Ovarian Cancer

Each year in the United States, more than 21,000 women are diagnosed with ovarian cancer and about 15,000 women die of the disease. The American Cancer Society estimates that about 21,550 new cases of ovarian cancer will be diagnosed in the United States during 2009. 14,600 deaths are expected to be caused by ovarian cancer in the United States in 2009. (Ovarian Cancer National Alliance)

The statement above is grim, but there are even more depressing statistics available from the Ovarian Cancer National Alliance or www.ovariancancer.org. I will be honest with you here, I do not have a great deal of personal knowledge about ovarian cancer. Last night I spent about an hour looking through on-line resources many of which I printed off and added to my binder. Talk about astonished, I knew that everyone says that the tests and screening available for this type of cancer were not good, but I had no idea about the statistics and facts related to it. Just the idea of being at high risk for ovarian cancer is a bleak one.

Let me go ahead and scare you a little. Early diagnosis of ovarian cancer is achieved in less than 20% of all cases meaning that 80% of women diagnosed are in the advanced stages of cancer. If you are one of the lucky 20% you have a much higher overall survival rate. Those not diagnosed in the early stages look forward to a 46% chance of surviving 5 years, and an even lower 39% chance of seeing an additional 10 years after diagnosis. Ovarian cancer is the fifth leading cause of cancer deaths in women. This is scary!

Why is the outlook so bleak? Detection. Overall symptoms of ovarian cancer can also be classified with other digestive and bladder disorders. Commonly women are diagnosed with another more common condition before finding they have cancer. The Mayo Clinic lists the following as available screening, but also states that none of these have been proven to give an early diagnosis and often they can lead to false positives. Pelvic exams preformed by your doctor to screen for masses or growths in your vagina, uterus, rectum, and pelvis. Ultrasound or high-frequency sound waves used to produce images from the inside of your body. This allows for an accurate way to look at the ovaries, but is not able to give definitive diagnosis of cancerous or non-cancerous masses. It is only able to establish if a mass is present. The last method of screening is the CA 125 blood test. You go in and have your blood drawn. This is probably the easiest of all of the screening methods, but it may also be the most variable by individual. Typically women with ovarian cancer have elevated levels of CA 125 protein in the blood. There are other conditions that can also cause higher CA 125 levels that are not associated with ovarian cancer, this can cause false positives and even result in unnecessary surgery and worry. CT and MRI are also available screening methods, but are not typically used as initial screening methods.

So what happens if one of your tests come back and it is necessary to confirm a diagnosis one way or the other. There are two typical methods used. A laparotomy can be performed where a surgeon makes an incision into your abdomen. Once the incision has been made samples are collected and tissue can be removed for pathological testing. The second less invasive method is laparoscopy. A couple of smaller incisions are made and small tools and a light source are used to explore and remove tissue once again to be sent for testing. If cancer is confirmed a larger incision may be necessary to remove as much cancerous tissue as possible.

It seems to me that more often than not, ovarian cancer or the possibility of ovarian cancer is directly associated with hysterectomy. Many women who are even facing the thought of cancer have a complete hysterectomy performed in lieu of tissue samples and testing.

If your pathology reports come back and you have cancer cells present you are looking at three possibilities. Common epithelial tumors make up 85 - 90% of all ovarian cancers and are unfortunately not usually found until they are in advanced stages. These cancerous tumors begin in the cells that cover the outer surfaces of the ovaries. Germ cell tumors involve the cells that produce the ova or eggs. Most occurrences of this cancer are in teenagers and women in their twenties. These types of cancers can be cured and fertility preserved if found in the early stages. The third type are known as stromal tumors. These are rare and involve the connective tissue which keeps the ovary in tact, and also the cells that produce the hormones estrogen and progesterone. Stromal tumors are usually considered low grade cancers and present as stage 1 being limited to one or both ovaries.

On a lighter note studies have shown that prophylactic oophoremtomy significantly reduces the risk of ovarian cancers. The Mayo Clinic states that risk can be reduced by up to 95% for ovarian cancer, and up to 50% for breast cancer. There is typically a trade off though. You can reduce your risk for breast and ovarian cancer, but usually you may increase your chances of other health conditions later on. Now that we know a little more about ovarian and breast cancer we can discuss what we will have to worry about later on if we choose to have preventative surgery.


http://www.ovarian.org
http://www.mayoclinic.com/health/ovarian-cancer
http://www.cancercenter.com/ovarian-cancer.cfm