Ovarian cancer is a frightening disease for older women and it frustrates their health care professionals. Why? Most ovarian cancer develops after menopause; half of ovarian cancers are found in women older than age 65. And only 24 percent of ovarian cancers are diagnosed at an early stage, when the disease is confined to the ovary. When cases are diagnosed after the cancer has spread to other parts of the body, it's difficult to treat successfully. For these reasons, ovarian cancer is the most fatal of all cancers involving a woman's reproductive tract.

The ovaries are the part of the female reproductive organs that produce egg cells every month during a young woman's reproductive cycle. The ovaries are about 1 1/2 inches long, but after going through menopause shrink down to about half their original size. They are located on either side of the lower abdomen. In young, relatively thin women, the ovaries can just barely be felt on a pelvic examination. Because they shrink in size after a woman stops having her periods, a normal ovary cannot be felt in a woman who has gone through menopause.

Ovarian cysts
Women who are still having periods can develop cysts on the ovary, which can be felt on a pelvic exam or seen via x-rays or other tests. They are rarely cancerous, particularly in younger women. Cysts are less common in women who have already gone through menopause, and when they do occur are more likely to be cancerous. A cyst or an enlarged ovary in a woman who has gone through menopause should always be evaluated quickly to make sure that it is not a cancer.

With ovarian cancer, cells of the ovary grow and divide uncontrollably. The cells may grow to form a tumor on the ovary, and can break off from the main tumor and spread to other parts of the body. Although ovarian cancer can spread throughout the entire body, in most cases it stays in the abdomen and affects organs such as the intestines, liver and stomach.

There are many different types of ovarian cancer. Most cancers of the ovary come from the cells that make up the outer lining, and are called epithelial ovarian cancers. Although most epithelial ovarian cancers occur in women who do not have a family history of the disease, about five to 10 percent of women with ovarian epithelial cancer have other family members who have also had the same kind of cancer.

While the symptoms of ovarian cancer (particularly in its early stage) are often not acute or intense, they include:

• pelvic or abdominal pain or discomfort
• vague but persistent gastrointestinal upsets such as gas, nausea and indigestion
• frequency and/or urgency of urination in absence of an infection
• changes in bowel habits
• weight gain or loss; particularly weight gain in the abdominal area
• pelvic or abdominal swelling, bloating or a feeling of fullness
• pain during intercourse
• ongoing fatigue
• abnormal postmenopausal bleeding

Copyright 2003 National Women's Health Resource Center Inc. (NWHRC)