Regular Exams: Best Way To Detect Ovarian Cancer

Each year, according to statistics of the National Cancer Institute, an estimated 20,000 new cases of ovarian cancer are diagnosed. That means that about one out of every 70 newborn girls will develop the disease during her lifetime.

Ovarian cancer causes more deaths than any other cancer of the female reproductive system; perhaps because it is a “silent” disease, showing no obvious signs or symptoms until late in it’s development. Although the causes of ovarian cancer remain unknown, research indicates that this kind of cancer tends to run in families. Childbearing appears to be the most important known factor in preventing ovarian cancer, which suggests that hormones may play a role in its development.

Women who have had children are half as likely to develop ovarian cancer as women who have not or who have delayed childbearing to their later years. Several pregnancies appear to confer even more protection. Use of birth control pills, which create a hormonal balance similar to that found during pregnancy, may reduce the risk of this disease by 10 to 50 percent.

Women who have had breast, colorectal or endometrial cancer are also at increased risk for ovarian cancer. Conversely, women who already have ovarian cancer are three to four times more likely to develop breast cancer.

Although no one knows exactly why, white women 40 to 50 years old living in highly industrialized countries develop the disease most often. Japan, has the lowest rate and (surprise!) Denmark has the highest. This suggests that there may be one or more environmental dietary influences.

The ovaries - two almond-sized glands containing egg cells that like in the lower abdomen, one on each side of the uterus - secrete hormones that help regulate menstruation and pregnancy. In addition to egg cells, the ovaries contain several other types of cells. Although cancer can affect any one of these, 80 to 90 percent of ovarian cancers arise from the layer of epithelial cells that surround the ovary. Epithelial cancers can develop in either ovary and develop in both ovaries at once in about one third of the cases.

Some ovarian tumors are benign and, while they may interfere with body functions and require removal, they do not invade neighboring tissue. Malignant tumors, on the other hand, do invade and destroy surrounding normal tissue. Cancer cells can break away from the tumor and spread through the bloodstream or lymphatic system to other

Parts of the body (metastasis). Ovarian cancer metastasizes through the lymphatic system.

There are currently no fully effective methods of mass screening to detect ovarian cancer. A thorough pelvic exam remains the most effective way to guard against undetected development and spread of the disease. During the examination, the doctor may be able to find a mass in an ovary, fallopian tube or the uterus in its early stages before it has a chance to spread. If the doctor suspects a tumor, an ultrasound exam, magnetic resonance imaging (MRI), or a CAT (computer assisted topography) scan may be ordered to confirm a diagnosis.

Unfortunately, there are no early symptoms of cancer of the ovary. The most frequent symptoms associated with ovarian cancer are enlargement of the abdomen (generally due to an accumulation of fluid or, less often, due to the presence of the tumor itself) and pelvic pain. Upper abdominal fullness and indigestion, fatigue, urinary frequency and shortness of breath may also be present as the disease progresses. Elevated estrogen production in certain kinds of tumors may cause abnormal uterine bleeding, but this is not usually associated with ovarian cancer.

It is important to point out that the Pap test - an excellent tool in the diagnosis of cancer of the uterine cervix - does not reveal ovarian cancer.

If the diagnosis imaging tests indicate that a tumor is present, the next step may be Laparoscopy to determine the extent and nature of the disease. This procedure involves cutting a tiny incision in the abdomen to allow the ovary to be examined with a special fiber-optic instrument. During Laparoscopy, a sample of tissue can be removed for microscopic examination. This biopsy is the only sure way of determining whether a growth is malignant or benign.

The physician may instead arrange for an operation called a laparotomy, which involves making an incision in the abdomen to reach the ovaries, conduct a biopsy, and then - if the diagnosis is cancer - proceed immediately with surgical removal of the entire cancerous growth. Beforehand, the patient should be thoroughly briefed so she understands that major surgery may be necessary if the biopsy shows malignancy.

Because operative management of ovarian cancer is aimed at removing as much tumor as is safely possible, a thorough abdominal exploration during the surgery is important. Usually, both ovaries, the uterus (hysterectomy) and fallopian tubes are removed, and any suspicious surfaces in the peritoneal cavity are also biopsied. Any grossly abnormal lymph nodes in the area are considered metastasis and removed, as well. In advanced disease, every effort is made to remove all intra-abdominal disease to enhance the effect of chemotherapy.

There are a number of factors that significantly influence survival rates; the stage of the disease and when diagnosed, the cell type, the grade of the tumor, the success of the surgery, and response to therapy. If ovarian cancer is diagnosed and treated early, about 85 percent of such patients live five years or longer. When diagnosis at an advanced stage, however, the survival rate drops to 23 percent. The survival rates for ovarian cancer are improving with modern chemotherapeutic agents.

If you are in the high-risk categories or have any reason to suspect ovarian cancer, or if you have not had a pelvic exam during the last 18 months, call your gynecologist as soon as possible. Your best chance of beating ovarian cancer is regular check-ups. Schedule one today.

Randy A. Birken, M.D., F.A.C.S., F.A.C.O.G.
Texas Medical Arts Tower
17070 Red Oak Drive, Suite 201 A - Houston, TX 77090
Office: 281.893.1246  Fax: 281.444.6259

Copyright 2000-2006 Randy A. Birken, M.D., F.A.C.S., F.A.C.O.G.  All Right Reserved
Disclaimer and Privacy Policy

Web Design by The Texas Network Houston, Texas