There is no effective routine screening for ovarian cancer and symptoms of the disease can be vague, which means delayed diagnosis is far too common.
Dr. John Schorge, a renowned gynecologic oncologist at Regional One Health, said there are still ways women can protect their health.
During September’s Ovarian Cancer Awareness Month, Dr. Schorge hosted a “Lunch & Learn” to educate patients about improved risk reduction and treatment options.
For too many women, ovarian cancer is diagnosed when the disease has already progressed to stage 3 or 4. During Ovarian Cancer Awareness Month, Dr. John Schorge, Chief of Regional One Health’s OB/GYN service and a renowned gynecologic oncologist, wants women to know there are steps they can take to protect their health.
“More and more women with ovarian cancer are being cured, and fewer are being diagnosed,” he said. “This shows the progress we’ve made in the past 10 years or so.”
Dr. Schorge hosted a “Lunch & Learn” to discuss that progress and how it impacts patient care.
He started by sharing the example of Ann Dunham, mother of former President Barack Obama, who died of ovarian cancer at just 52 years old. “She knew something wasn’t right, and she saw multiple doctors, but no one did a pelvic exam,” he said. “When she finally learned that she had ovarian cancer, her diagnosis had been delayed for almost a year.”
That is far too common, he said.
For one thing, there is no routine screening for ovarian cancer. Blood tests can identify a protein linked to the disease, but medical experts do not recommend the test for routine screening because it leads to too many false positives and unnecessary procedures.
“All the medical organizations agree: do not screen, because it does more harm than good,” Dr. Schorge said. “Unfortunately, there is no such thing as effective screening for ovarian cancer.”
Dr. John Schorge, a gynecologic oncologist at Regional One Health, said risk management and treatment for ovarian cancer have improved. “More and more women with ovarian cancer are being cured, and fewer are being diagnosed,” he said. “This shows the progress we’ve made in the past 10 years or so.”
Ovarian cancer also doesn’t have obvious, early symptoms for many women.
Dr. Schorge said bloating, difficulty eating, pelvic or abdominal pain, or frequent urination can be signs of ovarian cancer, and he urged women who experience those concerns for two weeks or more to talk to their doctor. That said, he noted those symptoms often don’t show up right away, so they don’t necessarily help with early detection.
There is good news, however. Dr. Schorge said two of the major risk factors for ovarian cancer – pelvic inflammation and genetics – can be managed.
On the first, taking oral contraceptives or other hormonal therapy to prevent pregnancy can help, since monthly ovulation is a repetitive source of inflammation. Dr. Schorge added pregnancy and breastfeeding, which also stop the menstrual cycle for a while, offer some protection as well.
Meanwhile, when a woman is found to be predisposed to ovarian cancer through genetic testing, surgery can help prevent the disease. About 15 percent of ovarian cancer diagnoses are hereditary.
Dr. Schorge said women who have a family member who had ovarian cancer or breast cancer at a young age should explore genetic testing for the BRCA genetic mutation, which raises the chance of getting ovarian cancer to 40 percent. “At Regional One Health Cancer Care, we offer genetic testing and counseling that allows us to identify women who are at a higher risk due to family history.” he said. “Then, we can intervene by removing the tubes and ovaries before you get the cancer.”
Dr. Schorge noted as more of these surgeries were done, doctors discovered that about 5 percent of the time the ovarian cancer had already started and appeared to start at the tip of the fallopian tubes – not the ovary.
This discovery led to the shift toward removing the tube instead of just tying them off at the time of tubal ligation. It is also common practice to now remove the tubes at the time of hysterectomy. As a result, the number of women in the United States diagnosed with ovarian cancer has decreased by 15 percent over the past five years.
Don’t ignore symptoms like bloating, difficulty eating, pelvic or abdominal pain, or frequent urination that last for two or more weeks. These can be signs of ovarian cancer, and your doctor can perform a pelvic exam to help determine what’s wrong.
Along with improved risk management, medical advances have given doctors better options for treating ovarian cancer.
Dr. Schorge said many women first have neoadjuvant chemotherapy to shrink the tumor, which makes surgical treatment more effective and easier. Then, patients have minimally invasive surgery to remove as much cancer as possible, a process known as “debulking.” Additionally, patients have a hysterectomy to prevent the cancer from spreading or returning.
Dr. Schorge said the hysterectomy can usually be done as a minimally invasive procedure, which often allows the patient to go home the same day and experience an easier recovery.
For women whose cancer is genetic, there are additional options to prevent recurrence, he said: “Patients who are diagnosed with ovarian cancer undergo genetic testing. Up to half will be found to have a defective gene – and that’s a good thing, because we can prescribe a PARP inhibitor, a medication that reduces the risk of cancer coming back.”
Dr. Schorge said research indicates PARP inhibitors can decrease the risk of dying from ovarian cancer by 80 percent: “This has revolutionized the treatment of ovarian cancer.”
Dr. Schorge and his team are proud to make that type of advanced care available right in the heart of downtown Memphis. “In no part of the country are there more health care disparities than here in the Mid-South, and we’re raising the level of care by improving the services that are available to women in our community,” he said.