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House Call: Know the early warning signs for ovarian cancer

Ovarian cancer is a rare, gynecologic malignancy that can affect women as they age. In the United States, it is estimated that 22,240 women will be diagnosed with ovarian cancer and more than 14,000 women will die from the disease. This makes ovarian cancer the most lethal gynecologic malignancy.

Our best chance to control and cure ovarian cancer rests with early diagnosis when the cancer is still confined to the ovaries. For example, women diagnosed with stage 1 of the disease have a 90 percent cure rate, whereas only 18 percent of those with stage 4 ovarian cancer survive.

Unfortunately, ovarian cancer has few symptoms in its early stages making early diagnosis very difficult.

Survivors of ovarian cancer say the disease “whispers” early on in its course and does not offer clear warning signs. Among the more common early symptoms are bloating, vague persistent abdominal pain or increase in abdominal girth.

Unfortunately these symptoms are not specific to ovarian cancer and often are dismissed by women as aging or another medical issue. As the cancer advances, women may experience reduction in appetite, feeling full quickly, constipation, shortness of breath and increasing abdominal pain.

Many of my patients ask about screening tests for this disease. Specifically I get asked about ultrasounds and tumor markers such as CA125 or OVA1.

Unfortunately, ovarian cancer is too rare of a disease and current tests are not effective screeners.

Regarding tumor marker CA125, many benign conditions such as endometriosis, infections, fibroid tumors and pregnancy can cause false readings.

Genetic testing for the BRCA1 and BRCA2 gene mutation is an effective way to identify a very small subset of women who have a specific gene mutation that will predispose them to developing breast and ovarian cancer. Women with BRCA mutations have a 60 percent risk of developing ovarian cancer, and even higher risk for breast cancer. In this subset of women, screening and early intervention may help early detection or prevent it altogether.

The treatment of ovarian cancer is complicated. Several studies have found that when treatment is orchestrated by a gynecologic oncologist, women had significantly better outcomes and survival rates.

In a small subset of patients with stage 1 cancer, surgery may be sufficient treatment. For the majority, however, aggressive surgery and chemotherapy are the mainstays of treatment.

In conclusion, ovarian cancer remains an elusive disease to diagnose at an early stage. However, with aggressive surgical treatment and chemotherapy, the prognosis, cure rates and quality of life have been significantly improved.

Women should listen to their own bodies and trust their instincts, particularly as they approach menopause. If medical symptoms persist, don’t ignore them and consult your physician.

Dr. Al Elbendary is board-certified in gynecologic oncology and on staff at Missouri Baptist Medical Center. He received his medical degree from Loyola University, completed his internship and residency at the University of Chicago, and completed a fellowship in gynecologic oncology at Duke University. To make an appointment, call 996-LIFE (5433).

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