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February 03, 2023

Ovarian cancer often is not caught until its late stages; here are the symptoms that should prompt a doctor's visit

The disease kills thousands of women each year, but unlike many other cancers, there is no preventative screening

Women's Health Cancer
Ovarian Cancer

Ovarian cancer will impact an estimated 22,000 women this year, though most are not diagnosed until the disease is in its late stages.

Ovarian cancer is called a "silent killer" because women often are not diagnosed until the disease has progressed into an advanced stage.

When ovarian cancer is caught at an early stage, 93% of women will live longer than five years after diagnosis. However, only about 20% of ovarian cancers are detected early, because the symptoms are vague and hard to pinpoint. The common symptoms — bloating, abdominal pain, trouble eating and urinary difficulties — can be attributed to several conditions.

"The symptoms are non-specific and are often things that women experience monthly," said Robin Cohen, co-founder and CEO of the Sandy Rollman Ovarian Cancer Foundation in Wynnewood, Montgomery County. "I always say that if you know yourself on a good day, you'll almost develop a sixth sense for when something just doesn't seem right. If symptoms like these persist for several weeks or are unusual for someone, they should seek medical attention right away." 

Abnormal vaginal bleeding or discharge, fatigue, back pain, pain during sex and abdominal swelling with weight loss also are possible symptoms of ovarian cancer. 

An estimated 22,000 women will be diagnosed with ovarian cancer this year, and nearly 13,000 women will die from the disease. These estimates are up from the 19,880 diagnosed cases and 12,810 deaths in 2022, according to the American Cancer Society

Women often are not diagnosed with ovarian cancer until it reaches an advanced stage partly because there is no standard screening test for people without symptoms. That's unlike many other cancers. Medical technology is still years away from developing a reliable screening test for ovarian cancer. 

"You can get a mammogram to test for breast cancer or a Pap smear to test for cervical cancer, but there is not a screening test for ovarian cancer, which means many people aren't diagnosed until the disease has advanced," Cohen said. "It's a complicated disease, and there are more than 20 types of ovarian cancer. Experts now believe that most ovarian cancers start in the fallopian tubes, which can be difficult to visualize on radiographic scans or on exams." 

For World Cancer Day, which occurs Saturday, Cohen wants women to be aware of their bodies and cautious of the possible symptoms of ovarian cancer. She encourage them not to put off treatment if they believe something could be wrong. Those experiencing persistent symptoms should ask their doctors about the need for a diagnostic test. 

Current screenings include rectovaginal pelvic exams, transvaginal ultrasounds or blood tests for those with unexplained signs or symptoms of ovarian cancer. In 2021, Penn Medicine developed an odor test that can distinguish between benign and cancerous pancreatic and ovarian cells with up to 95% accuracy, but it remains in development. 

There are various ovarian cancer treatment options available, including personalized therapies, Cohen said, noting ovarian cancer is not a "one-size-fits-all" disease. 

All people born with ovaries are at risk of developing ovarian cancer, which can originate in the ovaries or the fallopian tubes. The risk increases with age, Cohen said. In particular, women who inherit the BRCA gene mutations — most commonly associated with breast cancer — are more likely to develop ovarian cancer. 

A woman's specific risk of ovarian cancer depends on a variety of factors, including age, whether she has the BRCA-1 or BRCA-2 genetic mutations and her family medical history, according to the U.S. Centers for Disease Control and Prevention. Never having given birth or giving birth after age 35 also increases risk, as does being of Ashkenazi Jewish descent. 

Not everyone with a BRCA gene mutation will develop ovarian or breast cancer, but there are preventative measures that can be taken by those who have inherited the gene, so getting tested for possible genetic mutations is important. 

Cohen, who previously served as an oncology nurse at Lankenau Hospital, frequently worked with ovarian cancer patients who had little-to-no resources or treatment options available to them. When Sandy Rollman, a 32-year-old ovarian cancer patient in Cohen's care, died in May 2000, just six months after her diagnosis, Cohen teamed up with Rollman's sister Adrianna Way to start the foundation. 

"I think World Cancer Day unites us all under one voice to face one of the greatest challenges in our world," Cohen said. "Everyone knows someone that has been impacted by cancer. The theme of World Cancer Day is closing the cancer care gap, so that no matter where a woman with ovarian cancer lives or what her economic status is, she should be able to get the best care possible." 

The Sandy Rollman Ovarian Cancer Foundation aims to give women opportunities and resources that weren't available to Rollman, supporting patients and caregivers while also raising money to fund research. The organization hosts events dedicated to raising awareness about ovarian cancer. 

This includes the Sandy Sprint, a 5K run that will be held at the Philadelphia Museum of Art on April 22. Those who are interested in participating can sign up online. People looking to support the Sandy Rollman Foundation can find volunteer opportunities or donate on its website. 

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