Ovarian Cancer Symptoms, Early Warning Signs, and Risk Factors
Medical Author: Melissa Conrad Stöppler, MD
Medical Editors:
Dennis Lee, MD and William C. Shiel Jr., MD, FACP, FACR
Cancer of the ovary (ovarian cancer) is the seventh most common cancer in women in the U.S. with over 25,000 women newly diagnosed each year. Ovarian cancer is the fifth leading cause of cancer deaths in women. It frequently does not result in symptoms until the cancer has spread extensively beyond the ovary.
Ovarian cancer actually represents a group of different
tumors that arise from diverse types of tissue contained within the ovary. The most common type of
ovarian cancer arises from the epithelial
cells (the outside layer of cells) of the surface of the ovary. Other, rare
types of ovarian cancer develop from the egg-forming germ
cells or from the supporting tissue (stroma) of the organ. Benign
(non-cancerous) tumors and cysts are also found in the ovary and are much more
common than ovarian cancers.
The majority of ovarian cancers are diagnosed late, after the cancers have spread. Only about 20% of women are diagnosed early, when the disease may be curable. There is no definitive screening test for early ovarian cancer. Regular pelvic examinations, sometimes supplemented by ultrasound examinations or blood tests for cancer-related markers, have been routinely used for ovarian cancer screening, but none of these tests
are specifically able to detect ovarian cancer. Traditionally, it was believed that ovarian cancer does not produce any characteristic symptoms until the tumor is widespread, and that early symptoms of ovarian cancer were not recognizable.
However, in June 2007, the American Cancer Society, along with other medical societies including the Gynecologic Cancer Foundation and the Society of Gynecologic Oncologists, released a consensus statement about possible early symptoms of ovarian cancer. This statement was based on research suggesting that some of the early symptoms of ovarian cancer can, in fact, be recognized. In particular, possible early ovarian cancer symptoms include the following:
The researchers note that women who have these problems should see a gynecologist for cancer screening if these problems are new, if the symptoms are severe, and if they have been present continuously for over two to three weeks.
It is important for women to remember that these symptoms do not necessarily mean that a woman has ovarian cancer, as many other harmless conditions can produce similar symptoms. Moreover, other causes for these symptoms are far more common than ovarian cancer and, for example, include irritable bowel syndrome and urinary tract infection. Women may also experience some of these symptoms in the premenstrual phase of their monthly cycle.
Doctors do not know exactly what causes ovarian cancer.
However, some factors and conditions may increase a woman's risk of developing
this condition. Risk factors for the development of ovarian cancer include:
- A family history of ovarian cancer. Women who have one or more close relatives with the disease have an
increased risk of developing ovarian cancer. Certain genes, such as the BRCA 1 and 2 genes, are inherited
and result in a high risk for development of ovarian cancer.
- A family history of breast or colon cancer also confers an
increased risk for the development of ovarian cancer.
- Age. Women over 50 are more likely than younger women to get
ovarian cancer, and the risk is even greater after age 60. About 50% of
ovarian cancers occur in women over 63 years of age.
- Childbearing and menstruation. Women who have never given birth
have a greater risk of developing ovarian cancer than women who have had
children. In fact, the number of childbirths correlates directly with a
decrease in risk for developing ovarian cancer. The likely explanation for
this risk factor seems to be related to
the number of menstrual periods a women has had in her lifetime. Those who
began menstruating early (before age 12), had no children, had their first
child after age 30, and/or experienced menopause after age 50 have a greater chance of developing
ovarian cancer than the general population.
- Medications. Some studies
show that women who have taken fertility drugs, or hormone therapy after menopause,
may have a slightly increased risk of developing ovarian cancer. The use of oral contraceptive pills, on the other hand, seems to decrease a women's chance of getting the
disease.
- The American Cancer society reports that obese women have a higher
rate of death from ovarian cancer than women of normal weight.
- Talcum powder use. Some studies report a slightly elevated risk
of ovarian cancer in women who regularly apply talcum powder to the genital area.
A similar risk has not been reported for corn starch powders.
The lifetime risk
for development of ovarian cancer is less than 2% among the general population.
If you have a family history of ovarian cancer or other types of cancer, your
doctor can help you decide whether genetic testing or
other cancer screening procedures might be appropriate for you.
For more in-depth information, please read the following articles:
Last Editorial Review: 6/14/2007
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