Ovarian cancer is not as common as other cancers, accounting for just 3% of female cancers in the United States (for comparison, that number is 12% for breast cancer). However, an ovarian cancer diagnosis can be hard to receive. 1 in 5 cancer deaths amongst women is due to ovarian cancer. In this article, we’ll cover the basics of ovarian cancer and the connection between ovarian cancer and back pain.
What is Ovarian Cancer?
Ovarian cancer is a type of cancer that affects the 2 small organs located on either side of the uterus, known as the ovaries. Ovaries perform a range of functions within the female reproductive system, but because of their tiny size and location in the abdomen, detecting ovarian cancers can sometimes be tricky.
There are more than 30 different types of ovarian cancer. Cancerous tumors can start anywhere in the ovary, and left unchecked can grow in size, shifting internal organs in the relatively roomy pelvis and masking symptoms until the advanced stages of the cancer. There are a few different characteristics that ovarian cancer can have, and each diagnosis will come with the following information:
- A grade on a scale of 1 to 3, depending on how closely the cancerous cells resemble normal tissue.
- A grade on a scale of 1 to 4, depending on the size of the tumor(s) and whether the cancer has spread. These “stages” include stage 1, stage 2, stage 3 and stage 4 ovarian cancer.
- The type of cancer. This depends on how well the tumor(s) respond to different types of treatment, such as chemotherapy, and how fast they grow.
Because of the difficulty in diagnosing ovarian cancer, only 15% of women are diagnosed during early-stage ovarian cancer. This contributes to the higher mortality rate; the 5 year survival rate is just 46.5%.
One key to successful treatment is getting an early diagnosis, but oftentimes, that’s easier said than done. Many of the early warning signs of ovarian cancer can easily be overlooked as something minor. That’s why it’s so important for women to be vigilant, and understand the risk factors and symptoms of this disease.
Risk Factors for Ovarian Cancer
Many women who develop ovarian cancer have certain risk factors.
Physical and Genetic Factors
Overall, women have a 1 in 78 risk in developing ovarian cancer. However, certain factors can affect those odds. For example, ovarian cancer is much more prevalent in women over the age of 63. Half of all new diagnoses occur in patients above that threshold.
Additionally, existing medical conditions can also factor in: women with endometriosis, HPV, gastrointestinal cancer, or diabetes are slightly more at risk.
Women with inherited genetic factors are also more at risk – although having a family member with ovarian cancer is not itself a sign of a genetic problem. But if your family tree includes 2 or more cases of ovarian or breast cancer, you should talk to your doctor about your potentially elevated risk levels.
In addition to physical and genetic factors, there are also lifestyle factors that can increase your chance of getting ovarian cancer. These include:
- Use of hormone replacement therapy (HRT)
- Use of talcum powder around the genitals
- Having a child over the age of 35
- Never having been pregnant
- Receiving IVF
It’s not all bad news; there are some factors that can actually decrease your chances of getting ovarian cancer. These include:
- Use of the contraceptive pill. Some studies have shown that continued use over a 10 year period can actually halve your risk of ovarian cancer.
- Pregnancy and breastfeeding
- Healthy diet
- Regular exercise
Symptoms of Ovarian Cancer
Early diagnosis is vital to the successful treatment of ovarian cancer. Unfortunately, symptoms do not occur immediately. The size of the tumor usually dictates when physical effects become noticeable. When the tumor grows big enough, it puts pressure on other organs, such as the bladder and uterus. This pressure causes observable issues in the body.
The most common symptoms of ovarian cancer include:
- Frequent bloating
- Difficulty eating, feeling full very quickly
- Abdominal distension
- Weight loss or weight gain
- Frequent need to urinate
- Urgency to urinate
- Abdominal or pelvic pain
- Change in the menstrual cycle
- Vaginal bleeding
- Pain during intercourse
- Lower back pain
Many of these symptoms are often overlooked or assumed to be due to a more minor issue. For example, back pain, fatigue or abdominal cramps can all relate to heavy menstrual cycles, while indigestion and weight loss can be associated with stomach-related issues.
Additionally, few ovarian cancer patients experience every single symptom, making it even easier to dismiss the physical manifestations of the disease.
Ovarian Cancer and Back Pain
Back pain is an especially tricky symptom because such a large proportion of women experience back pain routinely. Studies show that 80% of all people experience chronic back pain at some point in their lives. It is the prevalence of these symptoms in everyday life that makes ovarian cancer so difficult to catch early.
When To Worry
Ovarian cancer symptoms present a double-edged sword: most women experiencing the symptoms we covered have a common medical issue, but because of this, many women with ovarian cancer may go undiagnosed.
So if you experience any of the symptoms listed above, do not be alarmed. The likelihood of ovarian cancer is low. However, given ovarian cancer’s deadly nature, it may still help to talk to your doctor about any unexplained symptoms, especially if you’re experiencing multiple symptoms you’re in a high-risk population.
A general rule of thumb recommended by doctors is that any symptoms that do not respond to treatment (for example, icing a sore back) after more than 2 weeks should be investigated.
Your doctor will need a few things for a proper diagnosis. This includes a run-down of your symptoms (how long you’ve had them, how often they occur, etc.), your family medical history, and a physical exam.
Because your ovaries are so small, most early ovarian tumors cannot be felt manually through the abdominal wall. So other physical tests are required. This can include blood tests, a transvaginal ultrasound, and CT scans.
Once a diagnosis is made, there are numerous treatment options, depending on the exact nature of the disease and its stage. Typical treatments include surgery, chemotherapy, radiation therapy, and hormone therapy. These all treat the root cause of the problem, but it’s important to also treat the painful symptoms, such as back pain and abdominal pain, with appropriate therapies and medication.
The earlier the disease is caught, the more effective treatment will be, with 94% of women receiving an early-stage diagnosis surviving past 5 years. Similarly, the younger you are when you’re diagnosed, the better your survival rate. To add to this positive news, the overall incidence rates of ovarian cancer are falling. There’s been a 30% reduction in ovarian cancer in the last 30 years.
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This post was updated in October 2019 with new information and resources.