A Shared Enemy
When a woman is diagnosed with ovarian cancer, she is not alone in fighting this disease. Statistically, one in every 70 women will develop ovarian cancer at some time in her life, with half of those cases occurring after the age of 65. In fact, every year there are approximately 22,000 new cases diagnosed in the United States.
Current research indicates that ovarian cancer is NOT a silent disease. It is a disease that can often be confused with other more common conditions such as ulcers, diverticular disease, endometriosis, ovarian cysts, and inflammatory diseases. Nearly 95 percent of women will experience one or more of the following 4 problems:
- Pelvic or abdominal pain
- An increase in the size of the abdomen or persistent bloating
- The need to urinate more frequently or urgently
- Feeling fully quickly even after a light meal
The following also are signs that should be noted if they are irregular for you:
- Excess gas and indigestion
- Unexplained weight gain or loss
- Irregular periods and menstrual cycles
- Vaginal bleeding that is not part of a menstrual cycle
- Painful intercourse
- Back Pain which seems to worsen over time
- Nausea, vomiting or indigestion
- Changes in bowel habits, including diarrhea or constipation
- Excessive fatigue which may be mistaken for Chronic Fatigue Syndrome
- A vague feeling of discomfort in the pelvic region
- Excessive hair growth
Cancer can begin in any of the different cell types that make up the ovaries.
The most common type is adenocarcinoma (a cancer of cells from glands). Less common are leiomyosarcoma (a cancer of smooth muscle cells) and transitional cell carcinoma (a cancer of the cells lining the fallopian tubes).
In addition to a physical examination, the following tests may be used to diagnose ovarian cancer:
The doctor feels the uterus, vagina, ovaries, fallopian tubes, bladder, and rectum to check for any unusual changes.
An ultrasound uses sound waves to create a picture of internal organs. In a transvaginal ultrasound, an ultrasound wand is inserted into the vagina and aimed at the uterus to obtain the images.
A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. The sample excised during the biopsy is analyzed by a pathologist (a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs).
Your doctor may recommend running laboratory tests on a tumor sample to identify specific genes, proteins, and other factors unique to the tumor. Results of these tests will help decide whether your treatment options include a type of treatment called targeted therapy. Often times this is done as part of a clinical trial.
Computed tomography (CT or CAT) scan
A CT scan creates a three-dimensional image of the inside of the body with an X-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a contrast medium (a special dye) is injected into a patient’s vein to provide better detail.
Combined PET/CT Scanning
Combined PET/CT scanning joins two imaging tests, CT and positron emission tomography (PET), into one procedure. A PET scan creates colored pictures of chemical changes (metabolic activity) in tissues. Because cancerous tumors usually are more active than normal tissue, they appear different on a PET scan.
Combining CT with PET scanning may provide a more complete picture of a tumor’s location, growth or spread than either test alone. The combined procedure can improve a healthcare professional’s ability to diagnose cancer, determine how far it has spread, and follow patient’s responses to treatment. The combined PET/CT scan may also reduce the number of additional imaging tests and other procedures a patient needs.
Magnetic resonance imaging (MRI)
An MRI uses magnetic fields, not X-rays, to produce detailed images of the body. A contrast medium may be injected into a patient’s vein to create a clearer picture.
Treatment options generally involve surgery and chemotherapy. Radiation therapy is rarely used.
The stage of the tumor determines the type of surgery used.
Early stage ovarian cancer, when the tumor is limited to the ovaries, is treated by surgical removal of the ovaries (called a salpingo-oophorectomy).
If the cancer has spread, the surgeon may remove the uterus (called a hysterectomy) and other structures in the abdomen and pelvis, including a fat pad called the omentum and nearby lymph nodes, to biopsy and conduct tests for the presence of cancer cells.
Chemotherapy is usually given after surgery for ovarian cancer.
A chemotherapy regimen (schedule) usually consists of a specific number of cycles given over a set period of time. A patient may receive one drug at a time or combinations of different drugs at the same time.
The most common types of chemotherapy to treat ovarian cancer are paclitaxel (Taxol) and carboplatin (Paraplat, Paraplatin).
The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.
Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to normal cells. Targeted agents are often used along with standard chemotherapy agents to enhance their effectiveness. A number of agents are being used secondarily as a part of active ongoing clinical trials.