Don’t ignore subtle signs of ovarian cancer, Parkland experts urge
Knowing symptoms, seeing specialist could save your life
It’s called ‘the whispering cancer’ and it often goes undetected until too late.
“Ovarian cancer is a silent killer. It has few early warning signs and those can be non-specific, like bloating, indigestion, nausea or weight loss. A woman with these symptoms probably won’t think, ‘this could be ovarian cancer,’” said Jayanthi Lea, MD, a gynecologic oncologist at Parkland Health & Hospital System and Associate Professor of Obstetrics & Gynecology at UT Southwestern Medical Center.
Although not common – there will be only about 22,000 new cases diagnosed in the U.S. this year, the American Cancer Society estimates – ovarian cancer ranks fifth in cancer deaths among women, accounting for more deaths than any other cancer in the female reproductive system. It often goes undetected until it has spread within the pelvis and abdomen. At this late stage, the disease is more difficult to treat and is frequently fatal.
“Unfortunately, there is currently no screening test for ovarian cancer,” Dr. Lea said. “Pap smears test for cervical cancer, but do not detect ovarian cancer.”
September is Ovarian Cancer Awareness Month and both staff and patients at Parkland’s Gynecology Clinic hope more women will become informed about the disease.
“Women need to be aware of changes in their bodies,” Dr. Lea said. “If a woman has pelvic pain or other symptoms associated with the disease she should ask her healthcare provider to consider ovarian cancer and see a specialist. The earlier this cancer is found, the better chance she has for survival.”
Every weekday, a group of women sit in comfortable reclining chairs in a bright, window-lined room at the Infusion Center in the new Women & Infants Specialty Health Clinic at Parkland. While receiving potent chemotherapy drugs intravenously, they chat and swap stories about their families, lives and their cancer. There is laughter, camaraderie and sometimes tears.
Lola Ann Ussery, 54, of Garland, arrives at the Parkland clinic at 7:30 a.m. and leaves around 4 p.m. on her treatment days. She was diagnosed with Stage 3 ovarian cancer in April 2015. Ussery initially thought she had constipation, but when the symptoms became alarming, she went to the doctor and learned she had cancer. After surgery she had chemotherapy for several weeks and was doing well. But in June this year, the cancer recurred and she is undergoing her second round of chemo.
“The first time, I was in shock more than anything, but I had a lot of fight in me. This time, it’s been harder, physically and emotionally. But I’ve got a lot family and friends supporting me and the staff at Parkland has been a ‘10.’ They take amazing care of you. They give you confidence and encouragement.”
Ussery received an innovative therapy available for Parkland patients called intraperitoneal (IP) chemotherapy, which delivers drugs directly into the abdominal cavity. “This treatment has been shown to significantly extend the lives of appropriate patients with advanced ovarian cancer,” Dr. Lea stated.
Debra Richardson, MD, a gynecologic oncologist at Parkland and Assistant Professor of Obstetrics & Gynecology at UT Southwestern, said that Parkland patients are encouraged to participate in clinical trials testing new drugs.
“I am inspired by working with ovarian cancer patients and watching them fight their battles,” Dr. Richardson said. “Our patients are very courageous and strong. Many of them choose to participate in clinical trials because there’s always hope that new drugs will prolong survival rates and eventually find a cure.”
"We are always trying for remission and that is definitely possible with our current treatments,” Dr. Lea added. “Every patient should shoot for that.”
Each about the size of an almond, the ovaries produce eggs (ova) as well as the hormones estrogen and progesterone. Symptoms of ovarian cancer may include abdominal swelling, weight loss, discomfort in the pelvis area, changes in bowel habits, such as constipation, and a frequent need to urinate.
Risk factors of the disease include having the BRCA1 or BRCA 2 gene, early onset of menstruation, late onset of menopause, a family history of ovarian cancer, advancing age – most patients are diagnosed at age 60, and no history of pregnancy. Protective factors that help lower risk include use of birth control pills, breastfeeding, tubal ligation, hysterectomy and pregnancy.
Treatment depends upon the stage at which the cancer is found, but usually involves surgery and chemotherapy. Doctors recommend every woman have an annual health screening exam, know the symptoms of ovarian cancer and be their own health advocate.
With two daughters and two granddaughters, Ussery urges them to be aware of their bodies. “Listen to those warning signs,” she said. “Women definitely need to learn the symptoms of ovarian cancer.”
“The most common thing I hear from patients is deep frustration because their cancer may have been diagnosed earlier if they and their physicians had recognized the early warning signs,” Dr. Richardson stated.
The American Cancer Society recommends that if you have symptoms similar to those of ovarian cancer almost daily for more than a few weeks and they can't be explained by other more common conditions, report them to your healthcare professional – preferably a gynecologist – right away.
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