Pop quiz: What gives you bloating, indigestion and heartburn?
A. Four-alarm chili
C. Ovarian cancer
D. All of the above
Unfortunately, "D" is the correct answer. Ovarian cancer involves the ovaries, fallopian tubes and the lining of the abdominal cavity known as the peritoneum. Because we all get intestinal upset sometimes, it is common for patients and health care providers to think that something else is the problem.
Ovarian cancer also can be difficult to diagnose when it is early. There is no nationally recommended screening test for ovarian cancer because none have been proven to lead to early diagnosis.
The four-alarm chili symptoms — bloating, indigestion and heartburn — tend to be gradual in onset, which contributes to late diagnosis in many patients. In about 70 percent of cases, ovarian cancer is diagnosed at an advanced stage, when it has spread to other body areas.
The National Cancer Institute estimates that ovarian cancer will occur in 21,290 women in the United States this year, and about 14,000 women will die of the disease. As noted above, diagnosis can be difficult and relies on physical findings, blood tests and radiologic studies such as a CT scan.
Patients with a strong history of breast or ovarian cancer may have a genetic predisposition to getting ovarian cancer related to the BRCA gene. A family history of early-onset colon cancer or uterine cancer also carries an increased risk of ovarian cancer. In that situation, removal of the fallopian tubes and ovaries can dramatically decrease the risk.
More recently, there is information that ovarian cancers may originate in the fallopian tubes. Special tests have detected noninvasive cancers in the removed fallopian tubes of patients with BRCA. Because of this, elective removal of fallopian tubes in younger women has been encouraged in many countries, including the United States.
So what can you do to decrease your risk of ovarian cancer?
A. Be aware of the symptoms
B. Know your family history of cancers
C. Consider appropriate risk-reduction surgery, such as removal of fallopian tubes, if you're having a hysterectomy
D. All of the above
HINT: Pick D!