September is Ovarian Cancer Awareness month and Greenville Women’s Care would like to make you aware of the signs and symptoms of this disease.
Ovarian cancer is a type of cancer that may have multiple causes and it may begin in the ovary or adjacent structures including the Fallopian tube and lining of our abdominal cavity. A woman’s reproductive system contains two ovary and Fallopian tube, one on each side of the uterus in the pelvis. Each ovary is about the size of an almond and produces hormones and eggs (ova) for the purpose of our female composition and reproduction. Your ovaries also produce the hormones estrogen and progesterone. The Fallopian tube is the tube or “conveyor belt,” if you will imagine that transports the egg to meet the sperm and travel back to the uterus for implantation. The Fallopian tube serves no other purpose.
Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen because there is not yet a perfect test, like a mammogram for breast cancer screening, to detect it early. Late-stage ovarian cancer is more difficult to treat. When the cancer is confined to the ovary, early-stage ovarian cancer, it is likely to be treated more successfully. The best chance of catching this cancer in its early- stages is to know your body well and to have regular exams with your Gynecologist. There are different types of ovarian cancer and each usually present at different age groups. No matter the type of ovarian cancer, it is generally treated with surgery and chemotherapy.
Types of Ovarian Cancer
Your ovaries are made up of three main types of cells and each can develop into a different type of tumor. The type of cell where the cancer begins is the type of ovarian cancer you have. The three types include:
- Epithelial tumors. These start in the thin layer of tissue on the outer surface of the ovary. Most, about 90%, ovarian cancers are epithelial tumors.
- Germ cell tumors. These start from the cells that produce the eggs (ova). This rare ovarian cancer tends to occur in younger females.
- Stromal tumors. These start from the structural tissue that produces the hormones estrogen and progesterone. These tumors, about 7%, are usually diagnosed at an earlier stage.
Benign tumor s(non-cancerous) don’t spread beyond the ovaries. Benign tumors are treated by either removing the ovary or removing the part of the ovary that contains the tumor. Malignant (cancerous) tumors can metastasize (spread) to other parts of the body and can be fatal. It must be treated.
Signs & Symptoms of Ovarian Cancer
Early-stage ovarian cancer rarely causes any symptoms. Women are more likely to have symptoms when the disease has spread beyond the ovaries. However, most of these symptoms are likely to be caused by other conditions, and most of them occur often in women who don’t have ovarian cancer.
Some of the signs and symptoms include:
- Pelvic or abdominal pain
- Trouble eating or feeling full quickly
- Urinary symptoms, such always feeling like you have to go or having to go often
- Upset stomach
- Back pain
- Pain during sex
- Change in bowel habits, such as constipation
- Menstrual changes
- Abdominal swelling with weight loss
Symptoms caused by ovarian cancer are typically more persistent and are a change from normal – meaning they occur more often and are more severe. It is important to know your body well and if any unexplained symptoms persist for an extended period of time, see your Gynecologist.
Causes of Ovarian Cancer
It’s not clear what causes ovarian cancer, however physicians have identified several factors that can increase the risk of the disease. Generally, cancer begins when a cell develops mutations in its DNA. The mutations tell the cell to grow and multiply quickly which creates a tumor of abnormal cells. Those cells continue living as healthy cells die. The abnormal cells can invade nearby tissues and break off from an initial tumor to metastasize in the body.
Risk factors of Ovarian Cancer
Factors that can increase your risk of ovarian cancer include:
- Beginning menstruation at an early age or starting menopause at a later age, or both, may increase your risk of ovarian cancer.
- Infertility or never having children or having them at a later age
- Pelvic conditions like endometriosis
- Older age. Although ovarian cancer can occur at any age, it’s most common in women 50 to 60 years of age.
- Inherited gene mutations. A small percentage of ovarian cancers are caused by gene mutations inherited from your parents. We have now learned of several genetic mutations and a blood test is available to determine if you are a carrier.
- Personal history of breast cancer
- Family history of ovarian cancer. Woman who have two or more close relatives with ovarian cancer have an increased risk of the disease.
Prevention of Ovarian Cancer
There’s no guaranteed way to prevent the disease, however there may be ways to reduce your risk:
- Consider taking birth control pills as a means for menstrual manipulation to protect your ovaries. Ask your gynecologist whether this approach may be right for you. A birth control pill places your ovaries into a dormant state and is thought to be protective of the ovary to stop ovulation. This is how it protects one from pregnancy. When a woman is not on birth control, each month ovulation occurs and the egg bursts out of the ovary. This process creates a small scar. The scar is thought to be one of the many causes that could set of the ovarian cancerous process overtime. Women who therefore ovulate monthly are at increased risk. A birth control pill much like pregnancy prevents the ovary from being able to ovulate and therefore protective. Oral contraceptives do have risks, so you should discuss whether the benefits outweigh the risks with your gynecologist.
- The other method to reduce your risk resides with the Fallopian tube. When one no longer desires future fertility, this structure can be removed. It is recommended to be considered at time of permanent sterilization, like a tubal ligation, or at a hysterectomy. Evidence shows that removing the entire Fallopian tube may be protective. It is believed that the more aggressive ovarian cancers may not start in the Fallopian tube and not the ovary. This operation is called an opportunistic salpingectomy. It is not recommended to have this surgery for this reason alone. Surgery comes with many risks and evidence has not yet confirmed this should be the sole reason for a surgery to warrant the risk of having surgery. It is recommended however to be done when one is already having surgery for other reasons, hence the opportunistic consideration.
Whether you’re worried about developing ovarian cancer, making decisions about treatment options, or trying to stay well after treatment for ovarian cancer, the physicians and staff at Greenville Women’s Care do care and are here to help!