Ovarian cancer care

Ovarian cancer symptoms can be difficult to notice and hard to detect. That’s why it’s important to know what is typical for your body. You may have no symptoms or only mild symptoms until the disease reaches an advanced stage, when it can be harder to treat.

Symptoms may include:

• a heavy feeling in your pelvis
• pain in your lower abdomen
• vaginal bleeding or abnormal periods
• weight gain or loss, gas, nausea, vomiting and loss of appetite
• unexplained back pain that gets worse
• unusual fatigue
• pain during sex

If your tumor is classified as benign, it is noncancerous and may never spread beyond the ovaries. Malignant tumors are cancerous and can spread (metastasize) to other parts of the body and may be fatal.

Risk factors for ovarian cancer include:

• have a family history of ovarian cancer
• are overweight
• have certain genetic risk factors
• have never had children (risk decreases with more pregnancies)
• use some types of hormone replacement therapy
• are age 60 or older or have gone through menopause

Genetic counseling and testing are recommended if you have a family history of ovarian cancer or the BRCA gene mutation. Women at high risk for ovarian cancer should be screened regularly. You are considered high-risk if you have:

• hereditary breast or ovarian cancer syndrome
• hereditary nonpolyposis colorectal cancer (HNPCC), also called Lynch syndrome
• the BRCA1 or BRCA2 gene
• the BRIP1, RAD51C or RAD51D gene

Gynecologic surgery. Tubal ligation and hysterectomy may reduce your risk of developing certain ovarian cancers. However, they should be done only for valid medical reasons and not simply to reduce your risk of ovarian cancer.

Birth control pills. Women who take birth control pills for five years or more decrease their risk of ovarian cancer by as much as 50 percent. Because birth control pills have risks and side effects, discuss whether you should take them with your doctor.

Diagnosis of ovarian cancer can include:

• pelvic exam
• biopsy through surgery, laparoscopy or fine-needle aspiration (FNA)
• CA-125 blood test
• CT scan
• MRI
• PET scan
• transvaginal ultrasound

If you are diagnosed with ovarian cancer, your doctor will discuss the best treatment options. Your treatment plan depends on several factors, including:

• the size of the tumor after surgery (debulking)
• the stage of the cancer
• your age and overall health
• your desire to have children
• whether surgery is performed by a gynecologic or surgical oncologist

You may receive one or more of the following treatments:

• surgery
• chemotherapy
• intraperitoneal chemotherapy (IP therapy)
• radiation therapy