Ovarian Cancer Treated by Baltimore Gynecologic Oncologists
Women in Baltimore, Washington, D.C., Virginia and across the Mid-Atlantic region have turned to these leading ovarian cancer doctors for their expertise in diagnosing ovarian cancer symptoms and their top quality surgical skills, including traditional and robotic surgery options, combined with their compassionate care and understanding nature.
About Ovarian Cancer
Ovarian cancer traditionally has been thought to begin in one or both of the ovaries. Current research is suggesting that ovarian cancer actually may begin in the fallopian tubes; however, researchers are continuing to investigate this theory.
The ovaries are the female reproductive glands that consist of three types of cells:
- Epithelial cells cover the ovaries
- Germ cells are inside the ovaries and develop into eggs for reproduction
- Stromal cells form the structural tissue of the ovaries and produce hormones
When these cells in the ovaries grow abnormally, they develop into tumors that either can be non-cancerous (benign) or cancerous (malignant). If cancerous tumors are not detected early, they can spread from the ovaries throughout the pelvic region as well as continue to spread to the abdominal area and other organs. The most common form of ovarian cancer begins in the epithelial cells.
Risk Factors for Ovarian Cancer
Risk factors for ovarian cancer can include:
- Genetic predisposition
- BRCA 1 or 2 (BReast CAncer) gene mutation
- Lynch syndrome
- Family history of ovarian cancer or breast cancer in a:
- First degree relative (parent, sibling or child)
- Second degree relative (aunt/uncle, grandparent, niece/nephew or grandchild
Ovarian Cancer Symptoms
A standard test for ovarian cancer does not exist, making it difficult to detect ovarian cancer in its early stages. Ovarian cancer symptoms can be similar to other medical conditions and often are overlooked as possible cancer symptoms. Ovarian cancer symptoms can include:
- Abdominal bloating
- Abdominal pressure
- Unintentional weight changes
- Pelvic discomfort, pressure, pain or pain during intercourse
- Urinary frequency without an infection
- Changes in bowel movements
- Nausea, indigestion, gas, constipation or diarrhea
- Trouble eating or feeling full
- Increase in abdominal girth
- Changes in the menstrual cycle
- Lower back pain
When to Seek an Ovarian Cancer Specialist
It is important to seek medical expertise when experiencing any of these possible ovarian cancer symptoms. The earlier ovarian cancer is diagnosed, the better the prognosis.
It is especially important to see a gynecologic oncologist specializing in ovarian cancer if any of the possible ovarian cancer symptoms:
- Appear suddenly
- Are persistent
- Gradually become worse
These characteristics of ovarian cancer symptoms are an important factor in differentiating the symptoms from other conditions.
While ovarian cancer symptoms may be common symptoms of other conditions, such as digestive disorders or urinary disease, it is important to see a gynecologic oncologist who specializes in ovarian cancer to determine if the symptoms are related to ovarian cancer.
Often ovarian cancer is overlooked as a possible cause of these symptoms since other specialists do not perform a pelvic examination as part of their physical exam. Women see various doctors to treat their symptoms, but by the time ovarian cancer is properly diagnosed by a gynecologic oncologist, it often is in the late stages.
Ovarian Cancer Diagnosis
Gynecologic oncologists specializing in ovarian cancer conduct a physical exam, imaging studies and blood tests when ovarian cancer is suspected. The physical exam consists of confirming the presence of a nodular or fixed pelvic mass and/or an abdominal mass as well as fluid (ascites) build up.
Imaging studies may include:
- Ultrasound – used to determine the size, appearance, consistency and location of the ovarian tumor
- CT scan or MRI – taken of the chest, abdomen and pelvis to confirm if the tumor has spread
Blood tests are conducted to help detect tumor markers, which are substances that may be found in blood or other bodily fluids when cancer is present. Blood samples may be tested for any or all of the following tumor markers:
- Cancer Antigen 125 (CA-125)
- Carcinoembrionic Antigen (CEA)
- Cancer Antigen 19-9 (CA-19-9)
A complete blood count and metabolic panel also are prepared from the blood samples.
Cancer specialists now are beginning to look at gene and protein patterns in the blood as additional tumor markers to help with cancer diagnoses. The OVA1 test looks at proteins that change when ovarian cancer is present. This test helps determine prior to surgery the likelihood of an ovarian mass to be cancerous.
A Risk of Ovarian Malignancy Algorithm (ROMA) also is starting to be used by ovarian cancer specialists. Using CA125 results and HE4 protein values establishes a ROMA score that can help classify a patient’s risk level of having epithelial ovarian cancer.
It is important that blood test results be examined along with the physical exam and imaging study results and the patient’s medical history to help determine the best treatment options possible.
Stages of Ovarian Cancer
The Lya Segall Ovarian Cancer Institute at Mercy has some of the Mid-Atlantic region's top doctors for determining the stages of ovarian cancer. Determining the stage of ovarian cancer is essential in developing an ovarian cancer treatment plan. The stages of ovarian cancer are:
- Stage I - ovarian cancer is in one or both of the ovaries
- Stage II - ovarian cancer extends to the pelvis area
- Stage III - ovarian cancer extends to the abdominal area
- Stage IV - ovarian cancer extends to locations outside the abdominal area
Ovarian cancer treatment typically includes surgery and chemotherapy. The stage of ovarian cancer dictates the extent of the surgery needed to remove the ovarian cancer. Stage I ovarian cancer may involve the removal of just one ovary while Stage IV ovarian cancer may involve the removal of ovaries, fallopian tubes, and uterus, as well as lymph nodes, abdominal tissues, and other areas to which the ovarian cancer may have spread. Mercy's gynecologic surgeons are skilled at removing ovarian cancer at any stage, guided by their extensive expertise and carefully-honed surgical skills.