It is estimated there would be 22,220 new cases of ovarian cancer in the United States in 2005 (American Cancer Society, 2005b). Though not as common as uterine or breast cancer, it is the most deadly of all gynecologic cancers; 61% of women die within 5 years
of developing it. Ovarian cancer is more common in Northern European and North American countries than in Asia or developing countries.
Ovarian cancer invades the body silently, with few warning signs or symptoms until it reaches an advanced stage. A woman in whom an ovarian lump is detected need not panic, however, for most lumps turn out to be relatively harmless ovarian cysts; about 70% of all ovarian tumors are benign.
The cause of ovarian cancer is unknown. An increased incidence is found in women who are childless, undergo early menopause, eat a high-fat diet, or who are from a higher socioeconomic status. Women who are lactose-intolerant or who use talc powder (especially on the vulva) have also been found to have higher rates of ovarian cancer. A decreased incidence is associated with having children, using oral contraceptives, or undergoing late menopause (American Cancer Society, 2003). Women who take birth control pills, who were pregnant at an early age, or who had several pregnancies, have particularly low rates of ovarian cancer (Modan et al., 2001). One study demonstrated that women who undergo tubal ligation (have their tubes tied to prevent pregnancy) also reduce the risk of ovarian cancer (Narod et al., 2001).
The most important factor in the survival rate from ovarian cancer is early detection and diagnosis. It is estimated that two-thirds of cases of ovarian cancer are diagnosed late (Mantica, 2005). Because the ovary floats freely in the pelvic cavity, a tumor can grow undetected without producing many noticeable symptoms (i. e., there is little pressure on other organs; see Figure 4.2).
There are several screening techniques for detecting ovarian cancer. These include blood tests, pelvic examinations, and ultrasound. Unfortunately, pelvic examinations are not effective in the early diagnosis of ovarian cancer, and both blood tests and ultrasound have fairly high false negatives. This is why many women with ovarian cancer are diagnosed after the cancer has spread beyond the ovary. Although there are a variety of screening tests available for ovarian cancer, including CA-125 and YKL-40, the United States Preventive Services Task Force recommends against routine screening for ovarian cancer, because the potential benefits of these tests remains low (Mantica, 2005; U. S. Preventive Services Task Force, 2005).
Early symptoms of ovarian cancer, if there are any, include vague abdominal discomfort, loss of appetite, indigestion, and anorexic symptoms, and later a patient may become aware of an abdominal mass or diffuse abdominal swelling. At this stage, nausea and vomiting may also occur due to intestinal obstruction. The only treatment is removal of the ovaries (with or without accompanying hysterectomy) and radiation and chemotherapy. As we stated earlier, early detection is crucial to maximizing the chance of a cure. Preventive surgery to remove the ovaries in women with a genetic risk has been found to decrease the risk of ovarian and other gynecologic cancers (American Cancer Society, 2003).
As you have learned throughout this chapter, understanding anatomy and physiology is an important piece in learning about human sexual behavior. It is important to understand all of the physiological and hormonal influences and how they affect the female body before we can move on to the emotional and psychological issues involved in human sexuality. Anatomy and physiology, therefore, are really the foundations of any human sexuality class. We will continue laying this foundation in the following chapter when we move on to “Male Sexual Anatomy and Physiology.”
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