Knowing Your Body
The Defense Against Ovarian Cancer
By Jamie Lober
It can be easy to write off changes in your body as female troubles. However,
tuning in to what is normal for you and scheduling an annual gynecological visit
are more important than you may think. "One in seventy women is susceptible to
developing ovarian cancer," informs Dr. John Sutherland of North Dover Ob/Gyn
Associates of Toms River, NJ. When you are familiar with your body and proactive
about receiving a pelvic exam, you are defending yourself against ovarian
cancer. Early detection matters.
Ovarian cancer develops in stages. "Stage 1 means it is confined to the
ovaries and we can cure it. Stage 2 is limited to the pelvic. Stage 3 is limited
to the abdominal cavity but spread to the upper abdomen. Stage 4 is when there
is either fluid in the lungs or cancer inside the liver or spleen," summarizes
Dr. Justin Chura, gynecologic oncologist of Crozer Keystone Health Network in
Upland, PA. Unfortunately, it is usually not spotted until it has progressed.
"75% of women are in stage 3 or 4 at diagnosis," tells Chura.
Symptoms of ovarian cancer are usually vague. "Ovarian cancer speaks very
softly, so we have to listen up," affirms Sutherland. There are a few trademark
signs. "If a woman complains of pelvic or rectal pressure, bladder complaints,
pain in the pelvis or weight gain, we are keen and try to investigate further,"
says Sutherland. Note how long you are in discomfort. "When a woman has had
symptoms of bloating, nausea or abdominal pain for two to three years, it is not
ovarian cancer. It is more worrisome when they have been there for a shorter
duration," advises Chura.
Do not confuse symptoms with another disorder and be sure to be open with the
gynecologist. "Symptoms like abdominal bloating, change in bowel habits,
increased abdominal girth or indigestion are subtle and mimic other disorders,"
points out Dr. Dominic Cammarano of Reading Ob/Gyn. Remember that it is normal
for women to have cysts before menopause, not after. "A normal cyst is part of
the ovulation process, but in menopause, you should not have cysts and ovaries
should be small," explains Chura.
Difficulty arises from the lack of a perfect screening test. "A CT scan may
show ovarian cancer but it is not very good. An ultrasound is the most sensitive
imaging test but there are a lot of ovarian cysts and enlargements that are
benign conditions and look identical to ovarian cancer. This subjects people to
surgery unnecessarily. The only real proof is removing the ovary and having it
studied under a microscope," explains Cammarano. Determine your risk.
Inquire about your family medical history. "If you find that you have a
strong family history, there are family risk assessment programs at the
hospitals where a genetic counselor will plot out your family tree and calculate
your real risk of ovarian cancer and breast cancer," shares Cammarano. The BRCA1
and BRCA2 genes have been linked to both ovarian cancer and breast cancer. Some
lifestyle choices may protect you. "Suppressing the function of ovulation will
lower the risk, like with birth control pills for more than five years or
pregnancy," says Chura.
If you are diagnosed, be sure to turn to a gynecologic oncologist. "A
gynecologic oncologist is a specialist in women's cancers which means ovarian,
cervical, uterine and vulvar," defines Chura. This person is very familiar with
the condition. "Since it is a rare condition, you want to see someone who sees
it everyday," insists Chura.
Treatment begins with surgery and sometimes involves chemotherapy. "The goal
of surgery is to determine the extent of the disease, meaning where it has
spread, and sometimes to remove all the cancer," says Chura. Just because the
cancer has been removed does not mean you are safe. "Surgery and chemotherapy
help 85% of women achieve complete remission, but the majority will have a
recurrence of the cancer later in life," warns Chura. Chemotherapy does not work
for everyone. "If there is no response, it is a bad prognostic sign and much
more aggressive," explains Chura.
Gathering support can make a difference. "The most important thing is that
you do not have to feel alone. Isolation, loss of hope and loss of control are
the three primary emotional problems in people with ovarian cancer and at the
Wellness Center, we can help deal with all three," shares Sean Hebbel, oncology
therapist and program director of Wellness Center of Wilmington, DE. It is
important to be optimistic about the future as medical advances offer hope.
"Women should be aware that with new gene testing, they will be able to
understand whether or not they are at higher risk than the average population,"
shares Sutherland.
Do not set this article aside because you are not affected. "When you read
this article, pass it on to someone else you know. You might end up saving
someone you love," expresses Robin Cohen, co-founder of Sandy Rollman Ovarian
Cancer Foundation of Hazelton, PA.
Jamie Lober is a freelance writer.
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