According to a new study from researchers affiliated with the University of California, Irvine (UCI) many California women with an ovarian cancer diagnosis are not receiving adequate care or treatments; the inadequate care can result in decreased survival from the disease. The findings were presented on March 11 at a meeting of the Society of Gynecologic Oncology in Los Angeles.
Approximately 22,000 new cases of ovarian cancer are diagnosed each year in the United States, and 15,000 woman die from the disease each year. Often these cases are caught at an advanced stage because definite symptoms do not appear at the earlier stages. The researchers found many flaws in ovarian cancer treatment. They noted that a large percentage of women received care from doctors who lack expertise; furthermore, they are receiving their care at hospitals that are not proficient in the proper care. These women who have an advanced stage of ovarian cancer would have a significantly better chance of survival if the appropriate treatment is begun promptly after diagnosis by skilled healthcare professionals.
The researchers reviewed medical records of more than 13,000 women who were diagnosed with ovarian cancer between the years of 1999 and 2006 in California. They found that more than 80% of the patients were treated by ‘low-volume’ providers (surgeons who have treated 10 or less cases) and hospitals treating 20 or less cases. Hospitals and doctors who have treated a higher volume of cases are more likely to stick to guidelines, and their patients live longer.
Ovarian cancer is cancer that starts in the ovaries, which are the female reproductive organs that produce eggs. It is the fifth most common cancer among women, and it causes more deaths than any other type of female reproductive cancer. The risk for developing ovarian cancer appears to be affected by several factors. The more children a woman has and the earlier in life she gives birth, the lower her risk for ovarian cancer. Certain genes (BRCA1 and BRCA2) are responsible for a small number of ovarian cancer cases. Women with a personal history of breast cancer or a family history of breast or ovarian cancer have an increased risk for ovarian cancer.
Older women are at highest risk. About two-thirds of the deaths from ovarian cancer occur in women age 55 and older. About 25% of ovarian cancer deaths occur in women ages 35 - 54. Women who take estrogen replacement only (not with progesterone) for 5 years or more seem to have a higher risk of ovarian cancer. Birth control pills decrease the risk of ovarian cancer. More recent studies suggest that fertility drugs do not increase the risk for ovarian cancer.
Ovarian cancer symptoms are often vague. Women and their doctors often blame the symptoms on other, more common conditions. By the time the cancer is diagnosed, the tumor has often spread beyond the ovaries. Early-stage ovarian cancer can cause symptoms, although these symptoms also occur with many other conditions. You should see your doctor if you have the following symptoms on a daily basis for more than a few weeks:
- Difficulty eating or feeling full quickly
- Pelvic or abdominal pain
Other symptoms are also seen with ovarian cancer. However, these symptoms are also common in women who do not have cancer:
- Abnormal menstrual cycles
- Increased gas
- Lack of appetite
- Nausea and vomiting
- Sense of pelvic heaviness
- Swollen abdomen or belly
- Unexplained back pain that worsens over time
- Vaginal bleeding
- Vague lower abdominal discomfort
- Weight gain or loss
Other symptoms that can occur with this disease:
- Excessive hair growth
- Increased urinary frequency or urgency
Take home message:
A pelvic examination by a gynecologist can often detect ovarian cancer. An ultrasound exam is a noninvasive procedure that can detect enlargement and abnormalities of the ovaries. An ultrasound examination can also determine which ovarian enlargements are most suspicious for malignancy. If you are diagnosed with ovarian cancer, you should have the surgery performed by a gynecologic oncologist: a gynecologic surgeon who has had specialized training in gynecologic malignancies. These doctors also often administer chemotherapy to their patients. In many cases, a woman may have her ovarian cancer diagnosed by her obstetrician/gynecologist. He or she may have delivered her children; thus, a woman often has an established, trusting relationship with this physician. However, a general obstetrician/gynecologist is not the best choice for surgical treatment of ovarian cancer. A gynecologic oncologist is a better choice. Women in Los Angeles have access to two state-of-the art medical centers: UCLA and Cedars-Sinai. Both are well equipped to provide high level care and the doctors on their staff have excellent credentials