Ovarian cancer is often referred to as a “silent killer” that is highly treatable if caught in its early stages, but is often not diagnosed until it is too late because symptoms can be ambiguous and the root cause is often not found until the later stages of the disease. September is National Ovarian Cancer Awareness Month, and as women it is incredibly important for us to know the signs and symptoms of this often difficult to diagnose malady.
The dialogue surrounding cancer is enormous and overwhelming. Some types of cancer garner much more attention than others, reaching out to the global community for action on discovering a cure. As women, we are most familiar with cervical cancer and breast cancer, and this is what we are routinely tested for year after year. We get a pap smear to screen for cervical cancer, and we use self breast exams and mammograms to screen for breast cancer. Accounting for only three percent of cancers in females, ovarian cancer is not always talked about, even though 1 in 75 women will develop it in their lifetime. Currently, there is no standard for screening or early detection, but it is imperative that we create rhetoric for awareness.
There are a number of reasons why ovarian cancer can be difficult to detect, but an obvious reason is the incredibly small size of the ovaries. During childbearing years, they are at their largest, approximately 3-5cm in length (about the size of a walnut), and shrink during menopause. Tumors on the ovaries are not always palpable, so manual examination is not adequate for detection (unlike a manual breast exam, where it is much easier to distinguish differing tissues). Additionally, the symptoms most commonly associated with ovarian cancer are ones that most women might not even consider to be abnormal, let alone a sign of ovarian cancer. The most common symptoms of ovarian cancer are: bloating, pelvic or abdominal pain, trouble eating or feeling full quickly, urinary urgency and frequency, nausea and heartburn, fatigue, pain with sexual intercourse, and menstrual changes. None of these symptoms are solely related to ovarian cancer, nor is it an exhaustive list of the possible symptoms of ovarian cancer, but they are the most common. The presence of ovarian would cause these symptoms to persist over a long period of time, and often get worse, and that is the most important warning sign. If you have symptoms like these that do not seem to resolve with other measures (diet, exercise, lifestyle change, or if they persist after you have seen a physician to rule out other problems), contact your gynecologist for further evaluation. As always, you should see your gynecologist at least once a year for a well-woman exam, and be honest and complete with your medical and family history, additionally, make the physician aware of any symptoms you are experiencing that may or may not be related to gynecological issues.
Early detection of ovarian cancer is key! When diagnosed in the early stages (I&II), the 5 year survival rate is greater than 90%, when diagnosed in the later stages (III&IV), the 5 year survival rate is approximately 30%.
Is there testing available?
Currently, there are a couple of options available when it comes to testing for the presence of ovarian cancer, and establishing personal risk for development of the disease. However, there are not currently any tests that can detect this cancer in its earliest stages.
- BRCA 1 & 2
This is a genetic test which evaluates human genes commonly referred to as tumor suppressors, which are that produce proteins that help repair damaged DNA or genetic alterations. When BRCA 1 & 2 are damaged or mutated, they may lack the ability to make those repairs, which can lead to cancer (as cancer cells grow uncontrollably). A quick questionnaire about your personal and family history, as well as a DNA sample (Either blood, or buccal swab) is all that is required. Currently, BRCA mutations account for 10-15% of all ovarian cancers, and 44% will develop ovarian cancer by age 70. Statistical information regarding these tests is constantly changing because there is not yet long term data. Our practice utilizes two different companies to carry out this testing, and more information can be found by visiting their websites at Myriad or Counsyl.
- The most important thing to do is to be aware of your body, and remember to have an annual physical with your gynecologist. Call and make an appointment today (415) 666-1250.
For more information on National Ovarian Cancer Awareness Month, please visit: