The new year has started with the hope of resolutions ringing true and the possibility of a new start and new adventures in life. What many women and their families may not be looking forward to is ovarian cancer, as approximately 22,000 new cases are diagnosed each year.
Affecting approximately 1 in 57 women, ovarian cancer is not as common as breast cancer, which affects 1 in 7 women, but it is considered more deadly, because of a much higher percentage of terminal cases. According to the American Cancer Society, ovarian cancer accounts for only 3 percent of all cancers among women, yet ranks fourth as a cause of their deaths from cancer. The American Cancer Society statistics for ovarian cancer estimate that annually there are about 22,220 new cases and 16,210 deaths.
Ovarian cancer is treatable when caught in its early stages, but it is known as the “silent killer” because its symptoms are vague and may be confused with other disease processes or may even go undetected until its later stages. Almost 70 percent of women with the common epithelial ovarian cancer are not diagnosed until the disease is advanced in stage and has spread to the upper abdomen (stage III) or beyond (stage IV). The five-year survival rate for women in stages III and IV is only 15 to 20 percent, whereas the five-year survival rate for stage I disease patients approaches 90 percent and for stage II disease patients approaches 70 percent, according to the National Ovarian Cancer Coalition.
Diagnosis of ovarian cancer is based on symptoms and confirmation by ultrasound, MRI, CT scan, blood tests and cell biopsy. It is currently being treated with chemotherapy, radiation and/or surgery, based on the stage and type of tumor.
Symptoms of the disease include a fullness or pressure in the abdominal or pelvic area, vague stomach pain or acid reflux, and abnormal vaginal bleeding may also occur. Unlike breast cancer, a routine monthly screening cannot be conducted at home due to the location of the ovaries. There are also no routine screening options, such as mammography.
Although symptoms can be vague, there are many factors that have been proven to contribute to a woman’s risk of ovarian cancer, including:
- increasing age
- having had breast cancer
- family history of ovarian cancer
- having certain types of colon cancer
- use of fertility drugs under certain circumstances
In addition to these, other aspects have been linked to an increased risk of ovarian cancer, such as the use of talcum powder in the vaginal area, hormone replacement therapy in postmenopausal women and certain types of complex ovarian cysts in women over age 50.
Research is also being currently tested concerning whether the age of menstruation and menopause is a risk factor. Some experts say that this is not a factor, but others strongly believe that it is linked to ovarian cancer risk.
On the other hand, having at least one child, breastfeeding, use of the birth control pill, and tubal ligation or having a hysterectomy have been shown to decrease women’s chances of having ovarian cancer. Current research is also being conducted on the effect aspirin might have on ovarian cancer, due to some women’s bleeding risks and stomach irritation associated with aspirin use. Some medical professionals warn against taking the drug until more studies can be conducted.
Screening tools for the disease are currently being developed, but some physicians are using ultrasound to detect early stage tumors in high-risk patients. A tumor marker, CA-125, is being used as a diagnostic tool, but it is currently being researched as a screening marker, similar to BRCA-1 and BRCA-2, which are screening markers for breast cancer.
January has been designated as Ovarian Cancer Awareness Month, lending to its increasing predominance in society and its reputation as the “silent killer.” As women make their New Year’s resolutions, they should remember to include a resolution to visit their physician and gynecologist for routine physicals, which provide the best method of early detection of ovarian cancer.
Andrea Yevchak is a registered nurse on the Medical/Surgical and Orthopaedics Unit at Mount Nittany Medical Center. She is also a graduate student at Penn State University, majoring as a clinical nurse specialist in adult medical/surgical nursing, with a formal minor in geriatrics. She is a Hartford Foundation Geriatric Nursing Scholar.