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Modern Hygienist | September 2008
Life | Ovarian Cancer That “other” female cancer A breast cancer survivor encourages us to look beyond pink ribbons.
JaneAnn was my Mom’s lifelong friend. When she told a joke, it would ignite laughter from even the most somber of human beings. Ruth was my best friend’s mother. She made the best Toll House cookies in the world. Gilda was a famous comedian. Although we never met, as “Roseanne Rosannadanna,” she made me stand up and cheer, “Live from New York. It’s Saturday Night!” Lynne was a beautiful woman from my church. She had the face and spirit of an angel. Each of these women embraced life and love with their family and friends. Each of these women touched my life in a special way. Each one made me smile, made me laugh, and eventually, made me cry. Each of these women had their life stolen by ovarian cancer. As a breast cancer survivor, I thank God everyday that I live at a time when early detection of breast cancer is possible. Breast cancer awareness is at its peak. Successful fund raising efforts have led to advanced research that produces new and better methods of early diagnosis and treatment. Breast cancer survival rates are ever increasing. Pink ribbons are everywhere. Do you know the color of the ovarian cancer ribbon? It is teal. Unfortunately, the teal ribbon is rarely seen. It’s a beautiful color, but it’s a very lonely ribbon. Detection deficit
Ovarian cancer is the leading cause of death from gynecologic cancers in the United States, and it is the fifth leading cause of cancer deaths in American women. It is estimated that more than 20,000 women in the U.S. will be diagnosed with ovarian cancer this year and more than 15,000 will die from the disease. It is a disease that most often strikes with no warning, causing only vague symptoms until the cancer has spread beyond the ovaries. In cases where ovarian cancer is detected before metastasis, more than 90% of women survive longer than five years. At present, there is no effective screening method for the early detection of ovarian cancer. One common misconception of the disease is that it can be detected with a PAP smear. A PAP test is used to detect cervical cancer, not ovarian cancer. We do have some examination methods available, but all are limited in their scope of adequacy. * A vaginal-rectal pelvic exam allows the ovaries to be manually examined from many sides. This exam should be performed at every woman’s annual gynecologic check-up. * A transvaginal ultrasound can create a picture of the ovaries allowing for detection of an irregular mass. It cannot diagnose malignancy, but can reveal levels of suspicion. * The CA 125 blood test measures a “marker” or protein in the blood that tends to be elevated in 80% of those with advanced ovarian cancer and 50% of those with early-stage cancer. This marker can be elevated from benign causes as well, and thus is not recommended as a screening procedure in the general population. It is used in cases where there is already a suspicion of ovarian cancer. Symptoms and risk As you can see, we need to find a method of early detection. At present, we must rely on recognition of symptoms as a means of detection. Some signs and symptoms of ovarian cancer include: * Persistent unexplained gastrointestinal discomfort such as gas, bloating, nausea, constipation or diarrhea, indigestion, or a feeling of “fullness” shortly after eating even small amounts * Pelvic, abdominal or lower back pain * Unexplained weight loss or gain * Fatigue * Shortness of breath * Loss of appetite * Abnormal postmenopausal vaginal bleeding and/or pain during intercourse The most significant risk factor is a mutation of one or both of the two “breast cancer genes”—BRCA1 and BRCA2. These mutations can be detected through a specific blood test. Other known risk factors are increasing age (being older than 50), family or personal history of ovarian, breast, endometrial, or colon cancer (family history includes both maternal and paternal sides of the family, but please note that only 10% of cases are linked to family history), and uninterrupted ovulation (no pregnancies and/or infertility). what can we do? As dental hygienists, what can we do in the fight against ovarian cancer? In our profession, we are in contact with many women, both patients and co-workers, on a daily basis. We have the opportunity to promote ovarian cancer awareness in so many ways. It starts with getting more information. I like to print out fact sheets to have on display in the operatories and waiting room of my office. Pay close attention to suspicious symptoms that your patients may mention to you in the course of reviewing their medical history. Recommend that they see a gynecologist if they experience any persistent symptoms. Don’t forget to donate and urge others to do so as well. Even the best organizations need money to aid in their research efforts to find a method of early detection and treatment. The Web sites listed in this article offer secure donation sites as well as links to sign a petition to create an ovarian cancer awareness postage stamp. Most importantly, listen to your own body. Do not ignore symptoms that could indicate ovarian cancer. Ovarian cancer awareness can start right here, right now with us. Far too many women have lost the battle to this deadly disease. As healthcare practitioners, we have the ability to join the fight. Maureen Murphy Chodaba, RDH, is a dental hygienist in the office of Alan Viani, DDS, in Poughkeepsie, NY. She is a certified Reach to Recovery volunteer for the American Cancer Society, serving as the co-coordinator of Reach to Recovery services in Ulster County, NY.
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