Breaking the silence of this deadly disease through early diagnosis
Ovarian cancer has historically been called a “silent killer” with one in every 100 women with the disease dying from. Why? Because it can spread before the condition is detected.1,2 The problem is the symptoms are common to other conditions, such as irritable bowel syndrome, gastritis, depression, menopause or a women’s period, and are not necessarily seen as indicative of ovarian cancer. This means diagnosis is often made late. In fact, 79% of women are diagnosed at an advanced stage, which is when the cancer has already spread to the lining of the stomach and lymph nodes.1,2
Be aware of the signs and symptoms
Key symptoms of ovarian cancer to be aware of include:
- Bloating and constipation
- Pelvic or abdominal pain
- Loss of appetite
- Urgent need to urinate
- Upset stomach
- Back pain
- Pain during sex
- Menstrual changes
- Weight loss
Be aware of the risk factors of ovarian cancer
All women are essentially at risk of developing ovarian cancer, but not all women are at high risk. If a woman’s mother, sister or daughter for example has (or has had) ovarian cancer, she may be at higher risk.2 This could be due to a mutation in one of two genes: the breast cancer gene 1 (BRCA1) or breast cancer gene 2 (BRCA2).6 Since these genes are linked to both breast and ovarian cancer, women who have had breast cancer also have an increased risk of ovarian cancer.2
The most common risk factors associated with the development of ovarian cancer are ovulating without a break, called incessant ovulation, and starting menstruation early or stopping late in life. The following can also increase a woman’s risk of getting ovarian cancer:
- Childbirth and menopause: Women who have never had children or who have never took oral contraceptives.7 Or who had early menstruation or late menopause
- Family history: If a family member has ovarian cancer, or had it, a woman’s risk is higher.5 Women who have a single family member with epithelial ovarian cancer (EOC) have a 4%–5% risk, whereas those with two family members with EOC have a 7% risk of developing EOC themselves.8
- Genetics: Overall, women with mutations in BRCA1 have an increased risk of up to 39% of developing ovarian cancer. Women with BRAC 2 mutations have an increased risk of up to 17%.6,,9-11
- Hereditary non-polyposis colorectal cancer (HNPCC) puts a woman at a 12% higher risk is hereditary non-polyposis colorectal cancer (HNPCC), also called Lynch II syndrome.12
- Age: Half of all ovarian cancers are found in women over 63.2
- Life style - smoking and obesity (if a woman has a body mass index of 30 or over.2)
- Hormone replacement therapy: If a woman is being treated or has been treated with the hormone estrogen for ten or more years.13
How an individual risk assessment can improve early diagnosis of ovarian cancer
Alerting a doctor to signs and symptoms experienced is the first step toward identifying ovarian cancer earlier. Since there is currently no single screening test for ovarian cancer, what comes next is a series of tests. Traditionally, if ovarian cancer is suspected, a gynecologist will probably perform2,14:
- Pelvic examination by transvaginal ultrasonography
- Measuring the CA 125 protein in the woman’s blood
While these tests are most effective when used in combination, they are not certain. The only way to confirm a diagnosis of ovarian cancer is surgery followed by tissue analysis, which may have side effects and increase morbidity.
1. GLOBOCAN. http://globocan.iarc.fr/Pages/fact_sheets_population.aspx. Last accessed November 2016.
2. American Cancer Society. Ovarian Cancer. Atlanta, GA: American Cancer Society; 2014.
3. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66:7-30.
4. American Cancer Society.http://www.cancer.org/cancer/ovariancancer/detailedguide/ovarian-cancer-survival-rates. Last accessed November 2016.
5. Goff B. Symptoms associated with ovarian cancer. Clin Obstet Gynecol. 2012;55(1):36-42.
6. Ramus SJ, Gayther SA. The contribution of BRCA1 and BRCA2 to ovarian cancer. Mol Oncol. 2009;3:138-150.
7. Collaborative Group on Epidemiological Studies of Ovarian Cancer, Beral V, Doll R, Hermon C, Peto R, Reeves G. Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23,257 women with ovarian cancer and 87,303 controls. Lancet. 2008;371(9609):303-314.
8. Daly M, Obrams GI. Epidemiology and risk assessment for ovarian cancer. Semin Oncol. 1998;25(3):255-264.
9. Risch HA, McLaughlin JR, Cole DE, et al. Prevalence and penetrance of germline BRCA1 and BRCA2 mutations in a population series of 649 women with ovarian cancer. Am J Hum Genet. 2001;68(3):700-710.
10. Ford D, Easton DF, Bishop DT, Narod SA, Goldgar DE. Risks of cancer in BRCA1-mutation carriers. Breast Cancer Linkage Consortium. Lancet. 1994;343(8899):692-695.
11. Finch A, Beiner M, Lubinski J, et al. Salpingo-oophorectomy and the risk of ovarian, fallopian tube, and peritoneal cancers in women with a BRCA1 or BRCA2 Mutation. JAMA. 2006;296(2):185-192.
12. Aarnio M, Mecklin JP, Aaltonen LA, Nyström-Lahti M, Järvinen HJ. Life-time risk of different cancers in hereditary non-polyposis colorectal cancer (HNPCC) syndrome. Int J Cancer. 1995;64(6):430-433.
13. Lacey JV, Mink PJ, Lubin JH, et al. Menopausal hormone replacement therapy and risk of ovarian cancer. JAMA. 2002;288(3):334-341.
14. American Cancer Society. Cancer facts and figures, 2016. Atlanta, GA: American Cancer Society; 2016.