The death of comedian Gilda Radner from ovarian cancer in 1991 pushed what is often called the “silent killer” into the spotlight. The past two decades have seen new approaches to treatment, yet survival rates remain distressingly low. Mostly this is because it is usually diagnosed after it has already reached an advanced stage. Although there is still no reliable screening test available, the American Cancer Society has identified certain classic symptoms that occur even in the early stages.
The most common of these symptoms include:
• Abdominal bloating
• Trouble eating or quickly feeling full
• Pain in the belly or pelvic area
• Urgent or frequent urination
Unfortunately, these symptoms are common, even in those who do not have cancer. In fact they usually do not signal ovarian cancer. If the symptoms are happening in the following situations, a doctor should be consulted if the symptoms:
• Are new or unusual
• Happen almost every day
• Last more than two weeks
• Are severe
Ovarian cancer was diagnosed in 22,430 women in the United States in 2007 and was responsible for almost 15,000 deaths. If detected early, which is rarely the case, the cure rate can be as high as 90 percent. Most often, however, ovarian cancer is detected in the later stages, when five-year survival is around 35 percent.
Current diagnostic tests include ultrasound, pelvic exams and a blood test to detect the protein CA125, yet none of these tests is able to reliably diagnose ovarian cancer at an early stage.
There are a number of factors that increase a woman’s risk of developing ovarian cancer. These risks include:
• Older age–Women over the age of 55.
• A family history of ovarian cancer in a sister or mother more than doubles the risk.
• If a woman has a personal history of breast, uterine, or colon cancer, the risk of ovarian cancer is also higher.
• Women who are older before menopause develops.
• Never having been pregnant or borne a child.
• Use of estrogen-only replacement therapy for 20 years may also be associated with increased risk.
The good news it that there are a few factors associated with a lower risk of ovarian cancer. These include having used oral contraceptives for four or more years, having had a tubal ligation, childbearing, breast feeding, or having undergone an oopherectomy.
When ovarian cancer is diagnosed, treatment may involve surgical removal of the ovary, removal of both ovaries and other female organs, and/or chemotherapy. A careful analysis of the spread of the disease along with personal treatment preferences is important in deciding the best course of therapy.
Progress against ovarian cancer has been disappointingly slow, but researchers continue to develop and test new treatment approaches. The search for a reliable test continues. If an accurate test with a minimum of false positives can be developed, it will offer women both peace of mind and a chance to catch this difficult disease at an earlier and more treatable stage.
Michelle Herbert, PharmD, CDE
Clinical Director, Richmond Apothecaries Incorporated
