600 women on average develop ovarian cancer in Switzerland each year. When diagnosed and treated in its early stages, recovery is possible.
Ovarian cancer
Risk
Ovarian cancer is a malignant tumor that develops when certain cells in the ovaries or fallopian tubes begin to multiply uncontrollably. In 85% of cases, women suffer one of two types of tumors: in one, ovarian cancer grows in the outer layer of tissue surrounding the ovary; in the other, borderline ovarian tumors exhibit malignant cellular changes to a varying degree from few to many, and grow less aggressively and less invasively. As part of the internal female reproductive organs, the ovaries are located in immediate proximity to other organs of the stomach and pelvic regions. Because of this, their cancer cells can settle in the uterus, the bladder, the intestine, the spleen or liver, then grow into these organs and develop metastases.
Ovarian cancer is one of the more rare cancers in women. On average, women are over the age of 60 when they develop it, but younger women can also be affected. The following factors and conditions may have an effect:
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over 50 years of age
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infertility, early onset of menstruation or undergoing late menopause
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obesity
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genetic predisposition (e.g., BRCA mutations)
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history of breast, uterine or colon cancer
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exposure to harmful substances (e.g., asbestos)
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hormone replacement therapy during and/or after menopause
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Schematic drawing of the uterus, fallopian tubes and ovaries (highlighted in red).
Prevention
There is no safeguard against developing ovarian cancer, though oral contraception, pregnancies and breastfeeding can reduce the risk of developing the disease. In contrast, infertility, the early onset of menstruation and late menopause are considered possible risk factors, particularly when they occur together.
Ovarian cancer is not directly hereditary, but the predisposition to the disease can be inherited. Between 5 and 10% of malignant ovarian tumors are thought to show a genetic predisposition. Indications of a familial risk could be breast or ovarian cancer in the family, as well as colon cancer (HNPCC). If one of these diseases has occurred in your family, talk to your family doctor or specialist about your risk.
Women with BRCA gene mutations are considered a high-risk group. In Switzerland, only 0.1 – 0.2 percent of women carry this gene mutation. Nevertheless, approximately 50% of those with BRCA1 mutations and 20% of those with BRCA2 mutations develop ovarian cancer. A genetic test can indicate whether a BRCA mutation is present.
Taking this into consideration, ultrasound exams in tandem with blood marker tests could predict the presence of malignant disease.
New research indicates that ovarian cancer originates in the fallopian tubes. As a result, women can reduce their risk by having their fallopian tubes removed. For BRCA carriers, however, this is not sufficient: they should always have their ovaries and fallopian tubes removed after childbearing is completed, or after the onset of menopause.
A hopeful outlook: new research shows that prevention is possible.
Early detection
Ovarian cancer often develops for an extended period without symptoms and there are currently no effective screening tests for early detection. As a result, the disease is not usually diagnosed until it has formed metastases in the pelvic region or abdominal cavity. Some of the typical symptoms are:
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persistent lower abdominal pain lasting longer than three to four weeks
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indigestion, constipation
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lack of appetite, feeling unusually full, bloating
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swollen or distended stomach, caused by accumulation of fluid in the abdominal area
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unexplained weight loss
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shortness of breath, caused by an accumulation of fluid in the stomach or lungs
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menstrual problems, irregular periods
Some of these complaints appear to be harmless gastrointestinal disorders and are often treated incorrectly. Others resemble the symptoms of menopause, meaning that women often endure them. Women with weight problems in particular misread the signals given by their bodies as resulting from eating disorders or diets.
Our founder, Manja Gideon, suffered from these symptoms for two years. Again and again she consulted her family doctor and specialists. Neither her gynecologist, her gastroenterologist nor her internist attributed her symptoms to ovarian cancer—the symptoms were just too general.
In the Jewish community there is a higher percentage of women, particularly those of Ashkenazi descent, with the relevant gene mutations. The Manja Gideon Foundation supports efforts to advance prevention in regards to this group of individuals with BRCA1 and BRCA2 mutations. We regard this as an opportunity for us to reach women earlier, to offer them preventive care and, in the case of a diagnosis, to potentially—hopefully—offer them a cure.