A cancer that is difficult to detect and one that tragically took the life of both comedy legend Gilda Radner and actress Madeline Kahn and ovarian cancer is still something too many people know far too little about.
Though it’s ultimately quite rare, according to the American Cancer Society, “Ovarian cancer ranks fifth in cancer deaths among women, accounting for more deaths than any other cancer of the female reproductive system.”
As September marks Ovarian Cancer Awareness Month, we wanted to get a better understanding of this disease, including the types of ovarian cancer, who is most at risk, and possible preventative measures you can take.
What is Ovarian Cancer, and How Is It Diagnosed?
Ovarian cancer can affect one or both of the ovaries, though there are over twenty different subtypes of the cancer, explains gynecologic surgeon and assistant professor of Obstetrics and Gynecology at Cedars-Sinai, Bobbie J. Rimel, MD. The most common type of ovarian cancer stems from epithelial tumors.
Still, ovarian cancer is a very difficult cancer to detect early and effectively. June Gupta, WHNP, Director of Medical Standards at Planned Parenthood Federation of America, explains that this is because, “there is no reliable way to screen during a regular wellness visit.”
What Are the Possible Signs and Symptoms of Ovarian Cancer?
Because ovarian cancer cannot be screened or detected in things like pap smears, it’s important to pay attention to the often subtle signs and symptoms of the disease. Unfortunately, a lot of these symptoms are quite common with other issues, and are easy to be mistaken for something else.
Gupta notes that some of the symptoms can include, “bloating or increased belly size, pelvic or belly pain, feeling full quickly or having trouble eating, or a frequent urge to pee.”
“If you notice any of these [symptoms],” Gupta says, “it’s important to talk to your provider. You may have a blood test, a pelvic exam, and/or imaging—like an ultrasound—of your pelvis and abdomen.”
However, because ovarian cancer is so rare, Dr. Rimel points out that it’s not uncommon for a misdiagnosis. So if you come back with a negative result, but are still experiencing the symptoms associated with ovarian cancer, you should continue to follow-up with your healthcare provider.
Who Is At Risk For Ovarian Cancer?
Post-menopausal women and/or women over age 60 are at highest risk for ovarian cancer, as are women with a genetic predisposition to ovarian cancer.
“Your provider can determine if you have a high-risk family history for ovarian cancer,” Gupta says, adding, “If you have a high-risk family history, your provider may recommend seeing a genetic counselor to see if genetic testing is right for you.”
What Happens if You Are Diagnosed with Ovarian Cancer?
Because diagnosis is so difficult, Dr. Rimel explains that nearly 75 percent of women who are eventually diagnosed are at stages 3 or 4 for the cancer. Ovarian cancer can sometimes be found in a CT scan after a patient has a distended abdomen or has been treated for abdominal pain. A pelvic ultrasound that uncovers a mass may also lead to an ovarian cancer diagnosis.
“If ovarian cancer is suspected based on your history and the results of any of these tests or exams, surgery may be recommended,” Gupta says, adding, “Surgery is the only way to know for sure whether or not you have ovarian cancer.”
Surgical removal of the cancerous ovary or ovaries, Dr. Rimel says, is to try and remove as much of the cancer as possible. After surgery Dr. Rimel says that the second step for most women is chemotherapy, followed by novel medications for maintenance to attempt to keep the cancer from coming back.
Unfortunately, because ovarian cancer is often found so late, Dr. Rimel says that upwards of 80% of patients diagnosed with ovarian cancer see it return even after treatment. (ACS statistics find that the lifetime chance of dying from ovarian cancer is about one in 108.)
How Can You Prevent Ovarian Cancer?
While ovarian cancer stats can be startling, prevention and persistence can be key. One of the most efficient tools in preventing ovarian cancer is birth control. Dr. Rimel says that taking birth control pills for five years or more can reduce your risk of ovarian cancer by 50 percent, if you are high or average risk.
Another possible way to prevent ovarian cancer is, if you are past your child bearing years or do not plan to have children, to have your fallopian tubes removed.
But the main precaution both healthcare experts urged women is that if they have any persistent symptoms, to continue to ask and get it checked out until you have an answer.