Women’s Health Watch: Endometriosis and Ovarian Cancer Link

Every female born in the United States has a 1 in 55 or 1.8 percent risk of developing ovarian cancer during her lifetime. A family history increases your chances substantially. Investigators who analyzed data from 13 studies discovered that a former bout of endometriosis also has a significant causal effect on three ovarian cancers. Endometriosis is a common disorder of the female reproductive organs that occurs when cells from the uterine lining grow in other areas of your body. It’s the leading source of chronic pelvic pain in women. If you’ve had or develop this condition, examining the ovarian cancer connection is essential.

Confirming the Link

According to a published in Lancet Oncology, a history of endometriosis more than tripled participants’ risks of developing clear-cell ovarian cancer, which accounts for less than 5 percent of all ovarian cancer cases. It also made endometrioid tumors and low-grade serous ovarian cancers more than twice as likely to occur. The Ovarian Cancer Association Consortium, a forum of cancer study investigators, compiled the data. Of the included 23,144 female subjects, 13,326 were controls, 7,911 had invasive ovarian cancer and 1,907 had borderline cancer. The study team didn’t find a correlation between endometriosis and high-grade serous, mucinous, serous borderline or mucinous borderline ovarian cancers. Lead author Celeste Leigh Pearce, a preventive medicine researcher at the University of Southern California, reported that this breakthrough could help identify women who are at increased risk of developing specific ovarian cancer subtypes.While this isn’t the first time researchers have linked endometriosis and ovarian cancer, Dr. Mark Einstein, director of gynecologic oncology at Montefiore Medical Center, noted that this additional confirmation strengthens the association. Dr. Diane Yamada of the Society for Gynecologic Oncology Communications Committee acknowledged that while the research may help identify symptoms of another disease process, it shouldn’t cause alarm among endometriosis patients. “Women should keep in mind that endometriosis is far more common than ovarian cancer,” Pearce said. “Most women with endometriosis do not go on to develop ovarian cancer.” Investigators concluded that women with endometriosis should seek medical care to limit ectopic endometrial growth. They also emphasized the importance of increased cancer surveillance for better prevention and early detection.

Understanding Endometriosis

When endometrium, tissue similar to your uterine lining, develops outside of your uterus, it occurs typically in the pelvic area or abdominal cavity. This may attach itself to your ovaries, the outside of your uterus, your intestines or other abdominal organs. It causes pelvic, abdominal and lower back pain before and while menstruating and during sexual intercourse. Other symptoms may include irregular bleeding and difficulty conceiving. Because endometriosis is a chronic disease, it may develop gradually. You may experience symptoms for years before your doctor makes a definitive diagnosis, which occurs usually between the ages of 25 and 35. Endometriosis affects about 10 percent of women during reproductive age. It’s more common in Caucasian women than African American and Asian women. Studies report that endometriosis tends to occur most often in tall, thin women with low body mass indexes (BMIs). If a first-degree relative had endometriosis, you’re significantly more likely to develop it, according to the National Institutes of Health. Other risks include beginning menstruation at a young age, never having children and frequent, long-lasting periods. Research suggests that frequent and early pregnancy, oral contraceptives and daily exercise may help decrease the incidence and severity of endometriosis.

Exploring Endometriosis Treatment Options

Your doctor will prescribe medication to halt or slow the progression of endometriosis. Norethindrone Acetate is a progestin female hormone that’s similar to progesterone, which your body makes naturally. Taking this drug at specific times during your menstrual cycle like birth control pills regulates the hormone change in your uterus to restore correct menstruation. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Naproxen and Ibuprofen can help with pain control. Surgery also may be necessary, especially if your disease is severe or advanced or your doctor suspects cancer.

Noticing Ovarian Cancer Symptoms

Ovarian cancer is most common when women are in their 50s and 60s, but it occurs often before or during the early 40s if you have a family history. This disease causes more deaths than any other gynecologic cancer and accounts for 5 percent of all cancer deaths among women. According to the MD Anderson Cancer Center, most women with ovarian cancer have vague symptoms. Often, they resemble less serious conditions including indigestion, weight fluctuations and aging. Symptoms may include:

• General abdominal discomfort or pain (gas, indigestion, pressure, swelling, bloating and/or cramps)
• Bloating and/or a feeling of fullness — even after eating a light meal
• Nausea, diarrhea, constipation or frequent urination
• Unexplained weight loss or gain
• Loss of appetite
• Unusual fatigue
• Back pain
• Abnormal vaginal bleeding
• Menstrual changes
• Pain during sex

These symptoms don’t always indicate ovarian cancer. But discuss them with your doctor or gynecologist if they are new, last more than a few weeks and/or occur more than 12 times a month.

Being Vigilant

You know that regular medical and gynecological checkups are vital to your health. But prompt endometriosis diagnosis and treatment no longer are enough. When you and your doctor are on high alert that this condition increases your ovarian cancer risks, you can address any new symptoms in a timely manner to achieve the best possible outcome.