Ovarian Cancer: What You Need to Know

About 22,000 new cases of ovarian cancer are reported each year in the U.S., compared with more than 250,000 cases of invasive breast cancer. While that makes ovarian cancer relatively rare, it remains the deadliest form of gynecologic cancer. More than 14,000 American women die from it annually -- partly because there is no good screening test for the disease.

“The CA-125 blood test and ultrasound scans have been studied as possible ways to screen for ovarian cancer,” said Andrew Berchuck, MD, a gynecologic cancer specialist with Duke.“ But even though they can detect some cases, they haven’t been shown to reduce a woman’s chance of dying from the disease.”

While ovarian cancer is often called a “silent killer,” there are some symptoms. Research has found women with advanced and early-stage ovarian cancer shared some or all of these symptoms:

• Pelvic and abdominal pain
• Increased abdomen size
• Abdominal bloating or swelling
• Difficulty eating
• Feeling full quickly after eating

Women who experience any of these symptoms for 12 or more days in a month should contact their primary care doctor. Most women diagnosed with ovarian cancer are post-menopausal; the median age at diagnosis is 63.

Knowing your family history is a powerful preventive tool. Tests can check for abnormal forms of the BRCA1 and BRCA2 genes, which are linked to the development of breast and ovarian cancer and are known to be hereditary. “We are now able to test high-risk individuals for abnormal forms of these genes and offer surgery to reduce their risk,” Dr. Berchuck said.

Women who are found to have an abnormal form of the BRCA1 or BRCA2 gene may elect to have their ovaries and fallopian tubes removed as a way to prevent the disease. Preventive care doesn’t always involve surgery, though. A healthy lifestyle, including getting exercise and eating right, plays a role in preventing all cancers. There are also some factors that can reduce your risk for ovarian cancer. These include bearing children, breastfeeding, and using oral contraceptives. For example, Dr. Berchuck said, “having three children or taking the pill for five years can reduce a woman’s risk by about half.”

Although a screening test eludes scientists, Duke researchers—along with an international ovarian cancer consortium— are looking for new diagnostic markers for the disease and new, targeted therapies. Women diagnosed with ovarian cancer can do a few things to help battle it. 

“First, get to the right doctor,” Dr. Berchuck said. A gynecologic oncologist (a specialist in treating female genital tract cancers) should be a part of an ovarian cancer patient’s treatment team for the best possible outcomes.

Surgery and chemotherapy are likely to be used in combination to treat ovarian cancer. And ovarian cancer is very responsive to chemotherapy. Fertility-sparing surgery may be an option for patients who want to have a child after treatment.

An ovarian cancer patient at Duke can count on expert physicians and access to genetic counseling and patient support groups. “It’s good to know you’re not alone,” Dr. Berchuck said. “A patient’s attitude can affect her outcome.”

There is reason for optimism. Researchers, including those at Duke, continue to look for an effective way to screen for ovarian cancer. In the meantime, women can identify the disease early by knowing the symptoms, and lessen their chances of getting the disease by living healthfully.