BY SHARMILA MAKHIJA, MD
Georgia Cancer Coalition Distinguished Cancer Scholar and Associate Professor, Department of Gynecology and Obstetrics, Emory University School of Medicine, and Director of Gynecologic Oncology for Emory Healthcare and Emory Winship Cancer Institute
Ovarian cancer may not be the most common cancer in women, but it may be the most feared by women. Each year in the United States, about 21,550 women are diagnosed with ovarian cancer. It is the eighth most common cancer among women, and one for which there is no known cause. The estimate for new cases of ovarian cancer in the United States in 2009 is 21,550 and estimated deaths are14,600, according to the American Cancer Society.
Ovarian cancer forms in tissues of the ovary (one of a pair of female reproductive glands in which the ova, or eggs, are formed). Most ovarian cancers are either ovarian epithelial carcinomas (cancer that begins in the cells on the surface of the ovary) or malignant germ cell tumors (cancer that begins in egg cells).
There are some relative risk factors, however, and the risk for developing ovarian cancer increases for women who are post menopausal, who have an immediate family relative with the disease and who have had a personal history of breast cancer. In addition, the risk is higher for Caucasian women than for African-American women.
Some research has shown a lower risk among women who have used birth control pills containing a combination of estrogen and progestin for at least five years, who have had at least one child or who have breast-fed. Also, a woman may be less likely to develop ovarian cancer if she has had a tubal ligation or hysterectomy. A diet that includes lots of fruits and vegetables may possibly lower a woman’s risk.
Since there are vague symptoms for ovarian cancer, it is difficult to catch early. Symptoms can include weight gain, increased abdominal girth, abdominal pain, pelvic pressure, gas or bloating. Most of these symptoms can also be caused by other less serious conditions, but when the symptoms are caused by ovarian cancer they tend to be more severe and are a change from how a woman usually feels. It is the persistence of these symptoms, for two weeks or more that warrant further examination and testing by your doctor.
Although there has been a desire by doctors to find a screening test for ovarian cancer, options are limited. There are two tests that are used most commonly to screen for ovarian cancer. These tests, transvaginal sonography and CA-125, are often offered to women who are at high risk of developing epithelial ovarian cancer, such as those with a strong family history. Transvaginal sonography, an ultrasound test, can help find a mass in the ovary. However, it can’t differentiate between benign masses and cancerous masses. CA-125 is a protein in the blood that is higher in many women with ovarian cancer. Yet, conditions other than cancer can also cause high levels of CA-125. In addition, someone with ovarian cancer can still have a normal CA-125 level.
Treatment of ovarian cancer typically involves extensive surgery to remove the tumor followed by chemotherapy to destroy any remaining cancerous cells. Doctors may recommend various combinations of therapies based upon a variety of factors, including stage and grade of the tumor as well as the age and overall health of the patient.
For women with ovarian cancer, Emory Winship Cancer Institute is offering clinical trials sponsored by the Gynecologic Oncology Group/National Cancer Institute. For more information on these clinical trials, visit http://www.gog.org.
For more information on Emory’s Department of Gynecologic Oncology, call 404-778-4416 or visit
American Cancer Society on Ovarian Cancer: http://www.cancer.org/docroot/CRI/CRI_2_1x.asp?rnav=criov&dt=33