The Ovarian Cancer Awareness program is observed in September every year. Ovarian cancer is of great concern to women over the age of 60. Over half the cases of ovarian cancer in the United States are detected in women over the age of 65, and most are diagnosed at 60. Ovarian cancer has a very high mortality rate, because it often goes undetected until it is quite advanced. According to the National Institutes of Health it is the fifth leading cause of death among women in the United States. The cause of ovarian cancer is unknown, but several risk factors are known. Are you at risk?
As was mentioned previously the incidence of this cancer rises with age. The American cancer society recommends an annual pelvic exam for all women over the age of forty, in hopes it may increase early detection.
White women in Europe and North America have a higher incidence of ovarian cancer, it is lowest in blacks and Asian women in their native countries.
- Genetic Background
As with most cancers a family history of ovarian cancer increases the risk. Women who inherit a genetic mutation found in the BRCA1 and 2 genes have a 64% risk of inheriting the disease. The mutation can be found in people of many ethnic backgrounds, but is higher in Asheknazi Jews (from eastern and central Europe).
Eating a diet high in fat, especially animal fats has been shown to increase the risk of ovarian cancer. It is higher in western, affluent countries where high fat diets are eaten.
- Pregnancy/Reproductive History
Women with no children/pregnancies or who had their first pregnancy after the age of 35 are at higher risk of ovarian cancer. It is also more common in women who had an early puberty (before age 12) or late menopause (after 50). Women who have used fertility drugs may also be at higher risk.
- Birth Control Pills
Taking birth control pills appears to reduce the risk of developing ovarian cancer. Additionally the longer they are taken the lower the risk, but the risk of breast cancer is higher while on the pill.
- Talcum Powder and Asbestos
Some studies have linked a higher risk of ovarian cancer with the use of talcum powder in the genital area. Though not proven researchers feel it may be due to particles of asbestos in the talc. Asbestos is known to cause cancer and women who have a high exposure to asbestos are at higher risk.
- Other Cancer
Women who have had endometrial or breast cancer appear to be at higher risk of ovarian cancer.
Detection of Ovarian Cancer
It is very important for all women who still have ovaries, no matter their age, to have a pelvic exam yearly. Your gynecologist can feel any enlargement or masses on the ovaries. An ultrasound can detect cystic or fluid filled masses, which are not cancerous. If the mass is solid a biopsy should be done to evaluate the ovary. The biopsy can be done through a laparotomy procedure. If the mass is found to be cancer, it will be staged (a way of measuring how extensive the cancer is and any spread to other organs). Treatment will depend on the stage, but will usually always involve a total hysterectomy at the least.
The only blood test presently available for ovarian cancer is a test called CA125. It is not an especially accurate test, and it can be elevated due to other conditions such as endometriosis.
Researchers have begun studies on another blood test for ovarian cancer, but it is still in it's early stages. They are looking at a test that would detect levels of lysophosphatidic acid (LPA) in the blood. LPA is a lipid that is found in high quantities in women with ovarian cancer. It is hoped that this test will prove to be a more accurate early detection tool of ovarian cancer.