Ovarian Cancer

Ovarian cancer develops when cell growth malfunctions in the cells of one or both of a woman’s two ovaries.  These malfunctioning cells, called cancer cells, do not die but continue to multiply in a disorderly manner.  Over time they can form a mass which may be malignant (cancerous).

There are no known causes of ovarian cancer. Women with a family history of ovarian, breast and/or colon cancer are at an increased risk of developing ovarian cancer, potentially due to a mutation of the BRCA1 or BRCA2 genes. Childbirth and the use of oral contraceptives appear to decrease the risk of developing ovarian cancer

The early signs of ovarian cancer might include vague and persistent digestive disturbances such as stomach distention, discomfort and gas. If it remains undetected and untreated, other symptoms appear. The most common one is an enlarged abdomen. The swelling is caused by a collection of fluid contained within the tumour (called a cyst). Other symptoms of ovarian cancer can be difficulty eating/feeling full very quickly, needing to pass urine more frequently and/or feelings of urgency, frequent heartburn, upset stomach or indigestion, pain during sexual intercourse, abnormal vaginal bleeding, change in bowel habits (e.g. – constipation), tiredness, and back pain.

Ovarian cancer is generally treated by a combination of surgery, radiation, and chemotherapy. Treatment is individualized to each patient?s needs and is determined by the type of tumour and whether it has spread.

There is no reliable, routine screening recommended for ovarian cancer.  However, your doctor may recommend that you have one of the following tests:

• Pelvic Exam – in which a medical practitioner inserts a gloved hand into your vagina and places the other hand on your abdomen. S/he is able to feel for any abnormalities in the size or shape of your uterus and ovaries.
• Transvaginal Ultrasound – in which an ultrasound probe is placed in your vagina to create an image of your ovaries.
• CA-125 Blood Test – a blood test which is elevated may indicate the presence of ovarian cancer.  This test can be elevated for reasons other than ovarian cancer, and you can also have normal levels and still have ovarian cancer.  For this reason this test is NOT recommended as a screening test for ovarian cancer.

Any factor that lowers your risk of developing a disease is known as a protective factor.  These factors do not guarantee that a disease will not develop.  Different cancers have different protective factors.  Protective factors for ovarian cancer prevention include:

• Pregnancy – a woman who has children has a lower risk of developing ovarian cancer than a woman who has had no children.  The risk gets lower with each pregnancy.
• Breastfeeding – women who breastfeed their children have a lower risk of developing ovarian cancer than women who do not breastfeed; the longer you breastfeed your child, the lower your risk.
• Oral Contraceptives – or the “pill” as it is known, will decrease your risk for developing ovarian cancer especially if used for a number of years.
• Gynecologic Surgery – women who have had tubal ligation surgery, or a hysterectomy for medical reasons may be at decreased risk for ovarian cancer.
• Diet – There is evidence to suggest that women who eat a low-fat diet, high in fruits and vegetables may have a lower risk of developing ovarian cancer.

Other risk factors for ovarian cancer include age (especially over the age of 63); estrogen exposure; previous diagnosis of cancer of the ovary, breast, or colon; infertility (especially with use of fertility drugs); endometriosis; obesity; smoking and alcohol.