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Talk with the Doc: September is National Ovarian Cancer Awareness Month

During the year 2019, there were approximately 22,000 new cases of ovarian cancer and more than 14,000 ovarian cancer deaths in the United States. Based on these 2019 statistics, this makes ovarian cancer the 4th most common cause of all fatal diseases among women. Further, the National Institutes of Health (NIH) predicts that ovarian cancer will represent about 1.2 per cent of all new USA 2020 cancer cases and about 2.3 per cent of all USA 2020 cancer deaths.

Following is a brief review of the female reproductive system anatomy. The ovaries are the reproductive glands of women. The ovaries produce eggs for reproduction. The eggs travel from the ovaries through the fallopian tubes into the uterus where the fertilized egg settles in and develops into a fetus. The ovaries are also the main source of the female hormones estrogen and progesterone. There is one ovary on each side of the woman’s uterus.

The ovaries are mainly made up of 3 kinds of cells. Each type of cell can develop into a different type of tumor. Epithelial tumors start from the cells that cover the outer surface of the ovary. Most ovarian tumors are epithelial cell tumors. Germ cell tumors start from the cells that produce the eggs. Stromal tumors start from structural tissue cells that hold the ovary together and produce the female hormones estrogen and progesterone.

One of the major risk factors for ovarian cancer is having a family history of various cancers. The risk for ovarian cancer is increased if a woman’s mother, sister, or daughter had ovarian cancer. The risk also gets higher with more relatives diagnosed with ovarian cancer. A family history of some other types of cancer such as colorectal and breast cancer is also linked to an increased risk of ovarian cancer.

Ovarian cancer may cause many various signs and symptoms. Women are more likely to have symptoms if the disease has spread, but even an early stage ovarian cancer can cause them. The most common symptoms include abdominal bloating, pelvic or abdominal pain, trouble eating or feeling full quickly, or urinary symptoms such as having to urinate urgently and frequently. Others symptoms of ovarian cancer may also include fatigue with 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, or abdominal swelling with weight loss.

There are two tests used to screen for and diagnose ovarian cancer. In addition to a complete pelvic exam by one’s health care provider, one might also be screened with a transvaginal ultrasound examination and a screening blood test known as the CA-125 blood test. The transvaginal ultrasound is a test that uses sound waves to look at the uterus, fallopian tubes, and ovaries by putting an ultrasound wand into the vagina to assess for a tumor in the ovary. The CA-125 blood test measures the amount of a protein called CA-125 in the blood. Many women with ovarian cancer have high levels of CA-125. This test can also be a useful tumor marker to assess the ovarian cancer treatment because a high level of CA-125 often goes down if the cancer treatment is working.

As with nearly all cancers, the treatment strategies and recommendations for ovarian cancers will depend on the stage of the cancer when it is diagnosed. Early detection will help to have the treatment options that are very promising and hopefully will be very effective. Current treatment options include combining surgery to remove all or part of the ovarian cancer, along with drug treatment and radiation therapy. Some of the advanced level treatment options include targeted therapy, immunotherapy, and hormone therapy. Chemotherapy is clearly a very vital part of the ovarian cancer treatment.

EDITOR’S NOTE: Dr. Jim Surrell is the author of “The ABC’s For Success In All We Do” and the “SOS (Stop Only Sugar) Diet” books.Contact Dr. Surrell by email at sosdietdoc@gmail.com.

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