Ovarian Cancer Awareness
WHY SHOULD YOU CARE?
September is Ovarian Cancer Awareness month.
Ovarian Cancer strikes only those among us who have or have had ovaries – an important part of the female reproductive system. During the course of a woman’s lifetime, the ovaries store eggs and produce sex hormones, including estrogen.
In 2021, the female population in United States was 168 million persons, and during that same year, 21,410 new cases of ovarian cancer were diagnosed in America – about 1.1% of all new cancer cases, according to the Center for Disease Control, the American Cancer Society and the Ovarian Cancer Research Alliance. In 2021, Ovarian Cancer accounted for an estimated 13,770 deaths – about 2.3% of all cancer deaths that year.
Comparatively, 42,915 people died in motor vehicle traffic crashes in the US during 2021.
So why should you care and why should you be more aware?
If you are male, no amount of debate can erase the fact that you have or have had a female mother. Maybe, a sister, an aunt, and maybe, a spouse or life partner. The same goes if you are a female.
While the chance of having Ovarian Cancer as part of your life in any capacity is small, it is the deadliest and second most common gynecologic cancer in the United States. And while Ovarian Cancer is not a common disease, it accounts for more deaths than any other cancer of the female reproductive system.
That matters, if you are female or share a part of your life with one.
When ovarian cancer first develops, it might not cause any noticeable symptoms. When ovarian cancer symptoms happen, they’re usually attributed to other, more common conditions. Because it typically is misdiagnosed by unaware family physicians, or not diagnosed until it has reached an advanced stage, ovarian cancer is often deadly. The path to trying to “cure” it can be almost as bad as failure to do so.
As a reader, we hope and pray that you do not have or have someone you love that is stricken by this illness. But if you do, we have provided information about Ovarian Cancer and the resources you might need to help in navigating the illness for you, a friend or family member. That information can be found below.
You can even order an Ovarian Cancer Awareness wristband, the proceeds from which are donated to the Ovarian Cancer Research Alliance.
So why should you care and why should you be more aware?
Because tomorrow, it might matter very much to you.
What You Should Know – When You Need To Know
The public’s attention was drawn to the subject of ovarian cancer since the January 2022 announcement that tennis hall of famer and ESPN on-air announcer Chris Evert was diagnosed with early-stage ovarian cancer. The 67-year-old Evert revealed the illness in a story posted on ESPN.com and noted that she learned of the cancer in December 2021 and began chemotherapy treatments soon thereafter. Evert won 18 Grand Slam singles titles, reached No. 1 in the WTA rankings and was inducted into the International Hall of Fame in 1995. Her sister, Jeanne Evert Dubin, died from ovarian cancer in February 2020 at age 62.
In an interview in January of 2020, Evert noted that she “lived a very charmed life. Now I have some challenges ahead of me.” Evert said “I have comfort in knowing the chemotherapy is to ensure that cancer does not come back.” “Be your own advocate. Know your family’s history. Have total awareness of your body, follow your gut and be aware of changes,” Evert said in the ESPN story. “Don’t try to be a crusader and think this will pass.”
AN OVERVIEW- UNDERSTANDING THE DISEASE
Ovaries are small, almond-shaped organs located on either side of the uterus and store eggs – known as germ cells – and produce estrogen and progesterone, two female hormones. Ovarian cancer is when malignant (cancerous) cells develop in, near, or on the outer layer of one or both ovaries.
There are many types of ovarian cancer. Normally, healthy cells in your body divide and form new cells to repair injuries and replace old or dying cells. Cancer cells are different because they:
- Grow uncontrollably, dividing into new abnormal cells
- Outlive normal cells
- Lead to the growth of a tumor; this can put pressure on nearby organs
- Can spread, or metastasize to other parts of the body through the bloodstream or lymphatic system
- The type of cancer is determined by the site where it started. So, when cancer cells are first formed in the ovaries and spread to other organs, it will be diagnosed and treated as ovarian cancer.
General Prognosis
Due to the nature of ovarian cancer, every woman’s ovarian cancer is different. This makes it impossible to provide a general prognosis – the chance of recovery or survival. Your outcome will depend on many factors, such as the stage and type of ovarian cancer, your age and overall health.
According to the American Cancer Society (ACS):
- An estimated 12,810 women will lose their lives to ovarian cancer this year
- The risk of a woman getting ovarian cancer is about 1 in 78 in her lifetime
- Ovarian cancer ranks fifth in cancer deaths among women and causes more deaths than any other gynecological cancer
- The five-year survival rate is over 93% when ovarian cancer is diagnosed and treated in its earliest stages
Only 20% of all cases are found early, meaning in stage I or II; if the cancer is caught in stage III or higher, the survival rate can be as low as 30%
Ovarian cancer is more common in white women than African American women, and tends to be diagnosed mostly in older patients, the ACS says. Roughly half of women diagnosed are over age 63, but it can develop in much younger women, too. Early cancers of the ovaries often cause no symptoms, according to the ACS. As a result, only about 20 percent of ovarian cancers are found at an early stage, which is when they are most treatable.
Ovarian cancer is most often discovered by accident, according to Louise E. Morrell, M.D., medical director of Lynn Cancer Institute at Boca Raton Regional Hospital, which is part of Baptist Health. “It’s growing inside of the ovary or fallopian tube where nothing can see it, then it starts shedding cancer cells into the abdomen very early in the process,” Dr. Morrell explains. “That’s why it’s so important to identify as early as possible those women who are predisposed to this type of cancer and, if it is diagnosed, to act quickly and decisively.”
EARLY DETECTION IS IMPORTANT
There is no effective screening test for ovarian cancer. A Pap smear test does not detect ovarian cancer, but rather screens for cervical cancer. The signs and symptoms of ovarian cancer can be easy to miss. They may also be difficult to notice or detect because the ovaries are located deep within the abdominal cavity. Often, the signs and symptoms are “silent,” making ovarian cancer difficult to detect in its early stages.
EARLY SIGNS OF OVARIAN CANCER
In its early stages, ovarian cancer may not cause symptoms you would notice. Even as the disease advances, the signs can be unclear. You might confuse them with other common problems, such as constipation. For many years, ovarian cancer was known as a “silent” disease. If you know the symptoms, you and your doctor will have a better chance of finding it early.
Ovarian Cancer Symptoms
Early ovarian cancer rarely has symptoms. As the disease progresses, some symptoms may appear. These include:
- Bloating or pressure in the belly
- Pain in the abdomen or pelvis
- Trouble eating or quickly feeling that you’re full
- Urinating more frequently
- Always feeling like you need to urinate urgency or frequently
Other symptoms that could mean you have ovarian cancer include:
- Getting tired easily and being tired a lot (fatigue)
- Pain during sex
- Back pain
- Upset stomach or heartburn
- Constipation
- Swelling in your belly
- Unexplained weight changes — losing weight without trying, or bloating that seems like weight gain
- Unusual vaginal discharge or bleeding, especially after menopause
Keep in mind that even though these things can be signs of ovarian cancer, it’s more likely that something else is causing them.
These symptoms can be caused by many conditions that are not cancer. If they occur persistently for more than a few weeks, report them to your health care professional.
When to Call the Doctor
Because the signs of ovarian cancer are common and somewhat vague, it’s hard to know when to call the doctor. Get checked out if your symptoms:
- Are new to you
- Happen more than 12 times in a month
- Don’t go away with changes such as exercise, diet, laxatives, or more rest
- Tell your doctor if ovarian cancer or breast cancer runs in your family.
Persistence of Ovarian Cancer Symptoms
Symptoms that last more than a couple of weeks are key to spotting ovarian cancer. Only about 15% of ovarian cancer is diagnosed in the early stages. Many women don’t notice problems until a tumor is more advanced.
DETECTION AND DIAGNOSIS
Although there is no consistently reliable screening test to detect ovarian cancer, research in this area is ongoing. If a woman has signs and symptoms of ovarian cancer, the following tests are available and should be offered especially to those at increased risk:
- Pelvic exam: This checks for an enlarged ovary or signs of fluid in the abdomen. The doctor examines the uterus, vagina, ovaries, bladder and rectum for any unusual changes such as a mass. Some cancers are very small before they spread and cannot be reliably detected by pelvic examination.
- Transvaginal ultrasound: This examination uses a small instrument placed in the vagina to look at the ovaries and uterus. This method is especially appropriate for women at increased risk for ovarian cancer or those with an abnormal pelvic exam.
- CA-125 blood test: This measures the level of CA-125, a protein found in higher levels in women with ovarian/fallopian tube cancer. While CA-125 is an important test, it is not always a key marker for the disease. Some non-cancerous diseases of the ovaries can also increase CA-125 levels, and some ovarian cancers may not produce enough CA-125 levels to cause a positive test. For these reasons the CA-125 test is not routinely used as a screening test for those at an average risk for ovarian cancer, but rather as a baseline for monitoring.
Positive Tests – If any test returns an abnormal result, a woman should consult a gynecologic oncologist. As a cancer specialist, they will evaluate the test results and may conduct a CT scan. However, the most accurate way to confirm an ovarian cancer diagnosis is by biopsy, a procedure in which the doctor takes a sample of the tumor and examines it under a microscope.
Stages of Ovarian Cancer
The initial surgery for ovarian cancer (including biopsy surgeries) will help determine how far the cancer has spread, described by the following stages:
Stage I: Confined to one or both ovaries
Stage II: Spread to the uterus or other nearby organs
Stage III: Spread to the lymph nodes or abdominal lining
Stage IV: Spread to distant organs, such as the lungs or liver
Types of Ovarian Cancer
The vast majority of ovarian cancers are epithelial ovarian carcinomas. These are malignant tumors that form from cells on the surface of the ovary. Some epithelial tumors are not clearly cancerous. These are known as tumors of low malignant potential (LMP). LMP tumors grow more slowly and are less dangerous than other forms of ovarian cancer.
Ovarian Cancer Survival Rates
Ovarian cancer can be a frightening diagnosis, with five-year relative survival rates that range from 93% to 19% for epithelial ovarian cancer, depending on the stage when the cancer was found. For LMP tumors, the five-year relative survival rates range from 97% to 89%.
OVARIAN CANCER TREATMENT
Ovarian Cancer Surgery – Surgery is used to diagnose ovarian cancer and determine its stage, but it is also the first phase of treatment. The goal is to remove as much of the cancer as possible. This may include a single ovary and nearby tissue in stage I. In more advanced stages, it may be necessary to remove both ovaries, along with the uterus and surrounding tissues.
Chemotherapy – In all stages of ovarian cancer, chemotherapy is usually given after surgery. This phase of treatment uses drugs to target and kill any remaining cancer in the body. The drugs may be given by mouth, through an IV, or directly into the belly (intraperitoneal chemotherapy). Women with LMP tumors usually don’t need chemo unless the tumors grow back after surgery.
The drugs given depend on the type of ovarian cancer. Usually, two different types of drugs are given together; there are many combinations of drugs. Chemotherapy may be used to:
- Kill cancer cells that may be left after surgery (“adjuvant” chemotherapy)
- Shrink ovarian tumors before surgery or radiation therapy to make the treatment easier (“neoadjuvant “ chemotherapy)
- Kill any cancer cells that have spread (metastasized) to other parts of the body
There are different forms of chemotherapy, all given at a cancer center, hospital or doctor’s office:
- By mouth in pill form
- Injected into a vein (IV)
- Injected into the intraperitoneal (IP) abdominal space by a catheter (thin tube)
- Circulated through the peritoneal cavity at the time of surgery (HIPEC)
Dosage and frequency may vary from once a day, once a week or even once a month, depending on the type of ovarian cancer and chemotherapy used. The duration of chemotherapy depends on what research shows to be the most effective for the particular type of cancer.
Managing chemotherapy side effects
Chemotherapy can cause physical, emotional and/or psychological side effects. Physically, it kills cancer cells, but can also attack some healthy cells and deplete the body’s strength. There are medications that can help manage those side effects. For more on the common side effects caused by chemotherapy, along with helpful tips, go to: https://ovarian.org/find-support/programs-and-resources-educational-materials/
Targeted Therapies – Researchers are working on therapies that target the way ovarian cancer grows. A process called angiogenesis involves the formation of new blood vessels to feed tumors. A drug called Avastin blocks this process, causing tumors to shrink or stop growing.
AFTER TREATMENT: MOVING ON
Women may find that it takes a long time for their energy to return after treatments end. Fatigue is a very common problem after treatment for cancer. Beginning a gentle exercise program is one of the most effective ways to restore energy and improve emotional well-being. Check with your health care team to determine which activities are right for you.
After Treatment: Early Menopause – When women have both ovaries removed, they can no longer produce their own estrogen. This triggers menopause, no matter how young the patient. The drop in hormone levels can also raise the risk for certain medical conditions, including osteoporosis. It’s vital that women have regular follow-up care after being treated for ovarian cancer.
Can Ovarian Cancer Return After Treatment?
Ovarian cancer is usually detected in the late stages. It is often widespread (metastasized) when diagnosed. Your doctor will remove as much of the tumor as possible by surgery. You will then need chemotherapy. When your body has no tumor left, you are in remission. Ovarian cancer relapses often. 23% of people have a relapse within 6 months of stopping chemotherapy, and another 60% after 6 months.
The Type and Stage of Ovarian Cancer Are Important
Your physician will send the tumor removed during surgery to the laboratory. Recurrence risk depends on the type of ovarian cancer. High-grade serous adenocarcinomas and endometroid carcinomas are the most likely to recur. Other types like clear cell adenocarcinoma, mucinous adenocarcinoma, low-grade endometrioid adenocarcinoma, and others have a lower risk. Women with Stage 1 ovarian cancer have a 5-year survival of 92%. Stage 3 and 4 ovarian cancers relapse early and often.
Ovarian Cancer Can Return Near or Far
Like other cancers, ovarian cancer can come back in three different locations.
- Local Recurrence. The cancer returns at the ovary’s location, even if the ovary was removed.
- Regional Recurrence. The cancer reappears in the lymph nodes near the ovaries.
- Distant Recurrence. The cancer appears in distant organs like the bones, liver, lungs, or brain.
More than 80% of women have recurrences in multiple places.
Ovarian Cancer Can Return After Hysterectomy
Ovarian cancer is treated by extensive surgery. The uterus, both ovaries and fallopian tubes, lymph nodes, and other tumor-affected parts are removed. Your physician will then prescribe chemotherapy. But the cancer usually survives because it has already spread when diagnosed. Even with such massive surgery, ovarian cancer does recur.
You Should Have Regular Checks
Frequent checkups are vital for catching recurrence early. In the first two years, your doctor will see you every 3 months. Later, the visits can be every 4 to 6 months. Your doctor will decide, depending on your earlier disease and physical examination, if testing is needed. This testing could include vaginal cytology, measurement of tumor markers, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) scans.
Don’t Wait for Symptoms
You shouldn’t depend on looking for symptoms. Your physician won’t do that, either. Ovarian cancer has a very high risk of recurrence. Your physician will screen you for recurrence at regular intervals. Almost all women with relapse are without symptoms when detected. Common symptoms of ovarian cancer recurrence are abdominal bloating or pain, nausea, poor appetite, and weight loss.
Blood Tests Can Help Detect Recurrence
A rise in certain chemicals in your blood tells your doctor about ovarian cancer recurrence. These chemicals are called tumor markers. Different types of ovarian cancer have different markers. Cancer antigen-125 (CA-125) is a tumor marker used to test for epithelial ovarian cancer. Other useful markers are CA 19-9, HE-4, and CEA. Alfa fetoprotein (AFP), human chorionic gonadotropin (HCG), and hormones like estrogen, inhibin, and testosterone are markers for other types.
CA-125 Is not a Magic Marker
A raised CA-125 doesn’t always mean your cancer is back. You can have high CA-125 without cancer recurrence. Ovarian cancer can return without high CA-125 levels. Raised CA-125 tells your doctor to look for recurrence. Starting chemotherapy with only raised CA-125 levels doesn’t provide any benefit. It also reduces quality of life. This tumor marker helps assess the response to treatment, if it was raised before treatment.
Recurrence Treatment Is Chemotherapy
Your doctor will probably offer you chemotherapy and targeted drugs. Depending on the time since your last treatment, the drugs may be the same ones as before, or different ones. Surgery for recurrence is rare. Radiotherapy helps shrink the tumor.
Maintenance Chemotherapy Doesn’t Prevent Recurrence
Once you have achieved remission, your physician will stop chemotherapy and screen you for recurrence at intervals. Maintenance chemotherapy is taking the drugs after you have achieved remission. But this is not helpful. The overall survival and length of remission are not better.
Healthy Life Habits Help
Giving up smoking and alcohol, being more physically active, and staying at a healthy weight will improve your overall health. It’s not known if these measures prevent ovarian cancer recurrence. There are no dietary supplements that are proven to prevent cancer recurrence.
CARING FOR YOURSELF WITH OVARIAN CANCER
Ovarian cancer is caused by uncontrollable cell growth in your ovaries. It can spread to other organs as well. Treatment can involve draining and may also include chemotherapy and surgery to remove your ovaries. The entire process can be exhausting or even completely overwhelming at times — but you need to take care of yourself so you can survive and recover. Here are 10 ways to take care of yourself with ovarian cancer.
Do Things That You Enjoy – You need to make time for activities that bring you joy. Having something to look forward to is a necessary part of maintaining a positive outlook on life. You can either keep up with old hobbies or try something new. Many people enjoy expressing themselves through art after their cancer diagnosis. Give painting, dancing, or writing a try.
Take Time for Your Emotional Health – You need to take the time to process all of the emotions that come with this condition. Try stress-relief techniques like meditation and journaling.
Stay Active – Even if you’re not feeling great, physical activity is good for both your mental and physical health. Stick to simple activities like stretching and calm walks.
Keep Eating – You might not always feel like eating when you have ovarian cancer, but you need calories to keep your strength up. Stick to foods that are high in protein to get the most energy out of a small meal. You can also try a liquid diet of shakes and broths since you may find them easier to consume.
Talk to a Therapist – A lot of unique issues come with ovarian cancer. You might be worried about your dating life, your hormonal changes, or any number of concerns. A therapist is a great person to talk to if you need to vent your frustrations and receive advice on what you can do to cope with your condition.
Find a Support Group – Sometimes, the best thing for your mental health is to talk to other people who are battling the same disease. Look for ovarian cancer support groups online or at community health centers.
Ask Your Friends and Family for Support – This particular cancer frequently occurs in young women — many of whom have only recently moved away from home. It can be difficult to ask for help when you’re getting your first taste of independence, but your loved ones are an invaluable resource in these difficult times.
Don’t Hesitate To Ask for Personal Space – On the other hand, your family could also become overly involved with your life and treatment after you get your cancer diagnosis. This is your cancer, though, and you need to handle it in the way that’s best for your physical and mental health. Always ask for space when you need it — your family should understand.
Keep Living – Life goes on despite your cancer diagnosis. Bills will need to be paid and important milestones will come and go. Don’t let your disease consume the rest of your life. You won’t be able to do everything that you could before your diagnosis, but people with cancer still need to engage with other aspects of their lives.
Stick to Your Survivorship Care Plan – Even once you’ve been declared cancer-free, your journey isn’t over. Your doctor should provide you with a survivorship care plan — feel free to ask for one if they haven’t. This will provide details on follow-up tests, prepare you for the long-term side effects of your treatment, and provide you with advice about proper diet and exercise. The best way to keep your cancer from returning is to follow the recommendations in this plan.
WANT MORE INFORMATION OR TO LOCATE SUPPORT?
THE JOURNEY BEGINS – NATIONAL OVARIAN CANCER COALITION (NOCC)
Everything changes when you or a loved one is diagnosed with ovarian cancer. Emotions are high. Your world feels out of control, filled with medical tests, surgical procedures, treatments and unfamiliar terms. It’s a scary, overwhelming time, but one thing is for sure. You are not alone. Whether you’re newly diagnosed or the disease has recurred, the National Ovarian Cancer Coalition (NOCC) is here for you every step of the way, including online support groups and events. Many of us are ovarian cancer survivors. All of us are here to answer your questions and offer compassion and encouragement whenever it’s needed. Many women with ovarian cancer gradually adjust and enjoy full and rewarding lives. NOCC can help get you there, too.
WANT MORE DETAILS?
About Ovarian Cancer – Get an overview of ovarian cancer and the latest key statistics in the US.
https://www.cancer.org/cancer/ovarian-cancer.html
Survival Rates for Ovarian Cancer
https://www.cancer.org/cancer/ovarian-cancer/detection-diagnosis-staging/survival-rates.html
https://www.cancer.org/research/acs-research-highlights/ovarian-cancer-research-highlights.html
National Foundation for Cancer Research (NFCR)
Key Facts and resources
WANT TO PURCHASE AN OVARIAN CANCER AWARENESS WRISTBAND AND HELP SUPPORT THE NATIONAL OVARIAN CANCER COALITION?
The New Jersey Free Press team has purchased a limited number of special OVARIAN CANCER AWARENESS wristbands which also include a “link” to this page to share much needed information about the illness.
If you would like to purchase a special wristband to show your support for Ovarian Cancer victims and their families, and help support the the National Ovarian Cancer Coalition (NOCC), end us an email at [email protected]. If you own a store and would like to make these wristbands available to your customers free of charge, contact us at 856 243 2499. A limited number are available, so call us today.
