According to the American Cancer Society, approximately 19,880 women will be newly diagnosed with ovarian cancer this year, and 12,810 women will die from it. It is the fifth most deadly cancer in women and the deadliest to affect the female reproductive system.
For September’s Ovarian Cancer Awareness Month, University of Minnesota Medical School expert Colleen Rivard, MD, speaks about the subtle signs and risk factors of ovarian cancer.
Q: What is ovarian cancer?
Ovarian cancer is the second most common and deadliest gynecologic malignancy in the United States. It is a malignant tumor that arises from the ovary or fallopian tube.
There are three main types of ovarian cancer:
- Germ cell tumors arise from the cells that give rise to the egg cells of the ovary.
- Stromal tumors arise from the supporting cells of the ovary that surround the egg cells.
- Epithelial tumors, which are by far the most common and deadliest, and which we will focus on today. Of the epithelial tumors, the most common are serous carcinomas, which we further subdivide into low-grade and high-grade.
Q: What are the subtle symptoms of ovarian cancer?
One of the biggest problems with ovarian cancer and why it is so deadly is that in the early stages there are often no symptoms and by the time women develop subtle symptoms, the cancer has already spread. Most ovarian cancers are diagnosed at stages three and four – at which point it is very difficult to cure.
The most common symptoms are abdominal symptoms, including pain, gas or bloating, changes in appetite or early satiety, and changes in bowel or bladder habits. These symptoms are often non-specific and can mimic other health conditions, such as: B. digestive problems, esophageal reflux or urinary tract problems.
Q: What are the risk factors for developing ovarian cancer and the currently available treatment options?
In general, age is the greatest risk factor for ovarian cancer, with the vast majority of epithelial tumors occurring in women aged 60 years and older.
Other risk factors include infertility, endometriosis, polycystic ovary syndrome, nulliparity, early menarche, or late menopause.
There are also several genetic mutations and syndromes that are associated with a significantly increased risk of developing ovarian cancer. These include hereditary breast and ovarian cancer syndrome and Lynch syndrome.
There are also a number of other genetic mutations that we know lead to an increased risk of ovarian cancer. In fact, these genetic mutations lead to up to 25% of ovarian cancer diagnoses and therefore it is recommended that all women diagnosed with ovarian cancer receive genetic counseling and testing. These mutations can also affect the treatment a patient receives.
The mainstay of early treatment for ovarian cancer is currently a combination of surgery and chemotherapy. Unfortunately, the cancer recurs in 85% of patients, and in these situations the mainstay of treatment is chemotherapy or enrollment in a clinical trial.
Q: If someone is diagnosed with ovarian cancer, what should they know about the diagnosis?
Being diagnosed with ovarian cancer can be very overwhelming for a patient and I think it can be helpful to take the diagnosis and treatment step by step. I think it is also very important for a patient to have an advocate who is either a family member or a friend who can attend the visits with them to help them remember and understand all the information discussed to understand. We also have the Minnesota Ovarian Cancer Alliance (mnovarian.org) which provides great resources for patients, families and providers. September is also National Ovarian Cancer Awareness Month and we just had the MOCA Run/Walk to raise money for ovarian cancer screening and treatment research.
Q: What are you doing in your research and practice to advance our understanding of ovarian cancer and patient relationships?
We have made many important discoveries in the treatment of ovarian cancer over the past 10 years, including PARP inhibitors and immunotherapy. As the Department of Gynecologic Oncology, we are committed to providing patient access and enrollment in clinical trials as the best way to improve outcomes for patients with ovarian cancer.
Colleen Rivard, MD, is a gynecologic oncologist at U of M Medical School and M Health Fairview. She is also a member of the Masonic Cancer Center.
