SURVIVORS TEACHING
STUDENTS: SAVING WOMEN’S
LIVES®
OBJECTIVES
Through the stories we will share with you today,
we hope to increase your understanding of
ovarian cancer symptoms and risk factors so you
will be able to diagnose the disease when it is in
its earlier, most treatable stages.
Ovarian Cancer: The Facts
 It is the tenth most common cancer in women.
 It is the deadliest of all gynecologic cancers and the
fifth leading cause of cancer deaths among American
women.
 More than 22,000 American women will be diagnosed
with ovarian cancer in 2013.
 About 14,400 women will die from ovarian cancer in the
United States each year.
Source: Statistical information from the American Cancer Society: Cancer Facts and Figures 2012
EARLY DETECTION GREATLY
INCREASES SURVIVAL
• Ovarian cancer is difficult to diagnose because the
symptoms are often subtle and easily confused with
other conditions.
 When ovarian cancer is detected before it has spread
beyond the ovaries, nine out of 10 women will survive
for more than five years. However, only 15 percent of
ovarian cancer cases in the United States are
diagnosed at this early stage. Source: National Cancer Institute’s Surveillance,
Epidemiology, and End Results (SEER) Program
 90% of women DO report symptoms, even at early
stages. Source: Journal of American Medical Association, May 2004
EVERY WOMAN IS AT RISK
• A woman’s lifetime risk of developing
invasive ovarian cancer is 1 in 72.
• A woman’s lifetime risk of dying from
invasive ovarian cancer is 1 in 95.
Source: Statistical information from the American Cancer Society: Cancer Facts and Figures 2011
HEREDITY
• HEREDITY – Although heredity is the strongest risk factor, it
accounts for only 10% of cases.
• Family history of any of the following cancers may indicate
an increased risk:
Breast cancer
Ovarian cancer
Colon cancer
Uterine cancer
 Genetic counseling should be suggested if there is a family
history. Both maternal and paternal family history should be
considered when assessing for increased risk.
GENETIC MUTATIONS RELATED TO
INCREASED RISK
• Mutations in the breast cancer genes, BRCA1
or BRCA2.
• HNPCC (hereditary nonpolyposis colorectal
cancer) or Lynch syndrome is associated with
mutations in MLH1, MSH2, and MSH6 genes.
HNPCC is primarily associated with increased
risk of colon cancer but has also been found to
be associated with increased risk of
uterine/endometrial cancer and ovarian cancer.
•
Source: Women’s Cancer Network, Gynecologic Cancer Foundation, 2012
RISK FACTORS THAT MAY INCREASE A
WOMAN’S RISK OF DEVELOPING OVARIAN
CANCER:
• Increased age
• Family and/or personal history of breast/ovarian cancer
• More menstrual cycles/early onset of menarche
• Never pregnant
• Hormone replacement
AGE AT DIAGNOSIS
2002-2006
• Under age 20 years
1.3%
• Between 20 and 34 years 3.6%
• Between 35 and 44 years 7.2%
• Between 45 and 54
18.5%
• Between 55 and 64
23.7%
• Between 65 and 74 years 20.4%
• Between 75 and 84 years 17.2%
• 85+ years
8.2%
Source: National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program
FACTORS THAT MAY DECREASE A WOMAN’S
RISK OF DEVELOPING OVARIAN CANCER:
• Oral contraceptive use
• Childbearing
• Breastfeeding
• Tubal ligation
• Removal of ovaries and fallopian tubes
REMOVAL OF OVARIES DOES NOT
ELIMINATE RISK
Women who have had their ovaries removed are
at risk of developing PRIMARY PERITONEAL
CANCER (PPC) which is closely related to
epithelial ovarian cancer.
The clinical presentation and treatment of PPC
are similar to that of ovarian cancer.
SYMPTOMS
The following four symptoms are more commonly
reported by women with ovarian cancer than by women in
the general public:
 BLOATING
 ABDOMINAL OR PELVIC PAIN
 DIFFICULTY EATING OR FEELING FULL QUICKLY
 URINARY SYMPTOMS – FREQUENCY/URGENCY
Source: Goff, Mandel, Drescher, Urban, Schurman, Patras, Mahony, Anderson, Development of an ovarian cancer
symptom index. Cancer 2007; 109:221-7.
OTHER SYMPTOMS
Additional symptoms may include fatigue, indigestion, back
pain, pain with intercourse, constipation/diarrhea and
menstrual irregularities.
CONSIDER OVARIAN CANCER
Consider ovarian cancer in the differential diagnosis
if the symptoms:
 Often occur frequently, approximately 12 times in a month
 Are persistent over the course of 2 or more weeks
 Are unusual for her and are unexplained by other causes
IF OVARIAN CANCER
IS SUSPECTED
The following should be performed:
• Pelvic and rectal examination
• Transvaginal or pelvic ultrasound
• CA-125 blood test if an irregularity is found on the
above exams or if the patient is symptomatic
Please see the Management Algorithm for Average-Risk Women with
Symptoms Suggestive of Ovarian Cancer on the handout provided for
further information.
Gynecologic Oncologist
Studies have shown that women diagnosed with
ovarian cancer generally have a better likelihood
of prolonged survival if treated by a gynecologic
oncologist.
QUESTIONS AND
ANSWERS