Ovarian cancer is known as the silent killer as the symptoms that can appear are usually in the later stages of cancer growth; and in addition, even when those symptoms do appear, many women do not realize the danger and can easily mistake them for non-threatening conditions. Awareness and education about ovarian cancer is of utmost importance and needs to be a major priority!
Understanding the Stealth and Severity of Ovarian Cancer
Ovarian cancer, often dubbed the “silent killer,” is a formidable adversary in the realm of women’s health. This malignant disease originates in the ovaries, the female reproductive organs responsible for producing eggs and hormones like estrogen and progesterone. The stealthy nature of ovarian cancer, characterized by subtle and often overlooked symptoms, makes it a significant threat.
The Nature of Ovarian Cancer
Ovarian cancer can be categorized into several types, with epithelial ovarian cancer being the most common, accounting for about 90% of cases. Other types include germ cell tumors and stromal tumors, which are rarer but still dangerous. Understanding the biology and classification of ovarian cancer is crucial for effective diagnosis and treatment.
Risk Factors
Several risk factors contribute to the development of ovarian cancer. Age is a significant factor, as most cases occur in women over 50. A family history of ovarian or breast cancer can also increase risk, suggesting a genetic predisposition. Mutations in genes such as BRCA1 and BRCA2 are known to elevate the risk substantially. Other risk factors include a history of endometriosis, never having been pregnant, and hormone replacement therapy.
Detecting Ovarian Cancer
Ovarian cancer develops in the cells of the ovary, the female reproductive organs that produce eggs and the hormones estrogen and progesterone. There are more than 30 types of ovarian cancer, but they typically fall under three classifications depending on the type of tissue affected:
- Epithelial cell: The cells that cover the surface of the ovary. While most ovarian epithelial tumors are benign, malignant tumors of this kind are the most common and dangerous form of ovarian cancer.
- Stromal cell: This type forms in the structural tissue of the ovary and produces hormones.
- Germ cell: This is a rare form of ovarian cancer that forms in the eggs in the ovary.
Because ovarian cancer symptoms tend to be vague and associated with other issues like gastrointestinal problems, it can be difficult to detect early in its most curable stages. If symptoms persist for more than two weeks, discuss them with your physician.
Signs & Symptoms
Early-stage ovarian cancer rarely causes any symptoms. However, as the disease progresses, the following signs and symptoms may become more apparent:
- Bloating and increased abdominal size
- Persistent pelvic or abdominal pain
- Feeling full quickly or difficulty eating
- Frequent or urgent need to urinate
- Fatigue
- Back pain
- Changes in bowel habits, such as constipation
- Menstrual irregularities
Because these symptoms are often vague and can be attributed to less serious conditions, ovarian cancer frequently goes undetected until it has advanced to a later stage. It is essential for women to be vigilant and consult a healthcare provider if they experience persistent or unusual symptoms.
Explanation of Symptoms
The symptoms of ovarian cancer can vary depending on the stage of the disease and the individual. However, there are several common signs that may indicate the presence of ovarian cancer:
1. Abdominal Bloating
Persistent abdominal bloating is one of the most frequent symptoms reported by women with ovarian cancer. This bloating is often described as a feeling of fullness or swelling in the abdomen that does not go away.
2. Pelvic or Abdominal Pain
Pain or discomfort in the pelvic or abdominal region can be a sign of ovarian cancer. This pain may be persistent or come and go, and it may feel different from typical menstrual cramps.
3. Difficulty Eating or Feeling Full Quickly
Women with ovarian cancer often experience a loss of appetite or a feeling of fullness after eating only a small amount of food. This symptom can contribute to unintentional weight loss.
4. Urinary Symptoms
Frequent urination or an urgent need to urinate, often without a corresponding increase in fluid intake, can be a symptom of ovarian cancer. These urinary symptoms are similar to those experienced with urinary tract infections but persist over time.
5. Changes in Bowel Habits
Ovarian cancer can cause changes in bowel habits, such as constipation or diarrhea. These changes may occur suddenly and persist over time.
6. Fatigue
Extreme tiredness or fatigue that does not improve with rest can be a symptom of ovarian cancer. This fatigue can be debilitating and affect daily activities.
7. Menstrual Changes
Irregular menstrual cycles, including heavier or lighter periods than usual, can be a sign of ovarian cancer. Postmenopausal women may experience unexpected vaginal bleeding.
Less Common Symptoms
In addition to the more common symptoms, there are other, less frequent signs that may indicate ovarian cancer:
1. Back Pain
Persistent back pain, especially if it is not related to physical activity or previous injuries, can be a symptom of ovarian cancer.
2. Pain During Intercourse
Pain or discomfort during sexual intercourse can be a sign of ovarian cancer, particularly if it persists over time.
3. Unexplained Weight Loss
While difficulty eating can contribute to weight loss, some women with ovarian cancer may experience significant weight loss without an obvious cause.
When to See a doctor
It is important to pay attention to your body and recognize when symptoms persist or worsen. If you experience any of the common or less common symptoms of ovarian cancer for more than a few weeks, it is essential to seek medical advice. Early detection of ovarian cancer can significantly improve treatment outcomes.
Diagnostic Procedures
If ovarian cancer is suspected, several diagnostic procedures may be used to confirm the diagnosis:
1. Pelvic Examination
A pelvic examination allows the healthcare provider to check for abnormalities in the ovaries and other reproductive organs. This examination may include a visual and physical inspection.
2. Imaging Tests
Ultrasound, CT scans, and MRI scans can help visualize the ovaries and detect any masses or abnormalities.
3. Blood Tests
Blood tests, such as the CA-125 test, measure the levels of certain proteins that may be elevated in women with ovarian cancer. While not definitive, these tests can provide valuable information.
4. Biopsy
A biopsy involves taking a sample of ovarian tissue for examination under a microscope. This is the most definitive way to diagnose ovarian cancer.
Ovarian Cancer Facts
- Ovarian cancer is the second most common type of female reproductive cancer; in fact, more women die from ovarian cancer than from cervical and uterine cancer combined.
- Ovarian cancer accounts for only 3% of all cancers in women, but it causes more deaths each year than any other cancers of the female reproductive system (CDC, 2017).
- 1/78 women will be diagnosed with ovarian cancer, with 70% diagnosed in advanced stages (American Cancer Society, 2019).
- Ovarian cancer generally presents at more advanced stages, has higher rates of reoccurrence, and poorer survival rates than other cancers.
- THERE IS NO EARLY DETECTION TEST FOR OVARIAN CANCER.
- There is no clear cause, but certain factors can increase risk of a woman developing ovarian cancer.
Treatment Options
The treatment of ovarian cancer typically involves a combination of surgery and chemotherapy. The primary goal of surgery is to remove as much of the tumor as possible, a procedure known as debulking. This may involve the removal of one or both ovaries, the fallopian tubes, the uterus, and other affected tissues. Chemotherapy is often used after surgery to target any remaining cancer cells.
Targeted Therapy and Immunotherapy
In recent years, targeted therapy and immunotherapy have emerged as promising treatment options. Targeted therapy involves drugs that specifically attack cancer cells while sparing healthy ones. PARP inhibitors, for instance, have shown effectiveness in treating ovarian cancer with BRCA mutations. Immunotherapy, which harnesses the body’s immune system to fight cancer, is also being explored, though its role in ovarian cancer treatment is still under investigation.
Clinical Trials
Participating in clinical trials can provide patients with access to cutting-edge treatments that are not yet widely available. These trials are crucial for advancing our understanding of ovarian cancer and developing new therapies.
Prevention and Risk Reduction
While there is no sure way to prevent ovarian cancer, certain measures can help reduce the risk. Oral contraceptives have been shown to lower the risk of ovarian cancer, especially when taken for several years. Preventive surgeries, such as the removal of ovaries and fallopian tubes, may be considered for high-risk individuals, particularly those with BRCA gene mutations.
Lifestyle Factors
Maintaining a healthy lifestyle is also important. A diet rich in fruits, vegetables, and whole grains, regular physical activity, and avoiding smoking can contribute to overall health and potentially lower cancer risk.
Awareness is key! Women need to be counseled routinely on the signs and symptoms of ovarian cancer; hopefully leading to early detection and treatment! So, while we all recognize the pink in October for Breast Cancer Awareness Month, let’s be sure to spend September wearing teal and raising awareness and education for ovarian cancer. Perhaps this silent killer can become more of a whisper!
REFERENCES
- Jasen P. From the “silent killer” to the “whispering disease”: ovarian cancer and the uses of metaphor. Med Hist. 2009 Oct;53(4):489-512. doi: 10.1017/s0025727300000521. PMID: 19876511; PMCID: PMC2766137.
- American Cancer Society. (2019). Key Statistics for Ovarian Cancer. Retrieved from https://seer.cancer.gov/statfacts/html/ovary.html#
- Centers for Disease Control & Prevention. (2017). Ovarian Cancer Epidemiology in the U.S. Retrieved from Slatnik, C. & Duff, E. (2015). Ovarian cancer: Ensuring early diagnosis. The Nurse Practitioner, 40(9). doi: 10.1097/01.NPR.0000450742.00077.a2
- National Comprehensive Cancer Network. (2019). Ovarian cancer including fallopian tube cancer and primary peritoneal cancer, version 1.2019. Retrieved from https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1453
- Nasiri F, Farrokhi K, Safarzadeh Kozani P, Mahboubi Kancha M, Dashti Shokoohi S, Safarzadeh Kozani P. CAR-T cell immunotherapy for ovarian cancer: hushing the silent killer. Front Immunol. 2023 Dec 7;14:1302307. doi: 10.3389/fimmu.2023.1302307. PMID: 38146364; PMCID: PMC10749368.
- Feeney L, Harley IJ, McCluggage WG, Mullan PB, Beirne JP. Liquid biopsy in ovarian cancer: Catching the silent killer before it strikes. World J Clin Oncol. 2020 Nov 24;11(11):868-889. doi: 10.5306/wjco.v11.i11.868. PMID: 33312883; PMCID: PMC7701910.
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