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Article Title:

Ovarian Cancer - Obstetrics and Gynecology New York


Summary:
Recently a friend came to me with devastating news. Her mother was diagnosed wit
h ovarian cancer. I must admit that the news was shocking to me also! Her mother
was in good health and she wasn’t afraid of the doctor’s office. “I don’t under
stand,” she said. “My mother always got her checkups and pap smears done. Her pa
p smears were always normal. How could she have ovarian cancer?” We didn’t think
that something like this could strike a healthy person without warning. Sadly,
we were all gravely mistaken.
Keywords:
Ovarian cancer screening, ovarian cancer obstetrics, developing ovarian cancer,
cancer, obstetrics, pap smears, breast cancer,
Article Text:
Co-Editor-in-Chief, Tracy E. Austin, MD
Friday, February 19, 2010 - 07:01 PM
Obstetricians/Gynecologists-OB-GYNs-New York

A Silent Killer of Women


Cancer is defined as a disease process in which cells grow unregulated by the bo
dy part it is inhibiting. Cancer can remain confined to that part of the body, w
here it starts, or it can spread (a process called metastasizing.)
Among American women, ovarian cancer is the fifth most common cancer. Of the can
cers that attack the female reproductive system, it is the leading cause of deat
h. About two-thirds of the deaths from ovarian cancer occur in women age 55 and
older. A quarter of ovarian cancer deaths occur in women between 35 and 54 years
of age.
Causes
The cause of ovarian cancer is unknown, as the risk for developing it is related
to many factors. The strongest risk factors are hereditary. Women with a person
al history of breast cancer, a family history of breast or ovarian, and/or mutat
ions of the BRCA1 and BRCA2 genes have an increased risk for developing ovarian
cancer.
Childbirth as Protection
Women, who conceive their first child at an early maternal age, have a reduced r
isk of developing ovarian cancer. The same goes for women that have multiple bir
ths earlier in life with the final pregnancy at an older age. Women using low do
se hormonal contraception have also been shown to have a protective effect where
ovarian cancer is concerned. In fact, women who used oral contraceptives for 10
years had about a 60% reduction in risk of ovarian cancer.
Symptoms
The symptoms of ovarian cancer are notoriously nonspecific. They are viewed as a
ny of the conditions that affect the abdominal, gastrointestinal, and pelvic reg
ions. The nature of these symptoms often causes ovarian cancer to be misdiagnose
d because a physician may conclude that another condition is to blame for your s
ymptoms. This appears to be the rule, rather than the exception. Unfortunately,
by the time the cancer is diagnosed, the tumor has often spread beyond the ovari
es to more vital organs. Thus, ovarian cancer is called a “silent killer.”
Some symptoms of ovarian cancer are:
• bloating, and/or vague lower abdominal discomfort,
• increased abdominal girth,
• difficulty ingestion normal meals, and/or feeling full quickly,
• abnormal menstrual cycles,
• pelvic or abdominal pain,
• and urinary symptoms (urgency or frequency).
Diagnosis
Physicians can run a myriad of tests, to aid in the diagnosis of ovarian cancer.
Some of the less invasive tests used are:
• a complete blood count (CBC),
• blood chemistry,
• CA125 (blood test),
• quantitative serum HCG (commonly known as a blood pregnancy test),
• alpha fetoprotein,
• abdominal x-rays/imaging,
• trans-vaginal ultrasound, or abdominal CT scan.
It is important to note that, although these tests could help render a diagnosis
, none of the above tests are part of routine screening for any gynecologic canc
er condition. Ultimately, the definitive diagnosis of ovarian cancer will come f
rom biopsy, which is a surgical procedure aimed at taking specimens from the abd
omen for analysis.
Ovarian Cancer Screening
As you’ve probably gathered from my personal story, the pap smear does not detec
t this cancer. In fact, the pap smear is a screening test for cervical cancer, n
ot ovarian cancer. What is a screening test? They are used to detect disease in
individuals without signs or symptoms of that disease. The intention of screenin
g is to identify disease early, thus enabling earlier intervention, treatment, a
nd possible cure.
In truth, there are no definitive screening tests or guidelines for ovarian canc
er. However, ovarian cancer is highly fatal (about 45% live longer than 5 years
after metastatic disease). It is also rarely diagnosed in its early stages. Beca
use of these factors, there has been an increasing amount of research and debate
over whether the medical community’s implementation of screening is for ovarian
cancer.
The screenings are already in place for other gynecologic malignancies such as c
ervical and breast cancer, via pap smears and mammograms respectively. In fact,
if diagnosis is made early in the disease, and treatment is received before the
cancer spreads outside the ovary, the 5-year survival rate of ovarian cancer is
about 94%.
Be Vigilant and Proactive
Until there is definite screening for ovarian cancer, it is important that all w
omen take a proactive position in terms of personal health. Call for an appointm
ent with your provider if you have any of the symptoms of ovarian cancer, or if
you are a woman over 40 years old with any of the above symptoms, and have not r
ecently undergone a pelvic examination. Women age 21 and above, should have rout
ine pelvic examinations annually. Ultimately, ovarian cancer detection highly re
lies on a woman’s personal vigilance and her awareness of her own body.
It is possible to beat these odds on your own, by being proactive. Women experie
ncing any of the aforementioned symptoms should see their gynecologist or reques
t a referral from to one from the family doctor. This will improve your chances
of early diagnosis, which will also lead to a brighter prognosis. For referenced
resourced information, go to http://www.smilemd.com/ob-gyn-obstetrician-gynecol
ogist/Ovarian-Cancer.aspx
Resources:
SmileMD Inc global publishing headquarters - Midtown Manhattan, New York. Nevill
e Coward, Chairman & CEO. http://www.smilemd.com instantly schedules nationwide
online medical and dental appointments for <a href="http://www.smilemd.com/blog/
article.aspx">Obstetrics and Gynecology New York doctors</a>. Patient versions o
f medical & dental articles are library referenced for online publication by co-
editors-in-chief Judy J. Johnson DDS and Tracy E. Austin, MD. Dr. Johnson is a m
ember of The New York Academy of Cosmetic Dentistry. Dr. Austin is a member of t
he A.M.A., American Medical Writers Association and the Association of Health Ca
re Journalists.