What is it?
Ovarian cancer is a disease that forms in tissues of the ovary. The ovary is a female reproductive gland in which the ova, or eggs, are formed. Most ovarian cancers are either ovarian epithelial carcinomas (cancer that begins in the cells on the surface of the ovary) or malignant germ cell tumors (cancer that begins in egg cells).
What puts me at risk?
- Family history: Women who have a mother, daughter, or sister with ovarian cancer have an increased risk of the disease. Women with a family history of breast, uterine, colon, or rectal cancer may also have an increased risk of ovarian cancer.
- Personal history of cancer: Women who have had breast, uterine, colon, or rectal cancer have a higher risk of ovarian cancer.
- Age over 55: Most women are over age 55 when diagnosed with ovarian cancer.
- Never pregnant: Older women who have never been pregnant have an increased risk of ovarian cancer.
- Menopausal hormone therapy: Some studies have suggested that women who take estrogen by itself (without progesterone) for 10 years or more may have an increased risk of ovarian cancer.
Source: National Cancer Institute. What You Need to Know About Ovarian Cancer. http://www.cancer.gov/cancertopics/wyntk/ovary/.
Several factors appear to reduce the risk of ovarian cancer. They include:
- Oral contraception (birth control pills) - Women who use oral contraceptives for three years or more reduce their risk of ovarian cancer by 30 percent to 50 percent, compared to women who have never used them.
- Pregnancy and breast-feeding - Having at least one child lowers the risk of developing ovarian cancer. Breast-feeding a child for a year or longer also may reduce the risk of ovarian cancer.
- Tubal ligation or hysterectomy - The Nurses' Health Study, which followed thousands of women for 20 years, found a substantial reduction in ovarian cancer risk in women who had had tubal ligations. The study also indicated that having a hysterectomy may reduce ovarian cancer risk, but not by as much as does tubal ligation.
- Prophylactic oophorectomy - Women at very high risk of developing ovarian cancer may elect to have their ovaries removed as a means of preventing the disease. This surgery is recommended primarily for women who have tested positive for a BRCA gene mutation or women who have a strong family history of breast and ovarian cancers. Studies have shown that prophylactic oophorectomy lowers ovarian cancer risk by up to 95 percent, and reduces the risk of breast cancer by up to 50 percent, if the ovaries are removed before menopause. Prophylactic oophorectomy is controversial, however, because it induces early menopause, which may have a negative impact on health, including an increased risk of osteoporosis, heart disease and other conditions.
Source: MayoClinic.com. http://www.mayoclinic.com/health/ovarian-cancer/DS00293/DSECTION=prevention
Screening for Early Detection
There is currently no standard or routine screening test for ovarian cancer. Clinical trials, however, are being done to study ovarian cancer screening. Information on clinical trials is available from the NCI website: http://www.cancer.gov/clinicaltrials.
The following tests that may detect ovarian cancer are being studied:
- Pelvic exam – An exam of the vagina, cervix, uterus, fallopian tubes, ovaries and rectum done by a doctor or nurse.
- Transvaginal ultrasound – A procedure used to examine the vagina, uterus, fallopian tubes, and bladder. An ultrasound probe is inserted into the vagina and used to bounce sound waves off internal tissues or organs. This creates a picture of body tissues called a sonogram.
- CA-125 assay – A test that measures the level of CA 125 (a substance released by cells) in the blood. An increased CA-125 level is sometimes a sign of certain types of cancer, including ovarian cancer, or other conditions.
Scientists at the National Cancer Institute are studying the combination of ultrasound and CA-125 levels as a way to get more accurate results from the screening tests.
Source: National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/screening/ovarian/Patient/page3
Symptoms may not be obvious in the early stages of ovarian cancer. As the cancer grows, however, symptoms may include:
- Pressure or pain in the abdomen, pelvis, back, or legs
- A swollen or bloated abdomen
- Nausea, indigestion, gas, constipation, or diarrhea
- Feeling very tired all the time
Less common symptoms include:
- Shortness of breath
- Feeling the need to urinate often
- Unusual vaginal bleeding (heavy periods, or bleeding after menopause)
These symptoms are usually not due to cancer, but only a doctor can tell for sure. Any woman with these symptoms should tell her doctor.
Source: National Cancer Institute. What You Need to Know About Ovarian Cancer. http://www.cancer.gov/cancertopics/wyntk/ovary/page5
Most women have surgery and chemotherapy. Radiation therapy is also sometimes used.
First, a surgeon may perform a laparotomy (a long cut in the wall of the abdomen). If ovarian cancer is found, the surgeon may remove the following:
- Both ovaries and fallopian tubes (salpingo-oophorectomy)
- The uterus (hysterectomy)
- The omentum (the thin, fatty pad of tissue that covers the intestines)
- Nearby lymph nodes
- Samples of tissue from the pelvis and abdomen
If the cancer has spread, the surgeon performs “debulking” surgery and removes as much cancer as possible.
Most women are given chemotherapy (drugs to kill cancer cells) for ovarian cancer after surgery. Some women have chemotherapy before surgery.
More than one drug may be given, and they can be given in different ways:
- By vein (IV): Drugs are given through a thin tube inserted into a vein.
- By vein and directly into the abdomen: Sometimes IV chemotherapy is given along with intraperitoneal (IP) chemotherapy . For IP chemotherapy, the drugs are given through a thin tube inserted into the abdomen.
- By mouth: Some drugs can be given by mouth.
Radiation therapy uses high-energy rays to kill cancer cells. It is rarely used in the initial treatment of ovarian cancer, but it may be used to relieve pain and other problems caused by the disease. The treatment is given at a hospital or clinic, and each treatment takes only a few minutes.
Side effects depend on the amount of radiation given and the part of the body that is treated. Radiation therapy to the abdomen and pelvis may cause nausea, vomiting, diarrhea, or bloody stools. Also, the skin in the treated area may become red, dry, and tender. The side effects can usually be treated or controlled, and they gradually go away after treatment ends.
Source: National Cancer Institute. What You Need to Know About Ovarian Cancer. http://www.cancer.gov/cancertopics/wyntk/ovary/page8
- Clinical trials are research studies in which people help doctors find ways to improve health and cancer care. Each study tries to answer scientific questions and to find better ways to prevent, diagnose, or treat cancer.
- A clinical trial is one of the final stages of a long and careful cancer research process. Studies are done with cancer patients to find out whether promising approaches to cancer prevention, diagnosis, and treatment are safe and effective.
For more information on clinical trials, log onto:
Coping with Cancer
- Side Effects/ Other Complications
- Nutritional Concerns
- Emotional Concerns
- End-of-Life Issues
- Treatment Related Issues
For more information on coping with cancer, log onto:
For information on home care, log onto:
For information on national organizations that offer services to people with cancer and their families, log onto:
Palliative Care - Palliative care is a coordinated, inter-disciplinary approach to healthcare that enhances the quality of life of people with cancer and other illnesses. It targets the physical and psychological symptoms and spiritual needs of survivors from the time of diagnosis to end-of- life care in all settings. (Comprehensive Cancer Control Plan)
For more information on Palliative Care, log onto:
Children Coping with Mothers with Ovarian Cancer
- Learn more about all different types of cancers
- Questions that children might have dealing with cancer
- Books to help children understand more about certain cancers
- Stories from other children
- Camps and foundations
For information on helping children coping with cancer:
- Kaleidoscope of Hope – Raises funds for ovarian cancer research and increases awareness of symptoms.
- Mary Anne Mazanec Ovarian Cancer Foundation – Provides financial assistance and support for patients and families, supports cancer research, and promotes awareness of ovarian cancer.
- The Maureen Fund - A section of the John Theurer Cancer Center at Hackensack University Medical Center that offers women the opportunity to learn more about ovarian cancer and to determine risk factors.
- Meghan’s Message – Raises awareness that ovarian cancer can affect young women in their 20’s.
- National Ovarian Cancer Coalition – Northern NJ Chapter –Dedicated to bringing people together to learn about ovarian cancer and reaching out to the communities of northern NJ with awareness and education.
- National Ovarian Cancer Coalition – Southern NJ / Delaware Valley Chapter – Committed to raising awareness, promoting ovarian cancer education and improving the survival rate and quality of life for women with ovarian cancer in Delaware, Philadelphia and southern NJ.
- Ovarian Cancer Research Fund – Funds research for early detection and ultimately a cure for ovarian cancer; provides education and outreach.
- Teal Tea Foundation – Raises ovarian cancer awareness and supports research efforts focused on early detection, treatments and the cure for ovarian cancer; dedicated to improving quality of life and long term recovery.
- Teal Wings of Hope Foundation – Provides awareness, education and support to patients, caregivers, families, and friends.
- Turn the Towns Teal® - Campaign to promote awareness of ovarian cancer and its symptoms by tying teal ribbons and distributing symptom cards and literature about ovarian cancer in towns throughout the country.
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