To answer some frequently asked questions about ovarian cancer, Everyday Health reviewed the most recent research and enlisted an expert to share her knowledge: Shannon Westin, MD, MPH, an associate professor of gynecologic oncology and reproductive medicine at the University of Texas MD Anderson Cancer Center in Houston. RELATED: Speaking Ovarian Cancer: A Glossary of Formal and Informal Terms Used to Describe Ovarian Cancer Tests, Treatment, Patients, and More
Is getting ovarian cancer after a hysterectomy still possible?
Yes, it’s still possible to develop ovarian cancer, or a closely related cancer called primary peritoneal cancer. “Your risk depends on the type of hysterectomy you have,” explains Dr. Westin. A partial hysterectomy (which just removes the uterus) and total hysterectomy (which removes the uterus and cervix) both leave the ovaries intact, which means you can still develop ovarian cancer. A total hysterectomy with salpingo-oophorectomy removes the cervix, uterus, both ovaries, and fallopian tubes. “Without ovaries, your risk of developing ovarian cancer is dramatically reduced,” explains Westin, but you still have a small risk of developing a type of cancer that looks and acts exactly like ovarian cancer. Called primary peritoneal cancer, it affects cells in the peritoneum, a covering that lines the abdominal organs. The risk of primary peritoneal cancer, however, is low — much lower than the lifetime risk of ovarian cancer if the ovaries remain intact. RELATED: Complications of Ovarian Cancer: How Does It Affect Your Body in the Short and Long Term?
Does talcum powder cause ovarian cancer?
You’ve probably heard about lawsuits between consumers and powder manufacturers claiming that talc causes ovarian cancer, some of which have been settled with big payouts. But should you really be worried? The theory behind the potential connection is that if talcum powder is used in the genital area, the powder particles could travel through the vagina, uterus, and fallopian tubes to the ovaries, where they could cause inflammation that might lead to cancer. Thus far, studies looking at the association between talc and risk of ovarian cancer have been mixed, with some reporting a slight increase and others not, according to the American Cancer Society. The largest study to date, published in the January 2020 issue of Journal of the American Medical Association, looked at more than 250,000 women over several decades. The authors concluded that there was no significant association between talc use in the genital area and the likelihood of developing ovarian cancer. But they noted that due to low incidence of ovarian cancer, the study might not have been large enough to pick up a possible small increase in risk. The bottom line? If there is any association between talc and ovarian cancer, the increase in risk for any individual woman is likely to be low. RELATED: Immunotherapy for Ovarian Cancer
Can eating soy products help ovarian cancer?
Soy and ovarian cancer — the combination is a source of confusion. Does soy raise risk? Is it protective? Much of the misunderstanding stems from the fact that soy foods contain isoflavones, which are substances that can act like the hormone estrogen in the body. Theoretically, isoflavones could increase a woman’s risk of cancers that are sensitive to estrogen, such as ovarian cancer. But plant estrogens appear to be much weaker than human estrogens. “So far we haven’t seen any association between excess soy intakes and risk of ovarian cancer,” says Westin. In fact, there is some evidence that isoflavones might help protect against ovarian cancer, possibly by blocking the more potent natural estrogens in the blood, says the American Cancer Society. Several large population studies have found that women who have high consumption of isoflavones have a relatively low incidence of ovarian cancer. Ovarian cancer is also less common in Asian countries, where high soy diets are consumed. Soy foods, like tofu, tempeh, edamame, miso, and soy milk, are good sources of protein. Soy has also been linked to lower rates of heart disease and may help lower cholesterol. If soy also ratchets down risk of ovarian cancer, consider it an added bonus. RELATED: Diet and Cancer: What You Need to Know — and Eat — to Feel Your Best While Fighting Cancer
Is there any way to pick up ovarian cancer early?
Only about 20 percent of ovarian cancers are found at an early stage, when it is easy to treat, before the cancer spreads outside the ovary, the American Cancer Society says. One reason is that, currently, there is no standard or routine screening test for ovarian cancer. Another problem is that early symptoms of ovarian cancer tend to be vague and easy to ignore. “Ovarian cancer is known as the silent killer, but frankly it’s not,” says Westin. “There are symptoms. It’s just that these symptoms are easy to blow off or attribute to other causes. If you’re feeling bloated or having some abdominal pain, for example, you’re likely to think it’s because of something you ate, or you just need to lose some weight. That’s why ovarian cancer is so tricky.” What separates early signs of ovarian cancer from other, more benign conditions is their persistence, and their deviation from what’s normal for your body in terms of frequency or severity. If you experience any of the following problems daily, or nearly daily, for two weeks, be sure to bring it up with your doctor:
BloatingPelvic or abdominal (belly) painUpset stomachConstipationTrouble eating or feeling full quicklyUrinary symptoms such as urgency (always feeling like you have to go) or frequency (having to go often)Extreme tirednessBack painPain during sex
RELATED: Is It Ovarian Cancer or IBS? If you’re at high risk of ovarian cancer due to an inherited genetic syndrome (such as Lynch syndrome), BRCA gene mutations, or a strong family history of breast and ovarian cancer, your doctor may recommend regular screening with transvaginal ultrasounds (which uses a wand-like device to emit sound waves that generate images of your pelvic organs), as well as CA125 testing (measuring levels of a blood protein that can be abnormally high in women with ovarian cancer). RELATED: Why I Had My Breasts and Fallopian Tubes Removed Due to a Gene I Inherited From My Dad
Can ovarian cysts become cancerous?
It’s possible, but not likely. Ovarian cysts are small fluid-filled sacs that can develop in or on a woman’s ovaries. Most cysts are harmless and occur as a normal part of the process of ovulation (egg release). These are called functional cysts and usually go away within a few months without any treatment. “Very rarely, an ovarian cyst can convert into cancer,” says Westin. “That’s why if you develop a cyst, your doctor will want to monitor it and make sure it doesn’t continue to grow.” If a cyst starts growing bigger or causing symptoms, your doctor may recommend surgery to remove it. An ovarian cyst can be more concerning in a woman who is no longer ovulating. While most of these cysts are benign, a small number could be cancer. “In a post-menopausal woman, we will move toward surgery much sooner than a woman who is still ovulating,” notes Westin. “That being said, the majority of these masses do not turn out to be cancer.”
Do fertility treatments raise your ovarian cancer risk?
Because some fertility treatments use hormones, there has been some concern that these treatments could increase risk of cancers that are stimulated by these hormones, including ovarian cancer. Many studies have examined possible associations between in vitro fertilization (IVF) and the use of fertility drugs like Clomid (clomiphene citrate) and ovarian cancer risk. But the results have been conflicting, with some reporting a small increase in risk and some finding no increased risk at all, according to the National Cancer Institute. Right now, the consensus is that any small increased risk of ovarian cancer associated with assisted reproduction is most likely due to the infertility itself, rather than the fertility treatments. “If you don’t get pregnant, you are constantly ovulating and, as a result are exposed to more estrogen than someone who has had pregnancies,” explains Westin. Some causes of infertility, such as obesity and endometriosis, may also slightly increase ovarian cancer risk. “Studies that have only looked at infertile women, comparing those who received fertility treatment to those who did not, have not seen an increased risk of ovarian cancer associated with these treatments,” adds Westin. More research is needed, but for now it looks like there is little reason to worry.
