The top 5 risk factors for ovarian cancer--how you can spot the early signs of ovarian cancer.

Ovarian cancer is cancer that starts in the ovaries, the female reproductive organs that produces eggs and horones such as estogen, progesterone and testerone.  Ovarian cancer is the fifth leading cause of cancer death among women and is the top cause of cancer death among cancer of the female reproductive organs, i.e., uterine cancer, cervical cancer, among others.  Ovaries--each the size of an almond--are located in the pelvis, one on each side of the uterus.

What are the symptoms of ovarian cancer?

In its early stage, ovarian cancer is known to cause vague symptoms that are often associated with digestive and bladder problems, such as constipation, increased urinary frequency or urgency, difficulty eating, vaginal bleeding, bloating and abdominal and pelvic pain.  Because the symptoms of early stage ovarian cancer often mimic digestive and bladder problems, it is rare that ovarian cancer is diagnosed in its early stage before the cancer has spread beyond the ovaries to the surrounding tissues in the pelvis and abdomen.  Furthermore, there are no lab or imaging studies that have been shown to diagnose ovarian cancer in its early stage.  By the time the ovarian cancer is diagnosed, the tumor has often spread beyond the ovaries.

Ovarian cancer is rarely diagnosed in its early stage and it is usually advanced by the time the diagnosis is made. About 3 out of 4 women with ovarian cancer survive one year after diagnosis and nearly half of women live longer than five years after diagnosis.  If the diagnosis is made early in the disease and treatment is received before the cancer spreads outside the ovary, the five year survival rate is very high. 

The key to surviving ovarian cancer is detecting the cancer and getting treatment before the cancer spreads to other organs and tissues surrounding the ovaries.  Patients whose ovarian cancer has not spread outside the ovary have a 90%-95% chance of living five years or longer after treatment.  Unfortunately, only about 20% of ovarian cancers are found in the early stages of the disease before it has spread.

What are the different types of ovarian cancer?

There are three types of ovarian cancer: (1) epithelial; (2) germ cell tumors; and (3) stromal tumors.  The type of cancer is based on the type of cells in which it occurs.  About 85%-90% of all ovarian cancers arise from epithelial cells--these are cells that cover the surface of the ovaries.  About 5% of ovarian cancers are germ cell tumors. 21,500 women in the U.S. will be diagnosed with epithelial ovarian cancer in 2009, according to the American Medical Society.

The stages of ovarian cancer range from stage I to stage IV, with I being the earliest stage and IV the most advanced.

What are the top five risk factors for ovarian cancer?

First, you shoud be familiar with the risk factors for ovarian cancer.  A family history of ovarian cancer is the strongest risk factor for this disease, and other risk factors include late menopause (after age 50), a personal history of breast or colorectal cancer, and age.  Older women are at highest risk of develping ovarian cancer and most ovarian cancer deaths occur in women age 55 and older.  Women who take estrogen replacement therapy for five year or longer have a higher risk of ovarian cancer.

Women with mutations in the BRCA genes have a particularly increased risk for ovarian cancer.  Women with the BRCA1 gene have a 45% lifetime risk of getting ovarian cancer and those with the BRCA2 gene have a 25% lifetime risk.  If you have a family history of ovarian cancer, you should ask your doctor to order genetic testing in order to determine if you have the BRCA gene.  BRCA testing should be done in women at high risk for ovarian cancer.

There are screening testsfor women with an increased risk of ovarian cancer due to a family history of the disease or BRCA mutations.  The CA 125 antigen may be found in the blood of women with ovarian cancer and it may be a sign of the disease.  Additionally, removal of the ovaries and fallopian tubes in women who have a mutation in the BRCA1 or BRCA2 genes will reduce the risk of developing ovarian cancer.

A pelic examination may reveal an ovarian or abdominal mass.  If you have any of the symptoms of ovarian cancer, you should ask your doctor to do a pelvic examination to check for an abnormal mass.  If you have the symptoms of ovarian cancer, a pelvic laparoscopy or exploratory laparotomy can be done to evaluate the symptoms and perform a biopsy to make the diagnosis.

What can be done about ovarian cancer?

Surgery is used to treat all stages of ovarian cancer.  Surgery may include removal of the uterus (total hysterectomy), removal of both ovaries and fallopian tubes (bilateral salpingo-oophorectemy), as well as the removal and biopsy of the lymph nodes and other tissues in the pelvis and abdomen.  Chemotherapy is used after surgery to treat any remaining disease.

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