2002-03-23 / Community

Facts About Ovarian Cancer

Facts About Ovarian Cancer

Many women are unaware of their risk for ovarian cancer, endometrial cancer, heart disease, and a number of illnesses that prove fatal to our health. In this issue I would like to discuss one of the diseases – ovarian cancer. It is rarely discussed, but it has a much higher mortality rate than breast cancer.

This is due to a well-known fact that ovarian cancer is usually diagnosed in its late stage, after it has metastasized (spread) to multiple organs. Many patients will see their doctor due to the complications of the spread of the disease. Some patients present shortness of breath due to the spread to the lung. Other patients exhibit deep vein thrombosis or worse with pulmonary embolisms, which may be fatal. And still others will have lower extremity swelling, uremic syndromes or urinary tract complications.

Ovarian cancer is generally asymptomatic in its early stages. No effective screening method exists outside of routine pelvic examinations, due to the low specificity of current methods and the lack of a precursor. At the time of diagnosis more than 75% of women have advanced stage disease that harm already spread beyond the pelvis (stage III or IV. No more than 10% of cases are hereditary; therefore, few opportunities exist to identify women at increased risk by family history.

The incidence of ovarian cancer has been relatively stable over the past two or three decades. However. Those women who died of a pulmonary embolism (PE) secondary to pelvic vein secondary to pelvic vein embolus due to ovarian cancer may not be accounted for in these statistics.

The five-year survival rate has notably increased; it has risen from 36.8% in 1970 to 50.4% in 1996. This has been due to two factors: 1) increased awareness by both doctors and patients; therefore, more gynecological visits by older women and increased vigilance of the physician for a--???????????????and pelvic masses; and 2) improved treatment for patients with extensive disease.

A lower risk of ovarian cancer is associated with a) having two or more children since this lower exposure to estrogen; b) having a hysterectomy lowers your risk of ovarian cancer. Scientists aren’t sure why - possible changes in hormone levels which protect the ovaries; c) oral contraceptives, and d) tubal ligation.

If you take oral contraceptives (birth control pills) for at least five years, you lower your risk of ovarian cancer. The longer you take the pill, the lower the risk. Birth control pills keep you from ovulating. Ovulation increases the amount of estrogen you are exposed to throughout your life. Estrogen is mainly released during the menstrual cycle. High levels of estrogen may cause cells in the ovaries to become cancerous.

Birth control pills can have plus and minus effects on your health. If taken for at least five years, birth control pills can lower your risk for colon, uterine and ovarian cancers. However, your risk of breast cancer is increased while you use oral contraceptives.

Scientists have also noted that tubal ligation lowers your risk of ovarian cancer; however, the cause of this is yet unknown to scientists.

Increased risk of ovarian cancer is associated with a) having no children or less than two children, b) never breastfeeding for greater than a year, c) having a family history, such as having a mother or sister with ovarian cancer. Some ovarian cancers are due to genetic mutation of your body cells and mutations can be passed from generation to generation. Discuss this risk with your doctor.

Women over forty should have their gynecologist examine for pelvic mass and ovarian mass if in a high-risk category. Also, all women should be encouraged to have an annual Pap smear. Those over forty years of age should also have a mammogram. All women should be taught to do self- breast exams regularly.

Finally, annual physicals are a must for all patients. For female patients that includes laboratory work to screen for early signs of cancer. Patients must be aggressive in addressing their healthcare problems. They must demand their physicians answer their questions.

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