Ovarian Cancer

If you read YesFive last week, you know that for me, this is the one that sends chills down my spine.   Like carbon monoxide, think of it as the silent killer.  There are no accepted screening tests, it presents with very mild, general symptoms, if any at all, and it is extremely aggressive.  I am counting down the days to menopause, so I can have my bilateral oophorectomy — getting the little bastards removed.   It will feel like Christmas when I was five.  I may throw a party.
Forgive me if I am dumbing this down too much, but women have two ovaries.  They are about the size of almonds or small walnuts and they sit low in the pelvis.  They undergo huge changes each ovulation cycle to release an egg.  They are the primary source of estrogen and testosterone, as well as other hormones that keep the body in balance. When the ovaries cease to function, menopause ensues.  However, there is good evidence that they do continue to release small amounts of hormones that are protective against heart disease.  Someday, I will be taking my chances with heart disease. My grandmother has heart disease and she is 95.

Facts about ovarian cancer:

1.  Each year about 21,000 women in the US will be diagnosed and about 15,000 will die from ovarian cancer.

2.  Ovarian cancer is the deadliest of the gynecological cancers and is the only one whose 5 year survival rate has not improved over recent years.

3. Less than 20% of women diagnosed with ovarian cancer are diagnosed at an early stage. This is due to lack of screening and vagueness or absence of symptoms.  Basically, this translates into: by the time we find it, it is really too late.

4.  Risk factors include:

– family history
– age – most often it occurs in women after menopause increasing in incidence until the late 70s
– nulliparity — having never been pregnant
– infertility in and of itself and, possibly*, taking fertility drugs (clomid) for more than one year
– obesity
– possibly* taking hormone replacement therapy for more than 5 years

* there is only a little evidence to support this

Taking birth control pills seems to be protective against ovarian cancer.  As with pregnancy, the thinking is that anything that prevents you from ovulating, lessens your chance of developing cancer in the ovaries.  Birth control pills work by preventing ovulation.

5.  Initial symptoms of ovarian cancer are essentially what most women experience every month or after eating Thanksgiving dinner:

– bloating
– abdominal pain
– feeling of fullness
– urinary symptoms of frequency or urgency

Often, it is diagnosed based on the symptoms that occur after it has spread to other organs.  Ovarian cancer has a predilection for metastasizing to the organs in your pelvis, including the uterus and fallopian tubes, the lining of your abdominal cavity, the liver, the intestines,  the diaphragm and the lining of the lungs.

You have to walk a fine line — steady now.  On the one hand, you cannot think that every ache or pain you have is something serious. This will be crippling.  On the other hand, you cannot ignore symptoms for too long — that’s why God created Doctors’ offices.  If you just can’t shake the thought that you may have a real problem, get it checked out.  If the doctor thinks you are a hypochondriac or a fruit loop, who cares?  You will walk out with a clear head or an EARLY diagnosis, and that is what is most important.

For more information, I like:

The American Cancer Society

The Ovarian Cancer National Alliance

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  • camille reid

    What do you think about the blood test to screen for ovarian cancer (C-3???)

    • Yes Five

      ca-125. It is a good test but not widely used because it lacks specificity. Several other conditions, some of which are benign, can cause an increase in your ca-125. This makes it a bad test for the general population because it would result in a lot of unnecessary testing. The hope is that they find something in the blood that is easy to screen for and that is very specific to ovarian cancer. (That’s my hope anyway!)