Your ovaries are the two almond-shaped sacs on either side of your uterus that release eggs during ovulation prior to menopause. Ovaries also create the hormones progesterone and estrogen. Cancer that originates in your ovaries can fall into three categories that cover about 30 different kinds of cancer. Ovarian cancer is a serious condition and and should always be evaluated full and treated in conjunction with your physician and any signs or symptoms should be fully evaluated.
All three types of ovarian cancer can spread to other parts of your body; in other words, they can metastasize. The three categories are:
- The most common type of ovarian cancer starts in the cells that cover your ovaries and is called epithelial ovarian cancer.
- Germ cell ovarian cancer is most common in younger women in their 20s. It begins in the egg-producing cells found inside the ovaries.
- Finally, sex cord-stromal ovarian cancer gets its start in the ovary connective tissues that produce female hormones.
Causes May Vary Widely
Unfortunately, the exact cause of ovarian cancer isn’t known. The closest researchers have come to pinpointing an origination is to say that genetics most likely play a role. Even then, just because there is a history of ovarian cancer in your family, there is no cause for alarm — you may never get it. Your concerns, however, are important to your OBGYN doctor, and genetic testing may calm your worries.
In general, doctors look for risk factors in determining whether your current symptoms suggest the beginning of ovarian cancer. In addition to family history, other risk factors that usually come into play include:
- If you have a body mass index (BMI) higher than 30, you’re at a greater risk.
- Nearly two-thirds of women who develop ovarian cancer are over the age of 55.
- The more children you’ve had, the lower your risk of developing ovarian cancer; conversely, if you’ve never been pregnant, you’re at greater risk.
- Other cancer. Your risk for ovarian cancer increases exponentially if you’ve ever had breast, endometrial or colorectal cancer.
Symptoms Can Hide
Unfortunately, early symptoms of ovarian cancer are rare. In fact, they are nearly non-existent. By the time you receive a diagnosis of ovarian cancer, it’s usually at an advanced stage, which is why the disease is so often fatal. Additionally, there isn’t a routine test for ovarian cancer.
Instead, your doctor considers your risk factors when treating other symptoms you may present, including:
- Bloated belly
- Bowel movement changes
- Frequent urination
- Nausea and indigestion
- Abdominal bleeding
- Loss of appetite or feeling full quickly when you eat
- Lower back pressure feelings
When treating other, more visible abnormalities, your obgyn new york city doctor may send tissue samples for testing for malignancies. Ovarian polyps vs cysts, for example can cause symptoms that may lead to further investigation. Ovarian cysts are pretty common, however, and don’t necessarily mean you have cancer, but they may lead to testing if you have any of the previously mentioned risk factors. And women who are post-menopausal are at a much higher risk of developing ovarian cancer when cysts are found.
Symptoms of ovarian cysts may include:
- Pelvic pain
- Pain during sex
- Difficulty urinating
- Abnormal bleeding
- Abdominal pain or pressure
One of the first things you need to know is that your annual Pap tests do not detect ovarian cancer. They can, however, help your doctor diagnose ovarian fibroids, endometrial polyps and cervical polyps that can indicate more tests are needed to see if you have cervical cancer. The pelvic exam your doctor performs when you get your annual screening, though, is a vital first step, as your OBGYN NYC feels for abnormal growth or tenderness that could be tumors.
Other tests that can further help discover the presence of ovarian cancer include:
- A blood test called a CA-125. Its purpose is to look for a protein called CA-125 that is responsible for producing ovarian cancer cells. It’s important to note that the presence of CA-125 cells doesn’t always mean that you have cancer, because other non-cancerous ovarian conditions can produce the protein.
- A transvaginal sonography is an ultrasound test done internally with a small device placed into your vagina.
- A CT scan may be performed if the other two tests prove positive.
- A biopsy is the final test to confirm the disease when a tumor is eventually discovered. By inspecting the tissues under a microscope, your doctor can see if cancer cells are present.
Stages of Ovarian Cancer
The most appropriate treatment for ovarian cancer is determined by the stage the cancer is in — in other words, how far it has progressed:
- Stage 1 means that the cancer is still limited to one or both of your ovaries and hasn’t moved into nearby lymph nodes. During this stage, cancer cells only may be found in fluid samples from your abdomen if a tumor ruptures.
- Stage 2 refers to the cancer progression into other pelvic organs, such as your fallopian tubes or uterus, but still has not moved into your colon, bladder or rectum.
- Stage 3, when most cases of ovarian cancer are found, means that the disease has progressed to your lymph nodes, which are small glands that carry fluids and waste through your body in the lymphatic system.
- Stage 4 refers to the progression of the cancer to parts of your body further away from your pelvic area, such as to your liver or your lungs.
As with other forms of cancer, treatment options abound. While many may have serious side effects, you and your doctor should decide which options best suit your overall health. Comprehensive cancer treatment requires not only state-of-the-art medicine and technology, but also a positive mindset and commitment to recovery.
Advanced cancer treatments may include:
- Hormone therapy
If you are still of child-bearing age and hope to have children once you beat ovarian cancer, you may want to consider ovarian cortex cryopreservation because it is very common for the cancer treatments to damage your eggs and reproductive organs. Surgery may require removing your ovaries to save your life. A very minimally invasive technique called a laparoscopy is performed to remove ovary tissue, which is then frozen until you are well. The tissue then can be transplanted back into your body and allow you to get pregnant.
A condition referred to as recurrent ovarian cancer is possible once you’ve undergone treatment. It means that some of the cancer cells survived and may begin to metastasize in your ovaries or even in other parts of your body, such as your intestines or bladder.
Just as symptoms and treatment vary widely between women, so recurrence rates vary. But nearly 70 percent of women who have had ovarian cancer fall into this category — all the more reason to continue with your annual pelvic exams and gynecological screenings and close follow up with your gynecologist.
Important Reminder: This information is only intended to provide guidance, not a definitive medical advice. Please consult obgyn doctor about your specific condition. Only a trained, experienced board certified gynecologist can determine an accurate diagnosis and proper treatment.
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Dr. Pedram Bral, Gynecologist (Gynecologist NYC, Midtown OB/GYN)
New York, NY 10010
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Dr. Pedram Bral, Gynecologist (Gynecologist NYC, Upper East Side OB/GYN)
New York, NY 10028
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