Disclaimer :: This great insight into ovarian cancer is sponsored and written by Dr. Catherine Bevan, a local Tarrant County OB/GYN.
September is ovarian cancer awareness month. Ovarian cancer is the second most common gynecologic malignancy behind uterine cancer and is the most common cause of death among women with gynecologic cancer. Each year, approximately 22,000 women in the United States are diagnosed with epithelial ovarian cancer, and an estimated 15,000 women die of this disease.
So, let’s talk about the ovary, and I’ll give you the facts you need to know.
There are three different types of ovarian cancer. The most common type (and the one I’ll be talking about in this blog entry) is epithelial ovarian cancer. This cancer originates from cells that line the ovary and accounts for 85-90 percent of ovarian cancer. The second type of ovarian cancer is germ cell cancer, which occurs in cells within the ovary that develop into eggs. Finally, stromal cell cancer occurs in the connective tissue (the internal structure) of the ovary.
The poor prognosis is due to the fact most women are diagnosed at an advanced stage of the disease, and the symptoms are often subtle and vague. Symptoms may include bloating, increase in abdominal size, abdominal or pelvic pain, urinary urgency, difficulty eating, or feeling full quickly after eating. However, if detected at its earliest stages, the five year survival rate is more than 90 percent.
Risk factors for epithelial ovarian cancer include age greater than 55; family history of breast, uterine, colon, or ovarian cancer; personal history of breast cancer; never having children; infertility; and endometriosis. There are also certain gene mutations we know predispose women to ovarian cancer, such as mutations in the BRCA1 or BRCA2 genes. Depending on family or personal history, you may qualify for genetic testing for these. This is something important to review with your OB/GYN.
How to Reduce Your Risk
Factors that can reduce your risk of ovarian cancer include using hormonal methods of birth control (pills, patch, vaginal ring, injection), being pregnant, breastfeeding, having your tubes tied to prevent pregnancy (and now, more OB/GYN’s are starting to offer removal of the ENTIRE tube, not just a small portion, in order to further reduce risk of ovarian cancer), and having your uterus/ovaries removed.
Unfortunately, there is no good screening test available for epithelial ovarian cancer at this time. A low index of suspicion is required in order to diagnose ovarian cancer. If ovarian cancer is suspected, the initial work-up by your doctor will likely include imaging with a transvaginal ultrasound and laboratory testing for CA 125 in addition to the history and physical examination. The results of these studies can guide management, and, based on the results of the testing, surgery may be needed to diagnose the cancer. The diagnosis of ovarian cancer is based on tissue obtained during surgery. Gynecologic oncologists (the gynecologic cancer and pelvic surgeon experts) need to be involved in the care if malignancy is highly suspected.
Because ovarian cancer is difficult to diagnose, it is even more important that each woman knows and understands the risk factors, symptoms, and how to reduce her risk of ovarian cancer. If you are concerned, talk to your OBGyn. An open dialogue is crucial to help prevent or treat this disease.
(Resources: Williams Gynecology, American Congress of Obstetricians and Gynecologists, and uptodate.)
Dr. Catherine Bevan is a board certified obstretician and gynecologist, who practices in Tarrant County, with offices in Fort Worth and Burleson. She is a Fort Worth native and received her Bachelor of Arts degree from Washington University in St. Louis where she graduated cum laude, Phi Beta Kappa. She then returned to Texas to complete her medical degree at UT Southwestern as well as her residency training at Parkland Memorial Hospital. She also spent an additional year as an assistant professor at UT Southwestern, specializing in gynecologic surgery and emergency women’s care. Providing excellent service to her patients is a passion for her as she guides them to the best possible healthcare outcomes.
You can contact Dr. Bevan at:
- 1250 8th Avenue, Ste 320 // Fort Worth, TX 76104 // (P) 817-924-2111 // (F) 817-564-3980
- 12500 S. Freeway, Ste 206 // Burleson, TX 76028 // (P) 817-447-0123 // (F) 817-426-4902