Ovarian Cancer: Understanding the Causes, Symptoms & Treatments

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Know your risks: Early detection and prevention are extremely important.

Cancer. Just that word alone is enough to send shock waves through someone’s body, especially when it is followed by the words “you have.” No matter the type of cancer, hearing those words and understanding what they mean require a greater understanding of the disease, its causes, its symptoms and its available treatments.

A snapshot of ovarian cancer

Ovarian cancer is a disease that affects women. The ovaries are the female reproductive organs in which egg cells are produced. With this type of cancer, certain cells in the ovary become abnormal and can multiply uncontrollably, forming a tumor. Cancer can occur in one or both ovaries of the female reproductive tract. The most common form of ovarian cancer starts in epithelial cells. These are the cells that line the surfaces and cavities of the body. These cancers can arise in the epithelial cells on the surface of the ovary. However, researcher has suggested many or even most ovarian cancers may begin in the epithelial cells on the fringes at the end of one of the fallopian tubes, and then the cancer cells then shift to the ovary.

Caryn Johnson, M.D.

An experienced physician’s point of view

Dr. Caryn Johnson, M.D., currently practices with University Health Women’s Care (UHWC) in Lee’s Summit, Missouri. A Board-Certified OB/GYN and certified in Robotic Surgery, Dr. Johnson attended medical school at the University of Buffalo School of Medicine and Biomedical Science, followed by the completion of her residency in Obstetrics and Gynecology at Duke University Medical Center. Prior to joining the team at UHWC, Dr. Johnson had a private practice in Decatur, Georgia.

“There are three main types of ovarian cancer,” Dr. Johnson indicated. “The most common type develops on the surface of the ovary. Over 90% of ovarian cancer fall into this category.”

The American Cancer Society estimates for 2019 indicate approximately 22,500 women will be newly diagnosed with ovarian cancer and approximately 14,000 will die from ovarian cancer. Older women are more often diagnosed with ovarian cancer than younger women. Further, the American Cancer Society noted over 50% of women diagnosed with ovarian cancer are 63 years of age or older.

Recognizing the initial symptoms of ovarian cancer

Dr. Johnson indicated some of the initial signs and symptoms of ovarian cancer are abdominal bloating, abdominal and pelvic pain and the sensation of feeling full easily.

“Some women may also experience vaginal bleeding, particularly women who have gone through menopause, at which time cyclic menstrual bleeding has stopped,” stated Dr. Johnson, who cautioned that any bleeding after menopause warrants evaluation from a gynecologist. 

Before sounding the alarm, however, the initial symptoms previously mentioned do not necessarily mean one has ovarian cancer. Such symptoms can also be associated with other conditions, but if these symptoms persist, it is important for the woman to seek medical care for evaluation of the cause.

“Ovarian cancer can develop without the presence of these symptoms initially, which makes early diagnosis difficult,” explained Dr. Johnson. “Unfortunately, that means when some of these symptoms are present, ovarian cancer may be very advanced.” 

The stages of ovarian cancer

When given a diagnosis of ovarian cancer, it is important to understand and know to which stage the cancer has advanced.

Dr. Johnson referenced the four main stages of ovarian cancer, each with several sub-stages depending on the degree to which the cancer has spread.

If the cancer is confined to one or both ovaries, it is considered Stage I. If the cancer in one or both ovaries has spread to other organs (such as uterus, bladder, colon or rectum), it is considered Stage II. If the cancer has spread and invaded nearby organs and has spread to nearby lymph nodes or the presence of deposits on the lining of the abdomen, it is Stage III. When the cancer has spread to distant organs such as the lung, liver, intestines, bone and brain, it is Stage IV.

Treatment for ovarian cancer

According to Dr. Johnson, ovarian cancer is primarily treated with surgical removal of the cancer. 

“This may require removal of the ovaries, uterus and fallopian tubes,” she mentioned. “Because cancer can spread to adjacent organs, other bodily tissue and organs of the abdomen and pelvis may need to be sampled or removed as well. This may include sampling of lymph nodes that are close by to the ovaries. Also, in most cases of ovarian cancer, chemotherapy is also used for treatment in conjunction with surgery.” 

The long-term pronosis after a diagnosis of ovarian cancer

A woman’s life expectancy after diagnosis of the disease typically depends on the type of cancer and the staging or progression of the disease when it is diagnosed.

“The majority of the most common type of ovarian cancer is diagnosed at later stages (III and IV),” explained Dr. Johnson. “The cure rate at these later stages is 18%.”

But there is good news. If the cancer is detected in its early at Stage I, the cure rate is 88%. 

Preventative measures to take to reduce the chances of developing ovarian cancer

Sadly, the diagnosis of ovarian cancer often comes at a late stage. Therefore, Dr. Johnson promotes strategies for early detection and prevention.

“Knowing your individual risk for developing ovarian cancer can give a heightened awareness to identify the symptoms as early as possible,” she noted.

Common risk factors for ovarian cancer include being older than age 55, a family history of breast, ovarian, colon cancer and endometrial cancer (cancer in the lining of the uterus), personal history of breast cancer, never having children, and infertility. 

Dr. Johnson explained certain genetic disorders are also at play when increasing a woman’s risk for developing ovarian cancer. The genetic mutations in BRCA-1 and BRCA-2 genes carry an increased risk of breast and ovarian cancer.

“There are genetic tests that can be done to see if you carry a gene mutation for these disorders,” said Dr. Johnson. “If you do carry any of these genes mutations, there are preventative measures that can be done. For example, surgically removing both ovaries after a woman has completed childbearing (if desired) and before cancer develops can drastically reduce the risk of developing cancer.”  

Dr. Johnson stated there are some cancers of the ovary that may have their origin in the fallopian tubes that then spread to the adjacent ovaries. 

“Surgical removal of the fallopian tubes after childbearing for permanent contraception or removal at the time of hysterectomy for other indications can potentially reduce the risk of developing certain types of ovarian cancer also,” she highlighted.

Birth control pills: more than one protection

Dr. Johnson noted combined oral contraceptive pills can also reduce the risk of developing ovarian cancer. 

“The longer a woman is on an oral contraceptive pill, the better,” she explained. “It is estimated for every five years of taking a birth control pill that has both estrogen and progestin in it can reduce the risk of developing ovarian cancer by 20%.”  

Looking to the horizon: research for early detection and treatment

Research continues with respect to developing strategies for early detection and treatment. It is extremely important to identify women who are at greater risk for developing cancer. The earlier the cancer is detected, the more promising the treatment can be.

For more information on Dr. Caryn Johnson and the University Health Women’s Care, call 816.404.2170 or visit universityhealthkc.org/clinics/womens-care

Source: ghr.nlm.nih.gov

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