer Society, it is the fifth-leading cause of cancer-related death in women and is the most common cause of gynecologic cancer deaths. Only about 15 percent of ovarian cancers are found at the localized stage. But when found early — before it has spread outside the ovaries — the five-year survival rate is 92 percent, reports the American Society of Clinical Oncologists.

Unlike other types of cancer, ovarian cancer can be difficult to detect in its early stages because its symptoms are subtle — easily attributable to something else — and there is currently no effective screening strategy for detecting it. A Pap test does not screen for ovarian cancer (it identifies cancerous or precancerous changes in the cervix), and the CA-125 blood test, which measures a particular protein level in the blood, is not reliable. While elevated CA-125 blood levels are often found in women with ovarian cancer, there are also harmless reasons for high levels.

Instead, women have to be aware of changes in their bodies and advocate for their care. “Paying attention to your health and recognizing the signs, symptoms and risk factors associated with ovarian cancer can help women take steps to detect it at an early stage when the chance of a cure is higher,” says Paul Lansdowne, OB-GYN on the medical staff at Methodist Mansfield Medical Center.

Lansdowne advises women to be aware of these symptoms:

• Prolonged abdominal bloating

• Pain in the pelvic abdominal area

• Difficulty eating

• Feeling full quickly

• Unexplained nausea

• Feeling an urgent or frequent need to urinate.

Also tell your physician about any changes in your general health. That includes lumps, skin changes, pain, dizziness, fatigue, sleep problems, abdominal swelling with weight loss, menstrual changes and changes in eating, bowel or urinary habits.

“When these symptoms are caused by ovarian cancer, they tend to be more persistent or severe than what a woman would consider normal for her,” says Lansdowne. “If a woman has these symptoms more than 12 times a month, she should see her gynecologist.”

Early detection matters. “Women who are alert to these symptoms may be able to catch the disease in its early stages when it is easier to treat.”

Another step toward prevention is to review your family medical history. Although the majority of cases occur at random, the BRCA1 and BRCA2 mutations are associated with 10 to 15 percent of ovarian cancer cases. Since these genes are linked to both breast and ovarian cancer, women who have had breast cancer have an increased risk of ovarian cancer.

If a family member has had ovarian cancer, genetic screening should be scheduled early to identify predisposing factors, when treatment is often more effective. A gynecologic oncologist should perform these screenings and discuss options and next steps if the mutations are present.

What is ovarian cancer? Ovarian cancer consists of a group of cancers that originate from the various tissues within the ovary. Many types of tumors that start in the ovaries are benign (noncancerous) and never spread beyond the ovary. Women with these types of tumors can be treated with a full or partial removal of the organ. Other types of tumors are malignant and can spread. These require more extensive treatments.

The three types of ovarian cancers include:

• Epithelial – generally in women age 50 and older, and the most common.

• Germ Cell – typically found in young women, from as early as birth to 25 years.

• Stromal Cell – can be found in women of all ages, and the least common.

Epithelial ovarian cancer, the most common type, rises from the ovarian surface and spreads rapidly throughout the abdominal cavity. The lifetime risk for women diagnosed with this type is about 1 in 70. It is typically seen in women over the age of 50 who are postmenopausal, but it can occur in women who are still menstruating.

“Since ovarian cancer does not reveal early signs or symptoms in most cases, the majority of women who are diagnosed with epithelial ovarian cancer are usually at an advanced stage of 3 or 4,” says Lansdowne.

What if ovarian cancer is detected? Ovarian cancer is highly treatable and responsive to surgery and chemotherapy. Treatment options usually include removal of all visible tumors, tubes and ovaries along with a hysterectomy. Chemotherapy is typically used either before and/or after surgery.

So how can a woman reduce her risk? There is no way of preventing ovarian cancer, but there are factors that seem to reduce a woman’s risk of developing it. Women who had a significant number of pregnancies, women who breast-fed and women who took oral birth control for five or more years in their lifetime have shown to have a significantly lower risk of ovarian cancer.

A little attention to your health goes a long way. 

Written by Angel Biasatti, director of community and public relations at Methodist Mansfield Medical Center.

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