Ovarian cancer affects approximately 2,800 Canadians per year, and while all people with ovaries have some risk of developing ovarian cancer, there are several factors that can increase your risk. In honour of Ovarian Cancer Awareness Month, Nanny Angel Network looks at some common risk factors, as well as what signs and symptoms you should look out for.
Epithelial ovarian cancer is the most common form of the three types of ovarian cancer, representing upwards of 90% of all cases of ovarian cancer. Epithelial ovarian cancer begins in the cells that cover the lining of the fallopian tube and the ovary, and it can be further divided into several, distinct sub-types: serious tumours (70% of cases), clear cell carcinoma (10-13% of cases), endometroid tumours, mucinous tumours (4% of cases), undifferentiated, and borderline ovarian tumours.
Germ cell ovarian cancer, which accounts for 5-10% of ovarian cancer cases, start from the cells from which eggs are formed (germ cells) and more often affects people in their 20s. Finally, sex cord stromal cell cancer represents less than 5% of all ovarian cancer diagnoses, and begins in the cells that hold the ovaries together, and is more likely to occur in people younger than 50. While the risk factors listed below are commonly known to increase the risk of epithelial ovarian cancer, the risk factors for the other types of ovarian cancer are less well known.
Risk for ovarian cancer increases if you have never given birth or have had difficulty conceiving, while it decreases if you have had gynecological surgery removing your fallopian tubes and/or ovaries. People with a history of endometriosis are also at a higher risk of developing ovarian cancer. Endometriosis is a painful disorder in which the endometrium – tissue that normally lines the inside of the uterus – grows outside of the uterus. People who have used estrogen hormone replacement therapy, particular those who have used it in the long-term and/or in large doses, are also at a higher risk. People who have used oral contraceptives, however, have a lowered risk.
The risk of developing cancer increases with age, with ovarian cancer being more common in people with ovaries aged 50-79. The age at which a person began, and stopped, menstruation is also a factor, with ovarian cancer occurring more often in people who began menstruating before age 12 or underwent menopause after age 52. It is also more common in Jewish people of Ashkenazi descent, as well as French Canadians of certain ancestries. As with all cancers, risk also increases with a family history of cancer, in particular a history of ovarian, breast, endometrial, or colorectal cancer. It also increases if you are a smoker.
Genetic mutations, such as the BRCA gene mutation, can also increase risk factor – the BRCA gene mutation is also associated with an increased risk factor of developing breast cancer. BRCA1 and BRCA2 genetic mutations are involved in most forms of hereditary ovarian and breast cancer. In addition to Ashkenazi Jewish people and French Canadians of certain ancestry, Icelandic and Dutch populations are also at an increased risk for having either the BRCA1 or BRCA2 mutations.
Ovarian cancer can be difficult to detect, as there is no reliable screening test for this type of cancer. People experiencing symptoms of ovarian cancer should visit their doctor, who will perform a complete pelvic exam, a transvaginal or pelvic ultrasound, and a CA-125 blood test. Common symptoms of ovarian cancer include: increased abdominal size/persistent bloating, difficulty eating or feeling full quickly, pain in the pelvic or abdominal areas, and a change both/either the urgency or frequency of urination. Other, less common symptoms, include changes in bowel habits, unexplained weight loss, and extreme fatigue. All of the symptoms of ovarian cancer are, unfortunately, often vague, and can be mistakenly attributed to other causes. However, if the symptoms are new, having started within the last year, persist more than three weeks, and occur frequently, it is important to see your doctor about them.
Once diagnosed, treatment for ovarian cancer can include surgery, chemotherapy, and radiation. For more information on ovarian cancer, including living with ovarian cancer, visit ovariancanada.org.