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.

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