Understanding how ovarian cancer is diagnosed

March 27th, 2019
A woman carrying a backpack in a park
One in 70 women will develop ovarian cancer in their lifetime, with incidence increasing sharply after age 50. Along with aging, there are other risk factors. Photo: Getty Images.

One in 70 women will develop ovarian cancer in their lifetime, with incidence increasing sharply after age 50, said Dr. Diana Medgvesy, a medical oncologist with UCHealth Cancer Care and Hematology Clinic – Harmony Campus in Fort Collins.

“I have a special interest in the prevention and treatment of breast and gynecologic cancers, including ovarian cancer,” she said.

With that in mind, here are some straightforward answers to commonly asked questions about the disease.

Who is at risk of developing ovarian cancer?

Besides aging, other risk factors for ovarian cancer include hormonal and reproductive factors (such as menarche before age 12, menopause after age 52, lack of pregnancies, endometriosis, polycystic ovarian syndrome, to name a few), genetic and environmental factors (smoking, asbestos exposure), diet (increased fat intake of animal sources) and obesity.

Protective factors include breast feeding, oral contraceptives, multiple pregnancies, and removal of ovaries and fallopian tubes.

Is there a genetic component to developing the disease? Is there any way to test for that?

It is estimated that up to 25 percent of ovarian cancers are linked to certain inherited genetic mutations. BRCA mutations account for the majority of hereditary ovarian cancers and a minority are linked to BRIP1, RAD51C, RAD51D, BARD and mismatch repair genes of Lynch syndrome. Knowing your family history of cancer can be a powerful tool in the prevention and early detection of ovarian cancer.

Women with a strong family history of ovarian cancer are highly encouraged to undergo genetic counseling and testing. The testing is performed on a sample of blood or saliva. It is covered by most insurance companies and the results are highly confidential. Laws are now in place where one can’t be discriminated against by an insurance company or employer for carrying a genetic mutation that increases their risk of cancer.

Dr. Diana Medgyesy, a medical oncologist, offers help to women who have ovarian cancer.

What are the early signs of ovarian cancer?

There are no reliable, validated screening tests for ovarian cancer in the general population. More than 70 percent of ovarian cancers are diagnosed at an advanced stage (III and IV) due to lack of signs and symptoms until the cancer is spread to the abdominal cavity or the lungs. Abdominal pain, bloating, feeling full soon into a meal, having changes in the bowel pattern, pelvic pressure and bladder emptying difficulties are few of the very nonspecific signs of the disease.

How is it usually caught/diagnosed?

The diagnosis is suspected when a pelvic mass is found on CT scan of the abdomen and pelvis. A blood test called CA125 can aid in the diagnosis, since 85 percent of ovarian cancers produce this cancer marker. The confirmatory diagnosis is made by either a biopsy or, more often, surgery to remove the mass and other sites of disease in the abdomen and pelvis.

What is the typical treatment?

The treatment of ovarian cancer consists of surgery to remove all the visible cancer. Surgery is best performed by a gynecologist oncologist, a gynecologist with special training in the treatment of gynecologic cancers. In most cases, this is followed by chemotherapy to eradicate small amounts of residual tumor. Cure rate, with treatment, ranges from 20 to 90 percent, depending on the stage of the disease. Ovarian cancer remains the fifth most common cause of cancer death in women.

Women who carry a genetic mutation in the BRCA 1 and BRCA 2 genes or have Lynch syndrome are highly encouraged to undergo risk-reducing removal of the ovaries and fallopian tubes (salpingo-oophorectomy) with or without removal of the uterus (hysterectomy) 10 years prior to the age of the youngest family member who was diagnosed with ovarian cancer and no later than age 40.

Is prevention possible with diet or lifestyle changes?

Lifestyle factors that may decrease the risk of ovarian cancer consist of avoidance of smoking, following a healthy diet rich in fruits, vegetables, legumes, grains and lean animal products, exercising regularly, and maintaining a healthy weight.

About the author

Linda DuVal is a freelance writer based in Colorado Springs who writes articles for UCHealth.