Ovarian Cancer Overview
Wellstar Health System provides superior care for ovarian cancer, offering a comprehensive spectrum of top-notch physicians, treatment options and diagnostic tools. In addition Wellstar offers such innovative advances in the fight against ovarian cancer, including:
- Advanced gynecologic oncologists who specialize in ovarian cancer and who practice state-of-the-art care in a collegial atmosphere.
- Expert surgical teams offering experience in hysterectomies and other procedures as well as robotic surgeries.
- The entire spectrum of diagnostic and interventional treatments - including ultrasounds and magnetic resonance imaging (MRI).
- Intensity Modulated Radiation Therapy (IMRT), a treatment that allows for the radiation to be tailored to the size and placement of the tumor, while sparing healthy tissue.
- A Tumor Board, which is comprised of a multi-disciplinary team, for review of difficult cases.
- Clinical trials - more than 200 patients are enrolled annually in Wellstar programs
Ovarian cancer begins in the ovaries, the female reproductive organs that produce eggs, and, if left undetected or untreated, can spread within the pelvis and abdomen. At this late stage, ovarian cancer can be difficult to treat and can be fatal.
The cause of ovarian cancer is unknown. In general, the cancer begins when healthy cells acquire a genetic mutation that turns normal cells into abnormal ones. As healthy cells die and abnormal ones accumulate, a tumor may form in the ovaries.
Ovarian cancer is generally categorized according to where the cancer began and helps your Wellstar physician and oncologist determine your prognosis and best treatment method. These cancers include:
- Epithelial tumors. The most common form of ovarian cancer, these tumors begin in the thin layer of tissue that covers the outside of the ovaries.
- Germ cell tumors. These cancers tend to occur in younger women and begin in egg-producing cells.
- Stromal tumors. These cancers begin in the ovarian tissue that produces the hormones estrogen, progesterone and testosterone.
Signs and symptoms of ovarian cancer are not all specific to the disease and can often be associated with other more common conditions such as menstruation, digestive or bladder problems. However, when ovarian cancer is present, the symptoms tend to be persistent and worsen over time.
Some of these symptoms are:
- Abdominal pressure or bloating
- Pelvic discomfort or pain
- Difficulty eating or persistent gas, nausea or indigestion
- Severe changes in bowel or bladder habits
- Sense of heaviness in the pelvis
- Vaginal bleeding or abnormal menstrual cycles
- Lower back pain
- Weight gain or loss
Although some symptoms can be indications of something far less serious, it is important to see your Wellstar physician if any of these symptoms persist for more than two weeks.
Although the cause of ovarian cancer is unknown, the risk for developing the disease appears to be affected by several factors. These factors include:
- Family history of the disease or a personal history of breast cancer.
- Inherited gene mutations, specifically the genes known as breast cancer gene 1 (BRCA 1) and breast cancer gene 2 (BRCA2). Another genetic link to ovarian and other types of cancer is called hereditary nonpolyposis colorectal cancer (HNPCC).
- Never been pregnant. Women who have never been pregnant have an increased risk of ovarian cancer; in fact, the more children a woman has and the earlier in life she gives birth, the lower her risk.
- Increasing age. Older women are at highest risk with about two-thirds of deaths from ovarian cancer occurring in women age 55 and older.
- Hormone replacement therapy. Women who take estrogen replacement for five years or more seem to have a higher risk. But women on birth control medication seem to be at lower risk.
Ovarian Cancer Prevention
There are no sure ways to prevent ovarian cancer, but you may reduce your chances of cancer by discussing your risk factors with your Wellstar physician.
Reduce Your Risk of Ovarian Cancer
Research into the risk factors for ovarian cancer have revealed important clues about steps women can take to reduce their risk of the disease. These include:
- Removal of the ovaries. For women who have a strong family history of ovarian cancer or have the BRCA1 or BRCA2 gene mutations, removal of the ovaries before any cancer develops can greatly reduce the risk. Following the removal of the ovaries, women will likely experience menopausal symptoms such as hot flashes and possibly in greater severity than women who reached menopause naturally. Removal of the ovaries also means that a woman can no longer bear children, so many women chose to postpone such a surgery until after they have decided to have no more children.
- Oral contraceptives. Studies have shown that the use of oral contraceptives has lessened the risk of ovarian cancer.
- Diet and exercise. As with most diseases and infections, a good diet and regular exercise can reduce the risks of ovarian cancer. Your Wellstar physician suggests a diet rich in whole grains, fruits and vegetables, while limiting consumption of red or processed meat and alcohol. You should engage in at least 30 minutes of moderate to rigorous physical activity at least five days a week.
Tests and Screenings
Early detection of ovarian cancer offers the greatest opportunity for treatment. Various tests and screenings for this type of cancer include:
- Annual pelvic examination. This exam remains the most common method in detecting ovarian cancer, so women should schedule a complete gynecologic examination at least once a year. During a pelvic exam, your doctor carefully inspects the outer exposed areas of your vulva and then inserts two fingers of one hand into your vagina to feel your uterus and ovaries. The doctor will also insert a device called a speculum you’re your vagina in order to visually inspect your vagina and cervix for abnormalities.
- Ultrasound. An ultrasound employs high-frequency sound waves to produce images of the inside of your body, allowing your doctor to investigate the size, shape and configuration of your ovaries. Your doctor may also insert a probe inside your vagina. This transvaginal ultrasound provides pictures of structures near your ovaries, such as the uterus.
- CA-125 testing. This blood test, often conducted along with a transvaginal ultrasound, detects the presence of the protein CA-125, which occurs in abnormally high levels in women with ovarian cancer. This test typically is not used for initial diagnosis of the disease but to confirm its presence and track treatment.
Ovarian Cancer Diagnosis
If screening tests or check-ups reveal abnormal results, your Wellstar physician will perform further evaluations regarding ovarian cancer as well as determine the extent to which it has infected your body.
- Pelvic Examination
- CA-125 Testing and Transvaginal Ultrasound
Ovarian Cancer Stages
When ovarian cancer is diagnosed, your Wellstar physician will categorize it by the current stage. The stage describes how large the tumor is and whether the cancer has spread to other parts of the body:
- Stage I - Cancer is found in one or both of the ovaries. Cancer cells may also be found in abdominal fluid.
- Stage II - Cancer is found in the ovaries and has spread to the uterus, the fallopian tubes or other areas of the pelvis. Such cells may also be found in abdominal fluid.
- Stage III - Cancer is found in the ovaries and has spread to other parts of the body within the abdomen, such as the surface of the liver, intestine or lymph nodes.
- Stage IV - Cancer is found in the ovaries and has spread outside the abdomen or inside the liver.
- Recurrent or Refractory - Recurrent describes cancer that has returned after treatment. Refractory means the cancer is no longer responding to treatment.
Ovarian Cancer Treatment
Your team of specialists in medical oncology, gynecologic oncology, radiation oncology, radiology and pathology will work together to assess your best course of ovarian cancer treatment. That will involve the creation of a coordinated plan, staging the disease and designing a personalized treatment plan consistent with the highest standards of care. Your treatment will be tailored to your specific type of ovarian cancer, and it may involve a combination of surgery, radiation and chemotherapy.
Ovarian Cancer Surgery
Surgery is part of the treatment for all stages of ovarian cancer, and in earlier stages it might be the only treatment. Wellstar offers some of the best ovarian cancer physicians in the nation and some of the top surgeons.
Surgical treatment typically involves an extensive operation that includes the removal of some or all of the reproductive organs as well as any cancer that might have spread into parts of the abdomen. For women with Stage 1 ovarian cancer, surgery may involve the removal of only one ovarian and its fallopian tube, preserving the ability for them to have children later.
In more advanced stages of the disease, treatment might require the removal of the uterus (total hysterectomy) or the removal of both ovaries and fallopian tubes (bilateral salpingo-oophorectomy).
Chemotherapy is the use of drugs given by mouth or injection to destroy cancer cells. It can be used to assist in the cure of cancer patients or to prolong life or the quality of life. Adjuvant chemotherapy is administered after surgery in certain circumstances when the patient is at high risk for recurrence.
Medical oncologists at Wellstar believe in a personalized approach to ovarian cancer therapy—often guided by the genetics of the cancer and the condition of the patient.
Since ovarian cancer is chemotherapy sensitive, radiation therapy plays a lesser role in this disease, but can be used for palliative purposes to lesson symptoms in a specific region.
Ongoing Care for Ovarian Cancer
You’ll be referred after your recovery from ovarian cancer surgery to Wellstar’s gynecology or medical oncology team for treatment, surveillance and survivorship programs. These comprehensive programs focus on diet, exercise and nutrition to help you reduce the risk of recurrence.
Cancer care at Wellstar is more than advanced technology, clinical research, and highly specialized physicians and nurses. It includes an array of supportive care services to improve the patient experience before, during and after treatment. All of these services are available within the Wellstar system, including:
- Counseling services for individuals, couples and families.
- Nutrition services, which allow cancer patients to stay strong through treatment and eat healthier foods that lower cancer risk.
- Physical therapy centers, which allow many rehab options and lymphedema therapy.
- Smoking cessation programs, which offer support to patients who need to come off cigarettes and nicotine. Special services are offered to those who have made prior attempts.
- Retail stores that offer wigs, mastectomy bras and other cancer support products.
- Genetic counseling services, which offer patients and family members who are at high risk to be tested for genetic abnormalities after meeting with a certified genetic counselor.
- Health Place, which offers programs for cancer patients to regain strength and fight fatigue after chemotherapy or radiation therapy.
Palliative Care and Hospice
Wellstar’s certified palliative care physicians and certified registered nurses are dedicated to providing compassionate, quality care in various settings, including home hospice, inpatient hospice nursing homes, assisted living facilities and nursing homes. Wellstar offers caring and compassionate hospice care for patients and their families in one of Georgia’s oldest hospice programs serving Bartow, Cherokee, Cobb, Douglas and Paulding counties.