At the doctors office

Alexander Raths

The risk of many diseases increases as we age, and ovarian cancer is no different. Although there are stories of younger women being diagnosed with ovarian cancer, it is most typically found in women in their late 50s or older.

“Ovarian cancer risk rises steeply around the time of menopause, and age is a big risk factor,” says Dr. Bill Helm, professor of obstetrics, gynecology and women’s health at Saint Louis University and a SLUCare gynecologic cancer specialist. The statistics tell the tale: At age 40, ovarian cancer affects one in 2,500 women; by age 50, it’s one in 1,500; and by age 60, incidence increases to one in 600.

Jan Paul, owner of Groundbreaking Design, a landscape design firm in St. Louis, was postmenopausal when she began losing weight rapidly and feeling full halfway through a meal. Like many women, her initial symptoms were somewhat vague and neither she nor her physician initially suspected ovarian cancer. By the time her cancer was diagnosed—after more weight loss, nausea and a blood clot in her leg— Paul’s cancer was advanced.

Since her diagnosis and treatment five years ago, Paul has been free of a cancer recurrence. She volunteers for St. Louis Ovarian Cancer Awareness, an organization dedicated to educating people about the disease. “As women, we know our bodies; we know when something is wrong, but too often we’re too busy to take time to take care of ourselves,” she says. “We’re taking care of our children, our parents, our spouses. We’re wrapped up in our careers and we think of something as a minor problem or annoyance in our health that we can take care of later. The message is to pay attention to our own body and be our own advocate.”

To do that, it’s important to seek medical care when a symptom—even something as vague as bloating—persists for more than a couple of weeks. Dr. Nick Chobanian, a Mercy Clinic gynecologic oncologist, echoes Paul’s advice. “Women need to continue to be aware of their bodies. They’re the ones who call the shots,” he says. “If they don’t say, Hey, there’s something going on that isn’t right, and bring the attention to it, they’re not going to get diagnosed.”

Chobanian notes that 75 percent of ovarian cancer cases are diagnosed when the disease is in an advanced stage, which depresses the survival rate. When caught earlier, surgery and chemotherapy can be very effective in eradicating the cancer.

Although age cannot be controlled, other risk factors are modifiable. Risk is reduced by taking oral contraceptives, having tubal ligation, bearing children and having a hysterectomy. Physicians agree that better screening and early detection are key, but the disease remains relatively rare and “it has been estimated that a test with even 100 percent sensitivity and 99 percent specificity would mean that 20 of 21 women undergoing surgery for an abnormal test would not have primary ovarian cancer,” Helm says. However, “if your physician thinks you might have ovarian cancer or you have a mass that might be cancer, seek consultation with a gynecologic oncologist who will specialize in this.”

Paul reiterates that message: “We’re very fortunate here in St. Louis to have access to top-notch medical care.” And she’s living proof.