| Ovarian cancer like
any disease comes about as a malfunction of one or more of your
bodies systems. Much if not most of the time this is a
result of a slow degenerative process due to the lack of adequate
bodily supplies of the elements necessary for normal function and
rejuvenation of affected organs. Commercial Farming and natural
erosion has depleted global farmlands of most essential elements
therefore it is not wise to assume that your diet contains enough
of these elements for normal body function and maintenance.
See Senate Document 264.
The exact causes of ovarian cancer are not
known. However, studies show that the following factors may increase the
chance of developing this disease:
- Family history. First-degree relatives
(mother, daughter, sister) of a woman who has had ovarian cancer are
at increased risk of developing this type of cancer themselves. The
likelihood is especially high if two or more first-degree relatives
have had the disease. The risk is somewhat less, but still above
average, if other relatives (grandmother, aunt, cousin) have had
ovarian cancer. A family history of breast or colon cancer is also
associated with an increased risk of developing ovarian cancer.
- Age. The likelihood of developing ovarian
cancer increases as a woman gets older. Most ovarian cancers occur
in women over the age of 50, with the highest risk in women over 60.
- Childbearing. Women who have never had
children are more likely to develop ovarian cancer than women who
have had children. In fact, the more children a woman has had, the
less likely she is to develop ovarian cancer.
- Personal history. Women who have had breast
or colon cancer may have a greater chance of developing ovarian
cancer than women who have not had breast or colon cancer.
- Fertility drugs.
Drugs that cause a woman to ovulate may slightly increase a woman's
chance of developing ovarian cancer. Researchers are studying this
- Talc. Some studies suggest that women who
have used talc in the genital area for many years may be at
increased risk of developing ovarian cancer.
replacement therapy (HRT). Some evidence suggests that
women who use HRT after menopause
may have a slightly increased risk of developing ovarian cancer.
|About 1 in every 57 women in the United
States will develop ovarian cancer. Most cases occur in women
over the age of 50, but this disease can also affect younger
As we learn more about what causes ovarian cancer, we
may also learn how to reduce the chance of getting this disease. Some
studies have shown that breast feeding and taking birth control pills
(oral contraceptives) may decrease a woman's likelihood of developing
ovarian cancer. These factors decrease the number of times a woman
ovulates, and studies suggest that reducing the number of ovulations
during a woman's lifetime may lower the risk of ovarian cancer.
Women who have had an operation that prevents
pregnancy (tubal ligation) or have
had their uterus and cervix removed (hysterectomy)
also have a lower risk of developing ovarian cancer. In addition, some
evidence suggests that reducing the amount of fat in the diet may lower
the risk of developing ovarian cancer.
Women who are at high risk for ovarian cancer due to a
family history of the disease may consider having their ovaries removed
before cancer develops (prophylactic oophorectomy).
This procedure usually, but not always, protects women from developing
ovarian cancer. The risks associated with this surgery and its side
effects should be carefully considered. A woman should discuss the
possible benefits and risks with her doctor based on her unique
Having one or more of the risk
factors mentioned here does not mean that a woman is sure to
develop ovarian cancer, but the chance may be higher than average. Women
who are concerned about ovarian cancer may want to talk with a doctor
who specializes in treating women with cancer: a gynecologist,
a gynecologic oncologist,
or a medical oncologist. The
doctor may be able to suggest ways to reduce the likelihood of
developing ovarian cancer and can plan an appropriate schedule for
Detecting Ovarian Cancer
The sooner ovarian cancer is found and treated, the
better a woman's chance for recovery. But ovarian cancer is hard to
detect early. Many times, women with ovarian cancer have no symptoms or
just mild symptoms until the disease is in an advanced stage. Scientists
are studying ways to detect ovarian cancer before symptoms develop. They
are exploring the usefulness of measuring the level of CA-125,
a substance called a tumor marker,
which is often found in higher-than-normal amounts in the blood of women
with ovarian cancer. They also are evaluating transvaginal
ultrasound, a test that may help detect the disease early. The Cancer
Information Service can provide information about this research.
|A large-scale study, known as the PLCO
(Prostate, Lung, Colorectal, and Ovarian) Cancer Screening
Trial, is currently evaluating the usefulness of a blood test
for the tumor marker known as CA-125 and a test called
transvaginal ultrasound for ovarian cancer screening.
Ovarian cancer often shows no obvious signs or
symptoms until late in its development. Signs and symptoms of ovarian
cancer may include:
- General abdominal discomfort and/or pain (gas,
indigestion, pressure, swelling, bloating, cramps)
- Nausea, diarrhea, constipation, or frequent
- Loss of appetite
- Feeling of fullness even after a light meal
- Weight gain or loss with no known reason
- Abnormal bleeding from the vagina
These symptoms may be caused by ovarian cancer or by
other, less serious conditions. It is important to check with a doctor
about any of these symptoms.
Diagnosing Ovarian Cancer
To help find the cause of symptoms, a doctor evaluates
a woman’s medical history. The doctor also performs a physical exam
and orders diagnostic tests. Some exams and tests that may be useful are
- Pelvic exam includes feeling the uterus,
vagina, ovaries, fallopian tubes, bladder,
and rectum to find any abnormality in
their shape or size. (A Pap test, a
good test for cancer of the cervix, is often done along with the
pelvic exam, but it is not a reliable way to find or diagnose
refers to the use of high-frequency sound waves. These waves, which
cannot be heard by humans, are aimed at the ovaries. The pattern of
the echoes they produce creates a picture called a sonogram.
Healthy tissues, fluid-filled cysts, and tumors look different on
- CA-125 assay is a blood test used to measure
the level of CA-125, a tumor marker that is often found in
higher-than-normal amounts in the blood of women with ovarian
- Lower GI series,
or barium enema, is a
series of x-rays of the colon
and rectum. The pictures are taken after the patient is given an
enema with a white, chalky solution containing barium. The barium
outlines the colon and rectum on the x-ray, making
tumors or other abnormal areas easier to see.
- CT (or CAT) scan
is a series of detailed pictures of areas inside the body created by
a computer linked to an x-ray machine.
- Biopsy is the
removal of tissue for examination under a microscope. A pathologist
studies the tissue to make a diagnosis.
To obtain the tissue, the surgeon performs a laparotomy
(an operation to open the abdomen). If cancer is suspected, the
surgeon performs an oophorectomy (removal of the entire ovary). This
is important because, if cancer is present, removing just a sample
of tissue by cutting through the outer layer of the ovary could
allow cancer cells to escape and cause the disease to spread.
If the diagnosis is ovarian cancer, the doctor
will want to learn the stage (or extent)
of disease. Staging is a careful
attempt to find out whether the cancer has spread and, if so, to
what parts of the body. Staging may involve surgery, x-rays
and other imaging procedures, and lab
tests. Knowing the stage of the disease helps the doctor plan
Treatment for Ovarian Cancer
Treatment depends on a number of factors, including
the stage of the disease and the general health of the patient. Patients
are often treated by a team of specialists. The team may include a gynecologist,
a gynecologic oncologist, a
medical oncologist, and/or a radiation
oncologist. Many different treatments and combinations of
treatments are used to treat ovarian cancer.
- Surgery is the
usual initial treatment for women diagnosed with ovarian cancer. The
ovaries, the fallopian tubes, the uterus, and the cervix are usually
removed. This operation is called a hysterectomy with bilateral salpingo-oophorectomy.
Often, the surgeon also removes the omentum
(the thin tissue covering the stomach and large intestine) and lymph
nodes (small organs located along the channels of the
lymphatic system) in the abdomen.
Staging during surgery (to find out whether the
cancer has spread) generally involves removing lymph nodes, samples
of tissue from the diaphragm and other organs in the abdomen, and
fluid from the abdomen. If the cancer has spread, the surgeon
usually removes as much of the cancer as possible in a procedure
called tumor debulking. Tumor
debulking reduces the amount of cancer that will have to be treated
later with chemotherapy or radiation therapy.
is the use of drugs to kill cancer cells. Chemotherapy may be given
to destroy any cancerous cells that may remain in the body after
surgery, to control tumor growth, or to relieve symptoms of the
Most drugs used to treat ovarian cancer are given
by injection into a vein (intravenously,
or IV). The drugs can be injected directly into a vein or
given through a catheter, a thin
tube. The catheter is placed into a large vein and remains there as
long as it is needed. Some anticancer drugs are taken by mouth.
Whether they are given intravenously or by mouth, the drugs enter
the bloodstream and circulate throughout the body.
Another way to give chemotherapy is to put the
drug directly into the abdomen through a catheter. With this method,
chemotherapy, most of the drug remains in the abdomen.
After chemotherapy is completed, second-look
surgery may be performed to examine the abdomen directly.
The surgeon may remove fluid and tissue samples to see whether the
anticancer drugs have been successful.
therapy, also called radiotherapy, involves the use of
high-energy rays to kill cancer cells. Radiation therapy affects the
cancer cells only in the treated area. The radiation may come from a
machine (external radiation).
Some women receive a treatment called intraperitoneal
radiation therapy in which radioactive
liquid is put directly into the abdomen through a catheter.
(research studies) to evaluate new ways to treat cancer are an important
treatment option for many women with ovarian cancer. In some studies,
all patients receive the new treatment. In others, doctors compare
different therapies by giving the promising new treatment to one group
of patients and the usual (standard) therapy to another group. Through
research, doctors learn new, more effective ways to treat cancer. More
information about treatment studies can be found in the NCI publication Taking
Part in Clinical Trials: What Cancer Patients Need To Know. NCI
also has a Web site at http://cancertrials.nci.nih.gov
that provides detailed information about ongoing studies for ovarian
cancer. Clinical trial information is also available from the Cancer
Information Service by calling 1-800-4-CANCER (1-800-422-6237).
|The NCI's CancerNet™ Web site provides
information from numerous NCI sources, including PDQ®, NCI's
cancer information database. PDQ contains information about
ongoing clinical trials as well as current information on cancer
prevention, screening, treatment, and supportive care. CancerNet
also contains CANCERLIT®, a database of citations and abstracts
on cancer topics from scientific literature. CancerNet can be
accessed at http://cancernet.nci.nih.gov
on the Internet.
Possible Side Effects of Treatment
The side effects of
cancer treatment depend on the type of treatment and may be different
for each woman. Doctors and nurses will explain the possible side
effects of treatment, and they can suggest ways to help relieve problems
that may occur during and after treatment.
- Surgery causes short-term pain and
tenderness in the area of the operation. Discomfort or pain after
surgery can be controlled with medicine. Patients should feel free
to discuss pain relief with their doctor. For several days after
surgery, the patient may have difficulty emptying her bladder and
having bowel movements.
When both ovaries are removed, a woman loses her
ability to become pregnant. Some women may experience feelings of
loss that may make intimacy difficult. Counseling or support for
both the patient and her partner may be helpful.
Also, removing the ovaries means that the body's
natural source of estrogen and progesterone is lost, and menopause
occurs. Symptoms of menopause, such as hot flashes and vaginal
dryness, are likely to appear soon after the surgery. Some form of
hormone replacement therapy may be used to ease such symptoms.
Deciding whether to use it is a personal choice; women with ovarian
cancer should discuss with their doctors the possible risks and
benefits of using hormone replacement therapy.
- Chemotherapy affects normal as well as
cancerous cells. Side effects depend largely on the specific drugs
and the dose (amount of drug given). Common side effects of
chemotherapy include nausea and vomiting, loss of appetite,
diarrhea, fatigue, numbness and tingling in hands or feet,
headaches, hair loss, and darkening of the skin and fingernails.
Certain drugs used in the treatment of ovarian cancer can cause some
hearing loss or kidney damage. To help
protect the kidneys while taking these drugs, patients may receive
extra fluid intravenously.
- Radiation therapy, like chemotherapy,
affects normal as well as cancerous cells. Side effects of radiation
therapy depend mainly on the treatment dose and the part of the body
that is treated. Common side effects of radiation therapy to the
abdomen are fatigue, loss of appetite, nausea, vomiting, urinary
discomfort, diarrhea, and skin changes on the abdomen.
Intraperitoneal radiation therapy may cause abdominal pain and bowel
obstruction (a blockage of the
Several NCI booklets, including Chemotherapy
and You, Radiation
Therapy and You, and Eating
Hints for Cancer Patients, suggest ways for patients to cope
with the side effects they experience during cancer treatment.
|Doctors and nurses will explain the possible
side effects of treatment, and they can suggest ways to help
relieve problems that may occur during and after treatment.
The Importance of Followup Care
Followup care after treatment for ovarian cancer is
important. Regular checkups generally include a physical exam, as well
as a pelvic exam and Pap test. The doctor also may perform additional
tests such as a chest x-ray, CT scan, urinalysis, complete
blood count, and CA-125 assay.
In addition to having followup exams to check for the
return of ovarian cancer, patients may also want to ask their doctor
about checking them for other types of cancer. Women who have had
ovarian cancer may be at increased risk of developing breast or colon