Ovarian cancer is a type of cancer that affects the ovaries, which produce the female reproductive hormones and eggs that are released during ovulation. It is the fifth most common cause of cancer death among women in the United States. Symptoms can include abdominal pain or bloating, sudden weight gain, difficulty eating and feeling full quickly, frequent urination, and abnormal vaginal bleeding. Treatment for ovarian cancer may include surgery, chemotherapy, radiation therapy, or a combination of these treatments.
The symptoms of ovarian cancer can vary, but the most common signs are:
- Abdominal bloating or swelling
- Quickly feeling full when eating
- Weight loss
- Discomfort in the pelvic area
- Changes in bowel habits, such as constipation
- A frequent need to urinate
- Pain during sex
- Abnormal vaginal bleeding or discharge
Other symptoms may include fatigue, indigestion, heartburn, pain in the back or legs, and menstrual irregularities.
There is no one known cause of ovarian cancer. Most ovarian cancer occurs sporadically, but some factors have been identified as risk factors for developing the disease, including genetics, hormone use, certain reproductive factors, and lifestyle and environmental factors.
Genetic Factors: Certain genetic mutations, such as mutations in BRCA1 or BRCA2, can increase the risk of developing ovarian cancer.
Hormone Use: Use of hormones, such as estrogen, can increase the risk of ovarian cancer.
Reproductive Factors: Women who have never been pregnant or have had their first full-term pregnancy after age 30 may have a greater risk of developing ovarian cancer.
Lifestyle and Environmental Factors: Obesity, smoking, high processed meat intake, and radiation exposure may also increase the risk of ovarian cancer.
Risk factors for ovarian cancer include increasing age, family history of ovarian, breast, or colorectal cancer, inherited genetic mutations (such as BRCA 1 or BRCA 2 gene mutations), a previous history of ovarian cancer, endometriosis, obesity, use of fertility drugs, a history of estrogen replacement therapy, and certain dietary and lifestyle factors (such as a high fat diet and smoking).
Ovarian cancer is typically diagnosed through a combination of physical and imaging exams, blood tests, and surgical techniques. A physical exam may involve looking for signs of a swollen or enlarged abdomen and assessing the pelvic area and ovaries. An imaging exam such as an ultrasound or CT scan can also be used to help diagnose ovarian cancer. Additionally, a blood test can be conducted to measure levels of the cancer antigen CA-125 which, when elevated, can be an indicator of ovarian cancer. If any of these tests come back positive, a surgical procedure such as a biopsy or laparoscopy may be performed to get a sample of tissue from the ovaries and confirm a diagnosis.
Ovarian cancer is divided into four main subtypes, each with different characteristics and prognoses.
- Epithelial ovarian cancer: This is the most common type of ovarian cancer, representing 85% to 90% of all cases. It begins in the cells that cover the outer surface of the ovary and can be either low-grade (non-invasive) or high-grade (invasive).
- Germ-cell ovarian cancer: This type begins in the cells that produce eggs and is most common in women under the age of 30. It is often found in one ovary and may spread to other organs.
- Stromal ovarian cancer: This type begins in the tissue that holds the ovaries in place and makes hormones. It accounts for 5% of all ovarian cancers.
- Small cell carcinomas: This rare type of ovarian cancer resembles the small cell lung cancer that occurs in smokers. It is quickly growing, but is usually treatable.
Treatment for ovarian cancer depends largely on the stage and type of cancer. Options may include surgery, chemotherapy, targeted therapy, radiation therapy, and hormone therapy.
Surgery: Surgery is usually the first line of treatment for ovarian cancer. It may involve the removal of one or both ovaries, the uterus, and other nearby tissues (bilateral salpingo-oophorectomy), or a hysterectomy (removal of the uterus).
Chemotherapy: Chemotherapy is a type of cancer treatment that uses one or more anti-cancer drugs to destroy cancer cells. This can be done intravenously (injected directly into a vein), intraperitoneally (injected directly into the abdominal cavity), or orally (taken by mouth).
Targeted therapy: Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack cancer cells without harming normal cells. This type of treatment is often used in combination with chemotherapy.
Radiation therapy: Radiation therapy is a type of cancer treatment that uses high-energy rays to kill cancer cells. It may be used to shrink large tumors before surgery or to reduce symptoms caused by cancer.
Hormone therapy: Hormone therapy is a type of cancer treatment that involves blocking or reducing the levels of certain hormones, such as estrogen and progesterone, which can help slow or stop the growth of certain types of cancer.
There are several things that can be done to reduce the risk of ovarian cancer.
- Get regular check-ups with a gynecologist: Scheduling regular check-ups with a gynecologist can help to identify any changes in the ovaries. This can help to catch any potential signs of cancer early.
- Know your family history: Knowing your family history of diseases can help to identify any possible inherited risks of ovarian cancer.
- Reduce the use of talcum powder: Talcum powder, when used in the genital area, has been linked to an increased risk of ovarian cancer. Reducing or avoiding the use of talcum powder can help to reduce the risk.
- Take hormonal birth control: Using hormonal birth control can help to reduce the risk of ovarian cancer.
- Maintain a healthy weight: Maintaining a healthy weight can help to reduce the risk of ovarian cancer.
- Exercise regularly: Regular physical activity can help to reduce the risk of ovarian cancer.
- Eat a healthy diet: Consuming a diet that is high in vegetables, fruits, and whole grains can help to reduce the risk of ovarian cancer.
- Quit smoking: Smoking has been linked to an increased risk of ovarian cancer. Quitting smoking can help to reduce this risk.
Yes, there are gender-specific differences in the presentation and management of ovarian cancer. Women tend to have more advanced stages of ovarian cancer when it is diagnosed compared to men, likely due to the fact that symptoms of ovarian cancer can be subtle and hard to recognize early on. Additionally, women are more likely to develop and be diagnosed with ovarian cancer due to the increased amount of exposure to hormones like estrogen, which can increase the risk of ovarian cancer. Lastly, women are more likely to receive recommended treatments for ovarian cancer, such as surgery and chemotherapy, than men, which may be due to the fact that ovarian cancer is more common in women than men.
Nutrition plays an important role in the management of ovarian cancer. Proper nutrition can help to optimize the body’s immune system, provide energy and help to reduce any side effects of treatment. Eating a balanced diet with plenty of fruits, vegetables, and proteins can also help reduce the risk of cancer recurrence. Additionally, certain foods may be beneficial in reducing inflammation and helping to prevent cancer progression. Foods that contain antioxidants and phytochemicals, such as tomatoes, tea, and berries, are especially recommended for ovarian cancer patients.
Physical activity has been linked to a decreased risk for developing ovarian cancer. Regular physical activity helps to reduce inflammation, improve hormonal balance and metabolic health, and support the body’s natural ability to repair and defend itself. Studies suggest that moderate physical activity of at least 30 minutes a day can lower the risk of ovarian cancer by up to 20%. Additionally, consistent physical activity has been shown to improve prognosis and survival in women diagnosed with ovarian cancer. The American Cancer Society recommends incorporating regular physical activity into your lifestyle as a way to reduce your risk of developing ovarian cancer.