Friday, May 8, is World Ovarian Cancer Awareness Day. Considered the most lethal female cancer, I recently “sat down” for a virtual chat with Dr. Patti Power, gynecologic oncologist with Eastern Health, to learn more about this disease and how women can better protect themselves.
Dr. Power is one of three gynecologic oncologists in Newfoundland and Labrador who specialize in gynecological cancers. Her colleagues include Dr. Cathy Popadiuk and Dr. Joannie Neveu.
“One of the most satisfying things about our specialty,” says Dr. Power, “is our long-term relationship with patients. We meet women at diagnosis, perform their surgeries, administer their chemotherapy and then follow patients for years. It’s unique as these roles are usually performed separately by a surgeon and a medical oncologist with other cancers. We not only get to know our patients well but we also get to know their families very well.”
Dr. Power calls ovarian cancer an insidious disease. According to the Oxford dictionary, the definition for insidious is, proceeding in a gradual, subtle way, but with harmful effects.
The challenge with ovarian cancer is that its presentation can be subtle and often there are few warning signs or symptoms until disease is quite advanced. Symptoms such as bloating or abdominal distention are often downplayed by woman as normal signs of aging or menopause.
There are four stages of cancer. For ovarian cancer, stage one means that the cancer is confined to the ovary and has not spread to other parts of the body.
Dr. Power says 80 per cent of woman have advanced stage three disease at presentation.
The earlier a cancer is detected, the better the outcomes for patients in terms of prognosis, treatment, quality of life and survival rates.
In fact, the five-year survival rate for diagnosis at stage one is greater than 90 per cent, while the five-year survival rate for women who present at very advanced stages is only 50 per cent.
Add to that, there is still no reliable screening test to detect this cancer. Which debunks the most common myth – that a Pap test can be used to detect ovarian cancer.
“Many of my patients say, ‘I had my Pap test last year. How can I have ovarian cancer?’”
While a Pap test is a key tool in diagnosing the precursor changes related to cervical cancer, “it has absolutely no role in detecting ovarian cancer, and often provides women with a false sense of gynecological good health,” stresses Dr. Power.
So what are the biggest risk factors?
Did your mother have ovarian cancer? An aunt? A grandmother?
Without a good screening test, it is very important for every woman to know if she might be at increased risk of an ovarian or fallopian tube cancer. While most ovarian cancers happen spontaneously, there are some genetic mutations that can increase a woman’s risk. Once diagnosed, 15-20 per cent of ovarian cancer patients will end up having a genetic mutation identified.
“With few exceptions all of our ovarian cancer patients are offered genetic testing,” says Dr. Power. “That’s important because, in clinical trials, targeted drug therapies have demonstrated improved survival in women with certain gene mutations. We now have access to such drugs.”
She added: “Testing is also important for family members because if a woman has a gene mutation identified, there is a high possibility that other relatives could have inherited the same mutation. In these situations, prophylactic or preventative surgeries could greatly minimize the cancer risk in male and female relatives.”
Males are included because some of gene mutations can be associated with other cancers, not just ovarian cancer.
“One little nick or abnormality in a gene may not cause one disease. One little nick in a gene could cause a constellation of diseases in men and women,” she adds.
Other risk factors
While the reason is still not fully understood, women who have never been pregnant or who have never taken oral contraceptive pills have increased rates of ovarian cancer.
The other common risk factor is age. In fact, the average age of women diagnosed with ovarian cancer is 60. This explains why vague symptoms are often confused with symptoms of menopause.
The signs and symptoms
Common symptoms include:
- Persistent bloating or abdominal distention
- Poor appetite or difficulty eating
- Feeling full quickly
- Pelvic/abdominal pain or pressure
- Urinary symptoms or change in bowel habits
- Night sweats
- Unexplained weight loss
What’s new in treatment
Overall numbers of women surviving ovarian cancer has not changed dramatically over the years, but active research is underway searching for new screening tools to help with earlier detection. Expanded surgical techniques are also improving outcomes and quality of life for women with ovarian cancer.
Also exciting, according to Dr. Power, are new targeted therapies that are resulting in ovarian cancer patients living for longer periods of time with much improved quality of life between chemotherapy treatments.
What woman can do to protect themselves
Dr. Power says that early detection and identifying your own personal risk factors is critical. Talk to family members and your family doctor – be proactive.
“Women should never minimize a new, persistent change that lasts more than two-weeks,” says Dr. Power. “These women need to see their family doctor, especially if they’re post-menopausal. Listen to your body. Watch for changes. Ask questions. That’s the bottom line.”
Resources and Support
Ovarian Cancer Canada – https://ovariancanada.org/Home?lang=en-CA
Women of Hope Ovarian Cancer NL support group founded by Ovarian Cancer survivor, Susan Glynn – Facebook page link – https://www.facebook.com/Womenofhopenl/
Belles with Balls, non-profit group supporting ovarian cancer research and education in NL – https://belleswithballsnl.com/
World Ovarian Cancer Awareness Day – https://ovariancancerday.org/