Two and a half years ago I lost my friend Patti to ovarian cancer. Patti was accomplished, wise, fun and had one of the warmest hearts I’ve known. She battled for three and a half years, but tragically her cancer was in an advanced stage when discovered. Unfortunately, Patti’s story is not uncommon: about 75 per cent of women are diagnosed in advanced stage. As September is Ovarian Cancer Awareness Month and if ever a disease needed more awareness it’s this one I think it’s an apt time to discuss 8 things you should know about ovarian cancer:
1. Symptoms of ovarian cancer.
Ovarian cancer has been dubbed the “silent killer” because symptoms are vague and can mimic other conditions experienced by many women. The most common ones include: bloating, pelvic or abdominal pain, feeling full quickly when eating, and urinary urgency or frequency. My friend Patti struggled with (and saw her doctor about) some of these symptoms for 10 to 15 years before she was diagnosed.
Other possible symptoms include change in bowel habits, nausea, fatigue, irregular menstruation, back pain, painful intercourse, and weight loss or gain.
2. What increases risk of ovarian cancer.
Being over 50 and having a family history of breast, ovarian or colon cancer.
3. What decreases risk of ovarian cancer.
Having used the birth control pill (even women who took it for only one to four years apparently experience a benefit), having a term pregnancy, breast-feeding, and in the extreme end of measures, removal of the ovaries and fallopian tubes, and tubal ligation.
- The good news/bad news about diagnosis.
While 75 per cent of women are diagnosed with ovarian cancer in advanced stage, resulting in five-year survival rates of less than 30 per cent, when found early the survival rate is 90 per cent.
The key is if you have a sudden appearance of any of the symptoms described above and they’ve lasted longer than three weeks, see your doctor and mention your concern about ovarian cancer.
5. There is no effective screening test.
Pap tests detect only problems with the cervix. (Although in Patti’s case, and this is apparently very unusual, her ovarian cancer was detected through a cell that dropped down into her cervix).
But that doesn’t mean you can’t be proactive: while no woman’s idea of fun, have regular pelvic exams and make sure you advise your doctor if you’re have troubling symptoms.
- If symptoms persist and your physician can find no cause.
Ask about a pelvic exam, a transvaginal ultrasound and a CA-125 blood test, which measures levels of a protein that is a so-called tumor marker or biomarker.
As I’ve experienced some of the symptoms associated with the disease, I’ve had all three tests. Luckily, they came out negative for me.
The transvaginal ultrasound is unpleasant and the CA-125 blood test isn’t covered by provincial health insurance in Ontario, where I live (I had to pay $75). And it’s only covered by Medicare in the U.S. when patients have had previous gynecological cancers, or to check the efficacy of cancer treatment. Saying that, I think they’re more than worth their discomfort and cost.
It must be noted, however, that CA-125 is thought not to be an effective screening tool for the early detection of ovarian cancer. (Not all women with ovarian cancer have high CA-125 levels, and in some healthy women levels can be elevated for reasons unrelated to cancer.) Rather, it’s used as a diagnostic when combined with the tests listed above for women with persistent symptoms.
- It’s now believed that most ovarian cancers start in the fallopian tubes, not the ovaries.
As a result, if you’re having gynecological surgery, ask your doctor if the removal of the fallopian tubes is warranted.
- Lifestyle measures that may be preventive.
While no study has been completely conclusive, a landmark one by the World Cancer Research Fund / American Institute of Cancer Research in 2007 noted that non-starchy vegetables may offer protection against ovarian cancer.
Other studies also point to the helpful preventive role of certain flavonoids found in tea, broccoli, carrots, beans, peppers and kale. Regular exercise, not smoking and controlling weight are also thought to play a protective role.
Patti appeared in a video for the website It’s Time to Shout about six months before she died. The website’s message is the need to shout for more awareness of ovarian cancer. Please add your voice so we can help prevent the disease that killed my friend (and continues to take about 1,750 Canadian women and 14,000 women in the U.S. each year). Let’s do what we can so it doesn’t take any more of our moms, sisters, friends or daughters.
And if you have symptoms that your doctor isn’t taking seriously, push for testing or find a new physician who is more responsive. In my case, I had to request the CA-125 test, as my family physician hadn’t initially mentioned it.