Guest Author - Dr. Denise Howard
Is it possible to prevent ovarian cancer? Is it possible to successfully treat ovarian cancer? The answer is yes, but it isnít easy. This is the most common cause of death of all gynecologic malignancy even though the lifetime risk is <2%. This is because ovarian cancer is difficult to detect early. When ovarian cancer is found at stage 1, the 5-year survival rate is more than 90%. When it is found at stage 2 and 3 it is 75-80% and at stage 4 for the 5-year survival drops to 25%.
Ovarian cancer is a silent killer. There are no early warning symptoms and there isnít an appropriate screening test available. In most cases the presenting symptoms are vague and described as pelvic discomfort, pain, fullness or bloating. These symptoms can be due to a number of causes and are usually not taken seriously. Many studies have been done to see if certain blood and imaging test can effectively detect early cancer. Unfortunately these tools are not beneficial on a large-scale basis like the mammogram and pap smear have been.
There are 3 major factors that increase a womanís chance of developing ovarian cancer: age, family history and the presence of a genetic predisposition. Ovarian cancer tends to occur in women age 50-59. Women in this age group should be more concerned about the vague symptoms mentioned above and doctors who care for these women should have a low-threshold to evaluate these symptoms more aggressively.
A womanís chance of developing ovarian cancer increases 3-fold when there is a first or second degree relative with ovarian cancer. This risk is even higher with multiple family members with this malignancy or even breast, endometrial and colon cancer. There are a number of familial genetic syndromes which increases the risk of ovarian cancer and in some cases this lifetime risk can be has high 25-50%. Genetic testing is available and women should be concerned if they have multiple family members with these cancers or relatives diagnosed with the cancers before age 50.
The risk of ovarian cancer has been found to be lower in certain women. Women who have had pregnancies, breastfed, underwent a tubal ligation or hysterectomy and took oral contraceptive pills have a lower risks. Birth control pills have been shown to decrease the lifetime risk of ovarian cancer by 50% in women who carry certain genetic mutations.
Women who have a genetic predisposition or who are at higher risk, have a number of options. They can have specifically tailored screen with a combination of blood tests and pelvic ultrasounds every 6-12 months to detect early changes. They can strongly consider having their ovaries removed between the ages of 35-40 or once they have completed their childbearing. In addition, they can elect to take oral contraceptive pills to reduce their risk. Women who are over the age of 50 should consider having their ovaries removed if given this option when undergoing surgery for other indications.
Ovarian cancer is typically found at an advanced stage where treatment is difficult. It is possible however to target certain high risk groups to minimize their chances and there are a number of other actions that decreases the risk of women in general. The key to beating ovarian cancer is early detection and prevention and this is possible for many.
I hope this article has provided you with information that will help you make wise choices, so you may:
Live healthy, live well and live long!