Ovarian cancer remains one of the most challenging gynecological cancers to detect and treat. In a recent Healthful Woman podcast, Dr. Monica Prasad Hayes, a GYN oncologist and director of the GYN oncology fellowship at Mount Sinai Hospital, offered a valuable perspective on symptoms, diagnosis, risk factors, and treatment options for ovarian cancer.
What Is Ovarian Cancer?
Ovarian cancer is a type of cancer that affects about 1 out of 70 women (1-1.5%) in their lifetime. 10-20% of ovarian cancer patients have genetically inherited the genes that increase the risk of cancer development; two of these genes are the BRCA1 and 2 genes. Additionally, ovarian cancer typically affects women over the age of 60.
Although it is not the most common type of cancer, it is often life-threatening because it goes undetected until it has reached advanced stages. Dr. Hayes explained that this is because, unlike breast cancer, where the masses are more easily visible, “you can’t palpate your ovaries and you don’t often feel anything until the ovarian cyst is quite large.” Additionally, the ovaries are small, and subtle growth will not be detected until symptoms arise. This is why awareness and early detection are so important.
Recognizing Symptoms of Ovarian Cancer
One of the biggest hurdles with ovarian cancer is its subtle symptoms that are often mistaken for common, benign issues. If the following symptoms persist for more than a few weeks or occur more frequently than normal, patients should seek medical advice immediately. Early intervention can improve the likelihood of successful outcomes.
- Persistent bloating or abdominal swelling
- Feeling full quickly after eating
- Frequent constipation
- Urinary urgency or frequent urination
- Weight gain caused by fluid retention
How Is Ovarian Cancer Diagnosed?
Diagnosis typically begins with an ultrasound, which requires no radiation and can be completed quickly. An MRI or CAT scan can also pick up on abnormalities, such as enlarged ovaries or excess fluid in the abdominal area. If abnormalities are detected, a surgical biopsy or needle biopsy is often the next step. If surgery is not an option, radiology can be used. The ovarian tissues will be examined under a microscope to determine if cancerous cells are present and, if so, what stage the cancer is at.
Dr. Hayes typically sees ovarian cancer patients once they are at stage three. She explained that although the American Cancer Society places “5-year survival around 20% to 30%, what we really typically see is probably around 40% to 50%.” The 5-year survival rate for stage four patients is closer to 20%.
Ovarian Cancer Treatment
When cancer is detected, treatment typically consists of surgery and chemotherapy. As much of the cancerous mass as possible will be surgically removed, and women will continue with about 4.5 months of chemotherapy to destroy the remaining cells. However, this treatment timeline varies based on the cancer stage. Dr. Hayes explains one alternative treatment, which is “neoadjuvant chemotherapy for very advanced stages, where we will give a few cycles of chemotherapy first and then do an interval surgery to remove the cancer, followed by more chemotherapy.”
After the initial treatment, maintenance therapies and observation may continue for years. A secondary surgery or secondary cytoreduction is a possibility, but there are differing opinions and ongoing research into the safety and successful outcomes of additional surgical procedures for recurring tumors.
Treatment Advances and Ongoing Research
Dr. Hayes shared her belief that “we need to do more research, [and] we need funding for more research on detection of early ovarian cancer.” There is no singular screening test available now, but research is being done in the US and Europe using blood markers like CA 125 and transvaginal ultrasound for cancer detection. Patients in a high-risk group, like those with a family history of ovarian cancer, may benefit from frequent screenings every few months to detect cancerous cells before they further develop.
Risk-reducing surgery is also an option for high-risk patients, but this requires the removal of a woman’s ovaries, which will cause menopause at an early age and does not provide 100% assurance of cancer prevention. Women considering this surgery will discuss it with their OB-GYN in detail, as the decision is a personal one that requires careful consideration.
Learn More On the Healthful Woman Podcast
By increasing awareness and sharing medical expertise, we can empower women to take charge of their health. To learn more about ovarian cancer and how you can stay proactive in your health, listen to the full podcast episode or schedule an appointment with our team at Carnegie Women’s Health.
