Ovarian Cancer: Signs, Symptoms, Risk Factors, and Treatment
This article was updated on: 09/15/2018
Ovarian cancer starts in the ovaries, the female reproductive glands that produce eggs and the hormones estrogen and progesterone. This type of cancer is frequently not detected until it has spread, or metastasized, to other organs in the abdomen and pelvis; for this reason, ovarian cancer is very difficult to treat successfully and is often fatal.
According to the American Cancer Society, about 1 woman in 75 will develop ovarian cancer, and 1 in 100 will die from the disease. About 22,000 women will be diagnosed with ovarian cancer each year and just over 14,000 will die from it. Because ovarian cancer is often not found until it’s at its advanced stages, it’s important to understand your risks, the signs and symptoms of ovarian cancer, and how you can improve your chances for early detection and treatment through appropriate screening.
Signs and symptoms of ovarian cancer
Unfortunately, most people with early ovarian cancer have few symptoms, or such mild, nonspecific symptoms that they are often mistaken for other conditions such as irritable bowel syndrome or even simple constipation.
The usual symptoms of ovarian cancer include:
- Bloating or swelling of the abdominal area
- Feeling full without eating much; weight loss
- Pelvic pain or discomfort
- Urinary urgency or frequency
- Changes in bowel habits, such as diarrhea or constipation
- Painful intercourse
- Menstrual-related changes
- Back pain
If you are at increased risk for ovarian cancer and have any unexplained symptoms, you should contact your doctor right away.
Risk factors for ovarian cancer
No one is certain what causes ovarian cancer, but most cancers in general are caused by genetic mutations. Because the signs of ovarian cancer can point to non-life threatening conditions, understanding your risk factors can help you know when it may be a good idea to consult with your doctor. Risk factors include:
- Age: Most women get ovarian cancer after menopause, and this type of cancer is rare in women under age 40. Half of all ovarian cancers occur in women over age 63, according to the American Cancer Society.
- Genetics: Having the inherited gene mutations known as BRCA 1 and BRCA 2, which also increase the risk for breast cancer.
- Hormone therapy: Long-term estrogen replacement therapy or high-dose estrogen therapy may increase risk of ovarian cancer.
- Menstruation history: Early menstruation (before age 12) or late menopause (after age 52) may increase your risk.
- Reproductive history: Women who never carry a baby to term or have their first term pregnancy after age 35 are at higher risk.
- Obesity: Women with a body mass index (BMI) of at least 30 have a higher risk of getting ovarian cancer.
- Fertility drugs: Use of fertility drugs may increase your risk.
- Family history: You have a higher risk if you have family members who have had ovarian cancer, breast cancer, or colorectal cancer.
How ovarian cancer is diagnosed
If you have signs of ovarian cancer, your doctor can perform a number of procedures to test for the disease. Usually, your evaluation begins with a pelvic exam and may include other follow-up tests such as:
- Transvaginal ultrasound (TVUS). A technician uses sound waves to produce images of your ovaries. This is often the first test your doctor will order to check for ovarian cancer.
- Computed tomography (CT) scan. This involves an X-ray that details your ovaries and other internal organs so your doctor can identify any ovarian tumors and possible signs of spread to other organs.
- Blood tests. The CA-125 blood test looks for tumor markers that indicate the presence of ovarian cancer cells.
- Tissue biopsy. If ovarian cancer is strongly suspected, your doctor may order a surgical biopsy of your ovaries to confirm the diagnosis. In this procedure, a tissue sample is removed and sent to a lab to check for cancer cells.
Treatment for ovarian cancer
In most cases, ovarian cancer is treated with a combination of surgery and chemotherapy. Depending on how advanced your cancer has spread, your doctor may recommend surgical removal of your uterus, ovaries, and/or fallopian tubes, as well as any regional lymph nodes. Your surgeon will also remove any cancer that has spread to your abdomen and pelvis. Chemotherapy is usually started after surgery, although in some cases, your doctor may recommend chemotherapy and no surgery.
Other, less aggressive courses of treatment may include hormone therapy or radiation. It’s important to carefully discuss your treatment options with your doctor before determining what may be best for your situation.
Medicare coverage for ovarian cancer
Original Medicare (Part A and Part B) covers certain services to prevent, diagnose, and treat ovarian cancer. Part A covers care you receive as an inpatient in the hospital, while Part B covers doctor visits, lab tests, and certain prescription drugs administered in the doctor’s office, such as chemotherapy or radiation. You may be responsible for cost sharing, including deductibles, copayments, and coinsurance.
Medicare Part B also covers screening pelvic exams and Pap smears, which are often a first line of defense for early detection of ovarian cancer. All women are eligible to receive these tests once every two years at no cost if performed by a doctor or health-care provider who accepts Medicare assignment. You may be eligible to get these screenings once every year in certain situations – for example, if you’re at higher risk for cervical or vaginal cancer, have had an abnormal Pap test result in the last 36 months, or you’re of a childbearing age.
If you have questions about Medicare coverage of screening tests and treatment for ovarian cancer, I’d be happy to help you. I can also discuss other Medicare plan options you may consider, such as Medicare Supplement plans, which may help with some of the out-of-pocket costs in Original Medicare.
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