Do You Know the Warning Signs of Ovarian Cancer?

More than 21,000 American women are diagnosed with ovarian cancer every year, and 14,000 die from it, according to the American Cancer Society (ACS). But only about 20 percent of ovarian cancers are found early, a dismaying statistic stemming from several key factors, says Donna McNamara, M.D., chief of medical gynecologic oncology at Hackensack University Medical Center and co-director of John Theurer Cancer Center.

“The problem with ovarian cancer is that it doesn’t present with many symptoms,” she explains. “There’s also no standardized screening test, because unfortunately scientists haven’t yet discovered any that detect this cancer at an earlier stage.”

Dr. McNamara notes that Pap smears—screening tests for cervical cancer—do not look at the ovaries, so they do not screen for ovarian cancer.

‘Hallmark’ Signs of Ovarian Cancer

Another obstacle to ovarian cancer detection is the fact that early symptoms are often vague and resemble those of other ailments. These signs can include:

• Bloating
• Fatigue
• Abdominal pain or pressure
• Nausea
• Gassiness
• Feeling unusually full after eating
• Changes in bowel habits
• Bladder changes, including increase in urination amount or frequency
• Lower back pain
• Menstrual changes
• Painful intercourse

If any of these symptoms are persistent or you experience them more than 12 times per month, Dr. McNamara urges you to make an appointment with your doctor.   

Lyndhurst, New Jersey, resident Diane Papamarkos learned she had ovarian cancer in 2017 after experiencing bloating that was so sudden and dramatic, it appeared as though the 64-year-old was pregnant—a symptom Dr. McNamara calls “one of the hallmark signs.”

“If tumor cells start falling off the ovary, which we call ‘seeding,’ they can spread anywhere throughout the abdominal cavity,” explains Dr. McNamara, who treated Diane after she was diagnosed at stage 3. “Ovarian cancer can then start leaking fluid into the abdominal cavity. Because the cancer is sitting on top of the bowel and this fluid is pushing on organs, we see gastrointestinal symptoms such as bloating and gassiness.”

Close-knit Treatment Team 

Diane didn’t have any specific risk factors for ovarian cancer, which Dr. McNamara says can include:

• Strong family history of breast cancer and/or ovarian cancer
• Mutation in BRCA1 or BRCA2 gene, as detected by genetic testing
• Family or personal history of breast cancer occurring in both breasts
• Ashkenazi Jewish heritage

After being diagnosed using imaging tests that included an ultrasound and CAT scans, Diane underwent nine rounds of chemotherapy that wiped out some of her tumors. So-called “debulking surgery” to remove her reproductive organs and all visible traces of cancer was next, then three more rounds of chemotherapy. This time, it also included an innovative technique that infuses warmed anti-cancer drugs directly into the abdominal cavity rather than a vein.

“This type of chemotherapy is more difficult to tolerate than pure intravenous chemo, but data at that time indicated it was more effective than IV chemo alone, and Diane was able to tolerate it,” Dr. McNamara says. “She had a tough time but was a trouper and always with a smile on her face.”

This newer strategy, with chemotherapy taking place before surgery, is fast becoming the norm in ovarian cancer treatment, Dr. McNamara notes. Other recent advances include using three oral chemotherapy drugs, known as PARP inhibitors, as follow-up maintenance therapy for all women with ovarian cancer, regardless of gene mutations.

“Using these novel agents, we’re seeing women experience longer periods without the disease recurring,” she says.   

‘Remarkable’ Outcome

Now 69, Diane is a grateful recipient of the leading-edge ovarian cancer approach. “Dr. McNamara was on target every time, about everything,” she says. “Why would I go anywhere else?”

Cancer-free since her treatment ended in late 2017, the mother of two grown children undergoes regular blood tests to confirm her tumor markers remain low. One of those markers, called CA-125, can detect a protein often found at higher levels in ovarian cancer. This test, however, isn’t useful as a general screening tool since CA-125 levels can also be tied to non-cancerous conditions.

“Diane is now four years out. Since most ovarian cancer tends to recur within two years, we’re very hopeful about her prognosis,” Dr. McNamara says. “Her tumor marker levels have been beautiful. With a 70 percent chance of recurrence within five years for stage 3 disease, it’s pretty remarkable she’s doing this well disease-free.”

Dr. McNamara says Hackensack stands out in ovarian cancer care because of its “close-knit team.” “I work very closely with our gynecologic surgical oncologists, and we have a very caring, empathetic support team,” she says. “Clinical trials are also available for our patients so they can receive cutting-edge therapies before they’re available to the general population.”

Next Steps & Resources:

• Meet our source: Donna McNamara, M.D.
• To make an appointment with Dr. McNamara or a doctor near you, call 800-822-8905 or visit our website.
• Learn more about gynecologic cancer treatment at John Theurer Cancer Center

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.