Ovarian Cancer

Ovarian cancer develops in one or both of a woman’s ovaries, the reproductive glands located within the pelvis on either side of the uterus.

There are many different types of ovarian cancer, but epithelial ovarian carcinoma — which develops on the outer surface of the ovary — is the most common form, accounting for 85 to 90 percent of cases.

According to American Cancer Society estimates, more than 22,000 women in the U.S. were diagnosed with ovarian cancer in 2017. Women have a 1 in 75 chance of developing the illness during their lifetime.

Treatment for ovarian cancer is very effective when the cancer is caught at an early stage, but once the cancer has already spread throughout the body, the disease is usually fatal.

Ovarian Cancer Facts:

• Linked to occupational and secondhand asbestos exposure
• Also linked to contaminated talcum powder products
• Signs often confused for symptoms of more common illnesses
• Treatment usually involves surgery followed by chemotherapy

Certain factors increase a woman’s risk of ovarian cancer, including old age, never having been pregnant, the use of certain hormone therapies, obesity and a family history of cancer. Regularly taking birth control pills seems to reduce the risk of ovarian cancer.

In addition, the International Agency for Research on Cancer (IARC) lists ovarian cancer as one of the four types of cancer definitely caused by asbestos exposure. The IARC’s 2012 review documented numerous research studies linking ovarian cancer to the accumulation of asbestos fibers in ovarian tissue.

How Does Asbestos Cause Ovarian Cancer?

Asbestos is a naturally occurring mineral that manufacturers added to many building materials and consumer products from the late 1800s until the 1980s. Many sources of talc also naturally contain asbestos, and some brands of talcum powder were commonly contaminated with asbestos until the mid-1970s.

Microscopic asbestos fibers cannot be seen, smelled or tasted, and asbestos exposure causes no immediate symptoms. Once asbestos fibers enter the body, however, they can become lodged in soft tissues permanently, causing inflammation and cellular damage over years. Researchers have different theories about how asbestos fibers accumulate in ovarian tissue.

Occupational and Secondhand Exposure

Most asbestos-related diseases are caused by inhaling or swallowing asbestos dust at a worksite. Women who worked in occupations associated with asbestos exposure have higher rates of ovarian cancer. The wives and daughters of asbestos-exposed workers also have a higher risk because of exposure to asbestos on the workers’ skin, hair and clothes.

In these cases, the inhaled or ingested asbestos fibers may have traveled to the ovaries through the bloodstream or lymphatic system.

Contaminated Talcum Powder

Asbestos-contaminated talcum powder products have caused cancer in people who inhaled the powder on a regular basis. Some researchers suggest when women applied contaminated talcum powder to their genitals after showering or bathing, asbestos fibers may have also traveled up the reproductive tract to their ovaries.

Regulations have required American talcum powder products to be asbestos-free since the 1970s, but because asbestos-related illnesses typically take decades to develop, new diagnoses are still arising from the use of contaminated talcum powder before the regulations took effect.

Symptoms

Ovarian cancer often does not cause major symptoms until it has grown and spread throughout the pelvis and abdomen.

Common symptoms include:

• Bloating
• Pelvic or abdominal pain
• Loss of appetite
• Frequently feeling the need to urinate

Other symptoms may include:

• Fatigue
• Back pain
• Digestive problems
• Abnormal menstruation
• Pain during sex

Many conditions besides cancer can cause these symptoms, so the key is to watch out for symptoms that are persistent and unusual. If a woman experiences any of these potential signs of ovarian cancer more often or more intensely than normal, she should make an appointment with a gynecologist.

Diagnosis

The process of diagnosing ovarian cancer typically begins with a gynecologist physically examining the pelvis, followed by an imaging scan such as an ultrasound, CT scan, MRI or PET scan. The diagnostic process is complex, because ovarian cancer can appear similar to other types of cancer such as peritoneal mesothelioma, which is also caused by asbestos.

If there is a buildup of fluid in the abdomen — a condition called ascites — doctors may drain the buildup through a hollow needle and then examine the fluid for cancer cells. A blood test for the CA 125 protein can also point to the presence of ovarian cancer.

A surgeon can then conduct a laparoscopy to examine the inside of the pelvis with a tiny camera probe. This allows the medical team to see the extent of the cancer growth before going ahead with a more invasive tumor-removing surgery.

Staging and Treatment for Ovarian Cancer

Doctors usually treat ovarian cancer with a combination of surgery and chemotherapy. However, an individual patient’s treatment plan and prognosis depends heavily on the cancer’s stage, which is defined by how far the cancer has spread.

Stage 1: Cancer Only in One or Both Ovaries

5-year survival rate: 90 percent

Currently, less than 20 percent of cases are diagnosed while the cancer is still localized to a single ovary. These fortunate patients sometimes have the option to have only one ovary and fallopian tube surgically removed, leaving their uterus and the other ovary intact so they can still have children. Depending on the specific cell type of the cancer, some stage 1 patients also may not need chemotherapy.

Stage 2: Cancer Spread to Other Parts of Pelvis

5-year survival rate: 70 percent

Ovarian cancer surgery usually involves removing the uterus and both ovaries and fallopian tubes, which will prevent the patient from ever becoming pregnant and cause her to go into menopause if she has not done so already. After surgery, the medical team usually administers three to six cycles of a chemotherapy drug combination such as carboplatin and paclitaxel.

Stage 3: Cancer Spread to Abdomen

5-year survival rate: 39 percent

If the cancer has spread into the abdomen, the surgeon may have to remove parts of the colon, bladder, stomach, liver, pancreas, spleen and gallbladder in addition to the reproductive organs.

Stage 4: Cancer Spread to Distant Parts of the Body

5-year survival rate: 17 percent

If the cancer has spread to distant organs in the patient’s body, the medical team may recommend surgery to remove as much tumor growth as possible, or they may advise the patient to only undergo chemotherapy to slow the growth of the cancer.