Blindsided By Ovarian Cancer
September is Gynecologic Cancer Awareness Month
SEPTEMBER is Gynecologic Cancer Awareness Month. This includes: Cervical Cancer, Endometrial Cancer, Vaginal Cancer, Vulvar cancer, etc., Today we will do a quick review of Ovarian Cancer.
Ovarian Cancer is deadly. It is the 4th leading cause of death in women and the leading cause of gynecological cancer death. The average lifetime risk is 1 in 70 with median age of diagnosis of 63 years. Like most other cancers, Ovarian Cancer is highly curable if diagnosed at an early stage, but 75% presents with more advance disease, at stage III or IV. Early diagnosis is usually very difficult, because patients often present with vague abdominal symptoms and there is a lack of good screening test with initial presentation.
Where Are the Ovaries?
There is an ovary found on each side of the body. The Ovaries are part of the female reproductive system. The ovaries produces ovum (eggs) that travels down the fallopian tube, down to the uterus that may become fertilized with a sperm (see image below).
How Do I Know If I Have Ovarian Cancer?
Ovarian Cancer symptoms are very vague and may be mistaken for common symptoms. However, if the symptoms below are new and/or persisting, you should speak with your Primary Care Manager or Provider (PCM/PCP). Let them know what you are experiencing, how long it has been going on, etc.,
- Abdominal discomfort/pain/bloating
- Increasing girth (increase size around waist/abdomen region)
- Change in bowel (movements) habits
- Early satiety (feeling full after eating small amount of food)
- Sister Mary Joseph Nodes (associated with ovarian cancer and of gastrointestinal tract)
- Ascites (fluid just under the abdominal skin, that shifts like a wave when tapped)
How is Ovarian Cancer Diagnosed?
In addition to the basic blood, liver and kidney evaluation, some specific labs (blood work) that may assist with ovarian cancer diagnosis includes:
- CA125 – elevated in 80% of ovarian tumors
- CA 19-9 – low sensitivity, but could be positive in other cancers
- CEA – elevated in 58% of advance stage ovarian cancers
- AFP & βHCG – Measure if <30 years old to help rule out other types of tumors
Because of its presentation, diagnosis usually involves quite a number of imaging as well: Transvaginal ultrasound, CT scan and/or MRI, cystoscopy, sigmoidoscopy, endometrial biopsy (if patient has abnormal vaginal bleeding), assessment of any ascites fluid, etc., Surgical exploration is also necessary to complete staging of disease (find out how advance and how far it has spread).
Stages of Ovarian Cancer
As with most cancers, the treatment for ovarian cancer is dependent on the final staging, but majority involves surgery followed by chemotherapy. If not a chemotherapy candidate, then Whole Abdomen Radiation Therapy (WART) may be considered after surgery. However, WART is falling out of favor, due to the toxicity and side effect profile. There are also many open trials and studies on-going for improved treatment for ovarian cancer. Ask your team, if interested, about open research trials.
This only a quick synopsis. As always, the best way to find out about any health issue, is to engage/talk with your PCM/PCM. Continue to do you annual physical and visit sooner if there are any concerning changes or abnormalities.
Until next time know that,
Life is beautiful and God is awesome. And know, you are pure awesomeness!
Ipsa Scientia Potestas est ——— Knowledge itself is power!
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Queen, Your Family Friendly Cancer Doc!