The exact causes of ovarian cancer are not known. However, studies show that the following factors may increase the chance of developing this disease:
|About 1 in every 57 women in the United States will develop ovarian cancer. Most cases occur in women over the age of 50, but this disease can also affect younger women.|
As we learn more about what causes ovarian cancer, we may also learn how to reduce the chance of getting this disease. Some studies have shown that breast feeding and taking birth control pills (oral contraceptives) may decrease a woman's likelihood of developing ovarian cancer. These factors decrease the number of times a woman ovulates, and studies suggest that reducing the number of ovulations during a woman's lifetime may lower the risk of ovarian cancer.
Women who have had an operation that prevents pregnancy (tubal ligation) or have had their uterus and cervix removed (hysterectomy) also have a lower risk of developing ovarian cancer. In addition, some evidence suggests that reducing the amount of fat in the diet may lower the risk of developing ovarian cancer.
Women who are at high risk for ovarian cancer due to a family history of the disease may consider having their ovaries removed before cancer develops (prophylactic oophorectomy). This procedure usually, but not always, protects women from developing ovarian cancer. The risks associated with this surgery and its side effects should be carefully considered. A woman should discuss the possible benefits and risks with her doctor based on her unique situation.
Having one or more of the risk factors mentioned
here does not mean that a woman is sure to develop ovarian cancer, but the
chance may be higher than average. Women who are concerned about ovarian
cancer may want to talk with a doctor who specializes in treating women
with cancer: a gynecologist, a gynecologic oncologist, or a medical
oncologist. The doctor may be able to suggest ways to reduce the
likelihood of developing ovarian cancer and can plan an appropriate
schedule for checkups.
Detecting Ovarian Cancer
The sooner ovarian cancer is found and treated, the better a woman's chance for recovery. But ovarian cancer is hard to detect early. Many times, women with ovarian cancer have no symptoms or just mild symptoms until the disease is in an advanced stage. Scientists are studying ways to detect ovarian cancer before symptoms develop. They are exploring the usefulness of measuring the level of CA-125, a substance called a tumor marker, which is often found in higher-than-normal amounts in the blood of women with ovarian cancer. They also are evaluating transvaginal ultrasound, a test that may help detect the disease early. The Cancer Information Service can provide information about this research.
|A large-scale study, known as the PLCO (Prostate, Lung, Colorectal, and Ovarian) Cancer Screening Trial, is currently evaluating the usefulness of a blood test for the tumor marker known as CA-125 and a test called transvaginal ultrasound for ovarian cancer screening.|
Ovarian cancer often shows no obvious signs or symptoms until late in its development. Signs and symptoms of ovarian cancer may include:
These symptoms may be caused by ovarian cancer or by
other, less serious conditions. It is important to check with a doctor
about any of these symptoms.
Diagnosing Ovarian Cancer
To help find the cause of symptoms, a doctor evaluates a woman’s medical history. The doctor also performs a physical exam and orders diagnostic tests. Some exams and tests that may be useful are described below:
If the diagnosis is ovarian cancer, the doctor will
want to learn the stage (or extent) of disease. Staging
is a careful attempt to find out whether the cancer has spread and, if
so, to what parts of the body. Staging may involve surgery,
Treatment for Ovarian Cancer
Treatment depends on a number of factors, including the stage of the disease and the general health of the patient. Patients are often treated by a team of specialists. The team may include a gynecologist, a gynecologic oncologist, a medical oncologist, and/or a radiation oncologist. Many different treatments and combinations of treatments are used to treat ovarian cancer.
Staging during surgery (to find out whether the cancer has spread) generally involves removing lymph nodes, samples of tissue from the diaphragm and other organs in the abdomen, and fluid from the abdomen. If the cancer has spread, the surgeon usually removes as much of the cancer as possible in a procedure called tumor debulking. Tumor debulking reduces the amount of cancer that will have to be treated later with chemotherapy or radiation therapy.
Most drugs used to treat ovarian cancer are given by injection into a vein (intravenously, or IV). The drugs can be injected directly into a vein or given through a catheter, a thin tube. The catheter is placed into a large vein and remains there as long as it is needed. Some anticancer drugs are taken by mouth. Whether they are given intravenously or by mouth, the drugs enter the bloodstream and circulate throughout the body.
Another way to give chemotherapy is to put the drug directly into the abdomen through a catheter. With this method, called intraperitoneal chemotherapy, most of the drug remains in the abdomen.
After chemotherapy is completed, second-look surgery may be performed to examine the abdomen directly. The surgeon may remove fluid and tissue samples to see whether the anticancer drugs have been successful.
Clinical trials (research studies) to
evaluate new ways to treat cancer are an important treatment option for
many women with ovarian cancer. In some studies, all patients receive the
new treatment. In others, doctors compare different therapies by giving
the promising new treatment to one group of patients and the usual
(standard) therapy to another group. Through research, doctors learn new,
more effective ways to treat cancer. More information about treatment
studies can be found in the NCI publication Taking Part in Clinical
Trials: What Cancer Patients Need To Know. NCI also has a Web site at
http://cancertrials.nci.nih.gov that provides detailed information about
ongoing studies for ovarian cancer. Clinical trial information is also
available from the Cancer Information Service by calling
|The NCI's CancerNet™ Web site provides information from numerous NCI sources, including PDQ®, NCI's cancer information database. PDQ contains information about ongoing clinical trials as well as current information on cancer prevention, screening, treatment, and supportive care. CancerNet also contains CANCERLIT®, a database of citations and abstracts on cancer topics from scientific literature. CancerNet can be accessed at http://cancernet.nci.nih.gov on the Internet.|
Possible Side Effects of Treatment
The side effects of cancer treatment depend on the type of treatment and may be different for each woman. Doctors and nurses will explain the possible side effects of treatment, and they can suggest ways to help relieve problems that may occur during and after treatment.
When both ovaries are removed, a woman loses her ability to become pregnant. Some women may experience feelings of loss that may make intimacy difficult. Counseling or support for both the patient and her partner may be helpful.
Also, removing the ovaries means that the body's natural source of estrogen and progesterone is lost, and menopause occurs. Symptoms of menopause, such as hot flashes and vaginal dryness, are likely to appear soon after the surgery. Some form of hormone replacement therapy may be used to ease such symptoms. Deciding whether to use it is a personal choice; women with ovarian cancer should discuss with their doctors the possible risks and benefits of using hormone replacement therapy.
Several NCI booklets, including Chemotherapy and You, Radiation Therapy and You, and Eating Hints for Cancer Patients, suggest ways for patients to cope with the side effects they experience during cancer treatment.
|Doctors and nurses will explain the possible side effects of treatment, and they can suggest ways to help relieve problems that may occur during and after treatment.|
The Importance of Followup Care
Followup care after treatment for ovarian cancer is
important. Regular checkups generally include a physical exam, as well as
a pelvic exam and Pap test. The doctor also may perform additional tests
such as a chest
In addition to having followup exams to check for the return of ovarian cancer, patients may also want to ask their doctor about checking them for other types of cancer. Women who have had ovarian cancer may be at increased risk of developing breast or colon cancer.
Disclaimer: This information is intended as a guide only. This information is offered to you with the understanding that it not be interpreted as medical or professional advice. All medical information needs to be carefully reviewed with your health care provider.
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