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Why Ovarian Cancer Awareness Is So Important

Ovarian cancer is the most deadly of gynecologic cancers. The disease is called the “silent killer” because its symptoms are often attributed to other conditions affecting women and so the majority of cases are caught too late, when the disease has advanced to a late stage.

That’s why spreading awareness about ovarian cancer and the need for early detection is crucial. Gina Mantia-Smaldone, MD, a gynecologic oncologist at Fox Chase Cancer Center, spoke about what women need to know about this disease.

The Numbers

Ovarian cancer is not a common disease; only about 2 percent of the population, or 22,240 women, are expected to be diagnosed this year.  But, ovarian cancer accounts for more deaths than any other cancer of the female reproductive system, with 14,070 women expected to die of their disease this year.  

When women are diagnosed with cancer limited to the ovary that has not spread, their overall five-year survival rates can be as high as 90 percent. But, that survival rate drops to about 45 percent for women whose disease has advanced to a later stage, which Mantia-Smaldone said is most regularly the case.

Risk Factors

One of the most important risk factors for ovarian cancer is family history. Women with a single first- or second-degree family member with ovarian cancer have a three-fold increased risk for ovarian cancer. Other risk factors include:

  • A strong family history of either ovarian cancer, or breast cancer alone
  • Confirmed genetic mutations in BRCA1 or BRCA2
  • Lynch syndrome

Women should talk with their family members and share their family history with their physicians. Genetic testing can be performed to arm women with knowledge that could help them make more informed decisions about their health.

Prevention and Screening

“Most ovarian cancer patients present with advanced-stage disease, unfortunately, due to the lack of specific symptoms and the lack of effective screening tools,” Mantia-Smaldone said.

Unlike cervical cancer – which can be prevented with the HPV vaccine – there is no vaccine which can prevent ovarian cancer.

“For this reason, clinicians have to rely on screening techniques like transvaginal ultrasound, pelvic exams and CA125, which are useful in helping to catch the disease early,” Mantia-Smaldone said.

For patients at a high risk for getting ovarian cancer, the most beneficial and cost-effective preventive tool that exists for ovarian cancer is prophylactic surgery. During this procedure, the ovaries and fallopian tubes are removed, resulting in more than 90 percent risk reduction in women with BRCA1 or BRCA2 mutations, and nearly 100 percent in women with Lynch syndrome.

“It’s recommended that woman at highest risk for ovarian cancer consider prophylactic surgery around the age of 35, or after they’re finished having children,” Mantia-Smaldone said.  “Screening with transvaginal ultrasound and CA125 is typically used until patients are ready to commit to prophylactic surgery.”

Other Risk-Reducing Behaviors

Oral contraceptive pill (OCP) use, breast feeding, and tubal ligation have all been identified as protective factors against ovarian cancer, and should be considered in women at any risk for ovarian cancer.

 “These protective factors can be considered in women at both average and increased risk for ovarian cancer, especially in those at-risk women who may not feel ready to commit to prophylactic surgery and the resulting surgical menopause,” Mantia-Smaldone said.

Education

In addition to identifying women at increased risk, all women should be educated on symptoms which could be linked with ovarian cancer.

Mantia-Smaldone said identifying symptoms specific to ovarian cancer has been a challenge, given that many of the symptoms are vague and nonspecific. However, certain symptoms in particular, have been significantly linked to women who have been diagnosed with ovarian cancer. They include:

  • Abdominal pain or bloating
  • Urinary urgency or frequency
  • Difficulty eating, or early satiety (a feeling of being full after eating very little food)

“Women should discuss their symptoms with their gynecologist, especially if they have occurred more than 12 times a month,” Mantia-Smaldone said.

She added that the overall incidence of ovarian cancer has decreased in recent years and by educating all women, especially those at increased risk for disease, “perhaps we can stop this disease before it destroys more lives.”

Learn more about ovarian cancer treatment at Fox Chase.

Learn more about the Risk Assessment Program and genetic testing at Fox Chase.