Ovarian Cancer

By Dr. Loretta Lanphier, ND, CN, HHP, CH

Ovarian cancer is a common disease that affects mostly older women who have already been through menopause. Much research has been done in attempts to discover why this killer is so pervasive, and what can be done to prevent it and reduce its devastating effects. Like many cancers and other diseases, it seems to run in families and leave a legacy of destruction in its path.

What is Ovarian Cancer?

Ovarian cancer is a disease in which cells in the ovaries, a major organ of the female reproductive system, begin to abnormally grow in an uncontrolled manner, and form groups of these cancerous cells called tumors. Most ovarian cancer takes place in the cells that make up the surface of the ovaries, and result in tumors known as epithelial cell tumors.

The ovaries are responsible for producing eggs (ova) and are also involved, along with the adrenal gland, in the production of female sex hormones such as progesterone and estrogen. They are a pair of almond-shaped structures that are located in the pelvis, one on each side of the uterus. Each one has afallopian tube that connects it to the uterus.

Ovarian cancer is the fifth leading type of cancer found in females in the United States, accounting for about 4% of all cancers in American women. However, the death rate for ovarian cancer is the highest for all cancers in women. Approximately 20,000 new cases are identified annually, and about 15,000 women die every year in the U.S. from ovarian cancer. The ovaries, and thus the tumors, are located deep within the pelvis, making it difficult to locate them during pelvic exams. Ovarian cancer also has very few symptoms during its early stages, causing most diagnoses to be determined after the illness has advanced significantly and possibly spread to other organs of the body. Only 20% of cases are found before the disease has spread (metastasized) beyond the ovaries. This relatively fast growing cancer thus has a very high mortality rate, and by the time it is discovered, does not generally respond well to typical allopathic treatments. Statistically speaking, the five-year survival rate for ovarian cancer is only 50% when treated with allopathic medicine.

There are three main types of ovarian tumors. Each forms in a different part of the ovary.

  • Epithelial cell tumors occur in the thin outer layer that covers the ovaries. They are most commonly found in postmenopausal women, and account for 85-90% of all ovarian cancers.
  • Germ cell tumors are found in the cells of the ovaries that are responsible for ovum production. This type is more common in younger women.
  • Stromal tumors generate in connective tissue within the ovaries that helps hold them together, and also is where estrogen and progesterone are produced.

Ovarian cancer is rated, like most cancers, according to where it has formed and how advanced it has become. The ratings are as follows:

  • Stage I:  Confined only to one or both ovaries.
  • Stage II:  The cancer has spread to other organs and tissues within the pelvic area.
  • Stage III:  Cancer has spread beyond the pelvic area into the lining of the abdomen  (peritoneum) and/or the abdominal lymph nodes. Most ovarian cancer is not discovered until it is in Stage III.
  • Stage IV:  The cancer has spread beyond the abdomen into the rest of the body.

What Are the Symptoms of Ovarian Cancer?

The standard thinking has been, until the last few years, that early stage ovarian cancer rarely had any discernable symptoms. But recent research indicates that there are indeed symptoms, but they often will mimic other disorders and thus the diagnoses of ovarian cancer is often initially missed.  One of the keys to identifying ovarian cancer early is consistent and persistent symptoms. For example, digestive or bladder disorders may have intermittent symptoms. Early stage ovarian cancer may exhibit similar signs, but they typically are constant, and get progressively worse. The most common symptoms of ovarian cancer include:

  • Pelvic pain or discomfort
  • Abdominal pressure, swelling, or bloating
  • Persistent indigestion or gas
  • Persistent nausea
  • Changes in bowel function. Can be diarrhea, constipation, or a combination.
  • Need for frequent urination
  • Dyspareunia (Pain during intercourse).
  • Unexplained weight gain (often due to accumulated fluid in the abdomen)
  • Unexplained weight loss
  • Loss of appetite
  • Lower back pain
  • Persistent fatigue and lack of energy
  • Vaginal bleeding in postmenopausal women

What Are the Causes of Ovarian Cancer?

Despite much research, there is still debate about the precise causes of ovarian cancer. Many theories focus on the mechanics of the monthly menstrual cycle. The nature of ovarian cancer tumors can be benign (non-cancerous) or malignant (cancerous). Benign tumors are composed of abnormal cells, but they do not spread throughout the ovaries or into other tissues as malignant ones do. Most malignant ovarian cancer cells spread “contiguously,” which means they metastasize into organs and tissues that are directly adjacent to them. In rare cases, ovarian cancer may spread through the lymph nodes or bloodstream, but it is not common, as it is with many other types of cancer.

One leading theory identifies the tissue-repair process involved with the release of an ovum through a minute tear in an ovarian follicle as a possible factor in ovarian cancer. Known as ovulation, it involves the rupturing of some cells at the site during every menstrual cycle. There is some evidence that this repeated action during the childbearing years might contribute to genetic errors that possibly may be linked to increased risk for ovarian cancer. Other theories point towards fluctuating hormone levels before and during ovulation as possible factors in ovarian cancer.

Other risk factors that contribute to the development of ovarian cancer have been identified. They include:

  • Inherited genetic mutations:  There are two genes that were originally linked to breast cancer development: breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2). It has since been discovered that about 5-10% of ovarian cancer patients also carry these mutated genes. Jewish women, especially Ashkenazi Jews, amongst all other ethnic groups, are particularly at high risk if they have either of these mutations.

Another genetic link that is not quite as much of a risk factor as BRCA mutations is an inherited syndrome passed down in families called hereditary nonpolyposis colorectal cancer (HNPCC).  Members of HNPCC families are at increased risk for a variety of cancers, including ovarian.

  • Age:  Most ovarian cancer develops after menopause. A woman’s risk for ovarian cancer increases steadily through her late 70’s. While the majority of cases are postmenopausal, a small percentage of ovarian cancer occurs in menstruating women.
  • Family history:  If you have a first-degree relative with a history of ovarian cancer, your risk is increased significantly, possibly by a factor of three.
  • High-fat diet:  The incidence of ovarian cancer is much higher in the affluent industrialized nations of the United States and Western Europe. The most likely reason for this is the amount of animal fat and dairy products that people in these countries consume, as compared to much of the rest of the world. The highest rates on the planet are in Switzerland, Denmark, and Sweden, where the per capita consumption of dairy is very high. The converse is true in Japan and Singapore, where very little dairy is consumed.
  • Childbearing is also a factor. Women who never bear children have an increased risk. On the contrary, women who have children, especially if their first is before the age of 30, are at decreased risk. More than one child decreases the risk even more. Women who breastfeed their babies also have a reduced risk for ovarian cancer.
  • Hormone Replacement Therapy (HRT):  The idea that HRT can increase risk for ovarian cancer has been debated by some in the medical community. However, a study by the National Cancer Institute released in 2006 shows conclusive evidence that women who used HRT for at least 5 years and have not had a hysterectomy face a significantly increased risk for ovarian cancer.
  • Ovarian cysts:  Ovarian cysts in premenopausal women are quite common and generally not considered abnormal. However, when these cysts occur in postmenopausal women, it puts them at increased risk for ovarian cancer.
  • Fertility drugs:  Some studies have shown a three-fold increase in ovarian cancer risk if certain fertility drugs have been used.
  • Infertility:  Women who struggle with infertility, especially if they are never able to give birth, have an increased risk for ovarian cancer. This is true even if they never use fertility drugs, and the exact reason why is not well understood as of yet.
  • Obesity in early adulthood:  Studies have shown that women who are significantly overweight by the age of 18 are at increased risk for ovarian cancer before menopause. Obesity has also been linked to certain forms of aggressive ovarian cancer.
  • Past history of breast cancer is also a risk factor for ovarian cancer.
  • Race:  Besides the genetic risks in Jewish women, Caucasian American women have twice the risk for ovarian cancer as African American women.
  • Talcum powder:  The use of talcum powder in the genital area or feminine hygiene products containing talc is also a risk factor that can possibly double a woman’s chances of succumbing to ovarian cancer. Talcum powder contains tiny particles of asbestos, which is a risk factor in many types of cancer.

What Treatments Are Available for Ovarian Cancer:

The most common allopathic treatment for ovarian cancer is surgery, often combined with chemotherapy after the surgery. Radiation treatment is not typically used for treating ovarian cancer.

If the cancer is discovered early enough, and it is contained in only one ovary, the removal of only that one ovary is a possibility, although this is a rare occurrence. The hope is to leave one ovary so that conception may still be possible. However, even in these cases, the chemotherapy often leads to infertility, thus defeating the purpose.

Most surgery involves removal of both ovaries, and often surrounding tissues as well, depending on how far the cancer has spread.

Some women, especially if they are considered high risk (such as a strong family history or the presence of BRCA mutations) will opt to have their ovaries or their entire reproductive system removed as a preemptive strike against ovarian or other reproductive system cancers. This operation is known as ahysterectomy, and it may be total or partial. Be aware that if you choose this option, it will bring on early menopause. The best way to deal with that is by the use of a natural USP progesterone product that will help balance your hormones without the use of dangerous synthetic hormones.

A healthy, proactive lifestyle in which you take excellent care of your body through eating whole natural foods and avoiding animal fats and other toxic substances is the best defense against cancer and disease of all kinds, and ovarian cancer is no exception. Staying away from any synthetic hormones, fertility drugs, or other known toxins will also greatly increase your odds of avoiding this most deadly of female cancers.

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