Ovarian Cancer: What are the symptoms and risk factors?

By: Lyuba Levine, MD
DHR Health Women’s Institute

Ovarian cancer is when abnormal cells in the ovary begin to multiply out of control and form a tumor. If left untreated, the tumor can spread to other parts of the body. This is called metastatic ovarian cancer.

The ovaries are two female reproductive glands that produce ova, or eggs. They also produce the female hormones estrogen and progesterone.

The ovaries are made up of three types of cells. Each cell can develop into a different type of tumor:

•Epithelial tumors form in the layer of tissue on the outside of the ovaries. About ninety percent of ovarian cancers are epithelial tumors
•Stromal tumors grow in the hormone-producing cells. Seven percent of ovarian cancers are stromal tumors.
•Germ cell tumors develop in the egg-producing cells. Germ cell tumors are rare.

Ovarian cancer often has warning signs, but the earliest symptoms are vague and easy to dismiss. About twenty percent of ovarian cancers are detected at an early stage.

Risk factors
Factors that can increase your risk of ovarian cancer include:

Older age. Ovarian cancer can occur at any age but is most common in women ages 50 to 60 years.
Inherited gene mutations. A small percentage of ovarian cancers are caused by gene mutations you inherit from your parents. The genes known to increase the risk of ovarian cancer are called breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2). These genes also increase the risk of breast cancer.

Other gene mutations, including those associated with Lynch syndrome, are known to increase the risk of ovarian cancer.

Family history of ovarian cancer. People with two or more close relatives with ovarian cancer have an increased risk of the disease.
Estrogen hormone replacement therapy especially with long-term use and in large doses.
Age when menstruation started and ended. Beginning menstruation at an early age or starting menopause at a later age, or both, may increase the risk of ovarian cancer.

What are the early symptoms of ovarian cancer?
It’s easy to overlook the early symptoms of ovarian cancer because they’re similar to other common illnesses or they tend to come and go. The early symptoms include:

•abdominal bloating, pressure, and pain.
•abnormal fullness after eating
•difficulty eating
•increase in an abdominal girth
•weight loss
•an increase in frequency of urination
•an increased urge to urinate

Ovarian cancer can also cause other symptoms, such as:

•fatigue
•indigestion
•Heartburn, especially persistent heartburn
•constipation
•back pain
•menstrual irregularities
•painful intercourse
•dermatomyosis (a rare inflammatory disease that can cause skin rash, muscle weakness, and inflamed muscles)

These symptoms may occur for any number of reasons and aren’t necessarily always due to ovarian cancer. Many women have some of these problems at one time or another. These types of symptoms are often temporary and respond to simple treatments in most cases.

The symptoms will persist if they’re due to ovarian cancer. Symptoms usually become more severe as the tumor grows. By this time, the cancer has usually spread outside of the ovaries, making it much harder to treat effectively.

Again, cancers are best treated when detected early. Please consult with your doctor if you experience new and unusual symptoms.

Contact your doctor if you have one or more of these symptoms for a significant period.