Ovarian cancer thrives in the shadows, but women who know the risk factors can bring this disease into the healing light of day. Treatment options are more effective than ever, and many of the new advances are coming from UAB's own Comprehensive Cancer Center.

Unfortunately, relatively few ovarian cancer patients are diagnosed in the early stages. This is when the disease is easiest to treat, before tumor growth has spread to nearby tissues and organs. "Only about 15 percent of patients have early stage or stage-1 cancer," says UAB gynecologic oncologist Mack Barnes, M.D. "It's critically important to identify those patients so that they can undergo appropriate surgery. If they do, a significant number can avoid chemotherapy and still have a cure rate of over 90 percent."

But early identification is a challenge, Dr. Barnes says, because ovarian cancer is difficult to detect by ultrasound or by CT or PET scans. And because the ovaries are seated deeply in the body, ovarian cancer can grow quietly for years before symptoms become apparent or doctors are able to detect abnormal growths. The symptoms themselves can be easy to overlook and are also common to other, less serious conditions.

Knowing the risk factors and warning signs of ovarian cancer can help women know when to seek advice from their doctors.

Risk factors

• - Age: Women older than age 50 are at increased risk for ovarian cancer; it develops most frequently after menopause.
• - Family history: Having a daughter, sister, or mother who has had ovarian cancer increases a woman's risk.
• - Personal history: A woman who has had colon or breast cancer may face a higher risk for ovarian cancer as well.
• - Medications: The use of fertility drugs that trigger ovulation may increase a woman's risk.
• - Pregnancy: Women who have never given birth face a higher risk, although the use of oral contraceptives appears to decrease risk slightly.
• - Obesity in early adulthood: Studies suggest that women who are obese as early as age 18 may be at increased risk of developing ovarian cancer.

Warning signs

• - abdominal pressure, fullness, swelling, or bloating
• - pelvic discomfort or pain
• - an urgent need to urinate
• - stomach discomfort, diarrhea, or constipation
• - decreased appetite or feeling full even after a light meal
• - weight gain or loss
• - abnormal vaginal bleeding
• - pain during intercourse
• - back or leg pain
• - persistent lack of energy

Caperton Gillett