Transcript Document

Ovarian Cancer National Alliance
www.ovariancancer.org
Ovarian Cancer:
What All Women Need to Know
Ovarian Cancer National Alliance
www.ovariancancer.org
Presentation Objectives
1. Realize the impact of ovarian cancer
2. Recognize the early symptoms
3. Understand the risk factors
4. Know the proper steps to take if you or someone
you know has persistent symptoms and where to go
for more information
Ovarian Cancer National Alliance
www.ovariancancer.org
What is Ovarian Cancer?
• A growth of abnormal malignant cells that begins
in a woman’s ovaries
• These ovarian cancer cells can metastasize or
spread to other organs in the pelvis or abdomen
Ovarian Cancer National Alliance
www.ovariancancer.org
The Female Reproductive System
Reprinted with permission from the American Cancer Society
Ovarian Cancer National Alliance
www.ovariancancer.org
What Causes Ovarian Cancer?
• The causes of ovarian cancer remain unknown
• Current theories:
– Repeated “wear and tear” which occurs during monthly
release of an egg may create a situation in which
genetic errors can occur
– Increased hormone levels before and during ovulation
may stimulate the growth of abnormal cells
Ovarian Cancer National Alliance
www.ovariancancer.org
Impact of Ovarian Cancer
• Strikes 1 in 69 women
• Is the 2nd most common gynecologic cancer
• Each year, approximately 20,000 women are
diagnosed with the cancer
– In 2007, it is estimated that 22,430 women will be
diagnosed
• Majority of women diagnosed have no family
history of disease
• Affects all women, regardless of race or ethnicity
Sources: American Cancer Society. (2007). Cancer Facts and Figures 2007. Available at www.cancer.org.
National Cancer Institute. (2006). SEER Cancer Statistics Review, 1975-2003. Available at http://seer.cancer.gov.
Ovarian Cancer National Alliance
www.ovariancancer.org
Impact of Ovarian Cancer
• Is the deadliest gynecologic cancer
• Ranks as the 5th leading cause of cancer death
among American women
• Kills about 15,000 women each year
– In 2007, it is estimated that 15,280 women will die
Sources: American Cancer Society. (2007). Cancer Facts and Figures 2007. Available at www.cancer.org.
National Cancer Institute. (2006). SEER Cancer Statistics Review, 1975-2003. Available at http://seer.cancer.gov.
Ovarian Cancer National Alliance
www.ovariancancer.org
Impact of Ovarian Cancer
• Overall 5-year survival rate is 45%
– This rate is even lower for black women at 40%
• Close to 75% of women are diagnosed at an
advanced stage after the cancer has spread beyond
the ovary
• When detected early, survival rates greatly improve
– 5-year survival rate is 93% for early-stage disease
Source: National Cancer Institute. (2006). SEER Cancer Statistics Review, 1975-2003. Available at http://seer.cancer.gov.
Ovarian Cancer National Alliance
www.ovariancancer.org
Compared to Breast Cancer
Ovarian Cancer
Breast Cancer
Women’s Risk of
Getting the Cancer in
Lifetime
1 in 69
1 in 8
Percent of Women
Alive Five Years After
Diagnosis
45%
89%
Source: National Cancer Institute. (2006). SEER Cancer Statistics Review, 1975-2003. Available at http://seer.cancer.gov.
Ovarian Cancer National Alliance
www.ovariancancer.org
What Do the Numbers Tell Us?
EARLY DETECTION
CAN SAVE LIVES
Ovarian Cancer National Alliance
www.ovariancancer.org
The Challenge
• Currently, there is no screening test for the early
detection of ovarian cancer
– The Pap test or smear does NOT screen for ovarian
cancer
• Most women are not aware of the symptoms or
risk factors
Ovarian Cancer National Alliance
www.ovariancancer.org
What All Women Need to Know
• Even in its early stages…
OVARIAN CANCER CAUSES
SYMPTOMS
• Research indicates that 95% of women with
ovarian cancer had symptoms and even 90% of
women with early-stage disease experience
symptoms
Sources: Goff BA, et al. (2000). Ovarian carcinoma diagnosis. Cancer, 89: 2068-2075.
Olson SH, et al. (2001). Symptoms of ovarian cancer. Obstet Gynecol, 98: 212-217.
Ovarian Cancer National Alliance
www.ovariancancer.org
Symptoms of Ovarian Cancer
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Bloating
Pelvic and abdominal pain
Difficulty eating or feeling full quickly
Urinary symptoms (urgency or frequency).
If a woman has a combination or many of these symptoms for
more than a few weeks and they are persistent and unusual
for her, she should see a health care professional, preferably a
gynecologist.
Ovarian Cancer National Alliance
www.ovariancancer.org
Other Symptoms Commonly Reported
• Fatigue
• Indigestion
• Back pain
• Pain with intercourse
• Constipation
• Menstrual irregularities
NOTE: These symptoms are not as useful in
identifying ovarian cancer because they are found
in equal frequency in women who do not have the
disease.
Ovarian Cancer National Alliance
www.ovariancancer.org
Symptoms of Ovarian Cancer
• Symptoms will vary from woman to woman
– Associated with the location of the tumor and its impact
on the surrounding organs
– Mimic other conditions such as irritable bowel syndrome
• Many of us experience these symptoms from time
to time – do not be alarmed!
• If they persist or worsen, see a medical professional
Ovarian Cancer National Alliance
www.ovariancancer.org
How is Ovarian Cancer Diagnosed?
1. Pelvic examination, including a complete
rectovaginal examination
2. Transvaginal or pelvic ultrasound
3. CA-125 blood test
Ovarian Cancer National Alliance
www.ovariancancer.org
How is Ovarian Cancer Diagnosed?
• If tests suggest the presence of ovarian cancer, insist
on a referral to a gynecologic oncologist
• Gynecologic oncologists are specialists in treating
ovarian cancer
• To find one in your area, use the “Find a Doctor”
resource of the Women’s Cancer Network at
www.wcn.org
Ovarian Cancer National Alliance
www.ovariancancer.org
Risk Factors
• Most women with ovarian cancer do not have any
known risk factors
• However, there are several factors that may
increase risk of ovarian cancer
• Having one or more of these risk factors doesn’t
mean that ovarian cancer will develop, but the risk
may be higher compared to the average woman
Ovarian Cancer National Alliance
www.ovariancancer.org
Risk Factors
• Inherited genetic mutations
– Often exhibited by a family or personal history of
breast, colorectal or ovarian cancer
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Family history of ovarian cancer
Age
Reproductive history and infertility
Hormone replacement therapy
Obesity
Ovarian Cancer National Alliance
www.ovariancancer.org
What Puts Women at Risk?
• Family history of ovarian and
breast cancers
• Infertility
• Endometriosis
• Talc use
• Hormone replacement therapy
Ovarian Cancer National Alliance
www.ovariancancer.org
Inherited Genetic Mutations
• Most significant risk factor is an inherited mutation
in BRCA1 or BRCA2 genes
– Women of Ashkenazi Jewish descent are at high risk of
carrying BRCA1 and BRCA2 mutations; however risk for
the mutations is not exclusive to this group of women
• Lower risk with inherited disease called hereditary
nonpolyposis colorectal cancer (HNPCC)
Ovarian Cancer National Alliance
www.ovariancancer.org
Family History of Ovarian Cancer
• Ovarian cancer can occur in more than one family
member but NOT as a the result of a known
inherited gene mutation
• Women who have one first-degree relative
(mother, daughter or sister) with ovarian cancer,
but no known genetic mutation, are still at
increased risk of developing the disease
Ovarian Cancer National Alliance
www.ovariancancer.org
Increasing Age
• Most ovarian cancers develop after menopause
– About 69% of women diagnosed are age 55 or over
• A woman’s risk of ovarian cancer increases with
age through her late 70s
• Although most cases of ovarian cancer are
diagnosed in women over age 55, the disease can
occur in younger women
Source: National Cancer Institute. (2006). SEER Cancer Statistics Review, 1975-2003. Available at http://seer.cancer.gov.
Ovarian Cancer National Alliance
www.ovariancancer.org
Reproductive History and Infertility
• Women at increased risk if:
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Started menstruating at an early age (before age 12)
Had no children
Had first child after age 30
Experienced menopause after age 50
• In addition, research indicates that infertility
increases the risk of ovarian cancer, even without
use of fertility drugs
Ovarian Cancer National Alliance
www.ovariancancer.org
Hormone Replacement Therapy (HRT)
• Women who use menopausal hormone therapy are at
an increased risk for ovarian cancer
• Risks differ according to HRT taken and
hysterectomy status
– Women who have not had a hysterectomy and use
estrogen plus progestin for five or more years are at an
increased risk
– Women who had a hysterectomy and use estrogen alone
for 10 or more years are at an increased risk
• HRT has other health risks so consult a doctor to
evaluate the risks and decide what’s best
Source: Lacey JV, et al. (2006). Menopausal hormone therapy and ovarian cancer risk in the NIH-AARP Diet and Health Study
Cohort. Journal of the National Cancer Institute, (98)19: 1397-1405.
Ovarian Cancer National Alliance
www.ovariancancer.org
Obesity
• The research in this area has not been totally
conclusive
• Recent studies suggest:
– Overweight/obesity in early adulthood is associated
with an increased risk of ovarian cancer
– A higher rate of death from ovarian cancer in obese
women
• Maintain a healthy weight and active lifestyle to
ensure overall health
Sources: Olsen, CM, et al. (2007). Obesity and the risk of epithelial ovarian cancer: A systematic review and metaanalysis. Eur J Cancer, 43(4):690-709.
Pavelka, JC, et al. (2006). Effect of obesity on survival in epithelial ovarian cancer. Cancer, 107(7):1520-4.
Ovarian Cancer National Alliance
www.ovariancancer.org
Risk Reduction
• Oral contraceptives or birth control pills
• Tubal ligation or hysterectomy
• Pregnancy and breast feeding
• Removal of the ovaries or prophylactic
oophrectomy
Ovarian Cancer National Alliance
www.ovariancancer.org
Risk Reduction
• If you or someone you know is concerned about risk
of ovarian cancer, talk with a health care
professional
• A health care professional can help identify ways to
reduce risk as well as decide if consultation with a
genetic counselor would be appropriate
• Women who are at high risk should develop a plan
for regular monitoring with their provider
Ovarian Cancer National Alliance
www.ovariancancer.org
Remember…
1. There are early symptoms of ovarian cancer
2. The main symptoms are:
–
–
–
–
Bloating
Pelvic or abdominal pain
Difficulty eating or feeling full quickly
Urinary symptoms (urgency or frequency)
If a woman has a combination or many of these symptoms
for more than a few weeks and they are persistent and
unusual for her, she should see a health care
professional, preferably a gynecologist.
Ovarian Cancer National Alliance
www.ovariancancer.org