Angelina Jolie's mother, Bing Crosby's first wife, and James Dean's mother all have at least one thing in common--falling victim to ovarian cancer. In fact, according to the Ovarian Cancer National Alliance, more than 21,000 women in the U.S. are diagnosed with ovarian cancer and 15,000 women die from it every year.
One of the most disappointing facts is that in over 30 years, the mortality rates for ovarian cancer have not been reduced. However, women diagnosed in the early stages have a much higher five-year survival rate than those diagnosed at later stages. For example, Oscar winner Kathy Bates was diagnosed in 2003 but now is in remission and back to work, thanks to an early diagnosis. Does that mean that women should get tested more often?
What Is Ovarian Cancer?
Ovarian cancer is cancer of the ovaries, which are endocrine glands located on either side of the uterus. Uncontrolled cell division starts in the ovaries or in the attached fallopian tubes, and may spread to other parts of the body. The cause of these tumors is unknown, though risk factors include a family history of the disease, early menarche (first menstrual cycle), late start of menopause, being over 65 years old, never having been pregnant, being overweight or obese, having endometriosis, having had breast cancer, and never having taken birth control.
Does Early Screening help?
So far, there are no recommended regular screening tests for ovarian cancer. Doctors can use three tests, however, to try to detect the disease in its early stages:
- Pelvic exam: Though this test is routine in yearly gynecologic appointments, women at risk for ovarian cancer can ask their doctors to pay special attention to the size, shape, and position of the uterus and ovaries.
- Transvaginal ultrasound: This test produces images of the uterus, fallopian tubes, and bladder. Electromagnetic waves in the ultrasound range bounce sound waves off tissues to create digital pictures that doctors can examine for potential abnormalities.
- CA-125 assay: This test measures the levels of CA-125 (cancer antigen 125) in the blood. The CA-125 is a protein that is found when tumors are present in the body. An elevated level of CA-125 may indicate cancer, though other follow-up tests are used to confirm the results.
Should these early screening tests be used to help prevent ovarian cancer deaths?
Scientists don't recommend it, as the current options cause too many false results. For example, a study of 78,000 women aged 55 to 75 published in the Journal of the American Medical Association revealed that those who received advanced screening had a higher mortality rate than those who received regular care. The screened women had higher mortality rates from ovarian cancer and from other cancers as well.
More than 3,000 women from the screening intervention group experienced false positive results after receiving transvaginal ultrasounds and CA-125 screening tests. Over 1,000 of those cases had a surgical removal of one or both ovaries, after which 15 percent had serious medical complications.
Meanwhile, participants who weren't screened for ovarian cancer had significantly fewer surgeries and were less likely to experience complications. Finally, researchers found that there wasn't a statistical difference between the cancers found through screening and the cancers found through normal care. The U.S. Preventative Services Task Force currently recommends against annual ovarian cancer screenings. If screenings aren't the answer, how can women reduce their risk?
Steps to Reduce Risk
As with most cancers, a healthy lifestyle is your best weapon. Eating a balanced diet, exercising regularly, refraining from smoking, and taking steps to managing stress and weight can all help you stay cancer-free. Some studies have also shown that a diet low in fat and rich in antioxidants like tea may help reduce the risk of ovarian cancer.
Being informed can help increase your chances of detecting any possible symptoms early. Ovarian cancer symptoms are tricky, as they can mimic other health conditions. Try to remember that a symptom isn't a cancer diagnosis. However, if you have a family history of ovarian cancer or feel you're at risk for other reasons, watch for potential signs like pressure or pain in the abdomen, pelvis, back, or legs, a constant feeling of fatigue, shortness of breath, unusual vaginal bleeding (heavy periods or post-menopausal bleeding), a swollen or bloated abdomen that persists, or frequent urination. All women may experience these symptoms at one time or another, but if they last for more than a week or two, it's best to make an appointment with your doctor.
The good news is that 75 percent of women who catch ovarian cancer before it spreads to other organs live five years or more after the diagnosis.
Remember to discuss your personal case with your doctor regarding any procedure or treatment plan.