Friday, January 1, 2010

Who gets ovarian cancer

The simple answer is anybody. More specifically, post-menopausal women (about 51 years of age in the U.S.), women who have never been pregnant, women who have never used birth control pills (yes, oral contraceptives are protective), women who have a first- or second-degree relative with ovarian cancer, and women who have a personal or family history of breast or colon cancers are prone to this disease.

The very strongest risk factor is family history, but only 5% or 1 in 20 women with a cancer of the ovary will have one of the genetic variants. This means that, for most patients, there is nothing in their family tree to alert concern.

Symptoms

For years, many believed that there were no symptoms associated with ovarian cancers in their early stages. The truth of the matter is that the symptoms are so vague and non-specific that oftentimes both patients and doctors attribute them to other causes. Heartburn and early satiety (fullness after eating) are blamed on the spicy foods they had for dinner.

An increase in abdominal girth is middle-age spread and too many rich meals. The pain in the lower abdomen is a muscle pull from moving the lawn. Or frequent urination is a fallen bladder. It is of little surprise then, that three-quarters of patients with ovarian cancer have a metastatic, advanced stage of the disease when they are diagnosed.

Diagnosis

Diagnosis is made at surgery for most patients. Usually there is evidence on an ultrasound or CT scan of abnormalities in the ovaries. Oftentimes, there is free fluid or ascites present in the abdomen. Many times, a woman's pelvic examination is abnormal. CA-125 is a blood test that is often elevated in women with advanced-stage epithelial ovarian cancer (80%), though only half of the women with cancer confined to the ovary will have an elevation of this test. In post-menopausal women with evidence of a mass on examination, ultrasound or CT scan, a CA-125 can predict, with great accuracy, whether there is a cancer present.

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