Understanding Ovarian Cancer and What You Can Do About It

doctor-patient

A lot of people worry about their cancer risk and for good reason. Cancer is the second biggest killer of Americans after heart disease and good amount of it is preventable. I’ve talked a lot about ovarian cancer on the show because it’s a big killer of women and because knowing your risk factors and some of the warning signs can be a lifesaver. Take some time with me this week to learn about this cancer and what you should you be looking for.

Why I Worry About Ovarian Cancer

As cancers go, ovarian cancer is one of the less common ones. Women living in the U.S. are much more likely to be diagnosed with breast, lung, or colon cancer than ovarian cancer. So what’s the big deal? Unlike some of these other cancers, ovarian cancer is hard to detect. Breast and colon cancer have great screening tests available that result in far fewer cancer deaths than cancer diagnoses every year. Unfortunately, there is no screening test for ovarian cancer. As a result, many women who find out they have ovarian cancer are diagnosed with late stage tumors that are harder to fight with cancer treatment and are more often deadly. On top of that, the numbers of diagnoses aren’t small. More than 20,000 women are diagnosed with ovarian cancer each year and over 14,000 of them die from it. With statistics like these, this cancer is one that should be on your radar.

The Deal With Screening for Ovarian Cancer

Screening for disease can be a tricky business. It involves picking a marker of disease that’s easy to find, specific enough to show up only in the disease you’re looking for, and broad enough that everyone with a disease gets picked up when you look for the marker. That might sound easy, but finding those markers is actually very challenging. Most of the time the markers are either too broad or too specific so that people without cancer get told they have it or people who have cancer get told they don’t.

If you’ve looked around online, you might have seen mention of CA-125 or pelvic ultrasound. Here’s the problem with those tests.

CA-125 is a protein made by some ovarian cancers that you can look for in the blood, but about half of women with early ovarian cancer don’t have a high CA-125. Other factors like age, ethnicity, smoking status, and menstrual periods can also affect the normal levels of CA-125, making it tough to know who might have an early stage cancer. This all means that a low CA-125 doesn’t necessarily mean you don’t have cancer and high one doesn’t necessarily mean you do.

Pelvic ultrasound or other pelvic exams are good at picking up masses and cysts in the pelvis, but that may or may not be a predictor of whether or not you have cancer. Most of the cysts and masses found during these procedures are harmless and will probably never turn into anything cancerous. The problem is that it’s hard to tell which is which. On top of that, tumors may be too small to be seen or felt with these exams. Some women also think the Pap smear is testing for ovarian cancer, but it’s actually testing for cervical cancer and won’t tell you anything about ovarian cancer.

What You Can Look Out For

That might paint a dismal picture of picking up ovarian cancer, but there is some information that can be helpful. Family history, for example, is key to knowing if you might be at risk. The infamous BRCA1 and BRCA2 genes up the risk of ovarian cancer significantly, but if you know your family history of cancer you should be able to find that risk. Get a detailed cancer history of everyone in your family going back one or two generations and look for breast and ovarian cancer. Take that history to your doctor and have a conversation about whether he or she thinks you might be at risk and whether genetic testing is worth getting. This may also help you find other diseases that might run in your family and endanger your health.

The other important step you can take is to know the early signs of ovarian cancer. Here are some symptoms to watch for:

  • Bloating
  • Pelvic or abdominal pain
  • Trouble eating or feeling full quickly
  • Feeling the need to urinate urgently or often
  • Fatigue
  • Upset stomach or heartburn
  • Back pain
  • Pain during sex
  • Constipation or menstrual changes

One symptom alone doesn’t make the diagnosis, but if you notice a constellation of these symptoms occurring together that refuse to go away you should see a doctor and ask specifically about ovarian cancer.

Finally, pay attention to your age. Ovarian cancer can occur in young women, but it’s much more rare. It becomes more common as you get older with the peak between 50 and 60. Being the right age doesn’t mean you’re going to get the cancer, but it might push you in that direction if you have a few of the symptoms above.

Trust Yourself

Even with all of this information, I think there’s one key thing many women forget to do: trust their instincts. You know when something is wrong with your body even if you can’t put all of the pieces together. You might have a new pain different from any other you’ve felt or a sense of being “off” that just won’t go away. Don’t ignore those signals.

Remember, you know your body better than anyone ever will and if you think something’s wrong, you should try to find out what’s going on. Trust yourself and take charge of your health to start a conversation with your doctor when you feel the need to.