By Deborah Wilson-Brosseau Ovarian Cancer By Deborah Wilson-Brosseau

What is Ovarian Cancer Ovarian cancer is any cancerous growth that develops in any part of the ovaries. Ovaries are small almond shaped organs located on each side of the uterus. During childbearing years the ovaries produce and release one egg as part of menstrual cycle. It is released into the fallopian tube and down to the uterus where it fertilizes. The ovaries secrete the female hormones estrogen and progesterone which regulates menstrual cycle and pregnancy and breast, body shape and body hair. During pregnancy and taking oral contraceptives ovaries do not produce any eggs.

Demographics of Ovarian Cancer Eighth most common cancer among women in the United States Accounts for 3.3% of all new cancer in American women Fifth most common cause of cancer death among women due to poor early detection One in 71 women will develop ovarian cancer One in 95 will die from it 21,550 new cases each year 14,600 deaths per year (6)

Demographic of Ovarian Cancer Most likely to occur over the age of 50 After menopause Caucasian Women have a higher risk especially Ashkenazi Jewish descent women African-American and Asian women have a lower risk of ovarian cancer Half of the ovarian cancer cases will develop in women over the age of 63 Highest incidence of ovarian cancer occurs in industrialized countries (6)

Symptoms of Ovarian Cancer It is often called the silent killer because it produces few symptoms in its early stages Most women are unaware they have the disease until it has progressed to advanced stages. Most early symptoms are vague and either abdominal or gastrointestinal in nature’ If you have any of the following symptoms that persist for two weeks or more contact your doctor (4,6)

Symptoms of Ovarian Cancer Digestive symptoms Gas, indigestion, constipation Bloating, distention or cramping Abdominal or low back discomfort Pelvic pressure Vaginal bleeding in post menopausal woman Frequent urination Unexplained changes in bowel habits Nausea or vomiting Pain or swelling in abdomen Loss of appetite Fatigue Pain during intercourse (4,6)

Risk Factors for Ovarian Cancer Age is the greatest risk factor Risk increases after menopause Family or personal history of cancers of the female reproductive tract or breast that is caused by an inherited the genetic mutation Early menstruation-before age 12 Late menopause Use of talcum powder in the genital area Female workers exposed to asbestos Genital deodorant sprays Eating a diet high in saturated fats Treatment with androgens (male hormones) Never having been pregnant Obesity increases risk If you have been pregnant, breastfed and took oral contraceptives your risk of developing ovarian cancer is lowered. (1,6)

How is Ovarian Cancer Diagnosed A complete medical history to assess all the risk factors A thorough bi-manual pelvic examination CA-125 assay Blood test to determine the level of CA-125 One or more various imaging procedure Ultrasound, CT, MRI A lower GI series or barium enema Diagnostic laparoscopy for definitive diagnose Uses a thin instrument inserted in the abdomen to visualize the organs inside the abdominal cavity(4,6)

Variations in Ovarian Tumors Three main types Epithelial Cells 90% of all ovarian cancers develop from epithelial cells lining the surface of the ovaries Stromal Cells 5% of ovarian cancers begin in the stromal cells that produce estrogen and progesterone Germ Cells 2% of ovarian tumors develop in the cells that would become eggs. Many are benign (noncancerous) (2,4)

Stages in Diagnosis Stage 1- Tumor limited to ovary or ovaries Stage 2- Ovarian tumor with pelvic extension, involves the uterus or fallopian tubes and/or other pelvic organs Stage 3- Tumor involving the upper abdomen or lymph nodes Stage 4- Tumor involving distant organs including pleural space or hepatic/splenic parenchyma (6)

Current Treatment Three treatments for ovarian cancer Surgery It is done to remove as much of the tumor as possible and it is usually followed by chemotherapy and/or radiation Chemotherapy It is used to target cells that have traveled to other organs and throughout the body via the lymphatic system or the blood stream Radiation It uses high energy, highly focused x-rays to target very specific areas of cancer. A machine with external energy beam and radioactive liquids are used for radiation treatments. (4,6)

Chemotherapy and Ovarian Cancer Chemotherapy is most often a systemic treatment It is used to kill cancer cells It is administered several ways Intravenous, IV Travels throughout the body Orally Intraperitoneal Is localized in the abdominal cavity (4,6)

Chemotherapy A combination of two or more drugs should be given to help to kill cancer cells Platinum compounds is the single most active drug in the treatment of Ovarian cancer The combination of intravenous platinum compound such as cisplatin and a taxane such as paclitaxel is the first line for many patients 3 to 6 cycles of chemotherapy should reduce the size of the tumor (4,6)

Cisplatin Platinol-AQ A chemotherapy treatment used for testicular, ovarian, bladder or lung cancer Intravenous- Parenteral Only It is sometimes combined with other cancer drugs Some Side Effects Altered taste, stomatitis, severe prolong vomiting and nausea, diarrhea, renal toxicity, weakness, infections, hair loss and peripheral neuropathy Anorexia and weight loss (3)

Cure or Remission Rate 5 Year Survival Rates Stage 1------92.8% Stage 2------78.6% Stage 3------50% Stage 4------17.5% (6)

The Impact of Cancer and Treatment on Nutrition Cancer can cause chronic nausea and early satiety Fatigue Pain Mental Stress Vomiting Metabolic changes Muscle wasting Altered taste perception intestinal cramping Diarrhea Constipation (5)

Nutrition Therapy Treatment for Bowel Issues Drink lots of fluid Eat small meals Have salty soup and broths Don’t eat or drink foods that will increase gas No caffeine No foods that contain high fat Talk to your doctor about using digestive enzyme replacements for prolong diarrhea (5)

Prevention Theories Decrease Ovulation Genetic Testing Surgery Pregnancy stops ovulation Multiple pregnancies Breastfeeding children Taking oral contraceptives Genetic Testing To detect if you are carrying certain genes that increase your risk Test positive for BRCA1 OR BRCA2 Surgery Having a tubal ligation lowers your risk Hysterectomy also lowers your risk Screening Women at high risk should talk to their doctor Regular Screening Blood test and ultrasound Annual pelvic exam (6)

Gynecological Cancer Support Group a support group for women diagnosed with gynecological cancer, their families and friends to share experiences. When: Meetings are held the second Tuesday of every month from 5 to 6:15 p.m. Where : Banner Desert Cancer Center Phone Number: (480) 412-HOPE (4673). Address: 1400 S. Dobson Road Mesa, AZ 85202

Citation Cancer.org. Cancer. 23 January 2012. <http://www.cancer.org/cancer/ovariancancer/overviewguide/ovarian-cancer-overview-what-is- ovarian-cancer>. Cherry, James Michael. Comparative study of molecular changes in ovarian tumor progression and the identification of biomarkers. 2009. <http://www.grin.com/en/doc/275123/comparative- study-of-molecular-changes-in-ovarian-tumor-progression-and>. Crowe, Zaneta M. Pronsky and Sr Jeanne P. "Food Medication Interaction." 2010: 84. Lippincott, Williams and Wilkins. "Cancer-Principles and Practice of Oncology 9th Edition." 2011: 1368-1377. Sharon Rady Rolfes, Kathryn Pinna and Ellie Whitney. "Understanding Normal and Clinical Nutrition." Sharon Rady Rolfes, Kathryn Pinna and Ellie Whitney. Belmont, Ca: Wadworth, 2009. 907-910. Thompson. "The Gale Encyclopedia of Cancer Third Edition Volume 2." 2010: 1090-1097.