What everyone must know about ovarian cancer

Each year, more than 12,000 women in the United States die of ovarian cancer. If treated early, before the cancer has spread, the five-year survival rate is over 90 percent. But survival rates drop steeply as the disease progresses.

With that in mind, here are the five things to know about ovarian cancer.

Symptoms tend to whisper

Ovarian cancer is difficult to detect in its early stages because there frequently aren’t symptoms. When there are symptoms, such as bloating or diarrhea, they may be easily overlooked or attributed to other issues. That said, signs of the condition include:

• Abdominal swelling
• Belly or pelvic pain
• Difficulty eating
• Feeling full quickly
• Having to urinate often or very suddenly
• Bowel habit changes
• Vaginal bleeding, particularly after menopause

In the course of a month, if you have any of these symptoms more than 12 times, see a healthcare provider (HCP).

Certain factors increase your risk

The biggest risk factor for ovarian cancer is family history. Having a first-degree relative (a sister, your mother) with the disease greatly increases your chances of developing it. Genetic mutations play a role, too. For example, people who inherit a harmful BRCA1 (BReast CAncer gene 1) variant have up to a 44 percent chance of developing ovarian cancer by ages 70 to 80, according to the National Cancer Institute (NCI). Up to 17 percent of those with a BRCA2 mutation will develop the disease. People with hereditary nonpolyposis colorectal cancer (Lynch syndrome) are also at higher risk.

But that only accounts for a small minority of cases. Ovarian cancer doesn’t run in the family for most people with the illness. Other factors increasing your risk include:

• Your age—about 88 percent of cases occur in those ages 45 and older
• Having never carried a baby to full term
• Having a baby for the first time after age 35
• Being overweight or obese
• Having endometriosis, a condition in which tissue similar to uterine lining grows outside of the uterus, usually elsewhere in the pelvis

Some studies suggest there may be a link between ovarian cancer risk and using hormone replacement therapy (HRT) in certain cases. The risk may gradually decrease once HRT is discontinued.

Other factors can lower your risk

Using birth control pills (specifically for premenopausal women) is one step you can take to help reduce the risk of ovarian cancer. Whether or not you have a family history of breast or ovarian cancer, taking birth control pills for at least five years (not necessarily consecutively) may cut your chances up to 50 percent.

Pregnancy and breastfeeding have also been shown to lower risk. So does undergoing tubal ligation, when the fallopian tubes are tied to prevent pregnancy. Depending on your individual medical situation, having a hysterectomy (removal of the uterus), a salpingectomy (removal of the fallopian tubes), or a salpingo-oophorectomy (removal of the ovaries and fallopian tubes) can reduce your risk, as well. Research suggests salpingectomy is significantly more effective than tubal ligation for lowering risk.

All of these factors cut the number of times a person ovulates, and research shows the risk of ovarian cancer decreases when you ovulate less.

Screening may not be a good option yet

There is no reliable ovarian cancer screening. The United States Preventive Service Task Force (USPSTF) is an group of independent experts who make recommendations for health care and disease prevention. After analyzing multiple studies of people screened for the disease, the USPSTF concluded ovarian screening tests do more harm than good because they lead to too many false positives.

When the disease is suspected, an HCP may order a transvaginal ultrasound and a blood test for cancer marker CA-125. These tests are typically reserved for people considered to be at high risk. This is why it’s so important to pay attention to potential warning signs.

Ovarian cancer is not a death sentence

Once you have symptoms or are diagnosed with ovarian cancer, it’s not too late. There are several ways to treat the disease depending on the type of cancer you have and how far it has spread. Treatments include chemotherapy, immunotherapy, targeted therapy, hormone therapy, surgery, and radiation therapy, or a combination of multiple treatments. Talk to an HCP about the options available to you, as well as the benefits and side effects.