Ovarian cancer known as a silent killer

November 21, 2012 By Jonathan Aaron Cosin, M.D.

Ovarian cancer is often called the silent killer since many women seemingly have no symptoms before diagnosis. In reality however, many women do have symptoms which are often mild and confused with other less serious illnesses. These symptoms can include abdominal bloating, constipation, diarrhea, urinary frequency or a feeling of fullness after only a small meal. Women should be mindful of symptoms like these if they do not resolve or improve within two weeks.

There is currently no effective screening test for ovarian cancer and screening is not recommended for average risk women with no symptoms.

In about 10 percent of ovarian cancer cases, patients develop their cancer because of an inherited gene. The most common genes involved are BRCA 1 and 2, and HNPCC, also known as Lynch syndrome. Patients with a BRCA mutation are at increased risk for breast and ovarian cancers. In the case of HNPCC, affected families show increases in colon, uterine, ovarian and other cancers as well. For women with a strong family history of cancer, genetic counseling and possibly testing is recommended. Screening with an ultrasound and CA 125 test is recommended for women with a known inherited gene, but women must also consider surgery to remove their fallopian tubes and ovaries once they have completed their family.

For all women, use of birth control pills, pregnancy and breast feeding are all believed to reduce a woman's risk for ovarian cancer. Any woman who experiences symptoms suggestive of ovarian cancer that last longer than two weeks or worsen over time should see their doctor. Initial evaluation should include a thorough physical examination and a pelvic ultrasound. A blood test to check the CA 125 protein may also be done. This may be elevated in women with ovarian cancer; however, it is often elevated in women without cancer and gives many false readings.

Once ovarian cancer is suspected, referral should be made to a gynecologic oncologist, a specialist with extra training in gynecologic cancer. Studies have shown that a woman's chance of beating ovarian cancer dramatically improve when a gynecologic oncologist is involved in her care.

Ovarian cancer treatment often includes a combination of surgery and chemotherapy. With aggressive treatment, women with early stage ovarian cancer have an excellent chance of being cured. Cure is still possible but less likely for women with more advanced disease. Yet even in these situations, women can often expect to live a long time with their disease. Newer and more effective treatments are constantly being sought and women with advanced ovarian cancer or cancer that has returned after treatment are encouraged to consider clinical trial participation. This often affords them access to the latest available treatments and helps expand and promote our knowledge of the disease and help bring us closer to a cure for every woman with this disease.

Dr. Jonathan Aaron Cosin is a member of The Hospital of Central Connecticut (HOCC) medical staff. For referrals to HOCC physicians, please contact our free Need-A-Physician referral service by phone at 800.321.6244.