Ovarian Cancer

• Ovarian cancer occurs in 1 in 55 women, at any age, but usually over age 50.
  
  
• Approximately 25,000 women are diagnosed with ovarian cancer each year (American Cancer Society).
  
  
• Ovarian cancer is the 5^th leading cause of cancer death among U.S. women.
  
  
• The American Cancer Society estimates that 14,500 women will die from ovarian cancer.
  
  
• Ovarian cancer has the highest mortality rate of all gynecologic cancers.
  
  
• 3 out of 4 women with ovarian cancer (75%) are diagnosed after the disease has reached an advanced stage (stage III or IV) because the symptoms of ovarian cancer are vague or “silent”.
  
  
• Despite aggressive surgical intervention and new chemotherapeutic regimens, the overall 5-year survival rate for women with advanced stage ovarian cancer has remained constant over the past 30 years, at approximately 15%.
  
  
• When women are diagnosed with cancer confined to the ovary (stage I), they have an overall 5-year survival approaching 90%.
  
  
• Women with the BRCa1 or BRCa2 genetic mutation for hereditary breast cancer are also at greatly increased risk of ovarian cancer.
  
  
• The Cancer and Steroid Hormone Study (CASH), the largest investigation to date, found an average 40% decrease in the likelihood of ovarian cancer in women who had ever taken birth control pills. The protective effect was observed with as little as 3 to 6 months of use, and persisted for 15 years beyond discontinuation of the pill.
  
  
• Another study, published in the American Journal of Epidemiology (8/1/00), found that pills containing lower doses of estrogen and progestin also cut a woman's ovarian cancer risk by 40 percent - the same risk reduction provided by higher dose pills.
  
  
• Exercise may reduce your risk of ovarian cancer by 27%, according to a study in the Journal of Obstetrics and Gynecology.
  
  
• Researchers have identified certain risk factors that increase a woman's chance of developing ovarian cancer. However, studies also show that most women with these risk factors never develop the disease, while many women who do develop the disease possess no risk factors. The risk factors for ovarian cancer may include:
  • Never having been pregnant.
    
  • Family or personal history of breast or ovarian cancer.
    
  • Family or personal history of BRCA-1 or BRCA-2 genetic mutation.
    
  • Abdominal obesity.
    
  • Women who began menstruating before age 12 or reached menopause after age 50.
    
  • Having had breast cancer, particularly before age 50.
  
  
• Factors that REDUCE ovarian cancer risk:
  • Pregnancy.
    
  • Breastfeeding.
    
  • Oophorectomy.
    
  • Taking birth control pills.
  
  
• The overall lifetime risk for ovarian cancer in most women is only 1.4%.



• About 7% of ovarian cancer cases have a strong hereditary component.



• If you have a first degree relative (mother, sister, or daughter) with ovarian cancer, your risk of ovarian cancer increases to 5%; if you have 2 first degree relatives with ovarian cancer your risk becomes 7%.



• In women with BRCa 1 genetic mutations (and to a lesser extent, BRCa-2), risk of ovarian cancer is 16%--44%. These mutations are also associated with earlier onset of the disease.



• The symptoms are generally subtle and vague so that women ignore them. The key is that the symptoms last more than 2-3 weeks and are otherwise unexplained. 90% of women with ovarian cancer reported having some of the following symptoms:
  • Increasing waist line size, for no obvious reason.
    
  • Digestive problems: gas, flatulence, bloating, loss of appetite, occasionally abdominal pain.
    
  • Abdominal pressure or discomfort.
    
  • Changes in bowel and bladder habits (e.g. urinary frequency, diarrhea, constipation).
    
  • Pain (less common) in the lower back, pelvis or legs.
  • Abnormal vaginal bleeding.
    
  • Unusual fatigue or backaches.
    
  • Unexplained weight loss or gain.
    
  • Shortness of breath.
    
  
  
• There is no effective screening test for ovarian cancer. Screening is not recommended for all women, but is recommended for women with symptoms of ovarian cancer and women at high risk (e.g. women with a family history or women with the BRCA-1 or 2 genetic mutations). However, ovarian abnormalities can be detected on a routine pelvic exam, with a screening vaginal ultrasound, or with a CA-125 blood test. Blood levels of CA-125 are elevated in about 50% of women with early ovarian cancer and about 80% of those with advanced disease. The only way to confirm the diagnosis, however, is with an ovarian biopsy.

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Created: 1/17/2001  -  Donnica Moore, M.D.
Reviewed: 6/23/2001  -  Donnica Moore, M.D.