Signs and symptoms of ovarian cancer

Posted: 09/20/2012
Last Updated: 13 hours and 38 minutes ago

Arizona Onology is a paid advertiser of Sonoran Living Live 

Arizona oncology encourages the community to know the signs and symptoms of ovarian cancer. 

Nearly 21,990 women are expected to be diagnosed with ovarian cancer this year.  Unfortunately, because most ovarian cancer cases are diagnosed at an advanced stage when the disease has already spread beyond the ovaries, nearly 15,460 will lose their lives. Ovarian cancer is the fifth leading cause of cancer related deaths in women.   

The five-year survival rate for ovarian cancer, if caught in early (stage one), is a promising 90 percent. If detected in an advanced stage (stage three or four), that survival rate drops to just 15-20 percent. Currently, there is no dependable screening for ovarian cancer, but because early diagnosis is so important, women should be aware of the risk factors and symptoms and consult their healthcare provider if they are at risk or notice any changes that may be signs of the disease. 

Factors that may increase the likelihood of developing ovarian cancer include: 
·    Age - most ovarian cancers develop after menopause, and half of all ovarian cancers are found in women over the age of 63 
·    Obesity - a study by the American Cancer Society found a higher rate of death from ovarian cancer in obese women 
·    Reproductive history - women who started menstruating before age 12, had no children or had their first child after age 30, and/or experienced menopause after age 50 may have an increased risk of ovarian cancer 
·    Fertility drugs - prolonged use of the fertility drug clomiphene citrate, especially without achieving pregnancy may increase the risk for developing ovarian tumors 
·    Family history - a woman's chance of developing ovarian cancer is increased if her mother, sister or daughter had ovarian, breast or colorectal cancer 
·    Breast cancer - women with BRCA mutation have an increased risk of ovarian cancer 
·    Talcum powder - women who use talc in the genital area may have a slight increase in risk 
·    Estrogen or hormone replacement therapy - some studies suggest using estrogen replacement therapy may increase a woman's risk of developing the disease 
·    Smoking and Alcohol use - Some studies have found an increased risk for one type of ovarian cancer (mucinous). 

Factors that may decrease the likelihood of developing ovarian cancer include: 
·    Female Surgery - Having your "tubes tied" (tubal ligation) may reduce the chance of developing ovarian cancer. A hysterectomy (removal of the uterus without removing the ovaries) also seems to reduce the risk of getting ovarian cancer. 
·    Diet - A recent study of women who followed a low-fat diet for at least 4 years had a lower risk of ovarian cancer. Some studies have shown a reduced rate of ovarian cancer in women who ate a diet high in vegetables, but other studies disagree. 

While early cancer of the ovaries tends to cause symptoms that are relatively vague, women who experience any of these symptoms should consult their healthcare providers: 
·    abnormal swelling of the stomach 
·    unusual vaginal bleeding 
·    pelvic pressure 
·    back pain 
·    leg pain 
·    digestive problems such as gas, bloating, indigestion, or long term stomach pain 
·    trouble eating or feeling full quickly 
·    having to urinate often or feeling like you have to "go" right away 

In addition to being aware of the risk factors and symptoms of ovarian cancer, Arizona Oncology reminds all women to speak with their healthcare providers about this disease and have an annual vaginal exam beginning at age 18. 

Arizona Oncology is proud to help Arizona patients in their battle against ovarian cancer by providing easy access a full range of advanced cancer care services. Our medical and radiation oncologists and their staff offer chemotherapy, injections, infusion services, radiation therapy and diagnostic imaging services in a convenient location that allows patients to remain close to their homes and support network of family and friends. As a result, patients have access the best possible treatment with the least amount of disruption to their daily lives.   

Our affiliation with The US Oncology Network, one of the nation's foremost cancer treatment and research networks, allows us to enhance access to the latest advances in therapies, clinical research and technology to patients in our community. In fact, The US Oncology Network is currently is involved in approximately 90 research trials for breast, colorectal, lung, ovarian, pancreatic and prostate cancer therapies, and has contributed to the development of 42 cancer-fighting drugs approved by the FDA.

ArizonaOncology.com 
Biltmore, Chandler, Deer Valley, Glendale, Phoenix, Scottsdale 
480-253-5300

Read more: http://www.abc15.com/dpp/lifestyle/sonoran_living/sl_sponsors/signs-and-symptoms-of-ovarian-cancer#ixzz277CkXKjA

Influence of a family history of breast and/or ovarian cancer on breast cancer outcomes.

Sept 2011

Cao AY, He M, DI GH, Wu J, Lu JS, Liu GY, Shen ZZ, Shao ZM.

Source

Breast Cancer Institute, Cancer Hospital/Cancer Institute, Department of Oncology, Shanghai Medical College, Institutes of Biomedical Science, Fudan University, Shanghai, P.R. China.

Abstract

Various published studies have been inconclusive in attempting to relate a family history of breast and/or ovarian cancer(BOC) to the survival of breast cancer patients. The aim of the study was to investigate the association of a family history of BOC with tumor characteristics, treatment response and the difference between the prognosis of familial breast cancer (FBC) patients and sporadic breast cancer (SBC) patients. Data on 348 operable FBC patients and 345 SBC patients were retrospectively analyzed. The overall survival (OS) and recurrence/metastasis-free survival (RFS) were compared for both groups. FBC cases were diagnosed at a relatively younger age (51.1±10.4 vs. 53.7±11.0 years, P=0.054) and presented a lower T stage (P=0.000) than the SBC cases. Patients with a family history of BOC had a significantly greater risk of recurrence/metastasis (P= 0.04) and a non-significantly increased risk of death (P=0.06) compared to the SBC patients. In a multivariate analysis, family history of BOC was an independent predictive factor for both recurrence/metastasis rate (P=0.01, HR=0.012, 95% CI 0.02-0.57) and mortality (P=0.044, HR=0.43, 95% CI 0.19-0.98) in the hormone receptor-positive population. Our results found that women diagnosed with FBC had an early onset of disease in the population studied, and the poor outcome of patients with a family history of BOC associated with survival was restricted to the hormone receptor-positive population.

PubMed

Ovarian Cancer: The Fifth Leading Cause of Cancer Death

Sunday September 16, 2012

Cancer is a disease in which cells in the body grow out of control. Cancer is always named for the part of the body where it starts, even if it spreads to other body parts later. When cancer starts in the ovaries, it is called ovarian cancer. Women have two ovaries that are located in the pelvis, one on each side of the uterus. The ovaries make female hormones and produce eggs.

Ovarian cancer causes more deaths than any other cancer of the female reproductive system. But when ovarian cancer is found in its early stages, treatment is most effective. Ovarian cancer often causes signs and symptoms, so it is important to pay attention to your body and know what is normal for you. Symptoms may be caused by something other than cancer, but the only way to know is to see your doctor, nurse, or other health care professional.

Who Gets Ovarian Cancer?

All women are at risk for ovarian cancer, but older women are more likely to get the disease than younger women. About 90% of women who get ovarian cancer are older than 40 years of age, with the greatest number of cases occurring in women aged 60 years or older.

Each year, about 20,000 women in the United States get ovarian cancer. Among women in the United States, ovarian cancer is the eighth most common cancer and the fifth leading cause of cancer death, after lung and bronchus, breast, colorectal, and pancreatic cancers. Ovarian cancer causes more deaths than any other cancer of the female reproductive system, but it accounts for only about 3% of all cancers in women. When ovarian cancer is found in its early stages, treatment is most effective.

Ovarian cancer screenings not recommended as a routine

Sept 2012

By Lena H. Sun, Published: September 10

A federal government task force recommended Monday that women not get routinely screened for ovarian cancer because doing so can put them at increased risk for unnecessary harm, such as major surgery.

The U.S. Preventive Services Task Force, an independent group of national experts, said it continues to discourage screening in women at average risk for ovarian cancer, which has the highest mortality rate of all types of gynecological cancer and is the fifth-leading cause of cancer death among women.

Although the task force made the same recommendation in 2004, the panel’s latest recommendation is based on the largest clinical trial published so far. It confirms previous findings, the task force chairman said.

“It was a pretty definitive study. It confirmed what we thought was the case,” said Virginia Moyer, the panel chair. Half the women in the study were screened with transvaginal ultrasounds and a blood test called CA-125, which is how screening is typically done. The other half of the women were not screened. There were 78,216 women in this trial.

“It made no difference in the outcome,” she said.

But a high percentage of women who undergo screening experience false-positive tests that then require invasive testing, such as major surgery to open up the abdomen and take out the ovary, she said.

“That puts those women at increased risk for being harmed. That’s major surgery.”

She said the task force tries to update its recommendations every five years based on new evidence. Its last recommendation against routine screening for ovarian cancer was issued in 2004. In 2008, review of the literature was commissioned by the task force and revealed no new evidence about the benefits of screening.

The task force did not make a recommendation, Moyer said, because the large clinical trial was underway.

Moyer said screening guidelines by other medical and public health organizations are in line with the panel’s. For example, the American Congress of Obstetricians and Gynecologists does not recommend screening for ovarian cancer in women who are not showing symptoms. Also, the American Cancer Society says there is no screening test proven to be effective and sufficiently accurate in the early detection of the cancer.

Women’s health advocates said the latest recommendation does show that better screening tools need to be developed.

“The important thing to remember is that if women do have symptoms or have a family history of ovarian cancer, they need to see a doctor,” said Pat Goldman, founder of the Ovarian Cancer National Alliance. Symptoms include persistent urinary or bowel changes or pelvic pain, or a feeling of fullness when you haven’t eaten.

Ovarian cancer is difficult to detect, so listen to your body

By Tara M. Ibarbo / For Healthy U

Posted:   09/03/2012 12:03:23 AM MDT

"It whispers, so listen." This slogan will always remind me of ovarian cancer. When I was in my second semester of nursing school, one of our first presentation style assignments was to pick a chapter in our nursing book and create a learning experience for our peers. Naturally my deep appreciation for cancer as a subject led me straight to its chapter. I was not only given an opportunity to research and uncover more about cancer, but I had the chance to choose one specific type of cancer and educate my peers. I opted for not only one of the most serious forms of cancer, but a cancer that always seems to have the least amount of attention. During my investigation I discovered one of the most profound slogans I have ever read and will forever remain aware of "It whispers, so listen."

So what exactly does this slogan mean? What it means is ovarian cancer usually does not produce any early symptoms, and when it does, they are so similar to typical symptoms of constipation, stomach upset, menstrual cramping and back pain, they essentially "whisper" and are commonly ignored. The key to "listening" to symptoms is really being familiar with your body. Usually if the unusual changes last longer than two weeks, it is important to seek medical attention. The major changes to pay attention to are: vaginal bleeding or discharge that is not normal for you, pelvic or low abdominal pain, back pain that persists, bloating in the lower region of your abdomen, feeling full quickly after eating, or a change in your bathroom habits — for instance prolonged constipation or diarrhea.

There is no screening for ovarian cancer, and please keep in mind that a Pap smear test will not detect this particular type of cancer; it is used as a screening tool for cervical cancer. The only prevention is listening to your body and noticing changes.

There are a few risk factors linked to ovarian cancer, which include: age, being of Eastern European (Ashkenazi) Jewish background, never giving birth, having a history of endometriosis, and genetic mutations. Two particular mutations called BRCA1 or BRCA2, are not only connected to breast cancer, but ovarian as well. They stand for BR (br-east) and CA (ca-ncer) and there are two susceptibility genes, thus the 1 and 2. If this gene is inherited, a woman's risk is significantly increased. The National Cancer Institute indicates that 1.4 percent (14 out of 1,000) will be diagnosed with ovarian cancer, compared with 15 to 40 percent (150-400 out of 1,000) of women who have a harmful BRCA1 or BRCA2 mutation. So, if there is a family history, especially close family, such as mother, sister, aunt or grandmother on either your father or mother's side of the family, it is important that your doctor is aware. Testing can be expensive and controversial, so it is important to talk to your health care provider if you feel you should have this done.

Teal is the awareness color for ovarian cancer and also stands on its own as a motto for bringing awareness. TEAL=Take Early Action & Live. As a reminder, September is Ovarian Cancer Awareness Month. If you would like to learn more about ovarian cancer, visit the National Ovarian Cancer Coalition website, www.ovarian.org.

Tara M. Ibarbo is a BSN/RN/ CTR employed at Memorial Medical Center Cancer Center and a current MPH graduate student at New Mexico State University.

LCSunNews

Ovarian cancer: why don't we ever talk about it?

When I heard the diagnosis of ovarian cancer, I assumed it was a death sentence. Lying on a gurney in a hospital hallway in Indiana, where I live and teach in a university, I concentrated on accepting my impending mortality with equanimity. I remember a moment of extraordinary calm.

My composure contrasts sharply with the often expressed sentiment "why me?" But I never believed that people get what they deserve. Regardless of my efforts to live a responsible life, it never entered my mind that I might be exempt from the common lot. I have known many young and old people with cancer, whose plight convinced me that it could strike anyone, anywhere, at any time. Given the high incidence of cancer in my circle of acquaintance, "why not me?" might have been a more predictable question. Victims, patients and survivors know that cancer just happens, whether because of genetics, lifestyle, diet, ageing or a radically compromised environment.

The unwilled surfacing of this moment of calm seemed astonishingly unexpected and, brief as it was, I wanted somehow to bank on it, to find in it some resource to draw upon through all the hardship to come. I was old enough at 63 to have acquired my share of wrinkles, grey hair, and the comprehension that my case was not tragic, not the tragedy, for instance, of a young woman robbed of her maturity. Should my daughters be diagnosed with such a disease in their early 30s: that would be devastating news, just about the worst thing that could possibly happen. With my two girls healthy and grown and most of my scholarly work done, I could hardly rail against the injustice of my fate.

In various venues, courageous women speak poignantly about ovarian cancer as a chronic and treatable illness with which they continue to live. Statistics, however, tell another, more pessimistic tale. Long-term survival rates have hardly improved since the 1970s because more than 70% of women present with disease spread beyond the ovaries. Even with sophisticated medical care, most of these patients suffer terminal recurrences a few years after diagnosis. "People with ovarian cancer die of ovarian cancer," a blunt doctor explains in a novel by Richard Powers.

What do women experience between diagnosis and death? There were 21,550 new cases of ovarian cancer in the US in the 2009 and an additional 14,600 women died from it [in the UK, 6,500 women are diagnosed with the disease every year, and 4,400 die every year]. It used to be estimated that one out of 70 American women would get the disease, the deadliest of all gynaecological cancers, though recently the number sometimes cited is one in 55. There are very few published personal accounts for them to consult, since for decades, indeed for centuries, women have generally maintained silence about the silent killer. So I began to inquire into the disease, and to write about it. Even at the moment of diagnosis, my age, family history and scholarly habits helped me to accept the disease and then to describe subsequent medical responses.

But I was not prepared for the horrific ordeals many ovarian cancer patients undergo. Acquiescence upon hearing the diagnosis would not sustain me during the six months that followed. Resolute acceptance tangled with dismay, and snarled with depression as I descended into deeper circles of an inferno in which I suffered less from the disease itself and more from grotesque surgeries and procedures performed by the most enlightened practitioners of contemporary medicine.

Yet weirdly, even after those horrific six months, I continued to seek out medical interventions. If I started out sceptical about the current treatments, and soon grew convinced of their barbarism, why did I continue to pursue them?

We have come a long way in the treatment of ovarian disease. Or have we? In 1998, one contributor to an anthology entitled Ovarian Cancer Journeys recounted that she heard a doctor at a nationwide conference declare: "Few ovarian cancer activists exist, because women don't live long enough to become activists." Over the next decade, there was little improvement in survival rates. Put another way, unlike early-detected breast or testicular, colon or prostate cancers, most ovarian cancer cases cannot be cured simply because they are not discovered before the disease has evolved into its third or fourth stages.

A Gynecologist's Second Opinion, published in 2003, opens a chapter on the disease with a sinister warning: "If 'cancer' is one of the most dreaded words in the English language, then for most women, 'ovarian' is the worst adjective to place before it. In all the bad news we sometimes deal with in gynaecology, this is the most frightening."

It is because warning signs and detection devices fail to reveal the early onset of most ovarian cancers that the diagnosis sounds like a death sentence. The leading cause of American and British women's deaths from gynaecological cancers, ovarian cancer exhibits warning signs that are easily missed or dismissed. What woman, after all, does not experience and generally put up with one or several of symptoms including bloating, fatigue, indigestion and back pain?

Discussing frequent delays in diagnosis, one influential study concluded that "women with ovarian cancer do have symptoms in contrast to what is stated in most textbooks and taught in most medical schools". If women and their physicians were educated about early warning signs, they could assign them proper significance and receive more effective treatment: ovarian cancer can be cured when it presents in its early stages.

Seemingly inconsequential, muted signs of the disease are easily blocked out, forgotten, or not experienced at all. The character in Powers's novel Gain wonders: "No warning signs at all. How could that be?" The philosopher Gillian Rose, who had to cope with a chemo-resistant ovarian cancer, answers this question by explaining that her fitness led her initially to overlook nausea and untimely premenstrual tension. Symptoms are often misunderstood because, as one oncologist puts it: "Ovarian cancer is the great impostor – it masquerades as some of the most common symptoms in middle life."

Misdiagnosis can also result from the unreliability of the CA-125 blood test often used to measure levels of ovarian cancer. While mammograms, MRIs, ultrasounds and needle biopsies can discover cancerous growths in the breast before they can be felt by fingers, no reliable screening tool for ovarian cancer exists. Nor does the disease silently advance only in older, postmenopausal women. Rosalind Franklin was 37 when her death from ovarian cancer made her ineligible for the Nobel prize awarded to Francis Crick and James Watson for the discovery of the structure of DNA.

No reliable screening device, no cure for the vast majority of patients; but what about causes? Low parity has been considered a factor or, as it is sometimes called, "poor reproductive performance". Frequent ovulation has been blamed, with some physicians touting the benefits of oral contraception. Asbestos exposure, talcum powder, hormone replacement therapy, and fallout from nuclear testing have all been linked to ovarian cancer, as have a diet high in fat, fertility drugs (or the infertility that caused them to be taken), and a number of the pollutants discussed with respect to other forms of cancer.

Recent research has shown that the genetic markers BRCA1 and 2 account for about 10% of ovarian cancers. But should healthy girls spend their young adulthood worrying about whether or not to be tested for a mutation? A positive result in such a test can trap an individual into the horrific conviction that she is doomed.

A second medical advance in ovarian cancer research, announced in 2010, promises progress in early detection. Dr Karen Lu used the CA-125 blood test over a period of eight years to screen post-menopausal women. No invasive tumours were missed, and most of those found were in early enough stages for successful surgical interventions. Because of Lu's small sample, unfortunately, American women will not receive standard annual testing. A larger British study should appear in 2015. Meanwhile, as some scientists experiment with emerging treatments, others speculate that there may be many different types of ovarian cancer that should be treated differently, and that gene sequencing will provide an approach to each case.

With warning signs easily ignored or misread, and descriptions of the disease's progress marginalised in cancer literature, ovarian cancer – whether or not it is genetic in origin – establishes a series of issues quite distinct from those in breast cancer. No visible, external body part gets sliced off the ovarian cancer patient in surgery. She need not mourn an amputation and ostentatious scarring on her body, nor the loss of an erogenous zone. Nor need she display or conceal the ravages of her cancer. Except for a vertical line of stitches down the belly, the wounds remain inward, invisible, though they can rob younger women of their fertility. Many breast cancer survivors today believe that if you've got to have breast cancer, it's a good time in history to have it. The same claim cannot be made about ovarian cancer.

In her book Blood Matters, about illness and heredity, Marsha Gessen calls ovarian cancer "breast cancer's poor neglected cousin", in part because breast cancer is imagined as a disease that can be overcome, whereas ovarian cancer remains "intractable, unimaginable, unspeakable". "You hear about breast cancer all the time," one ovarian cancer patient points out, "but you never hear about ovarian cancer." According to one British patient: "For the average person who is not a hypochondriac, or a reader of medical journals, ovarian cancer seems one of the best-kept secrets in the medical world."

There are very few personal accounts of dealing with ovarian cancer, not only because it is difficult to narrate progress within a cheerful recovery framework, but also because such stories would inevitably address still stigmatised (and thus hidden) bodily afflictions. Who, in search of inspiring or comforting assurances, wants to buy, much less read, a yucky downer? Breast cancer, which has received much more attention and research money, and afflicts many more women, has its own patron saint, St Agatha, who offers her sliced-off breasts on a platter.

To my knowledge, there is no patron saint of ovarian cancer, and most people could not name the colour of its ribbon (teal). The state of medical responses to ovarian cancer corresponds to the state of medical responses to breast cancer half a century ago.

Of course, no one person can represent all the women struggling with ovarian cancer. Nor can I, as a privileged professor at a university that provides me job security as well as health benefits. Those who credit their survival of ovarian cancer to "positive thinking, trust and hope" may judge me defeatist, or worse, complicit in my illness. Yet after my diagnosis, and despite my hunch about the disease's fatality, I did undergo all the operations, therapies and interventions specialists advised. Given my love of life and of the people in my life, it seemed wrong simply to submit to the cancer's inevitable progress.

Motivated by a desire to tackle a writing problem that Virginia Woolf believed the literary women of her generation had failed to solve – telling the truth about the experiences of the female body – I sought in writing about my illness to record precisely what I could not or would not say to most of my family and friends. Too often, it seems to me, squeamish euphemisms glamorise the fight against cancer and inhibit efforts to deal with suffering and death. Why I can report on a computer keyboard what I cannot bear to say aloud remains a mystery to me, but so it goes.

Women need to heed the muted or misunderstood symptoms of ovarian cancer, and to agitate for early detection tools. We must save our successors from an undetectable and then unfixable condition that continues to threaten the health and welfare of future generations.

This is an edited extract from Memoir of a Debulked Woman: Enduring Ovarian Cancer by Susan Gubar, published by WW Norton on 4 September, price £16.99.

GuardianUK

Annette Mattern: What Every Woman Should Know About Ovarian Cancer

Annette Mattern: What Every Woman Should Know About Ovarian Cancer

Annette Mattern: What Every Woman Should Know About Ovarian Cancer

“How do I know if I have ovarian cancer?” the question most asked by women about the disease that, for years, was called the silent killer. Ovarian cancer is the fifth leading cause of cancer-related death among U.S. women and yet, most women know very little about it.

What you should know:

1. Every woman is at risk.

2. One is 72 women will develop ovarian cancer; one in 95 women will die from it.

3. Increased risk factors:
• Personal history of breast cancer
• Family history of breast or ovarian cancer.
• BRCA1 or BRCA2 genes, responsible for 5-10% of ovarian cancers. Women of Ashkenazi Jewish descent are at higher risk of carrying these mutations.

4. There is no screening tool, not even the PAP, so it is critical that women recognize the symptoms as early as possible.

• Stage I recurrence rate is only 10%.
• Stage III or IV (about 75% of cases) recur 85-95% of the time. Their 5-year survival rate is only 46%.

5. 95% of women with ovarian cancer experience symptoms, 90% at early stage. Symptoms:
• Bloating
• Pelvic or abdominal pain
• Difficulty eating or feeling full too quickly
• Urinary urgency or frequency

Other symptoms: fatigue, indigestion, back pain, pain with intercourse, constipation and menstrual irregularities.

What you should do:

If you exhibit persistent symptoms for more than a few weeks and this is not normal for your body, see a gynecologist. Your exam may include a CA-125 blood test, pelvic exam, and a trans-vaginal ultrasound. The only conclusive way to determine if it is cancer is by performing a biopsy.

Help spread the word.

Most women with ovarian cancer were misdiagnosed for years while their cancer spread. An earlier diagnosis is a woman’s best hope for a good prognosis.

Bio notes:

Annette Mattern is a 21-year survivor of ovarian cancer and recently survived breast cancer. She is the founder and president of the Ovarian Cancer Alliance of Arizona and serves on the board of directors of the Ovarian Cancer National Alliance. Her book on survival, Outside The Lines of Love, Life, and Cancer, is available on www.amazon.com.

Links: www.ocaz.org
www.ovariancancer.org