Early detection is key in the fight against ovarian cancer

"Currently, there is no reliable screening test to identify early ovarian cancer. Women need to focus on good health habits, listen to their bodies and tell their doctor if a change occurs," said Diljeet Singh, MD, gynecological oncologist and co-director of the Ovarian Cancer Early Detection and Prevention Program at Northwestern Memorial Hospital.

Catching ovarian cancer early increases five-year survival odds from 30 percent to more than 90 percent. But the symptoms of ovarian cancer often mimic other less dangerous conditions making it difficult to recognize. Singh says women should be aware of possible early warning signs which include:

• Bloating
• Pelvic or abdominal pain
• Difficulty eating or feeling full quickly
• Urinary symptoms (urgency or frequency)
• Increased abdominal size (pants getting tighter around waist)

Singh comments that the frequency and number of symptoms is important and women who experience a combination of these symptoms almost daily for two to three weeks should see their doctor.

Doctors say it is not clear what causes ovarian cancer but there are factors that increase the odds of developing the disease including carrying a mutation of the BRCA gene, having a personal history of breast cancer or a family history of ovarian cancer, being over the age of 45 or if a woman is obese. If a woman is high-risk, doctors recommend screening begin at age 20 to 25, or five to 10 years earlier than the youngest age of diagnosis in the family. In addition, there are genetic tests available that can identify women who are at a substantially increased risk.

While ovarian cancer is difficult to detect, specialized centers such as the Northwestern Ovarian Cancer Early Detection and Prevention Program, a collaborative effort between the hospital and the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, have strategies for monitoring women at risk. Patients are monitored with physical examinations, ultrasound and blood tests every six months. "The goals of the program are to help women understand their personal risks and what they can do to decrease their risk, to help develop methods of early detection and prevention and to identify women who would benefit from preventive surgery," said Singh, also an associate professor at the department of obstetrics and gynecology at Northwestern University Feinberg School of Medicine and member of the Lurie Cancer Center.

Studies have shown there are ways to reduce the risk of developing the disease. Women who use birth control pills for at least five years are three-times less likely to develop ovarian cancer. In addition, permanent forms of birth control such as tubal ligation have been found to reduce the risk of ovarian cancer by 50 percent. In cases where women have an extensive family history of breast or ovarian cancer, or who carry altered versions of the BRCA genes, may receive a recommendation to remove the ovaries and fallopian tubes which lowers the risk of ovarian cancer by more than 95 percent.

"Eating a diet rich in fruits and vegetables, getting regular exercise, maintaining a normal body weight and managing stresses are all ways women can help decrease their risk of ovarian cancer," added Singh.

Treatment for ovarian cancer usually begins with surgery to determine if the cancer has spread. Doctors at Northwestern Memorial also use a form of chemotherapy called intraperitoneal chemotherapy, which is injected directly into the abdominal cavity and has been linked to a 15-month improvement in survival.

"The best scenario would be to prevent this cancer entirely but until that day comes women need to focus on good health behaviors, listen to their bodies and know their family history" stated Singh.