Every year, the American Cancer Society highlights different types of cancers with month-long awareness campaigns. It chose September to draw attention to ovarian cancer, a type of cancer that starts in the reproductive organs of women. Every female has two ovaries, one on each side of her uterus. The right and left ovaries are each about the size of a walnut. When a woman has her menstrual cycle each month, the ovaries alternate producing eggs that travel down the fallopian tube for possible fertilization and eventual pregnancy.

Early Ovarian Cancer Often Goes Undetected

According to the Mayo Clinic, most women don’t realize that they have ovarian cancer until the disease has become quite advanced. That is because it typically produces few symptoms in the early stages. When women do experience early symptoms of ovarian cancer, they often attribute them to other causes. Some of the most common early symptoms include:

• Abdominal or pelvic pain
• Bloating
• Constipation or other changes in bowel habits
• Difficulty eating or feeling full too quickly
• Unplanned weight loss
• Urinary issues such as feeling the need to urinate often or feeling an urgent sense to relieve yourself and then producing little urine

Although these symptoms can mean ovarian cancer, the most common cause is a benign tumor or cancer in another organ of the body. One clue that you could be dealing with ovarian cancer is that the symptoms remain persistent and become more severe over time. The American Cancer Society recommends scheduling an appointment with your doctor if you notice any of these symptoms occurring more than 12 times per month. You are welcome to schedule an appointment at Western Maryland Health System any time you feel concerned about your health.

Advanced Symptoms of Ovarian Cancer

Symptoms will become more severe and obvious to women as tumors spread from the origination point in an ovary. Some of the most common symptoms associated with progressive ovarian cancer include:

• Abdominal swelling and additional weight loss
• Back pain
• Changes in menstrual bleeding for pre-menopausal women such as irregular bleeding or bleeding heavier than normal
• Pain during intercourse
• Severe constipation
• Stomach distress

The American Cancer Society states that oncologists use a TNM staging system devised by the International Federation of Gynecology and Obstetrics and the American Joint Committee on Cancer. TNM stands for the following:

• T: Size of the tumor. Has it spread, and if so, has it moved past the fallopian tube or ovaries? Has it reached the bladder, uterus, or other pelvic organs?
• N: Oncologists consider whether cancer has spread to lymph nodes located in the aorta or pelvis.
• M: Oncologists consider whether cancer has spread to distant sites. They also determine if has spread to distant organs such as the bones or liver or to the fluid around the lungs.

After evaluating these factors, oncologists assign a stage to ovarian cancer from 1 to 4B. Higher numbers and letters after a number mean the cancer is more advanced.

Ovarian Cancer Types and Risk Factors

Epithelial tumors originate in a thin layer located outside of the ovaries. Approximately 90 percent of women diagnosed with ovarian cancer have this type. Another seven percent have stromal tumors that start in hormone-producing cells in the ovarian tissue. It’s usually easier for oncologists to diagnose these types of tumors earlier than other types. The rarest type of tumor is a germ cell tumor. These begin in the egg-producing cells of younger women.

Risk factors are conditions that increase your likelihood of developing ovarian cancer. Like all diseases, you can control some risk factors and not others. The most common ones include:

• Age, since ovarian cancer is most common in women between 50 and 60
• Family history, especially if two or more close blood relatives have had the disease
• Inherited gene mutation of breast cancer genes called BRCA1 and BRCA2
• Long-term and/or high doses of estrogen replacement therapy
• Starting menstruation before age 12 or completing menopause after age 55
• Previous fertility treatments
• Never carrying a pregnancy to full-term or giving birth for the first time after age 35
• Having a body mass index (BMI) that puts you in the overweight or obese category
• Previous history of breast cancer

Is It Possible to Prevent Ovarian Cancer?

At UPMC Western Maryland, we encourage you to speak to your regular gynecologist to see if there’s anything you can do to reduce your risk of developing ovarian cancer. Taking hormonal birth control pills has shown promising results in lowering the risk but it has other risks of its own. Be sure to let your doctor know if you have a family history of breast or ovarian cancer. If so, he or she may refer you to a genetic counselor so you can further discuss prevention strategies.