Ovarian
cancer is a stealth enemy, but you can outsmart it by caring for your body and
knowing the ambiguous danger signs.
When 37-year-old TV host Giuliana Rancic’s
breast cancer was caught after a mammogram ardered by her fertility doctor, a
storm of speculation ensued. Were her in vitro fertilization (IVF) treatments
to blame? Experts sais no, and scientists have found no solid IVF connection to
breast cancer. Soon after, though, another study reported that the fertility
treatments might increase the risk for an often-deadlier disease: ovarian
cancer.
Your greatest defense against the disease is understanding
your vulnerability
Upon closer inspection, the correlation
turned out to be less alarming than it seemed (see”Is IVF Dangerous?” at
right). But some good did come of the research: It pointed a spotlight on the
so-called silent killer. Ovarian cancer is less common than breast cancer, but
it’s faster-growing and astonishingly lethal, killing nearly three out of four
late-stage patients within five years ( approximately one in eight patients in
under age 45). “The ovaries are hooked up to a great blood supply and are
inundated with hormones-two things that create an ideal cancer breeding ground,
“ explains Barbara Goff, M.D., director of gynaecologic oncology at the
University of Washington. And because screening is difficult a and symptoms are
often vague and misinterpreted, early detection rates are poor. Your greatest
defense against the disease is understanding your vulnerability, caring for
your body, and knowing how to spot the danger signs.
The
Quiet Threat
First, a little sixth-grade sex ed: Your
ovaries, two almond-size organs that hover on each side of your uterus, have a
couple of big jobs. One is to churn out the female sex hormones estrogen and
progesterone. The other is to produce eggs. Every month, an ovary releases an
egg, and, well, you know what happens next.
Most woman’s ovaries hum along just fine,
but sometimes, due to a host of unclear reasons, ovarian cells can malfunction
an become malignant. Even then, the ovaries don’t scream and shout. The
cancer’s main symptoms-bloating, abdominal aches, heartburn. Feeling full
quickly, pelvic pain, and the frequent need to uriate-are subtle and easily
mistaken (by patients and their doctors) for benign maladies such as
indigestion or irritable bowel syndrome, The result: tumors often aren’t
discovered until they’ve grown and spread.
When found at an early stage, breast and
avarian cancers both have survival rates of more than 90 percent. But while 60
percent of breast cancer cases are caught early, about 60 percent of ovarian
cancer cases are not diagnosed until the disease has distantly metastasized
(most commonly into the abdomen).
Another problematic issue: screening. For
starters, because the ovaries lie deep inside your body, it’s difficult for
your doctor to examine them. And there’s no Pap smear or mammogram equivalent
for testing for ovarian cancer. A current test-a painless transvaginal
ultrasound coupled with a CA125 blood test that measures a cancer-indicating
protein-isn’t sensitive enough to catch most cases early, even if done
regularly. In fact, a 2011 study in Journal of the American Medical Association
found that annual screening among average-risk women did nothing to reduce the
number of deaths from ovarian cancer; instead, it yielded many false positives.
“A false positive on a mammogram.
Is
IVF Dangerous?
Recent
research raised the question. Here, the unvarnished truth.
Fertility treatments like IVF work by
bombarding the ovaries with high doses of artificial hormones that stimulate
them to release multiple eggs ( which are collected, fertilized in a lab, then
transferred back into the uterus). Problem is, even a single egg breaking
through the ovarian wall every month during natural ovulation might
theoretically increase cancer risk.
Doctors theorized that the more times the
body needs to fix such damage (which also occurs after an IVF cycle), the more
chances there are for a repair error that could lead to mutated cells, says
colleen Feltmate, M.D., a gynaecologic oncologist at Brigham and Women’s
Hospital in Boston. “Plus, since we know that things that suppress ovarian
activity-like pregnancy and being on the Pill-reduce a woman’s risk of
developing ovarian cancer, doctors feared that fertility treatments, which
increase ovarian activity, might heighten that risk, “ says Sherman Silber,
M.D., medical director of the infertility Center of St. Louis.
A buzzed-about recent study seemed to
validate that concern: Researchers found that infertile women who’d had one or
more rounds of IVF were four times more likely to develop borderline ovarian
cancer.
The news was terrifying-but a closer
analysis revealed the situation is much less scary than it sounds. The elevated
risk translates into a 0.4 percent chance, and borderline tumors represent a
different type of cancer, one that’s slow-growing and treatable. While
borderline ovarian cancer tumors can grow larger than size of a cantaloupe and
require surgery, they rarely morph into a deadly form of the disease, says
Feltmate.
