Ovarian Cancer: 8 Things Doctors Want You to Know

  • Cancer patient hugging granddaughter
    The outlook is changing for ovarian cancer.
    More than 20,000 women in the United States will receive a diagnosis of ovarian cancer this year, and about one in 78 women will be diagnosed with it in their lifetime. There are more than 20 types of ovarian cancer, but the most common usually affects women between ages 55 and 64. Hear what some top doctors want you to know about risk factors, ovarian cancer screening, symptoms, and new treatments, which are revolutionizing the prognosis for many women with ovarian cancer.
  • Happy family of four at park during autumn
    1. “The most important risk factor for ovarian cancer to be aware of is family history.”
    When it comes to risk factors, “By far, family history is the most striking element,” says Suzanna Campos, MD, a medical oncologist at the Dana-Farber Cancer Institute in Boston. “Patients who carry the BRCA1 or BRCA2 gene mutation are at increased risk for family transmission. You have to have a dialogue within your family about these diseases.” Can you reduce your risk? “Having more children and breastfeeding can in some ways decrease risk,” says Rachel Grisham, MD, medical oncologist at Sloan Kettering Cancer Institute in New York. ”Also, being on oral contraceptive pills has been linked to a decrease in ovarian cancer. But there are not a lot of lifestyle modifications one can easily make.”
  • Young African American female dermatologist talking to older Caucasian female patient
    2. “There’s no general screening for ovarian cancer like there is with breast cancer.”
    “We just don’t have that equivalent test unfortunately. We do screen high-risk women, usually BRCA mutation carriers,” says Dr. Stefanie Udea, a gynecological surgeon at the University of California San Francisco. Researchers tried mass screenings, but ended up with several false positives. “You found a lot of patients with ovarian masses who underwent surgery—and surgery has risks—and then in the end it was found to be benign,” Dr. Udea says. However, says Dr. Grisham, “If your mother or your sister has BRCA1 or BRCA2, you should be screened.” A blood test can determine if you have the mutation, and you can discuss further testing and monitoring with your physician.
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    3. “There are few early symptoms of ovarian cancer.”
    “The signs and symptoms are ones that most women have during the course of their lives: abdominal bloating, a change in bowel habit, a feeling of fullness. Some people will describe hair loss as their first sign,” says Dr. Campos. “One or two of these symptoms may not be alarming, but when you have a constellation of symptoms, that should come to the attention of their primary care doctor or gynecologist,” she says. “In general, when someone has cancer-associated symptoms, they persist. They don’t come and go,” adds Dr. Grisham.
  • Middle age Caucasian woman holding stomach in pain while standing next to kitchen counter
    4. “We often find ovarian cancer after it has spread because of the vague symptoms.”
    “The vast majority of our patients are diagnosed with advanced stage disease—stage 3 or 4—because these cells start in the fallopian tubes and you can’t see them or feel them and then they spread onto distant sites,” says Dr. Grisham. “Most patients have disease that has spread to the abdomen and pelvis at the time that they’re diagnosed, unfortunately,” she says. Adds Dr. Udea: “The most common type is called epithelial ovarian cancer and those patients are generally diagnosed over the age of 50 or 60, and these are the patients with advanced stage ovarian cancer.”
  • male doctor with concept of healthy female reproductive system showing vaginal canal, cervix, uterus, fallopian tubes and ovaries
    5. “High-risk women past their childbearing years can reduce their chance of ovarian cancer with an elective procedure.”
    Ovarian cancer usually starts in the fallopian tubes, so one option for certain women in the high-risk category is to have them removed. “If they were already going to have surgery for some other indication in the pelvis, I do counsel patients that there is a minimal risk of additional bleeding, infections, and slightly longer operative time [to add a removal of the fallopian tubes]. But generally, if you’re already going in for surgery, the risk is pretty low and there’s not much downside in removing fallopian tubes to decrease the risk of ovarian cancer,” says Dr. Udea.
  • Patient in infusion room smiling
    6. “A game-changer in the treatment of ovarian cancer has improved the prognosis for many women.”
    Recently, drugs known as PARP inhibitors redefined the ovarian cancer landscape. PARP inhibitors are a targeted therapy that prevent cancer cells from repairing, allowing them to die, while leaving healthy cells mostly unaffected. “That is monumental. I try to make known to patients that it’s so very different today than it was several years ago. What we’ve seen is striking progression-free survival,” says Dr. Campos. “A lot of patients get a combination of surgery and chemo, and then if they are thought to be candidates, they get a PARP inhibitor as maintenance therapy for up to two years,” adds Dr. Udea.
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    7. “Until PARP inhibitors came along, we could treat ovarian cancer but it often recurred.”
    “We could put it into remission, but keeping it in remission has been exceedingly difficult. About 80% of people’s ovarian cancer would recur and that’s a dismal dialogue, but with the introduction of PARP, especially with people who carry the BRCA1 and BRCA2, these patients have remarkable responses. There’s a study that is just a beautiful graph of how women are out so long without a recurrence,” says Dr. Campos. “Now we’re seeing that there’s an even broader scope of patients who also might benefit beyond just the BRCA mutation carriers,” adds Dr. Udea.
  • Mother, grandmother and granddaughter blowing bubbles together
    8. “A diagnosis of ovarian cancer today is not what it used to be.”
    “I think women need to know that despite a diagnosis that has been very grim in the past, perhaps because of its late presentation, there are so many advances today that I want people to have hope. There’s light out there,” says Dr. Campos. “Whether it be through PARP, or maybe through the work of immunotherapy, and other agents that are coming to light, there are women living many many years and hopefully being cured by many of these advances. There’s so much out there today and this was not the case yesterday.”
Ovarian Cancer: 8 Things Doctors Want You to Know
Contributors
  • Rachel Grisham MD - Healthgrades - Ovarian Cancer: 8 Things Doctors Want You to Know
    Dr. Rachel Grisham is a medical oncologist at Memorial Sloan Kettering, New York
  • Suzanna Campos MD - Healthgrades - Ovarian Cancer: 8 Things Doctors Want You to Know
    Dr. Suzanna Campos is a medical oncologist at the Dana-Farber Cancer Institute, Boston
  • Stefanie Udea MD - Healthgrades - Ovarian Cancer: 8 Things Doctors Want You to Know
    Dr. Stefanie Udea is a gynecologic surgeon at the University of California San Francisco

About The Author

Nancy LeBrun is an Emmy- and Peabody award-winning writer and producer who has been writing about health and wellness for more than five years. She is a member of the Association of Health Care Journalists and the American Society of Journalists and Authors.
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  3. Ovarian Cancer. Medline Plus, National Library of Medicine, National Institutes of Health. https://medlineplus.gov/ovariancancer.html
  4. Ovarian Cancer Screening Guidelines. Memorial Sloan Kettering Cancer Center. https://www.mskcc.org/cancer-care/types/ovarian/screening/screening-guidelines-ovarian
  5. Ovarian Cancer Risk Factors. American Cancer Society.https://www.cancer.org/cancer/ovarian-cancer/causes-risks-prevention/risk-factors.html
  6. Key Statistics for Ovarian Cancer. American Cancer Society.https://www.cancer.org/cancer/ovarian-cancer/about/key-statistics.html
  7. PARP Inhibitors Show Promise as Initial Treatment for Ovarian Cancer. NIH National Cancer Institute. https://www.cancer.gov/news-events/cancer-currents-blog/2019/parp-inhibitors-ovarian-cancer-initial-treatment

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Last Review Date: 2021 Aug 20
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