A Silent Killer - Ovarian Cancer

One of my October facebook profile picture from JustForDoes.com

October is Breast Cancer Awareness month, and I hope you've seen Pink everywhere from the NFL fields to the profile pictures of your facebook friends.  But as we move to the close of October and thoughts turn to the scary things of Halloween, let them also turn to one more silent killer of women: Ovarian Cancer. Even though September is Ovarian Cancer Awareness month, while I've got the attention of all the ladies because even the NFL is in on wearing pink, I wanted to throw this one back out there.  In my post on breast cancer awareness I gave links to how to do a self breast exam, because knowing how your breasts feel when they are normal is the easiest way to know when something is not right.  We can also be more proactive when it comes to our ovaries, when things don't feel right or our cycle changes, it's fear that is your enemy.   Be informed, not afraid.  Ovarian cancer is not entirely silent but it is very, very quiet, we can hear it if we listen to our bodies, we just have to know what we're listening for.

Ovarian cancer is the "silent" killer of thousands of women each year, but it doesn't have to be.  16,000 women die every year from this cancer, but when caught early the cure rate is 90%, so how do you catch it early?  What do we need to know to not be part of the 80% who catch it way too late?

3 Risk-Reducing Steps to Take Now

1. Know your risk profile - At least 10% of women with ovarian cancer have a relative who has also had it. Do a thorough screening of your family on both sides to see if anyone has had breast, ovarian, or uterine cancer.   ...If you have never been pregnant, began menstruating before age 12 or have had hormone replacement therapy for menopause symptoms, you may be at an increased risk for ovarian cancer.
2. Consider the birth control pill. - Being on the pill for more than 5 years will reduce your risk of ovarian cancer by about 50%. Discuss it with your doctor, since it can also raise the risk of other health conditions.
3. Add 3 Cancer-Fighting Foods to Your Daily Diet -
   Oatmeal has been shown to reduce the risk of ovarian cancer, and is a healthy, fiber-filled way to start your day.
   Spinach and other vibrant vegetables are packed with cancer-fighting chemicals called flavonoids that help your body deal fight the free radicals that can wreak havoc on our bodies, including the fallopian tubes and ovaries, and predispose us to cancer.
   Broccoli and caulifower are both full of compounds that can break down cancer-causing chemicals in your body. Both been shown to reduce the risk of ovarian cancer and help patients with it live longer.

The Symptoms of the Silent Killer

The problem with the symptoms of ovarian cancer are that they are common, vague.  They mimic less serious diseases and so are misleading.  Know your body, know what is normal for you and if things are out of sorts, be persistent when you communicate with your doctor.  Know your patient bill of rights, and know that your doctor has limited time with you so you will need to be proactive in giving them the information they need to know.  Ask the right questions.  If you experience any of these symptoms for 2 weeks, talk to your doctor.  

According to the 2007 joint consensus issued by the American Cancer Society and other gynecologic organizations, early ovarian cancer symptoms may include:

• Bloating. You may be most familiar with bloating during PMS or when you eat too much, but women with ovarian cancer experience bloating every day and there is no relief. It may be mild bloating like they only feel a little full or may be severe to the point where it is difficult to button pants. Call the doctor if you are bloated every day for two weeks and do not get relief from OTC medications like gas relievers or diuretics. Often Misdiagnosed as: diet, gas, constipation, and other gastrointestinal ailments.
• Pelvic Pain. As with bloating, you may have experienced pelvic pain during PMS or ovulation. Pelvic pain that occurs even when you are not menstruating or ovulating can be an early ovarian cancer symptom. It can feel like dull menstrual cramps or more severe, requiring you to lay down and take medication to relieve them. Remember that chronic pelvic pain that is not related to menstruation is not normal, regardless of the cause. Pelvic pain can be a serious indicator of something being wrong and merits evaluation by your doctor. Often misdiagnosed as: constipation, gas, stress, PMS, IBS, and other less serious ailments. It is important to let your doctor know how painful your pelvic pain is and what helps to relieve it.
• Feeling Full Quickly While Eating. If you find yourself feeling full before you have finished an average sized meal and it occurs frequently, then you need to mention it to your doctor. Feeling full is not the same as lack of appetite - you physically feel full after eating a small amount of food. Often misdiagnosed as: gastrointestinal ailments.  -  You can see a common trend that ovarian cancer is often initially misdiagnosed as gastrointestinal conditions. Sometimes it take you being persistent in your healthcare or even changing doctors to get an accurate diagnosis.
• Frequent Urination and/or Strong Urgency To Urinate. If you feel like you are urinating more often and have not increased your fluid intake, then a trip to the doctor may be necessary. If you have the urge to urinate and do not actually go, it should also be evaluated by a doctor who will likely order a urinalysis to check for abnormalities. Often misdiagnosed as: urinary tract infection. A UTI is the most common culprit of frequent urination or having the urge, despite not having to go. If your doctor prescribes antibiotics for a UTI, make sure you take them all. You may not experience relief until right after taking the last of the antibiotics. If you still experience symptoms after finishing the prescribed medication, see your doctor.
• Increased abdomen size
• Difficulty eating

While there are early symptoms, not all women will have them.   Others that have them will be misdiagnosed.  Not all women will have these symptoms when they are diagnosed, but the key is to be diagnosed early!  As you can see, the symptoms are vague and may be brushed off or not noticed.  Remember that the important thing to note with these symptoms of ovarian cancer is that they are persistent and more severe than the other diagnosis they may mimic.  An example is constipation, most women have had this.  But, if you have it daily for weeks, then it's time to see your doctor and look for a cause.  Ovarian cancer is not common, so logically your doctor will look for more likely causes first, jumping past ovarian cancer as the suspect.  Misdiagnosis may be common with ovarian cancer, but these symptoms aren't likely caused by ovarian cancer in most women.  If you have these symptoms, don't panic, but do have a conversation with your doctor about them if they persistent for more than a few weeks, new to you, and you experience them more than 50% of the time.  Ask to be screened.    Do the Dr. Oz One Sheet below, print it out and take it with you to your doctor appointment and go over it with your health care provider.  Visit the American Cancer Society and print out the page of questions to ask your doctor.   Being an informed patient makes you more proactive and a better partner for your doctor in you health care. I've had many conversations with my doctor over the years, and when I had no reason to worry he spent time with me to explain why.  A good doctor will not be offended that you looked for your own answers, but will work with you to address your concerns and treat you as a whole person.  My family doctor is the best!

The Screening
A general exam will be first, which includes pelvic and recto-vaginal exams.  This is done digitally and allows your doctor to feel your ovaries, they sit behind your uterus.  If it feels normal,   the likely next step is to wait and recheck.  If the symptoms continue, the next step is an ultrasound, trans-abdominal and trans-vaginal.  Some doctors will also perform a blood test, the CA-125 test,  to look for a protein that is usually higher in women with ovarian cancer.  Other conditions can cause elevated levels of this protein, however, so the blood test in and of itself is not definitive.  

The Dr. Oz One Sheet

Click HERE for the printable version of the Dr. Oz Ovarian Cancer one sheet.
Please note, if this One Sheet link does not open for you, I have the pdf. on file, contact me to ask for it!

This is a great tool to use with the women in your family and yourself.  Have this conversation. I found out that there is a history of this in my family while having this conversation with my mother, one of her aunts died due to ovarian cancer.  So, then I had the conversation with my sister.  Open and honest communication is the best.  Though these conversations aren't easy to start with, they do get easier each time you have the dialogue.  
  
Teal Ribbons
We all know that Pink is the colour of breast cancer awareness, but fewer of us know that Teal is the colour for ovarian cancer awareness.  Teal is also the colour for Polycystic Ovarian Syndrome, Polycystic Kidney Disease, Myasthenia Gravis, Sexual Assault, Substance Abuse and Panic Disorders.  As a woman who suffers with PCOS (Ploycystic Ovarian Syndrome), this is a a colour near and dear to me.  It took me years to get an answer, and many, many doctors because I was brushed off as too sensitive, just having cramps, and their favorite was endometriosis.   Finally, after multiple doctors and many prescriptions that didn't help, I found a doctor who listened.  While I went through the years of pain, the many days of being bed ridden with it and the many diagnosis I'd had that didn't help me, he just sat and listened.  He asked some questions and we talked some more.  We talked a lot before he ever touched me to do an exam.   I told him that the last doctor I had refused to go back to because her answer was "if the pills don't work we'll just do a hysterectomy".  I was in my late 20's at the time, only a few years into my marriage, I did not want to think hysterectomy, we were still thinking family.  He said "no, we don't need to do that.  Why would they want to do that?  I'm not convinced it's any of those things, your symptoms don't tell me endometriosis, they say PCOS."  When he explained what that was it was scary, but I was also relieved.  I had a laundry list of tests to go through yet, but I was finally being heard and I was finally going to get an answer.  Sometimes we have to be persistent and demand we be heard by our doctors, but there are doctors out there who will listen.  Be your own best advocate.  If you have pains you can't explain, have them checked out.  This was how my mother found her colon cancer.  That was how she survived it.

Resources:
Dr. Oz show - stopping a secret killer
About.com - Early Ovarian Cancer Symptoms
The Ovarian Cancer Worksheet 
Ovarian Cancer FAQ
National Cancer Institute Information on Ovarian Cancer
American Cancer Society on Ovarian Cancer 
American Cancer Society - pdf Fact Sheet 
American Cancer Society - Questions for and Talking to your Doctor.