September is dedicated to the awareness of several cancers: prostate cancer, childhood cancer, gynecologic cancer, leukemia and lymphoma and thyroid cancer. It is also National Ovarian Cancer Awareness Month. Because ovarian cancer is often misdiagnosed or overlooked until its late stage, I thought it the appropriate cancer to focus on this month.
In case you left biology class far behind in high school, as I did, here is a short biology lesson. A woman has two ovaries, each about the size of an almond, on either side of her uterus. The ovaries release eggs as part of the woman’s reproductive cycle and are also responsible for producing the hormones estrogen, progesterone and testosterone.
Ovarian cancer begins in the ovaries and usually goes undetected until it has spread to other parts of the pelvis and abdomen. Because it is usually detected after it has spread, ovarian cancer is difficult to treat and is often fatal.
According to the American Cancer Society, ovarian cancer is the ninth most common cancer in women, excluding non-melanoma skin cancers. It ranks fifth in cancer deaths among women, accounting for more deaths than any other cancer of the female reproductive system.
There is a wonderful local organization, Gail’s Anatomy, which is dedicated to spreading the awareness about ovarian cancer. Visit them on Facebook or see Gail’s story at www.ovariancancerawareness4life.org. Through their dedication and hard work, South Carolina Gov. Nikki Haley has proclaimed this month as Ovarian Cancer Awareness Month in South Carolina.
WHAT TO LOOK FOR: Ovarian cancer is most often misdiagnosed because the symptoms are not specific to the disease and tend to mimic other benign, more-common conditions, including digestive problems. Symptoms include bloating, pelvic or abdominal pain, trouble eating or feeling full quickly, and feeling an urgent or frequent need to urinate. Other symptoms can be persistent gas, indigestion or nausea, change in bowel habits, such as constipation, a persistent lack of energy, and lower back pain. There can also be pain with sex, menstrual changes and weight loss accompanied by abdominal swelling.
The difference between ovarian cancer symptoms and other more common causes is the persistence of the symptoms. They represent a change from the normal, occur almost daily and can be quite severe. If a woman has these symptoms daily for more than a few weeks, she should see her doctor. A gynecologist is recommended.
DIAGNOSIS: Diagnosing ovarian cancer begins with a pelvic exam to check for an enlarged ovary and signs of fluid in the abdomen. If a doctor sees signs that ovarian cancer could be present, more tests will be ordered. These can include imaging tests such as CT scans, MRI and ultrasound. These tests cannot diagnose cancer but they can tell if a mass is present and whether further testing is needed. Imaging tests also help in staging ovarian cancer.
STAGE I: Ovarian cancer is confined to one or both ovaries
STAGE II: Ovarian cancer has spread to other locations in the pelvis such as the uterus or fallopian tubes
STAGE III: Ovarian cancer has spread beyond the pelvis or into the lymph nodes of the abdomen
STAGE IV: Ovarian cancer has spread to other organs beyond the abdomen, such as the liver or lungs
If a mass is found, a doctor will perform a biopsy. In this procedure, a sample of tissue is removed from the tumor and examined under a microscope by a pathologist. If fluid is in the abdomen, a sample may also be removed and tested. Blood tests will be performed to test for white blood cell count, red blood cell count and platelets. Tests will also check kidney and liver function and general health. A CA-125 blood test may also be ordered. CA-125 is used as a tumor marker in patients with some forms of cancer.
TREATMENT: Treatment for ovarian cancer usually combines two or more of the following: surgery, chemotherapy, hormone therapy, target therapy and radiation therapy. The choice of therapy usually depends on the type of cancer, the stage of the disease and your general health. Do not rush into treatment without understanding the risks and side effects of each treatment.
RISK FACTORS: Risk factors include inherited gene mutations, family history of ovarian cancer, having a previous cancer diagnosis, increasing age and never having been pregnant. Other risk factors can be obesity, the use of fertility drugs, estrogen therapy and hormone therapy, having a personal history of breast cancer, and using talcum powder in the genital area.
Having risk factors for ovarian cancer does not necessarily mean that you will develop the disease; however, your risk may be higher than the average woman. Knowing and listening to your body and talking with your doctor can help in catching the disease in its earlier stages, thus improving the outcome of treatment. Remember, you are your own best health advocate.
PREVENTION: There is no absolute way to prevent ovarian cancer, but there are ways to decrease your risk. Studies show that women who take oral contraceptives have a decreased risk of ovarian cancer. However, oral contraceptives carry their own risks, so discuss these with your doctor and make an informed decision about your health.
Discuss your risk factors for ovarian cancer with your doctor. In some cases, your doctor may be able to refer you to a genetic counselor to see if genetic testing is right for you. If you have a gene mutation that makes you more susceptible to ovarian cancer, you can discuss options, such as surgery to preemptively remove your ovaries, with your doctor to make the choice that is right for you.
Bottom line: talk with your doctor.
ASSISTANCE If you have been diagnosed with ovarian cancer, or any form of cancer, the Savannah River Cancer Foundation can help. The foundation helps anyone residing in Aiken, Allendale, Barnwell and Edgefield counties with any type of cancer being treated at any facility, regardless of the patient’s age. Financial assistance is available for help with transportation to and from cancer treatments and with cancer medication cost for patients who qualify. Regardless of income, the foundation also provides referrals to other organizations that provide assistance and maintains the Web site www.savannahrivercancerfoundation.org, which has cancer information and links to other cancer organizations.
The foundation also co-facilitates a support group for cancer patients, their families and caregivers. It is held the third Wednesday of each month (excluding December) from 3 to 4 p.m. in the parlor at Aiken’s First Baptist Church, 120 Chesterfield Street, NE, in downtown Aiken. The support group allows attendees to share their experiences, exchange information about available resources and reinforce the sense that they are not alone in their journey to survivorship.
Financial assistance applications can be found on the foundation’s Web site, or patients can call (803) 649-LIFE (5433) to request an application by mail. The Savannah River Cancer Foundation is at 235 Barnwell Avenue, NW, Aiken, SC 29801. Office hours are 8:30 a.m. to 5 p.m. Monday-Friday.