There may be no symptoms in the early stages of the disease. When symptoms do appear, they are often vague, leading many women to ignore them and doctors to suspect other problems. The ovaries lie deep within the pelvis, and symptoms are usually not noticed until the cancer has spread to the abdomen. Typical symptoms may easily be mistaken for a gastrointestinal or bladder problem. Symptoms include:
- pelvic or abdominal pain or discomfort
- gas, nausea, and indigestion
- frequency or urgency in urination
- changes in bowel habits
- unexplained weight gain or loss
- swelling of the pelvis or abdomen
- painful intercourse
- abnormal vaginal bleeding
- back pain
Ovarian cancer of the sex cord-stromal type may actually secrete female or male sex hormones. Therefore, this type of ovarian cancer can cause symptoms of hormonal imbalance, such as a change in menstrual periods, bleeding after menopause, the appearance of facial hair, or a change in the voice.
Many risk factors have been identified for ovarian cancer. However, most cases develop in women who are not in a high-risk group.
The risk for ovarian cancer increases as a woman gets older. An estimated one woman in 70 will develop ovarian cancer during her lifetime. The majority of ovarian cancers of the epithelial type are diagnosed in postmenopausal women.
A personal or family history of ovarian cancer, as well as certain other cancers, is an important risk factor. A family history on either the mother’s or father’s side, or both, of the following cancers can carry an increased risk for ovarian cancer:
- colon or rectal
Risk is increased if one of these cancers is present in a close relative, such as a parent, sibling, or child, or in more than one distant relative, such as a grandparent or aunt.
Women with a strong family history may wish to be tested for mutations to BRCA 1 and BRCA 2 genes, which indicate a high lifetime risk of ovarian and breast cancer. Jews of Eastern European descent are at a much higher risk of having these mutations than other groups, at a rate of 2 in 100 rather than the 2 in 1,000 in the general population. Women with the mutation are also more likely to develop ovarian cancer before menopause. In addition, if a women has had breast cancer, then her risk of ovarian cancer may be increased.
The risk for ovarian cancer increases when women do not have children or do not use birth control pills. In fact, using birth control pill for 5 years or longer can cut the risk of ovarian cancer in half.
Using hormone replacement therapy with estrogen and progesterone to treat menopause has been shown to be safe in most studies. In one study, however, a slightly increased risk was found in women who took HRT for longer than 15 years. Therefore, this issue requires further study.
Dietary factors are suspected of being involved in many different types of cancer; however, specific associations are still unclear. Because women who live in industrialized countries (with the exception of Japan) have the highest rates of ovarian cancer, a diet high in animal fat is suspected to be a risk factor for the disease. However, the role of fat in the diet is complicated, not only because there are many different kinds of fats, but also because fats are high in calories. Therefore, it is not known whether fats themselves, or simply a high-calorie diet, is responsible for the increased cancer risk.
The NCI American Cancer Society Guidelines on Diet and Nutrition recommends adhering to the following guidelines to the reduce the risk for all cancers:
- Maintain a desirable body weight
- Eat a variety of foods daily, including fruits and vegetables
- Eat more high-fiber foods such as whole grain cereals, legumes, vegetables, and fruits
- Reduce the amount of dietary fat you consume
- Cut down on the amount of alcohol you drink, if you drink at all
- Reduce the amount of food you eat that is salt-cured, smoked, or nitrite-preserved
Using talcum powder on the genitals is suspected to be associated with an increased risk for ovarian cancer. It is possible, however, that this risk is attributable to asbestos, a known cancer-causing agent that used to be an ingredient in many body powders until it was banned 20 years ago. Long-term studies on women who use the newer, asbestos-free products remain to be done.
Factors have also been identified that decrease a woman’s risk. Using oral contraceptives for five or more years, for example, is known to reduce a woman’s risk for ovarian cancer. Other possible factors that can reduce the risk but are more controversial include having a tubal ligation (fallopian tubes tied to prevent pregnancy), or using aspirin or other NSAIDs over an extended period.
- Common Side Effects of AntidepressantsFind out about common and not-so-common side effects of antidepressants and how to manage them.
- How Drugs Can Lower CholesterolDiscover how cholesterol-lowering medications work in your body to bring your cholesterol numbers down to ideal levels.
- Do Over-the-Counter Proton-Pump Inhibitors Work?You might wonder why you need a prescription for GERD if many PPIs are available over the counter. Get the answers to this and other questions about OTC PPIs.