Some cancers of the female reproductive tract have obvious signs or early warning signs. With uterine cancer, you have bleeding after menopause. Cervical cancer is a Pap smear that shows abnormal cells. Ovarian cancer of the gland that produces eggs and produces the hormone estrogen and progesterone often has no obvious symptoms or early warning signs. In the abdominal cavity, a tumor can grow undetected for years and cancer cells can spread silently through the peritoneal fluid in the abdominal cavity.
A woman’s reproductive system has two ovaries, one on each side of the uterus. Your ovaries are about the size of an almond. They produce eggs (ova) and the hormones estrogen and progesterone.
Among women whose ovarian cancer was detected and treated early while it was still confined to the ovary, the five-year survival rate was 93%. Unfortunately, every year among the newly diagnosed women with ovarian cancer, women in the United States already had 80% cancer that had spread to other parts of their bodies. Those women had a five-year survival rate of only 20 to 30%.
Every woman should determine her risk of ovarian cancer. You should pay attention to the subtle, easy-to-miss warning signs of ovarian cancer:
Abdominal swelling or bloating
Pelvic pressure or abdominal pain
Feel full quickly while eating
Urgent or frequent urination
Changes in bowel habits, such as constipation
All of these symptoms can be caused by irritable bowel syndrome or urinary incontinence. These signs are more likely to indicate ovarian cancer if your symptoms include:
Symptoms appear in the past year
Are serious and occur almost every day
Last more than a few weeks
For every 100 women who inherit a mutated form of the genes linked to breast cancer, BRCA1 and BRCA2, 60 of them, depending on the specific mutation, are likely to develop ovarian cancer. You are also at higher risk if:
Your mother, sister or daughter had ovarian cancer
Your grandma aunt had ovarian or breast cancer
You have a personal history of breast cancer diagnosed before menopause
Any family member who has had ovarian cancer
If you are at high risk, be proactive and talk to your doctor about a plan to reduce your risk and ensure early detection. Get genetic counseling. This counseling charts your family’s genetic history for the BRCA1 and BRCA2 genes to determine if genetic testing is necessary. Genetic counseling is available at most university cancer centers.
You will also want to have a frequent screening test at least once a year:
A pelvic exam where the doctor manually examines the ovaries and uterus
Transvaginal ultrasound where the probe is placed in the vaginal vagina to check for ovarian tumors
Blood test for CA-125 a protein produced by ovarian cancer cells. This test detects about half of the early stages of ovarian cancer and about 80% when used with a symptom questionnaire.
A barium enema may be ordered. A barium enema is a test to see if the cancer has spread to the colon or rectum. Usually, a colonoscopy is done instead.
An X-ray may be taken to determine if ovarian cancer has spread (metastasized) to the lungs.
Laparoscopy can help doctors plan your surgery or other treatments and can help confirm the stage (how far the tumor has spread) of the cancer. Doctors can manipulate small instruments through the laparoscopic incision(s) to perform biopsies.
If any of these test results are suspicious, your doctor will order a magnetic resonance imaging (MRI) or computed tomography (CT) scan.
Even if you’re not at high risk, your chance of developing ovarian cancer may be above average. Your risk increases with the following factors:
Age: 2/3 of ovarian cancer patients are 55 years of age or older
Menstrual history: Ovulation increases ovarian risk. If you started menstruating before age 12 and/or reached menopause after age 55, your risk is higher.
No history of oral contraceptive use: The pill prevents ovulation, so women who have been taking oral contraceptives for at least two years have a lower risk.
History of Infertility: This link may be due to increased ovulation and/or decreased progesterone.
History of endometriosis (overgrowth of tissue lining the uterus): The link is unclear, but it may be due to increased inflammation.
The more of those risk factors you have, the more important it is to have annual pelvic exams. Also ask your doctor if a CA 125 blood test and ultrasound are necessary for you.
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