Ovarian Cancer and Breast Cancer

Women with a personal or family history of breast cancer may be at increased risk for ovarian cancer as well. (This is also true if you have a personal or family history of ovarian, colon, or uterine cancer.)

Ovarian cancer is much less common than breast cancer. Breast cancer affects 1 in 7 women over the course of their lifespan, and ovarian cancer affects 1 in 68 women. While ovarian cancer is much less common, it's more life-threatening and harder to diagnosis early. Ovarian cancer is usually diagnosed in its later stages, and treatment options are limited.

When ovarian cancer is detected early, before it has spread beyond the ovaries, more than 90% of women will survive longer than five years. Unfortunately, only 25% of women are diagnosed in the early stages. Primary care doctors don't usually check for signs of this disease in younger women.

Ovarian cancer is often difficult to diagnose because symptoms may be subtle and are easily confused with those of other diseases. Also, there is no single reliable, easy-to-administer screening tool. Unlike breast self-exams, there are no self-exams for ovarian cancer. However, all women can learn to listen to their bodies to pick up clues for anything unusual.

Most women who get ovarian cancer have no known risk factors. Women of any age are at risk, as are those who have never given birth to a child and those who have taken hormone replacement therapy for more than five years. Using talc in the genital area for several years also increases risk. Risk increases with age. Women with a personal or strong family history of breast cancer might be at increased risk of ovarian cancer. And women with a personal or family history of both breast and ovarian cancer are at increased risk of ovarian cancer. Women who have had breast cancer before the age of 50 are twice as likely to develop ovarian cancer (instead of 1 in 68, the risk is 2 in 68).

Both breast and ovarian cancer can be associated with abnormal changes in the BRCA1 and BRCA2 genes. About 1 in 10 cases of ovarian cancer are hereditary. Women who have an altered BRCA1 gene have a 40% to 60% risk of developing ovarian cancer by age 85. Studies suggest that ovarian cancer risk is between 16% and 27% in women with an altered BRCA2 gene.

Who Is at High Risk for Ovarian Cancer?
According to the National Cancer Institute, you are at high risk for ovarian cancer if you have:

• two or more close blood relatives with breast or ovarian cancer, or
• one or more close blood relatives with breast or ovarian cancer and you are of Ashkenazi Jewish descent, or
• a close blood relative (mother, father, sister, brother, daughter, son, aunt, uncle, grandmother, or grandfather) who has tested positive for the BRCA1 or BRCA2 gene mutation (abnormal change).

If you are at increased risk, it's important that you know about this disease and have good questions to ask your doctor. In addition, plan to have:

• an annual CA-125 blood test,
• an annual transvaginal ultrasound, and
• a twice-a-year pelvic and rectal exam.

Genetic counseling is also recommended to discuss the role of genetic testing as well as the possible role of preventive (prophylactic) removal of the ovaries and fallopian tubes.

Symptoms of ovarian cancer
Although most people believe that ovarian cancer has no symptoms, there ARE things to look for. Any of the symptoms below could be related to other conditions; however, when several appear together and don't go away, you should see your doctor. Symptoms include:

• persistent and progressive abdominal pain, bloating, or discomfort,
• pain with intercourse,
• nausea, indigestion, or gas,
• urinary frequency, constipation, or diarrhea,
• abnormal vaginal bleeding,
• unusual fatigue,
• unexplained weight loss or gain, and
• shortness of breath.

Personal Quote
“Symptoms are opportunities—that's what I discovered after years of being put off by doctors who didn't take my symptoms seriously. I was diagnosed with everything from yeast infections to gall bladder attacks to irritable bowel syndrome to diverticulitis. When I started having a sharp pain in my chest and shoulder when I took deep breaths, I was told it was anxiety. The thing was, even the severe pelvic pain and spotting I developed soon after never kept me from doing anything, and I appeared healthy and fit. I never connected the dots between the pelvic symptoms and my frequent urination, hip pain, lower back aches, and weight loss.
“My diagnosis of stage IIIC epithelial ovarian cancer came five years after my first symptoms appeared, only after an emergency room visit led to a CAT scan of my abdomen and ovaries. I should never have been such a 'good' patient and listened to those who told me nothing was wrong. I should have pushed harder to get the right diagnosis earlier. I want to be able to spread the word that every woman knows her body best. Trust yourself, and don't overlook or diminish any symptom.”—Ayala

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