Carlos Alberto Herrera, M.D., F.A.C.O.G.
Gynecology Oncology
DHR Health Oncology Institute
Ovarian cancer originates in the ovaries. The ovaries, located on each side of the uterus, are the pair of reproductive organs that produce eggs and are the main source of the primary female hormones, estrogen and progesterone. Ovarian cancer is the most lethal of the gynecologic malignancies.
Risk Factors
The risk of developing ovarian cancer increases with age, and most cases develop after a woman reaches menopause. The average age at which women develop ovarian cancer is 63. A subset of women who are genetically predisposed to developing ovarian cancer may develop cancer at a younger age. The following factors have been associated with developing ovarian cancer:
• Family history of ovarian, breast, or colon cancer
• Personal history of breast cancer
• Ashkenazi Jewish origin
• Carrier of a genetic mutation that predisposes to ovarian cancer
• Obesity
• Never having children
Prevention
Being aware of one’s personal and family history may lead to genetic testing that may identify a mutation. If a mutation is identified, the patient may elect to undergo prophylactic removal of the ovaries and fallopian tubes. Women should receive regular pelvic examinations, where a healthcare professional can feel the ovaries for size, shape, and consistency. A Pap test is not an accurate indicator for ovarian cancer.
Recent studies have shown that women who use oral contraceptives for five or more years have a 50 percent lower risk of developing ovarian cancer than women who have never used oral contraceptives. However, the choice to use oral contraceptives should not be made solely for ovarian cancer prevention.
Symptoms
The most common symptoms of women with ovarian cancer are bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly, and urinary symptoms such as urgency (always feeling like you have to go) or frequency (having to go often). Since such symptoms are very vague, if they are persistent, they need to be evaluated by a physician.
Diagnosis
If a physician detects irregularities during a physical or pelvic exam or suspects that ovarian cancer may be present, a transvaginal ultrasound or a blood test (CA-125) may be recommended.
True diagnosis of ovarian cancer is usually confirmed during time of surgery when tissue or fluid is obtained.
Treatment
Treatment for ovarian cancer usually involves advanced surgery and chemotherapy. If ovarian cancer is found, a salpingo-oophorectomy (removal of the tubes and ovaries), a hysterectomy, removal of the omentum (a fatty area of tissue near the stomach and colon), and a lymph node dissection may be performed. The goal of surgery is usually to remove as much of the tumor as possible. Chemotherapy is frequently given after surgery and occasionally before surgery. It is in chemotherapy that the majority of the most recent advances have been made. By looking at the genetic makeup of tumors and/or patients, certain chemotherapy medications–called targeted therapies–can be used to target and kill (or contain) certain types of ovarian cancers and assist in the control and eradication of such tumors. Radiation therapy is rarely used. Survival is best when the specialized surgery is performed by a gynecologic oncologist — an expert in ovarian cancer surgery and treatment.
For more information or to schedule an appointment with one of our experts, contact DHR Health Oncology Institute at 956-362-2250.
