Signs of ovarian cancer

Signs of ovarian cancer include abdominal pain and bloating. Unfortunately, when these signs of ovarian cancer are present the disease is usually in its later stages.

What about screening tests that can be used prior to the signs of ovarian cancer developing?

The FDA recently suggested that screening tests for ovarian cancer are not reliable and should not be used. The FDA stated that, “Despite extensive research and published studies, there are currently no screening tests for ovarian cancer that are sensitive enough to reliably screen for ovarian cancer without a high number of inaccurate results.”

The FDA gives an example of one screening company

Abcodia Incorporated began marketing the Risk of Ovarian Cancer Algorithm (ROCA) test in the United States, with claims that the ROCA test can screen for and detect ovarian cancer before signs of ovarian cancer appear. The tests are marketed to increase the chance of survival. Yet, available data do not support its claims.”

Why is the FDA concerned?

Screening tests for ovarian cancer results may suggest ovarian cancer even though no cancer is present, this is referred to as a false-positive. A positive test would require additional testing and perhaps even surgery. Surgery comes with the risk of complications such as bleeding and infection even though the procedure itself may not have been indicated in the first place. 

What about a blood test for tumor markers such as CA-125 along with ultrasound?

According to the CDC, “Several large trials have investigated the use of CA-125 (alone or in combination with trans-vaginal ultrasound [TVU]) as a screening test for ovarian cancer. However, this test generally has been associated with a low positive predictive value, and trials have concluded that screening asymptomatic women in the average-risk population with CA-125 is not beneficial. Still, widespread discussion continues, and ovarian cancer screening tests that include CA-125 are being marketed.” The blood test is performed in people who have no signs of ovarian cancer.

What does the FDA suggest?

  • The FDA does not recommend using screening tests for the general population of women who do not have signs of ovarian cancer.
  • Caution should be used when testing for ovarian cancer in higher risk asymptomatic patients, as there are no proven benefit and is not a substitute for preventive actions that may reduce their risk.
  • Consideration should be given to referring high-risk patients to a gynecologic oncologist and or a genetic counselor for possible genetic testing.
  • Consider genetic testing if you have a family history of ovarian cancer, a family member who was diagnosed with breast cancer when they were younger than 45 or multiple family members with breast cancer.
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How many people are affected by ovarian cancer?

The National Cancer Institute estimates that in 2016, more than 22,000 women will be diagnosed with ovarian cancer.

Who are at increased risk for developing ovarian cancer?

  • Women who have a family history of ovarian cancer.
  • Women with the BRCA1 or BRCA2 genetic mutations.
  • Being older. About 90 percent of women who get ovarian cancer are older than 40.
  • A history of breast, uterine, or colorectal cancer increases your risk of ovarian cancer.
  • Ashkenazi Jewish background increases your risk of ovarian cancer.
  • If you never have given birth or have had trouble getting pregnant you may be at higher risk of developing ovarian cancer.
  • Having endometriosis may also increase your risk of developing cancer.

Those at a decreased risk for ovarian cancer

  • If you have used birth control pills for more than five years.
  • If you had a tubal ligation.
  • Pregnancy decreases the risk of ovarian cancer.
  • Breastfeeding may reduce the risk of ovarian cancer.

What do the ovaries do?

  • The ovaries make female hormones and produce eggs.

What are the signs of ovarian cancer?

  • Stomach swelling
  • Feeling full after eating
  • Vaginal secretions that are different from what you have experiences in the past.
  • Vaginal bleeding, especially when you are post menopausal.
  • Pelvic and or back pain.
  • Change in bowel habits.
  • Increased urination.

How is ovarian cancer treated?

  • Surgery to remove the tumor.
  • Chemotherapy  can be used treat ovarian cancer. Chemotherapy can be given by a pill, intravenously or directly into the abdominal cavity.
  • Targeted therapy such as Bevacizumab (Avastin®) can slow blood vessel growth which decreases tumor growth.
  • Hormone therapy will aim to switch off estrogen production by the ovaries.
  • Radiation can be used to treat cancer.Douching Increases Risk Of Ovarian Cancer

    The study was supported by the National Institute of Environmental Health Sciences and published in journal Epidemiology Researchers followed 41,000 women. Their results showed that women who douched double their risks of developing ovarian cancer.

    • Prior studies have linked douching with cervical cancer.

    living with multiple sclerosisDouching information

    • Douching is the process of cleaning the vagina out with fluids.
    • Office on Women’s Health at the U.S. Department of Health and Human Services (HHS) estimates that 1 in 4 women douche.
    • Douching is not receommended by the American College of Obstetricians.
    • There is a concern that douching changes the natural flora in the vagina.
    • There is also a concern that douching pushes bacteria up into the uterus which can increase risk of infections.
    • Douching increase risks of bacteria infections in the vagina.

    Ovarian cancer Information

    • The CDC estimates that 20,000 develop ovarian cancer each year.
    • It is known as the silent killer as symptoms develop later stages.

    Johanna’s Law was signed into law in 2007 to increase ovarian cancer awareness.

    Risk factors for developing ovarian cancer

    • Family history of ovarian cancer and BRCA defects.
    • Personal history of breast, uterine, or colorectal cancer.
    • History of endometriosis.
    • Ashkenazi Jewish background.
    • Older age. The CDC estimates that 90% of people who develop ovarian cancer are older than 40 years of age.

    What decreases your risk of ovarian cancer

    • History of given birth.
    • Birth control pill use for more than 5 years.
    • History of tubal ligation.
    • Breastfeeding
    • Hysterectomy

     

  • What ovarian cancer screening tests are available?
    • Recto-vaginal exams
    • Sonograms
    • CA-125

    What is CA 125

    Ca-125 is a tumor marker elevated in 80% of patients who present with epithelial ovarian carcinoma. A blood test is drawn and the level is checked. It is also elevated in cancers of the fallopian tube, endometrium, and cervix.

    CA-125 can be elevated in other conditions as such as,

    • Endometriosis
    • Uterine fibroids
    • Liver disease
    • Cancer of the uterus, breast, lung and pancreas.

    It is usually not recommended as a random screening test unless the women has an elevated risk of ovarian cancer.

     

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