Ovarian cancer: Know your body, know your risk

"There is no effective surveillance technique for the detection of early stage ovarian cancer, so the only effective way to prevent it and save lives is to identify women at risk," said David A. Fishman, MD, Director of the Mount Sinai Ovarian Cancer Risk Assessment Program and Professor and Fellowship Director in the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Medicine at the Icahn School of Medicine at Mount Sinai.

He recommends that women with a family history of ovarian and breast cancers get a formal genetic evaluation by a board-certified genetic counselor. For women who have tested positive for a BRCA mutation or are identified to be at a high risk for developing ovarian cancer, preventive surgery should be considered to remove the ovaries and fallopian tubes before ovarian cancer can develop.

Facts About Ovarian Cancer

• About 75 percent of women with ovarian cancer are diagnosed with late-stage disease. Only 15-40 percent of women survive for five years after initial aggressive cytoreductive surgery that is performed to remove cancerous tissue from the abdominal cavity in combination with chemotherapy.

• Almost 90 percent of women who are diagnosed while the disease is still confined to the ovary (stage I) survive for five years. They also require less surgical intervention, may not require chemotherapy and have a better quality of life.

• After removal of the ovaries and fallopian tubes, the risk of developing ovarian cancer is close to zero and the incidence of peritoneal cancer is about 1 percent.

Tips for Ovarian Cancer Prevention

• Family and personal history is important to identify women at increased risk: At least 10 percent of ovarian cancers are attributed to the inheritance of genetic mutations (such as BRCA, HNPCC) that increase the risk of certain cancers (breast, colon, endometrial, thyroid, and melanoma). If you have a history of these cancers in your family (either in men or women), get your risk assessed for ovarian cancer by a board certified genetic counselor.

• Take oral contraceptives: Long term use of oral contraceptives reduces the risk of developing ovarian cancer by approximately 50 percent.

• Pay attention to symptoms: Swollen or bloated abdomen; pressure or pain in abdomen, pelvis, back or legs; difficulty eating or feeling full quickly; nausea, indigestion, gas constipation or diarrhea; feel tired; urinary symptoms; and unusual vaginal bleeding.

New Treatment

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is an innovative technique being used by Dr. David Fishman and other oncologists at The Mount Sinai Hospital to treat ovarian cancer in women undergoing cytoreductive surgery. The HIPEC treatment combines cytoreductive surgery with a chemotherapy "bath" that delivers heated chemo directly into the abdomen cavity for two hours. The chemo "bath" then penetrates the diseased tissue, directly killing any remaining cancer cells in the area, destroying undetected cancer cells and preventing them from forming into new tumor while having minimal exposure to the rest of the body.