The recent Johnson & Johnson baby powder cancer lawsuits have brought the issue of ovarian cancer to the forefront, bringing some much-needed attention to women’s gynecological health. Ovarian cancer is the deadliest of all gynecological cancers, yet, unlike breast cancer, there is a real lack of information about the disease. There are 22,000 diagnoses of ovarian cancer across the United States each year, and approximately 14,000 deaths. A new research project and clinical trials supported by Stand Up to Cancer, the Ovarian Cancer Research Fund Alliance and the National Ovarian Cancer Coalition are underway.

The goal of these trials and projects is to provide women with high-quality education about ovarian cancer, as well as creating new options for genetic testing, surgical prevention and counseling. The primary reason ovarian cancer is so deadly, is because it is rarely detected early, therefore prevention techniques are crucial for all women, whether they have known risk factors or not. About one-fifth of all ovarian cancers are hereditary, driven by genetic defects, while other factors associated with ovarian cancer are not nearly as well-understood.

The law firm of Sullo & Sullo has set up this Ovarian Cancer Information Guide, not only for those victims of talcum powder ovarian cancer, but for women with ovarian cancer in general. Being diagnosed with ovarian cancer can bring anxiety, stress and fear, however women who are knowledgeable about all aspects of ovarian cancer are able to make better, more informed decisions for their future. 

What is Ovarian Cancer and what are the Different Known Types of Ovarian Cancer?

The first question most women have is “what is ovarian cancer?” When cells which were normal in a woman’s body become abnormal, growing out of control, cancer is present. The normal cells in the body form new cells only to repair injuries or replace worn out cells, while cancer cells grow and divide continuously, outliving normal cells and creating abnormal cells until a tumor exists.  Ovarian cancer begins in a woman’s ovaries, which lie on each side of the uterus. Tumors in the ovaries could be benign—that is, noncancerous—or could be cancerous.

What are the Key Statistics for Ovarian Cancer?

Just a few of the more important statistics regarding ovarian cancer include:

• Nearly half of all those diagnosed with ovarian cancer are 63 years old, or older;
• A woman’s overall chances of being diagnosed with ovarian cancer during her lifetime is one in seventy-five;
• The more children a woman has had, the less likely she is to develop ovarian cancer, and
• The number of women who survive a diagnosis of ovarian cancer for five years is only 42 percent.

What Factors Indicate a Predisposition for Ovarian Cancer?

Although some women with many risk factors will never develop ovarian cancer and others with no risk factors will be diagnosed with ovarian cancer, in general, the following factors increase or decrease a woman’s chance of developing epithelial ovarian cancer, which is the most common type:

• Age (Older women are more likely to develop ovarian cancer);
• Obesity increases the risk;
• Reproductive history (having more children lowers the risk);
• The use of birth control pills lowers the risk;
• Tubal ligation or hysterectomy lower the risk;
• The use of fertility drugs increases the risk;
• The use of estrogen after menopause increases the risk;
• Women with a close family relative with ovarian cancer are more likely to be diagnosed with the disease;
• Those with inherited mutations are more likely to develop ovarian cancer, and
• A low-fat diet and one high in vegetables appear to lower the risk.

Do We Know What Exactly Causes Ovarian Cancer?

While there is no definitive answer to the question of “what causes ovarian cancer,” there are certain risk factors. Since the more pregnancies a woman has had and whether she has taken birth control pills appear to lower the risk of ovarian cancer—and both these events reduce the number of times a woman ovulates—some researchers believe there is a link between ovulation and a woman’s risk of developing ovarian cancer.

How Can I Potentially Lower My Chances of Developing Ovarian Cancer?

The question now becomes whether ovarian cancer can be prevented. The following are known strategies for potentially reducing the risk of developing epithelial ovarian cancer:

• Using birth control pills for five or more years gave women about a 50 percent lower risk of being diagnosed with ovarian cancer, although birth control pills have some risks of their own.
• Women who have had a tubal ligation or hysterectomy appear to have less chance of developing ovarian cancer.
• Women with a BRCA mutation gene or a strong family history of ovarian cancer should undergo genetic counseling and testing.

Can Ovarian Cancer be Detected Early?

Ovarian cancer is often called the “silent killer.” When ovarian cancer is found early and remains localized, about 94 percent of women can expect to live longer than five years. Unfortunately, finding early stage epithelial ovarian cancer is extremely difficult, due in part to the fact that the ovaries are small, and deeply imbedded within the abdominal cavity.

What are the Symptoms and/or Warning Signs of Ovarian Cancer?

The symptoms of ovarian cancer are fairly vague, and can apply to any number of medical issues. Some of the most common symptoms of ovarian cancer include:

• Changes in bowel or bladder habits with no explanation;
• Nausea, gas or indigestion;
• Bloating or swelling in the pelvic region or abdomen;
• Discomfort in the pelvic region or abdomen;
• Feeling as though you are constantly “full,” even when you are not overeating;
• Extreme fatigue;
• Abnormal bleeding, or
• Unexplained weight gain or loss.

What Diagnostic Tests are used to Identify Ovarian Cancer?

All women—especially those with known risk factors—should consider the following as far as diagnosing ovarian cancer early, thus having a higher chance of survival:

• Have regular pelvic exams;
• Have regular Pap tests;
• See your health care professional if you have symptoms associated with ovarian cancer, and
• Consider screening tests and genetic testing for ovarian cancer.

What Methodologies are used to correctly “Stage” Ovarian Cancer?

If ovarian cancer is suspected, your doctor may order an MRI scan, an ultrasound, or a CT scan to determine whether a mass exists. A PET scan can also be useful in spotting small collections of cancerous cells. The cancer will be given a stage I, II, III or IV, with addition subcategories within those stages. Inaccurate staging can result in cancer which has spread outside the ovaries being missed, therefore not treated. Ovarian cancer is generally treated by using chemotherapy, surgical removal of the tumors, hormone therapy, radiation therapy, targeted therapy or a combination of these treatments. Some women will join a clinical trial in order to potentially have a better chance of survival through the use of a new treatment.

What are the Survival Rates for Ovarian Cancer by Stage?

What Treatment Modalities are used for Ovarian Cancer?

Surgery is the primary treatment for most types of ovarian cancer, although the level of surgery you will undergo depends on whether the cancer has spread, if it has spread, how far, your overall level of health, and whether you are still in your childbearing years and want to have children, or more children.

Chemotherapy for ovarian cancer, is the use of specific drugs, given in such a way that they reach all areas of the body. In situations where the cancer has spread, chemotherapy can be especially beneficial. The drugs used in chemotherapy are given by mouth, or injected into a vein. Because such powerful drugs are used, chemotherapy can make you very ill.

Targeted Therapy is a newer type of treatment for ovarian cancer, using a drug or substance to identify, then attack cancerous cells while mostly leaving normal cells undamaged. Targeted therapy attacks cancerous cells from the inside out, altering the way a cancer cell grows, repairs itself, divides and interacts with other cells.

Hormone Therapy will be used as a treatment for ovarian cancer in some cases. Just as female hormones are sometimes used to fight prostate cancer, hormones and hormone-blocking drugs may be used to treat ovarian cancer, particularly stromal tumors.

Radiation Therapy may be used to treat ovarian cancer. During radiation therapy, high energy x-rays are used to target and kill cancerous cells. In the past, radiation was the primary treatment for ovarian cancer, however it is used less often today, primarily in women whose ovarian cancer has spread to other parts of the body.

Treatments for Specific Types of Ovarian Cancer

The treatment for Invasive Epithelial Ovarian Cancers includes:

• Tumor-removing surgery in Stage I epithelial ovarian cancer;
• For a grade 2 Stage I epithelial ovarian cancer, 3-6 cycles of chemotherapy could be administered;
• Stage II epithelial ovarian cancer will usually include a hysterectomy, removal of as much of the tumor as possible, and chemotherapy;
• Stage III epithelial ovarian cancer is the same as for Stage II, however the omentum—the fatty tissues from the upper abdomen—are also removed;
• Stage IV ovarian cancer treatment is for cancers which have spread to the bones, liver or lungs, and is the same as Stage III treatment, only with additional chemotherapy.

For Borderline Ovarian Tumors (epithelial tumors which have low malignant potential), women who are through having children may choose to have their ovaries, fallopian tubes and uterus removed. For a woman who wants to conceive, only the ovary with the LMP epithelial tumor as well as the fallopian tube on that side will be removed. Assuming the low malignant potential tumor was only found in one ovary, no further treatment would be recommended, however follow-up visits every six months are advised. If a LMP tumor spreads, deposits could be left on the lining of the abdomen or the surface of other organs, in which case it would be classified as invasive.  

The treatment for Ovarian Germ Cell Tumors, which occur when malignant cancer cells form in the egg cells of the ovary or ovaries—is removal of the affected ovary and fallopian tube, or removal of both ovaries and fallopian tubes among women who are through having children. Less than 2 percent of all ovarian cancers are germ cell tumors. The only symptoms generally associated with germ cell tumors are post-menopausal vaginal bleeding or abdominal swelling. If a germ cell tumor returns, chemotherapy will probably be the next recommended treatment.

Treatment for Ovarian Stromal Tumors is surgery to remove the affected ovary in Stage I, followed by chemotherapy, or possibly radiation. If the surgeon feels the entire ovarian stromal tumor was removed in Stage I, the patient may simply be watched closely following surgery. Stage II, III and IV ovarian stromal tumors are surgically treated, followed by chemotherapy or hormone treatments. Recurrent stromal tumors are treated with repeat courses of chemotherapy. 

What Should You Ask Your Doctor About Ovarian Cancer?

If you have been diagnosed with ovarian cancer, some of the most important questions you will want to ask your doctor include:

• What type of ovarian cancer do I have?
• What are the grade and stage of my ovarian cancer?
• What treatment do you recommend?
• What are the risks associated with the treatment?
• What side effects can I expect with this treatment?
• What is my prognosis?
• Should I consider a clinical trial?

What Should I do after My Ovarian Cancer Treatment is Complete?

You may wonder what will happen after you undergo treatment for your ovarian cancer. If you are considered “cured” you will return for follow-up visits, and may experience anxiety about your cancer coming back. If your cancer never completely goes away, you will undergo treatment to keep the cancer from spreading. Many women liken this to a constant emotional roller coaster, with the inability to live their lives as they once did. In any case, you will continue to be closely monitored by your healthcare professional.

Can I Get Another Cancer After Having Ovarian Cancer?

You may wonder whether you now have a higher risk of getting another type of cancer. In fact, ovarian cancer survivors do have a higher risk of being diagnosed with small intestine cancer, colon cancer, rectal cancer, breast cancer, bladder cancer, cancer of the bile duct, renal pelvic cancer acute leukemia and melanoma of the eye.

Lifestyle Changes to Consider Making after being treated for Ovarian Cancer

Some of the lifestyle changes you might consider after having ovarian cancer include eating healthy foods, getting plenty of exercise, getting plenty of rest, and taking care of yourself, both physically and mentally.

How Does Ovarian Cancer Impact Your Emotional Health?

As far as your emotional health is concerned, many women have an overwhelming feeling their cancer will recur which can prevent them from enjoying any aspect of their life. Depression is very normal among those who have been through ovarian cancer as are feeling of being out of control, difficulty concentrating, feeling overwhelmed, being unable to sleep, or sleeping too much, fatigue which does not go away, and even suicidal thoughts.

What are my Options if My Ovarian Cancer Treatments Stop Working?

If your ovarian cancer treatments stop working, you will have to make the decision as to whether to continue with treatments which make you feel ill, in the hopes something will work, or to discontinue treatments. You may make the difficult decision to have palliative care which helps you feel as good as you can for as long as possible.

What are the Latest Developments in Ovarian Cancer Research and Treatment?

Scientists are working hard to find new treatments for ovarian cancer which include:

• Mathematical models which estimate the number of years a woman with a BRCA mutation could gain by having both ovaries and fallopian tubes removed;
• A test known as OVA1 which measures four different proteins in the blood, placing a woman with current ovarian cancer in a high or low risk group;
• New chemotherapy drugs which make platinum-resistant ovarian cancers sensitive to the drugs again;
• Targeted therapy drugs which identify and attack cancerous cells, yet do not damage normal cells, and,
• Immunotherapy which includes a tumor vaccine which will allow our bodies to recognize cancerous cells and fight infection better.

Helping Victims of Ovarian Talcum Powder Cancer and Ovarian Baby Powder Cancer

Sullo & Sullo Attorneys has put forth this informational guide to help women afflicted with Ovarian Cancer. Sullo & Sullo can also specifically help women who are victims of talcum powder ovarian cancer. It is our hope that you will find our ovarian cancer pages helpful. It could also be beneficial for you to speak to one of our experienced, knowledgeable attorneys regarding your diagnosis. We can answer your questions regarding ovarian cancer, and can be your advocate in the event your ovarian cancer was caused by the use of talcum powder (talc is contained in “Shower to Shower” and/or baby powder with talc) for feminine hygiene.