Ovarian Cancer At A Glance

Ovarian Cancer At A Glance

• Most ovarian growths in women under age 30 are benign, fluid-filled cysts.
• There are several types of ovarian cancer.
• Factors that increase the chance of developing ovarian cancer have been identified.
• The symptoms of ovarian cancer can be vague.
• Detection of ovarian cancer involves physical examination (including pelvic exam), ultrasound, X-rays, the CA-125 blood test and biopsy of the ovary.
• The treatment of ovarian cancer depends on the stage of the disease and the age and health of the woman.

Source: National Cancer Institute, U.S. National Institutes of Health (NIH).

What resources are available to patients with ovarian cancer?

National Cancer Institute information resources

You may want more information for yourself, your family, and your doctor. The following NCI services are available to help you.

Telephone

The NCI's Cancer Information Service (CIS) provides accurate, up-to-date information on cancer to patients and their families, health professionals, and the general public. Information Specialists translate the latest scientific information into understandable language and respond in English, in Spanish, or on TTY equipment. Calls are free. The service is available to callers in the United States and its territories.

Telephone: 1-800-4-CANCER (1-800-422-6237)
TTY: 1-800-332-8615

Internet

The NCI's Web site (http://www.cancer.gov) provides information from numerous NCI sources. It offers current information on cancer prevention, screening, diagnosis, treatment, genetics, supportive care, and ongoing clinical trials. It has information about NCI's research programs and funding opportunities, cancer statistics, and the Institute itself. Information Specialists provide live, online assistance through LiveHelp at http://www.cancer.gov/help.

National Cancer Institute publications

NCI provides information about cancer, including the publications mentioned in this booklet. You can order these materials by telephone, on the Internet, or by mail. You can also read them online and print your own copy.

• By telephone: People in the United States and its territories may order these and other NCI publications by calling the NCI's Cancer Information Service at 1-800-4-CANCER.



• On the Internet: Many NCI publications can be viewed, downloaded, and ordered from http://www.cancer.gov/publications. on the Internet. People in the United States and its territories may use this Web site to order printed copies. This Web site also explains how people outside the United States can mail or fax their requests for NCI booklets.



• By mail: NCI publications can be ordered by writing to the address below:
  
  
  Publications Ordering Service
  National Cancer Institute
  Suite 3035A 6116
  Executive Boulevard, MSC 8322
  Bethesda, MD 20892-8322

What research is available for ovarian cancer patients?

The promise of cancer research

Doctors all over the country are conducting many types of clinical trials (research studies in which people volunteer to take part). They are studying new and better ways to prevent, detect, and treat ovarian cancer.

Clinical trials are designed to answer important questions and to find out whether new approaches are safe and effective. Research already has led to advances, and researchers continue to search for more effective methods.

Women who join clinical trials may be among the first to benefit if a new approach is effective. And even if the women in a trial do not benefit directly, they may still make an important contribution by helping doctors learn more about ovarian cancer and how to control it. Although clinical trials may pose some risks, researchers do all they can to protect their patients.

Researchers are conducting studies with women across the country:

• Prevention studies: For women who have a family history of ovarian cancer, the risk of developing the disease may be reduced by removing the ovaries before cancer is detected. This surgery is called prophylactic oophorectomy. Women who are at high risk of ovarian cancer are taking part in trials to study the benefits and harms of this surgery. Other doctors are studying whether certain drugs can help prevent ovarian cancer in women at high risk.



• Screening studies: Researchers are studying ways to find ovarian cancer in women who do not have symptoms.



• Treatment studies: Doctors are testing novel drugs and new combinations. They are studying biological therapies, such as monoclonal antibodies. Monoclonal antibodies can bind to cancer cells. They interfere with cancer cell growth and the spread of cancer.

If you are interested in being part of a clinical trial, talk with your doctor. You may want to read the NCI booklets Taking Part in Clinical Trials: What Cancer Patients Need To Know and Taking Part in Clinical Trials: Cancer Prevention Studies. NCI also offers an easy-to-read brochure called If You Have Cancer�What You Should Know About Clinical Trials. These NCI publications describe how clinical trials are carried out and explain their possible benefits and risks.

NCI's Web site includes a section on clinical trials at http://www.cancer.gov/clinicaltrials. It has general information about clinical trials as well as detailed information about specific ongoing studies of ovarian cancer. NCI's Information Specialists at 1-800-4-CANCER or at LiveHelp at http://www.cancer.gov/help can answer questions and provide information about clinical trials.

Where can ovarian cancer patients find support?

Sources of support

Learning you have ovarian cancer can change your life and the lives of those close to you. These changes can be hard to handle. It is normal for you, your family, and your friends to have many different and sometimes confusing feelings.

You may worry about caring for your family, keeping your job, or continuing daily activities. Concerns about treatments and managing side effects, hospital stays, and medical bills are also common. Doctors, nurses, and other members of your health care team can answer questions about treatment, working, and other activities. Meeting with a social worker, counselor, or member of the clergy can be helpful if you want to talk about your feelings or concerns. Often, a social worker can suggest resources for financial aid, transportation, home care, or emotional support.

Support groups also can help. In these groups, patients or their family members meet with other patients or their families to share what they have learned about coping with the disease and the effects of treatment. Groups may offer support in person, over the telephone, or on the Internet. You may want to talk with a member of your health care team about finding a support group.

It is natural for you to be worried about the effects of ovarian cancer and its treatment on your sexuality. You may want to talk with your doctor about possible sexual side effects and whether these effects will be permanent. Whatever happens, it may be helpful for you and your partner to talk about your feelings and help one another find ways to share intimacy during and after treatment.

For tips on coping, you may want to read the NCI booklet Taking Time: Support for People With Cancer. NCI's Information Specialists at 1-800-4-CANCER and at LiveHelp (http://www.cancer.gov/help) can help you locate programs, services, and publications. For a list of organizations offering support, you may want to get the NCI fact sheet "National Organizations That Offer Services to People With Cancer and Their Families."

Nutrition and physical activity

It's important for women with ovarian cancer to take care of themselves. Taking care of yourself includes eating well and staying as active as you can.

You need the right amount of calories to maintain a good weight. You also need enough protein to keep up your strength. Eating well may help you feel better and have more energy.

Sometimes, especially during or soon after treatment, you may not feel like eating. You may be uncomfortable or tired. You may find that foods do not taste as good as they used to. In addition, the side effects of treatment (such as poor appetite, nausea, vomiting, or mouth sores) can make it hard to eat well. Your doctor, a registered dietitian, or another health care provider can suggest ways to deal with these problems. Also, the NCI booklet Eating Hints for Cancer Patients has many useful ideas and recipes.

Many women find they feel better when they stay active. Walking, yoga, swimming, and other activities can keep you strong and increase your energy. Whatever physical activity you choose, be sure to talk to your doctor before you start. Also, if your activity causes you pain or other problems, be sure to let your doctor or nurse know about it.

Radiation therapy

Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells. A large machine directs radiation at the body.

Radiation therapy is rarely used in the initial treatment of ovarian cancer, but it may be used to relieve pain and other problems caused by the disease. The treatment is given at a hospital or clinic. Each treatment takes only a few minutes.

Side effects depend mainly on the amount of radiation given and the part of your body that is treated. Radiation therapy to your abdomen and pelvis may cause nausea, vomiting, diarrhea, or bloody stools. Also, your skin in the treated area may become red, dry, and tender. Although the side effects can be distressing, your doctor can usually treat or control them. Also, they gradually go away after treatment ends.

NCI provides a booklet called Radiation Therapy and You: A Guide to Self-Help During Cancer Treatment.

Supportive care

Ovarian cancer and its treatment can lead to other health problems. You may receive supportive care to prevent or control these problems and to improve your comfort and quality of life.

Your health care team can help you with the following problems:

• Pain: Your doctor or a specialist in pain control can suggest ways to relieve or reduce pain. More information about pain control can be found in the NCI booklets Pain Control: A Guide for People with Cancer and Their Families, Get Relief from Cancer Pain, and Understanding Cancer Pain.



• Swollen abdomen (from abnormal fluid buildup called ascites): The swelling can be uncomfortable. Your health care team can remove the fluid whenever it builds up.



• Blocked intestine: Cancer can block the intestine. Your doctor may be able to open the blockage with surgery.



• Swollen legs (from lymphedema): Swollen legs can be uncomfortable and hard to bend. You may find exercises, massages, or compression bandages helpful. Physical therapists trained to manage lymphedema can also help.



• Shortness of breath: Advanced cancer can cause fluid to collect around the lungs. The fluid can make it hard to breathe. Your health care team can remove the fluid whenever it builds up.



• Sadness: It is normal to feel sad after a diagnosis of a serious illness. Some people find it helpful to talk about their feelings. See the "Sources of Support" section for more information.

Chemotherapy

Chemotherapy uses anticancer drugs to kill cancer cells. Most women have chemotherapy for ovarian cancer after surgery. Some women have chemotherapy before surgery.

Usually, more than one drug is given. Drugs for ovarian cancer can be given in different ways:

• By vein (IV): The drugs can be given through a thin tube inserted into a vein.



• By vein and directly into the abdomen: Some women get IV chemotherapy along with intraperitoneal (IP) chemotherapy. For IP chemotherapy, the drugs are given through a thin tube inserted into the abdomen.



• By mouth: Some drugs for ovarian cancer can be given by mouth.

Chemotherapy is given in cycles. Each treatment period is followed by a rest period. The length of the rest period and the number of cycles depend on the anticancer drugs used.

You may have your treatment in a clinic, at the doctor's office, or at home. Some women may need to stay in the hospital during treatment.

The side effects of chemotherapy depend mainly on which drugs are given and how much. The drugs can harm normal cells that divide rapidly:

• Blood cells: These cells fight infection, help blood to clot, and carry oxygen to all parts of your body. When drugs affect your blood cells, you are more likely to get infections, bruise or bleed easily, and feel very weak and tired. Your health care team checks you for low levels of blood cells. If blood tests show low levels, your health care team can suggest medicines that can help your body make new blood cells.



• Cells in hair roots: Some drugs can cause hair loss. Your hair will grow back, but it may be somewhat different in color and texture.



• Cells that line the digestive tract: Some drugs can cause poor appetite, nausea and vomiting, diarrhea, or mouth and lip sores. Ask your health care team about medicines that help with these problems.

Some drugs used to treat ovarian cancer can cause hearing loss, kidney damage, joint pain, and tingling or numbness in the hands or feet. Most of these side effects usually go away after treatment ends.

You may find it helpful to read NCI's booklet Chemotherapy and You: A Guide to Self-Help During Cancer Treatment.

You may want to ask your doctor these questions about chemotherapy:

• When will treatment start? When will it end? How often will I have treatment?



• Which drug or drugs will I have?



• How do the drugs work?



• Do you recommend both IV and IP (intraperitoneal) chemotherapy for me? Why?



• What are the expected benefits of the treatment?



• What are the risks of the treatment? What side effects might I have?



• Can I prevent or treat any of these side effects? How?



• How much will it cost? Will my health insurance pay for all of the treatment?