The Importance of Early Detection in Ovarian Cancer

As a survivor of ovarian cancer, I am committed to leveraging my journey to raise awareness and educate others for an earlier diagnosis.

Recent statistics from OCRA (The Ovarian Cancer Research Alliance) reveal that ovarian cancer ranks as the 11th most common cancer and the fifth leading cause of cancer-related deaths among women. Furthermore, a woman’s lifetime risk of developing ovarian cancer is reported to be 1 in 78.  Ovarian cancer is often diagnosed at an advanced stage because early symptoms can be subtle or absent, making early detection difficult.

Unfortunately, certain groups of women have a much higher risk of acquiring ovarian cancer. For example, women of Ashkenazi Jewish decent or women who have never had children are at a higher risk.  For this reason, it is vital to know your familial history. If you have a family history of breast, uterine, ovarian, or colorectal cancer this increases your risk.

Your family medical history can provide valuable information about potential genetic or hereditary risks for various health conditions, including ovarian cancer. Many health conditions, including certain types of cancer, can have a genetic component.

The BRCA1 and BRCA2 genes are critical in understanding the genetic risk factors for certain cancers, including breast and ovarian cancers. Mutations in these genes can significantly increase the risk of developing these cancers.  Individuals with a strong family history of breast and ovarian cancers should consider genetic testing to identify mutations in these genes.

It is estimated that 1 in 40 women of Ashkenazi Jewish descent have a BRCA mutation.  Also, women of Jewish descent have a higher risk than the regular population of being BRCA positive.  Women with a BRCA mutation have a 50% lifetime risk for ovarian cancer.

Age is a significant factor in the risk of developing ovarian cancer, and the risk tends to increase with age, especially after menopause.  However, it is important to note that having one or more risk factors does not guarantee that an individual will develop ovarian cancer, and many women with ovarian cancer have no ——-known risk factors.

Prior to my diagnosis of ovarian cancer, I would characterize my health as excellent.  I had been a physically active woman for the last 50 years, eating a healthy diet and weighing in at the same weight I was in high school. My only family history of cancer is a maternal grandmother with stomach cancer in her sixties and being of Ashkenaz decent.

Vaginal bleeding was my only symptom. This led me to call my gynecologist, who quickly ordered a vaginal ultrasound which found a large ovarian tumor. Based on my oncologist’s recommendations, I decided to undergo a total hysterectomy.  My pathology report indicated that I had a highly aggressive tumor and chemotherapy was ordered.

It was shocking for me to get this diagnosis, particularly since I led such a healthy life for decades. I was fortunate enough to get an early diagnosis and am cancer free at this time.

Breast cancer has received widespread public attention.  In contrast, ovarian cancer has often been less talked about, and there are several reasons for this. One challenge is that ovarian cancer is often asymptomatic or presents with vague symptoms, making early detection difficult. The lack of routine screening tests, like mammograms for breast cancer, adds to the complexity of detecting ovarian cancer at an early stage.

Discussions related to ovarian cancer may involve sensitive topics such as reproductive health, as the ovaries are essential for fertility. This has contributed to a certain level of discomfort or taboo surrounding this subject for both women and their healthcare providers.

Ovarian cancer can be challenging to treat, and the statistics are very concerning. The outcome for individuals diagnosed with ovarian cancer depends on various factors, including the stage at which the cancer is detected, the type of ovarian cancer, the overall health of the individual, and how well they respond to treatment.

The lack of a routine screening test, like the Pap smear for cervical cancer, also contributes to the challenges in early detection. The advanced stage diagnoses that many experience may be due to the lack of noticing and reporting specific early symptoms to your health practitioner, effective screening methods and the need to educate many health care practitioners of the early signs of this disease.

The symptoms of ovarian cancer can be subtle and easily attributed to other less severe conditions, which can lead to delayed diagnosis.

Here are some common symptoms that may be associated with ovarian cancer:

1. Pelvic or abdominal pain: Persistent pain or discomfort in the pelvic or abdominal region is a common symptom associated with ovarian cancer.
2. Bloating: Feeling consistently bloated, especially if it persists for more than a few weeks, can be a sign.
3. Trouble eating or feeling full quickly: A sudden change in appetite, difficulty eating, or feeling full despite eating very little can be indicative of various health issues, including ovarian cancer.
4. Frequent urination: Increased urgency to urinate and more frequent bathroom trips.
5. Vaginal bleeding: This symptom needs to be reported to your gynecologist immediately.
6. Changes in bowel habits: Any significant changes in bowel habits, whether it’s constipation or diarrhea, should be discussed with a healthcare professional.
7. Unexplained weight gain or loss: Sudden and unexplained changes in weight can be a symptom of various health issues, including ovarian cancer.
8. Fatigue: Feeling unusually tired or having low energy levels consistently.
9. Back pain: Pain in the lower back may be a symptom.

It is also crucial to note that these symptoms can be indicative of various conditions, and experiencing them does not necessarily mean someone has ovarian cancer. However, if these symptoms are persistent and unexplained, for several weeks, it is important for individuals to consult with a healthcare professional, particularly a gynecologist.

Consider requesting a vaginal ultrasound and a CA 125 which is a biomarker test for ovarian cancer to rule out potential concerns. Early diagnosis can significantly impact the effectiveness of any necessary interventions and is crucial for improving survival rates in ovarian cancer.

Studies indicate that specific risk factors elevate the chances of developing ovarian cancer, whereas other factors may lower a woman’s likelihood of contracting the disease. It is crucial to bear in mind that the presence of risk factors does not guarantee the development of ovarian cancer for all individuals.

Some women who get this type of cancer have no known risk factors.

Factors that may increase your risk for ovarian cancer:

• A family history of ovarian, breast, uterine or colorectal cancer
• Increased age
• Genetic mutations like in your BRCA genes  https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet
• Being post-menopausal
• Ashkenaz Jewish decent (this group of individuals have a higher risk of getting ovarian cancer).

If you think you may be at risk for ovarian cancer, you should speak with your doctor, preferably your gynecologist.

Factors that can decrease your risk for ovarian cancer:

• The use of oral contraceptives
• Pregnancy
• Breastfeeding

Please be vigilant and advocate for your health care. Be attuned to any unusual or persistent symptoms mentioned above, and if they persist for more than a few weeks, take proactive steps to seek medical attention. Your awareness and proactive approach can make a significant difference in early detection and overall health outcomes.

If diagnosed with ovarian cancer, it is essential to research your disease to enhance your understanding and recognize that you may not have all the answers. A wealth of information is accessible online, including reputable sources like OCRA (Ovarian Cancer Research Association), National Ovarian Cancer Coalition (NOCC), the National Cancer Institute, and the Clarity Foundation. These sites provide evidence-based research, and links to them can be found at the end of this article.

Facing a diagnosis of ovarian cancer and undergoing chemotherapy was a difficult journey for me and resulted in many complex emotions.  I found out that I could embrace both happiness and sadness independently and simultaneously.

I found out that as I was facing adversity, with two additional chemotherapy treatments, along with a hospitalization for bilateral pulmonary blood clots, I was able to keep a sense of humor.  Sharing laughter with my friends and family, created a sense of connection and support for me during that difficult time.

At the beginning, I feared the unknown.  Not knowing how I would respond to treatment, along with how I would proceed after treatment was completed. There were sad days of not having an appetite or not having the energy to even go for a walk. My ability to find moments of happiness and acceptance, gave me the strength and resilience I needed.

Looking ahead several months to taking one day at a time was challenging for me. I found it helpful to make plans for the future, whether it was having a friend over for coffee, going out to lunch or planning a weekend trip to celebrate my completion of chemotherapy.

Early detection is associated with higher survival rates.

My hope for increased public awareness, open conversations, and improved efforts in early detection and research for ovarian cancer is crucial. The progress made in breast cancer awareness, early detection, and treatment options has been significant, and there’s great potential for similar advancements in the field of ovarian cancer diagnoses.

Ovarian cancer is relentless!  If there is one thing, I would ask that each of you who read this article to take away from my experience, is to gain an understanding of the symptoms and risk factors associated with ovarian cancer, coupled with undergoing annual gynecological check-ups. This will lead to a diagnosis at an earlier, more treatable stage.  Furthermore, advocating for research to enhance screening methods and develop more effective treatments is crucial in minimizing the impact of ovarian cancer on women’s health.

• • Ovarian Cancer Research Association Foundation;  https://ocrahope.org/
  • National Ovarian Cancer Coalition;  https://ovarian.org/
  • The National Cancer Institute;   https://www.cancer.gov/
  • The Clearity Foundation;  https://www.clearityfoundation.org/
  • Nancy’s list;  https://nancyslist.org/

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Linda Winkler Garvin
Health Advocacy & Consulting
Founder & President; Patient Advocate Bay Area, Inc.
E-mail: lindawgarvin@gmail.com
Phone: (510) 520-0186
Web: patientadvocatebayarea.com