Ovarian CancerBy Deborah Wilson-Brosseau

What is Ovarian CancerOvarian cancer is any cancerous growth that develops in any part of the ovaries.

Demographics of Ovarian CancerEighth most common cancer among women in

the United StatesAccounts for 3.3% of all new cancer in

American women Fifth most common cause of cancer death

among women due to poor early detectionOne in 71 women will develop ovarian cancer One in 95 will die from it21,550 new cases each year14,600 deaths per year (6)

Demographic of Ovarian CancerMost likely to occur over the age of 50After menopauseCaucasian Women have a higher risk

especially Ashkenazi Jewish descent womenAfrican-American and Asian women have a

lower risk of ovarian cancerHalf of the ovarian cancer cases will develop

in women over the age of 63Highest incidence of ovarian cancer occurs

in industrialized countries (6)

Symptoms of Ovarian CancerIt is often called the silent killer because it

produces few symptoms in its early stagesMost women are unaware they have the

disease until it has progressed to advanced stages.

Most early symptoms are vague and either abdominal or gastrointestinal in nature’

If you have any of the following symptoms that persist for two weeks or more contact your doctor (4,6)

Symptoms of Ovarian CancerDigestive symptoms

Gas, indigestion, constipation

Bloating, distention or cramping

Abdominal or low back discomfort

Pelvic pressureVaginal bleeding in

post menopausal woman

Frequent urinationUnexplained changes

in bowel habitsNausea or vomitingPain or swelling in

abdomenLoss of appetiteFatigue Pain during

intercourse (4,6)

Risk Factors for Ovarian CancerAge is the greatest risk factorRisk increases after menopauseFamily or personal history of

cancers of the female reproductive tract or breast that is caused by an inherited the genetic mutation

Early menstruation-before age 12

Late menopauseUse of talcum powder in the

genital areaFemale workers exposed to

asbestosGenital deodorant sprays

Eating a diet high in saturated fats

Treatment with androgens (male hormones)

Never having been pregnant

Obesity increases risk

If you have been pregnant, breastfed and took oral contraceptives your risk of developing ovarian cancer is lowered. (1,6)

How is Ovarian Cancer DiagnosedA complete medical history to assess all the risk

factorsA thorough bi-manual pelvic examinationCA-125 assay

Blood test to determine the level of CA-125 One or more various imaging procedure

Ultrasound, CT, MRIA lower GI series or barium enemaDiagnostic laparoscopy for definitive diagnose

Uses a thin instrument inserted in the abdomen to visualize the organs inside the abdominal cavity(4,6)

Variations in Ovarian TumorsThree main types

Epithelial Cells 90% of all ovarian cancers

develop from epithelial cells lining the surface of the ovaries

Stromal Cells 5% of ovarian cancers begin in

the stromal cells that produce estrogen and progesterone

Germ Cells 2% of ovarian tumors develop in

the cells that would become eggs. Many are benign (noncancerous) (2,4)

Stages in DiagnosisStage 1- Tumor limited to ovary or ovariesStage 2- Ovarian tumor with pelvic

extension, involves the uterus or fallopian tubes and/or other pelvic organs

Stage 3- Tumor involving the upper abdomen or lymph nodes

Stage 4- Tumor involving distant organs including pleural space or hepatic/splenic parenchyma (6)

Current TreatmentThree treatments for ovarian cancer

Surgery It is done to remove as much of the tumor as possible and

it is usually followed by chemotherapy and/or radiationChemotherapy

It is used to target cells that have traveled to other organs and throughout the body via the lymphatic system or the blood stream

Radiation It uses high energy, highly focused x-rays to target very

specific areas of cancer. A machine with external energy beam and radioactive liquids are used for radiation treatments. (4,6)

Chemotherapy and Ovarian CancerChemotherapy is most often a systemic

treatmentIt is used to kill cancer cellsIt is administered several ways

Intravenous, IV Travels throughout the body

Orally Travels throughout the body

Intraperitoneal Is localized in the abdominal cavity (4,6)

ChemotherapyA combination of two or more drugs should

be given to help to kill cancer cellsPlatinum compounds is the single most active

drug in the treatment of Ovarian cancerThe combination of intravenous platinum

compound such as cisplatin and a taxane such as paclitaxel is the first line for many patients

3 to 6 cycles of chemotherapy should reduce the size of the tumor (4,6)

Cisplatin Platinol-AQA chemotherapy treatment used for

testicular, ovarian, bladder or lung cancerIntravenous- Parenteral OnlyIt is sometimes combined with other cancer

drugsSome Side Effects

Altered taste, stomatitis, severe prolong vomiting and nausea, diarrhea, renal toxicity, weakness, infections, hair loss and peripheral neuropathy

Anorexia and weight loss (3)

Cure or Remission Rate5 Year Survival Rates

Stage 1------92.8%Stage 2------78.6%Stage 3------50%Stage 4------17.5%(6)

The Impact of Cancer and Treatment on NutritionCancer can cause chronic nausea and early satietyFatiguePainMental StressVomitingMetabolic changesMuscle wastingAltered taste perception intestinal cramping DiarrheaConstipation (5)

Nutrition Therapy Treatment for Bowel IssuesDrink lots of fluidEat small mealsHave salty soup and brothsDon’t eat or drink foods that will increase gasNo caffeineNo foods that contain high fatTalk to your doctor about using digestive

enzyme replacements for prolong diarrhea (5)

Prevention TheoriesDecrease Ovulation

Pregnancy stops ovulation

Multiple pregnanciesBreastfeeding childrenTaking oral

contraceptivesGenetic Testing

To detect if you are carrying certain genes that increase your risk

Test positive for BRCA1 OR BRCA2

SurgeryHaving a tubal ligation

lowers your riskHysterectomy also

lowers your riskScreening

Women at high risk should talk to their doctor

Regular Screening Blood test and ultrasound

Annual pelvic exam (6)

Gynecological Cancer Support Groupa support group for women diagnosed with

gynecological cancer, their families and friends to share experiences.

When: Meetings are held the second Tuesday of every month from 5 to 6:15 p.m.

Where : Banner Desert Cancer CenterPhone Number: (480) 412-HOPE (4673).Address: 1400 S. Dobson Road Mesa, AZ 85202

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Lippincott, Williams and Wilkins. "Cancer-Principles and Practice of Oncology 9th Edition." 2011: 1368-1377.

Sharon Rady Rolfes, Kathryn Pinna and Ellie Whitney. "Understanding Normal and Clinical Nutrition." Sharon Rady Rolfes, Kathryn Pinna and Ellie Whitney. Belmont, Ca: Wadworth, 2009. 907-910.

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