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Treating ovarian cancer

Improved awareness, treatment can save lives


Ovarian cancer is the leading cause of death due to gynecologic cancers in the United States and it’s also the fifth-leading cause of cancer death among American women. But with early detection, the disease can be successfully treated.

In 2014, nearly 23,000 women in the United States were diagnosed with ovarian cancer and about 15,000 women died from the disease. Unfortunately, most women diagnosed with ovarian cancer are in advanced stages of the cancer when the disease has spread from the ovaries.

Dr. Matt McDonald, a gynecologic oncologist at Novant Health Gynecologic Oncology Associates said that women with a history of cancer in their family should consider a genetic screening for gene mutations associated with ovarian cancer.

As a result, only 44 percent of these women survive longer than five years. In fact, only 19 percent of ovarian cancer cases are caught before the disease has spread beyond the ovaries. However, when ovarian cancer is detected and treated in its early stages, the five-year survival rate soars to more than 92 percent.

“The most important thing a patient can remember to do if she is diagnosed with ovarian cancer is to get a gynecologic oncologist involved in her care upfront,” McDonald said. “Many women are unaware of this and seek treatment from a surgeon or gynecologist alone, but the best cure comes from management with a gynecologic oncologist. However, only 30 percent of patients in the Unites States are seen by a gynecologic oncologist.”

The symptoms of ovarian cancer are vague so that many women will generally ignore them and hope they go away. However, if symptoms persist for two to three weeks, it is advisable to consult your doctor.

“Ovarian cancer doesn’t really give symptoms until it’s already in an advanced stage, McDonald said. “If you notice that you have recurring and persistent changes in bowel movements or urgency in urinating, you should consult with your primary care doctor.”

McDonald said common symptoms include:

  • Digestive issues such as gas, flatulence, bloating, loss of appetite, or abdominal pain.
  • Pressure in the abdomen.
  • Changes in bowel movements and frequency of urination.
  • Abnormal vaginal bleeding.
  • Uncommon fatigue or backaches.
  • Loss or gain in weight.

About 90 percent of women who have been diagnosed with ovarian cancer have experienced these symptoms.

While there is no screening test for ovarian cancer, if a woman has symptoms of the disease her provider may recommend diagnostic testing for the condition. These tests include a rectovaginal pelvic exam, a transvaginal ultrasound, or a CA-125 blood test.

After the diagnostic tests are done and cancer is detected, your cancer care team will recommend one or more treatment options, including surgery, chemotherapy and for more uncommon types of ovarian cancer, some other therapies.

“Most patients undergo surgery and some type of chemotherapy, either intravenous or intraperitoneal,” McDonald said. With intraperitoneal chemo, drugs are injected directly into the abdominal cavity through a catheter.

Surgery is the main treatment for most ovarian cancers. What the surgery removes depends on whether your cancer has spread.

Most patients will have chemotherapy treatments for six months and after that, will be evaluated every three months for two years through a physical exam and blood work, McDonald said.

Epithelial cancers are the most common type of ovarian cancer, accounting for 85 to 90 percent of cases and develop from the cells that cover the outer surface of the ovary.

McDonald said the five year survival rate for ovarian cancer patients has significantly improved over the last decade. He is hopeful that with continued advancements in targeted and immunotherapy treatments, those numbers will continue to improve.

In a survey conducted by the Ovarian Cancer National Alliance, 89 percent of women were unaware of ovarian cancer symptoms before being diagnosed. However, 81 percent of these respondents said that in hindsight, their symptoms existed before diagnosis and were often with confused with other conditions, such as irritable bowel syndrome, stress, acid reflux, endometriosis or gall bladder issues.

To learn your risk of ovarian cancer, take the Novant Health Ovarian Cancer Risk Assessment.





Published: 9/5/2016