Doctors

Ovarian cancer is a malignant ovarian neoplasm (an abnormal growth located on the ovaries).

ovarian cancer symptoms

• sense of pelvic heaviness
• vague lower abdominal discomfort
• vaginal bleeding
• weight gain or loss
• abnormal menstrual cycles
• unexplained back pain that worsens over time
• increased abdominal girth
• non specific gastrointestinal symptoms:
• increased gas
• indigestion
• lack of appetite
• nausea and vomiting
• inability to ingest usual volumes of food
• bloating
• Additional symptoms that may be associated with this disease:
• increased urinary frequency/urgency
• excessive hair growth

Note: There may be no symptoms of ovarian cancer until late in the disease.

Women experiencing these symptoms should insist on having a blood test called CA-125 done. While this test is far from perfect, and is generally not regarded as usefull for large scale screening by the medical community, a high value will immediately signal the need for further testing. Normal values range from 0 to 35. Values can be temporarily elevated due to a number of non-cancerous causes.

CA-125 stands for Cancer Antigen 125. The CA-125 test looks for the presence of a protein on the surface of cells from the ovary. Elevated levels of this protein have been associated with other types of cancer, but it is considered a biomarker for ovarian cancer.

Further screening may involve CT scans, trans-vaginal ultrasounds, or retesting of the CA-125 value at a later date.

signs of ovarian cancer

Physical examination may reveal increased abdominal girth and /or ascites (fluid within the abdominal cavity). Pelvic examination may reveal an ovarian or abdominal mass. The pelvic exam should include a rectovaginal component for better palpation of the ovaries.

Causes

Ovarian cancer is the fourth leading cause of cancer death in women, the leading cause of death from gynecologic malignancies and the second most commonly diagnosed gynecologic malignancy while the exact cause is unknown (i.e., idiopathic), the disease is more common in industrialized nations, with the exception of Japan. In the United States, females have a 1.4 percent to 2.5 percent (1 out of 40-60 women) lifelong chance of developing ovarian cancer.

Older women are at highest risk. More than half of the deaths from ovarian cancer occur in women between 55 and 74 years of age and approximately one quarter of ovarian cancer deaths occur in women between 35 and 54 years of age.

The risk for developing ovarian cancer appears to be affected by several factors. The more children a woman has, the lower her risk of ovarian cancer. Early age at first pregnancy, older ages of final pregnancy, and the use of some oral contraceptive pills have also been shown to have a protective effect. Ovarian cancer is reduced in women after tubal ligation.

The link to the use of fertility medication has been controversial. An analysis in 1991 raised the possibility that use of drugs that stimulate ovulation may increase the risk for ovarian cancer. Several cohort studies and case-control studies have been conducted since then without providing conclusive evidence for such a link with the possible exception that prolonged use (> 1 year) of clomiphene citrate should be avoided.1 It will remain a complex topic to study as the infertile population differs in parity from the "normal" population.

There is good evidence that in some women genetic factors are important. Carrier of mutations of the BRCA1 or the BRCA2 gene are at higher risk of both breast cancer and ovarian cancer already at a younger age. Patients with a personal history of breast cancer, or a family history of breast and/or ovarian cancer, may have an elevated risk. A strong family history of uterine, colon, or other gastrointestinal cancers may indicate the presence of a syndrome known as hereditary non-polyposis colon cancer (HNPCC), which confers a higher risk for developing ovarian cancer. Patients with strong genetic risk for ovarian cancer may consider the use of prophyllactic oophorectomy after completion of their reproductive goal.