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OVARIAN CANCER

1. Does my response to chemotherapy depend on the type of ovarian cancer I have?

Yes. Different types of ovarian cancer respond differently to chemotherapy. For example, serous, endometrioid, and undifferentiated cancers respond the best to standard chemotherapy. Clear cell and mucinous cancers do not respond as well.

2. Can I have sex if I have ovarian cancer?

There is no reason to avoid sexual relations when you have ovarian cancer. It is not contagious or sexually transmitted and it will not cause the cancer to return. Many women may experience pain during intercourse if they had a hysterectomy, because the vagina is shortened during this procedure. Chemotherapy may also irritate the vaginal membranes. You may choose to use vaginal lubricants (i.e. K-Y Jelly), which can alleviate some of the pain you may experience. For more information on sexuality and gynecologic cancers, click here.

3. If no one in my family ever had ovarian cancer, does that mean I won’t get it?

Every woman is potentially at risk for ovarian cancer. It is believed that 5 to 10 percent of the 26,600 ovarian cancer cases are hereditary. 90 to 95 percent of the cases are of unknown origin.

4. Can the food I eat cause ovarian cancer?

Diet can play a role in ovarian cancer. It appears that in the highly industrialized countries (with the exception of Japan) -- where a high fat, low fiber diet is most common -- ovarian cancer is also more common.

5. Will fertility drugs cause ovarian cancer?

Not necessarily. Many women who take fertility drugs never develop ovarian cancer.

6. Does using birth control pills cause ovarian cancer?

Actually, using birth control pills can decrease a woman’s risk of ovarian cancer by 40 to 50 percent.

7. Does the use of estrogen replacement therapy cause ovarian cancer?

Studies show different results for women taking estrogen replacement therapy. Some report a decreased risk of ovarian cancer while others report an increased risk. It is important to note that in one study that reported a slightly increased risk for the development of ovarian cancer with long-term use of ERT, patients primarily were treated with a higher dose than is recommended today. (Please remember to discuss with your physician before making any decisions.)

8. Can I still develop ovarian cancer even if my ovaries were surgically removed?

No. Once your ovaries are removed, you cannot develop ovarian cancer.

9. What are the symptoms of ovarian cancer?

It depends; not all women have symptoms, but some will experience prolonged abdominal swelling (clothes getting tighter), abdominal pain or pelvic discomfort, back pain, fatigue, gastrointestinal symptoms and/or vaginal bleeding.

10. Isn’t it true that ovarian cancer can’t be diagnosed early?

No, ovarian cancer can be diagnosed early. However, many times it is not because the symptoms were not recognizable until a later stage. The three methods of diagnosis include: a pelvic examination, CA125 blood test and an ultrasound test. None of these is foolproof when used alone; when used together, however, they can be quite useful in diagnosing ovarian cancer in its earliest stages.

11. Do I have cancer if my CA125 level is elevated?

Although a CA125 is a useful tool for the diagnosis of ovarian cancer and for following the course of treatment, it is not uncommon for a CA125 count to be elevated for reasons unrelated to the ovarian cancer. For example, uterine fibroids, liver disease, inflammation of the fallopian tubes and ovaries, endometriosis and many other types of cancer can also elevate a woman’s CA125 level.

12. My Pap smear was normal. How can I have ovarian cancer?

A Pap smear allows the physician to examine cells directly from the cervix and is therefore useful in detecting cervical cancer as well as other disorders and infections in that area. A Pap smear is not used to diagnose ovarian cancer.

13. Is there anything I can do to prevent ovarian cancer?

A number of factors appear to offer women some protection against ovarian cancer. Pregnancy, breast-feeding and the use of birth control pills all appear to be associated with a decreased risk of ovarian cancer. In addition, following a low fat, high-fiber diet may also reduce a woman’s risk.

14. How rapidly does ovarian cancer spread? Will it spread more rapidly if it is exposed to air during surgery?

It is difficult to say how rapidly ovarian cancer will spread. It depends on the type of cancer and its stage. The more advanced the cancer is, the more rapidly it will spread. Exposure to air during surgery will not make it spread more rapidly.

15. If I have a hysterectomy, do I still have to worry about ovarian cancer?

It depends. A total hysterectomy involves the removal of the uterus and the cervix; the ovaries are not removed. As a result, a woman can still develop ovarian cancer. A total abdominal hysterectomy with bilaterial salpingo-oophorectomy involves the removal of the uterus, tubes and ovaries. Since the ovaries are removed during this surgery, it is not possible to develop ovarian cancer.

16. What are some common side effects of chemotherapy?

The most common side effects of chemotherapy include nausea and vomiting (which can be quite severe); however, medications known as antiemetics are available to help control these side effects. Other common side effects include mouth sores, fatigue, anemia, dizziness, infection, pain, hair loss, and loss of appetite.

17. If I have stage I ovarian cancer, do I need chemotherapy?

Most cases of stage I ovarian cancer will not require chemotherapy, but you should discuss with your physician.

18. Why are different types or classes of chemotherapy drugs used?

Different types of chemotherapy drugs have different mechanisms of action (e.g., act on cancer cells differently), so doctors may use two or more different types of drugs to be most effective in fighting the cancer. This is referred to as combination treatment. Combination treatment also helps prevent cancer cells from becoming resistant to individual drugs.

19. If first-line chemotherapy doesn’t work, is my situation hopeless?

No. There are several other chemotherapeutic agents available for the treatment of ovarian cancer that your doctor might try.

20. Even if first-line treatment is successful, can’t the cancer still come back?

Although the cancer may recur after first-line treatment, there are currently a number of different chemotherapies used in the second-line treatment of recurrent ovarian cancer. One newer treatment is Hycamtin (topotecan), the first of a new class of topoisomerase I inhibitors approved for treating ovarian cancer.

21. Isn’t it true that I will never be cured of ovarian cancer?

While ovarian cancer is a very serious disease, it appears that 8 to 15 percent of patients will be cured. In addition, the average survival for women with advanced stage ovarian cancer in the last 15 years has increased from one year to more than three years. You should discuss your personal circumstances with your physician.

22. Isn’t it true that all cancer patients suffer from pain?

While many cancer patients do suffer pain as a result of treatment and/or surgery, it can be managed. You should discuss this with your physician.