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Ovarian cancer is the fifth leading cause of cancer-related deaths among women.  Because the symptoms of early stage ovarian cancer are non-specific, it presents a deadly statistic—60% of patients are already at an advanced stage before it is diagnosed.  That means that it has spread beyond the ovaries, and is much more difficult to treat effectively.  The survival rate for early diagnosis is about 98%, whereas advanced-stage diagnosis is only 35%.  The best advice is to observe the changes of your body, become aware of the common symptoms, and get regular physical examinations from your doctor. 

The Composition of the Uterus:

A woman’s uterus consists of the vaginal opening that leads to the cervix.  Beyond the cervix, on either side of the uterus, two ovaries about the size of almonds produce eggs which are conducted through the fallopian tubes.  The ovaries also produce the sexual hormones estrogen and progesterone. 

 What Are the Facts?

Ovarian cancer occurs when ovarian cells begin to reproduce abnormally, thus subjugating normal cell development by taking up space within the womb and diverting oxygen and nutrients that healthy cells need to survive.   

The most common type is ovarian epithelial carcinoma, where cancer cells form on the surface in the tissue that covers the ovary.  This type accounts for about 80% of cases, usually occurring in women between 40-70 years.  Conversely, germ cell ovarian cancer occurs within the egg cells, but is a much less common form, generally reported by younger women.  Stromal tumors make up around 10% of ovarian cancers, developing in the tissue that produces estrogen and progesterone, and affects women aged 40-60.   

When cancer cells multiply, they create a mass called a tumor.  Benign tumors are non-cancerous because they have not spread to surrounding tissue, while malignant tumors are cancerous as they will multiply and metastasize to other bodily tissues. 

Malignant tumors can spread in two ways.  Most common is when they spread to nearby tissues, organs, and lymph nodes in the pelvis and abdomen.  Rarely, they may spread through the bloodstream or lymphatic channels, traveling to other parts of the body, such as the lungs or kidneys.  

The Symptoms:

The signs of ovarian cancer are often confused with other common ailments like digestive and bladder disorders.  Women with ovarian cancer usually report at least two of the following symptoms: abdominal pressure, an urge to urinate, pelvic pain, indigestion, diarrhea or constipation, loss of appetite, pain during intercourse, lack of energy, lower back pain, and an unexplained gain or loss of body weight. 

Because these symptoms are somewhat ambiguous, an indicator could be that these symptoms persist and worsen over time.  Where the signs of a digestive disorders fluctuate during certain situations, i.e., after eating, the symptoms for ovarian cancer will be constant.  

Early Symptoms:

Diagnosis of ovarian cancer at an early stage has proven difficult because many women report only mild symptoms, and sometimes no symptoms at all.  The earlier the cancer is diagnosed, the better are the odds of recovery.  Only around 20% of ovarian cancers are diagnosed before tumors have spread to other organs and tissue. 

Stages of Ovarian Cancer:

Ovarian cancer passes through four stages: 

Stage I – Cancer is confined to one or both ovaries, detected through cells or in fluid in the abdomen.

Stage II – Cancer cells have spread beyond the ovaries to other tissues within the pelvis, to the fallopian tubes or the uterus, but is still confined to the pelvic area.

Stage III – Cancer has spread to the lining of the abdomen, to lymph nodes within the abdomen, or has spread outside the pelvis to other lymph nodes.  This is the most common stage of diagnosis. 

Stage IV – Cancer cells have spread beyond the pelvis to other organs, like the liver or kidneys. 

Screening & Diagnosis: 

If you observe persistent symptoms, congruous to the signs of ovarian cancer, seek medical advice immediately.  Women at a high risk and are over the age of 35, should seek regular screening.  The first step is a pelvic exam, where the doctor will feel the inside of the uterus—the ovaries, fallopian tubes, bladder, and rectum—to determine if there are any abnormal changes in size and shape.  Pap tests will not help to diagnose ovarian cancer. 

Ultrasounds, CT scans, blood tests, and biopsies are other ways for a doctor to determine whether you have ovarian cancer. 

Are You at Risk?

The causes of ovarian cancer are still unknown.  Yet, certain studies have suggested factors that could heighten the risk of its development. 

A first-degree family history of ovarian cancer increases risk.  If one family member—a sister, mother, or daughter—has been diagnosed, the risk increases to about 5% over your lifetime.  If two or more first-degree members are affected, the risk is much higher.  Ovarian cancer has been linked to colon and breast cancer, so even if more distant family members (grandmother, aunt, cousin) have developed one of these cancers, the risk is increased.  Personal histories of breast or colon cancer also present a higher risk.  

Genetic mutations indicate a significant risk, and ovarian cancer has been associated with the breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2).  Inheriting one of these genes increases the risk between 5-10%.  Hereditary nonplyopsis colorectal cancer (HNPCC) is another gene that causes cancers of the uterine lining, the colon, the ovaries, and the small intestines. 

As women age, the risk increases.  It generally occurs in post-menopausal women over the age of 50. 

A woman who has never had children is at an increased risk.  Studies show that the more children a woman has, the less likely she will develop the disease. 

Hormone Replacement Therapy (HRT) presents an increased risk for post-menopausal women, especially if they have been taking estrogen for 10 years or more. 

Ovarian Cancer Awareness:

The teal silicone bracelet denotes ovarian cancer awareness.  Inscribed with the words Hope, Faith, Courage, Strength, the bracelet raises funds for ovarian cancer research, early detection measures, and overall prevention of this silent killer.