Employee & Community Health

Ovarian cancer: Listen to your body

9/14/2017 by Dr. Marcia O'Brien

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When I was a teenager, a close relative died from metastatic ovarian cancer shortly after it was diagnosed. About the same time, her sister (my favorite aunt) was diagnosed with recurrent breast cancer and eventually died. This was pretty traumatic for me because these women were relatively young - in their 50s. 

During medical school, I learned that breast cancer and ovarian cancer could be related. So I encouraged their daughters to talk with their family doctors and undergo medical genetics consultation and testing. Testing showed no genetic syndrome, which provided great relief to them and their families. 

As a family doctor, I now provide care to families, including women of all ages, often from the same family, throughout the various stages of their lives. I answer questions every day regarding health-risk reduction, age-appropriate cancer and disease screening, risks associated with family history, and disease prevention. I also have helped care for women with ovarian cancer. 

Ovarian cancer by the numbers

  • Ovarian cancer accounts for approximately 3% of cancers in women. 
  • Among women, it is the eighth most-common cancer and the fifth leading cause of cancer-related deaths. 
  • On average, women have a one-in-75 lifetime chance of getting ovarian cancer. The risk is greater for women with a genetic predisposition, such as BRCA 1 or 2 or other inheritable cancer syndromes. 
  • In the U.S., it is the deadliest of the gynecologic cancers. Each year, about 22,300 women are newly diagnosed with ovarian cancer and about 14,250 will die from it. That's been a trend for 50 years. 
  • Ovarian cancer is rare in women of child-bearing years, diagnosis typically is between the ages of 55 and 64, usually during menopause. 
  • Women who are older than 65 when they are diagnosed have a worse prognosis than women diagnosed at a younger age. 
  • About 15% of the time, this cancer is diagnosed in its early stages. The five-year survival rate for women with early detection is 93%. 

Symptoms to watch for

Because the symptoms tend to be vague, ovarian cancer is most often diagnosed in advanced stages, resulting in poorer outcomes. Studies show that most women have symptoms for three to six months before seeking medical care. These include: 

  • Nausea, vomiting, indigestion, loss of appetite, feeling full early
  • Abdominal bloating and/or cramping, abdominal-back-pelvic pain or pressure, increasing abdominal girth
  • Vaginal bleeding
  • Urinary frequency or urgency, changing bowel habits
  • Weight loss
  • Fatigue
  • Pain during intercourse
  • Leg swelling

It is important for women to be aware of these symptoms and seek further evaluation by their provider. 

Next steps

Women with symptoms will undergo a physical exam. A pelvic exam, lab tests, such as blood testing for CA-125 (ovarian cancer tumor marker), and imaging by pelvic ultrasound can help aid the diagnosis, which is made by analyzing a tissue sample. 

Currently, routine screening for ovarian cancer is not available or recommended. So it is up to women to listen to their bodies and take note of symptoms -- even vague ones -- that persist. Women should be aware of their family history, any changes in that history and keep their health care provider updated. 

In women with a family history of ovarian cancer, BRCA 1 or 2 or other inheritable cancer syndromes, they should share this history with their health care providers and schedule regular follow up and specialty consultations to develop individualized care plans for reducing risk. 

Reducing your risk

Reducing your risk of ovarian cancer is the same for all cancers. Avoid tobacco use, excess alcohol consumption, diets high in animal protein and animal fat, and being overweight/obese. 

There is no specific prevention for ovarian cancer, although these general wellness practices are encouraged. 

Diet. Eat less animal protein/fat, more vegetables and fruits, and cut back or eliminate eating processed foods. 

Exercise. Strive for 30 minutes of moderate-intensity exercise five times per week, including aerobic, strength, balance and flexibility and 10,000 steps a day. 

Weight. Achieve and maintain a healthy body weight, with a body mass index (BMI) of 19-24.9. 

Sleep. Aim for seven to nine hours a night. 

Dr. Marcia O'Brien is a Family Medicine physician at Employee and Community Health's (ECH) Mayo Family Clinic Northeast. She practices the full spectrum of family medicine including hospital medicine, newborn nursery and obstetric care.