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Ovarian Cancer: Risk Factors, Early Signs and Treatment

September 12, 2013 3:59 PM with Carolyn Kirschner

Approximately 22,000 women will be newly diagnosed with ovarian cancer each year and each year approximately 15,000 women will die in the United States from ovarian cancer. If detected early, ovarian cancer is highly treatable but many women don’t seek treatment until the cancer is advanced. September is National Ovarian Cancer Awareness Month. This month, let's help spread awareness of the signs and risk factors for ovarian cancer. Carolyn Kirschner, MD, Gynecologic Oncology at NorthShore, will answer questions about the early signs and risk factors of ovarian cancer, treatment options and recovery. Submit your questions early.

Brenna (Moderator) - 3:41 PM:
Our online chat Ovarian Cancer: Risk Factors, Early Signs & Treatment will begin in approximately 20 minutes. You can submit questions at any point during the chat. However, this is a popular topic so we apologize in advance if we are unable to answer all questions. Find out more about NorthShore's Kellogg Cancer Center here.

  Helen (Glenview, IL) - 4:01 PM:
What is the most cost effective screening test for early detection of ovarian cancer?
Carolyn Kirschner (NorthShore)
That is a great question! Most experts would say that screening should only be performed on women who are at increased risk of ovarian cancer - for example those with a BRCA gene or a strong family history of ovarian cancer. These people may be screened with ultrasound and serum CA125. Unfortunately, there may be false postitives, especially in younger women, which may result in unnecessary tests or even surgery.

  Jackie (Wisconsin) - 4:06 PM:
What are the early signs of ovarian cancer that you might not notice? When do you know it is time to see a doctor?
Carolyn Kirschner (NorthShore)
Abdominal pain, bloating, being full after eating a little, new constipation or diarrhea, urinary frequency, fullness in the pelvis, low back pain, nausea/vomiting, fatigue are all possible symptoms of ovarian cancer - but are vague and may be symptoms of other problems. If symptoms occur several times per week for a month, medical care should be sought. Start with a good primary care physician who can do an exam and then possible imaging studies.

  denise (chicago illinois) - 4:14 PM:
Can a cyst on the ovary be a sign of cancer?
Carolyn Kirschner (NorthShore)
Ovarian cysts by definition are fluid filled and are very common and usually not a sign of cancer. They can be a part of the normal menstrual cycle, and can go away on their own. If a cyst grows or becomes "complex" (develops solid areas inside), it still may not be cancer but may need treatment.

  Brenda (Bradenton) - 4:20 PM:
Is it possible to mistake ovarian cancer for fibroids on both a transvaginal ultrasound and a pelvic MRI?
Carolyn Kirschner (NorthShore)
Yes, mistaking ovarian cancer for fibroids can happen. Fibroids are common and ovarian cancer is not. Fortunately, imaging has become better and better, so that these days this mistake does not happen commonly. Also, a woman who undergoes ultrasound and/or MRI imaging can request a disk with the images on them and get a second opinion if there are any concerns about a diagnosis.

  Jennifer (Oswego, Il) - 4:26 PM:
My Mom passed away from stage IV Ovarian cancer. I had the BRCA one and two test, and I'm not a carrier. I am still worried about my chances of getting ovarian cancer. Should I be requesting any further testing or follow up?
Carolyn Kirschner (NorthShore)
Your concerns are completely understandable. Most ovarian cancer is not hereditary, so your risk should be the same as the general population, which is less than 2%. If you are premenopausal, oral contraceptives may decrease your risk. Vitamin D may also be protective. Keep in contact periodically with the genetics staff, in case there is a breakthrough in this area. NorthShore has a high risk clinic through our division of gynecologic oncology, and this may be a good way of staying on the "cutting edge".

  Kim - 4:35 PM:
I am a 44 year old women who has never had children- is that a risk factor for developing ovarian cancer? I also am currently on birth control medication without breaks to assist in migraine prevention- is this a risk factor? Progesterone only.. any less of a risk? Thanks
Carolyn Kirschner (NorthShore)
Well, yes, never having children seems to be associated with an increased risk of ovarian cancer, but I don't recommend getting pregnant just to decrease the risk! The birth control is protective because it prevents ovulation. It is theorized that breaks in the surface of the ovary which occur with ovulation may result in injuries which lead to cancer. Either type of oral contraceptive would be effective.

  Marcia (Elgin, IL) - 4:39 PM:
Are you seeing an increase in the incidence of LMP ovarian cancer? If so, do you feel this is due to increased awareness?
Carolyn Kirschner (NorthShore)
LMP refers to ovarian tumors of "Low Malignant Potential". They contain cancer cells and can metastasize and rarely cause death, but do not invade into the ovarian tissue and usually have an excellent prognosis. Yes, I think the increase in LMP is due to more accurate diagnoses by our pathologists.

  rizalina (chicago, illinois) - 4:42 PM:
if a person is diagnosed with stage 4 ovarian cancer, what are the chances of survival? supposing the ovary was removed plus the uterus and the patient had chemotherapy; what will be the survival rate? what will you suggest for the patient to do as far as the kind of food to eat? does organic food help? what other preventative suggestions would you make?
Carolyn Kirschner (NorthShore)
The average survival with stage 4 disease is about 18 months, but patients with advanced disease can live for years if they undergo aggressive surgery and chemotherapy. Organic food in most studies has not been shown to be helpful, but diet is important. Cancer risk is increased with obesity. I recommend a plant based, whole grain diet. Limit saturated fats, white flour and refined sugar. I am a firm believer in exercise for weight control and sanity. Connect with a religious institution for support.

Brenna (Moderator) - 4:46 PM:
There are 15 minutes left in this chat. Please submit your final questions.

  Jane (Atlanta, GA) - 4:51 PM:
I lost my grandmother and her sister to ovarian cancer. At age 42 I had my ovaries removed. Today, I am experiencing bloating and nausea. Can you still get ovarian cancer without your ovaries?
Carolyn Kirschner (NorthShore)
Yes, even after removal of the ovaries, a cancer similar to ovarian cancer, called primary peritoneal neoplasia (PPN) can occur. But bloating and nausea can be due to many other things. I would suggest you call your primary care physician. Make sure he or she knows your history. An ultrasound may still be helpful.

  Heather (Surrey, BC Canada) - 4:55 PM:
what is the best scan? CT, MRI, Ultrasound or PET?
Carolyn Kirschner (NorthShore)
Each has some advantages. The ultrasound is the least invasive, least expensive and does not use radiation. The CT and MRI look at anatomy. The PET looks at function. For screening, the ultrasound is best.

Brenna (Moderator) - 4:59 PM:
Thank you for your participation in our online chat. We apologize that we were unable to address all our submitted questions today. For more information on NorthShore's Kellogg Cancer Center, click here.

Brenna (Moderator) - 5:00 PM:
A transcript of this chat will be available shortly.

Carolyn Kirschner (NorthShore) - 5:01 PM:
Thanks to everyone who participated.

This chat has ended.

Thank you very much for your participation.