Community Voices for Health

By: Dr. Tanvi Maharaja PT, DPT

March is Ovarian Cancer Awareness month, and for good reason. Ovarian cancer is known as the “Silent Killer,” and according to the American Cancer Society, of the nearly 20,000 women who get diagnosed with ovarian cancer in the US each year, about 12,800 women die of this cancer. On the bright side, this means it is not as common, however, its high fatality rate is what makes it so concerning.

Ovarian cancer ranks fifth in the list of the most deadly cancers in women and is the second most common gynecological cancer. Despite its prevalence, it is one of the hardest cancers to diagnose, due to its vague symptoms that are often ignored, and lack of screening. Therefore, awareness of what this cancer looks and feels like is very important in timely diagnosis and treatment.

RISK FACTORS:

Some of the known risk factors are age (women>63 years of age), race (white women > African American women), and family history of cancer (BRCA-1, BRCA- 2, Lynch syndrome). More ovulatory cycles (early start of menstruation, late menopause, fewer or no pregnancies: all of which mean that more ovulation/more menstrual cycles occurred over the life span than with someone who had early menopause or more pregnancies and therefore had fewer menstrual cycles over their life span) is another risk factor, besides being overweight, estrogen hormone replacement therapy (especially if the estrogen is not combined with some form of progesterone), and having endometriosis. 

SYMPTOMS:

The symptoms, like we mentioned above, are vague, and often hard to connect to one system or one condition. They may seem so random and out of context, that women often do not associate with “something is not right,” and hence neglect them as minor inconveniences.

• Bloating
• Pelvic or abdominal (belly) pain
• Trouble eating or feeling full quickly
• Urinary symptoms such as urgency (always feeling like you have to go) or frequency (having to go often)

        Other symptoms of underlying ovarian cancer are:

• Fatigue (extreme tiredness)
• Upset stomach
• Back pain
• Pain during sex
• Constipation
• Changes in a woman’s period, such as heavier bleeding than normal or irregular bleeding
• Abdominal (belly) swelling with weight loss

YOUR VOICE MATTERS!

As you can see, these symptoms are all over the place. And women sometimes do not associate them with a pathological process. This is why it is so important to talk to your doctor about ALL of your symptoms, even if YOU don’t think they are associated. Women can sometimes be hesitant to speak up, for fear of their symptoms being brushed aside or dismissed, and feel like they are asking for “too much.” Advocating for your own health is not “too much.” Doctors can only help you if you let them know what is going on. On the flip side, some doctors unfortunately do make light of things, and you may be left feeling unheard or not validated. If you do not feel heard for your concerns, or if you feel that your concerns are being trivialized, it may be time to find a healthcare provider who will listen to you. 

TREATMENT:

Treatment for ovarian cancer is largely based on TNM staging (T : extent/size of tumor // N : spread to lymph nodes in the pelvis or aorta // M : metastasis to a distant site). Staging can be complex, due to the possibility of multiple variables of the above, and your doctor can explain it to you. In any case, early detection is key to treatment. Treatment can be focused around surgery, radiation, hormone therapy, chemotherapy, targeted therapy, and a combination of these usually works best.

AWARENESS SAVES LIVES!

It is vital that women understand how this “Silent Killer” operates, and be able to identify the signs so that they can bring up their concerns to their doctors. For ovarian cancer, more so than many other more recognized conditions, awareness can save lives!