Dr. Linda Hendricks, a practicing physician and managing partner at Central Georgia Cancer Care of Warner Robins and Macon, talks about ovarian cancer, its signs and treatment.
Q: September was Ovarian Cancer Awareness Month — what is the scope of ovarian cancer?
A: It’s one of the most common gynecologic cancers along with cervical and endometrial cancer. In the U.S., it’s the leading cause of death from gynecologic malignancy and there are around 22,000 new cases diagnosed a year with 14,000 cancer-related deaths. Internationally, almost 250,000 new cases occur annually and it’s the seventh most common cancer in women.
Q: Is ovarian cancer treatable?
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A: The thing is, everybody has heard of the PSA test as an effective screening for prostate cancer for men, but our problem is there is no similar, effective, early screening approved for ovarian cancer. It’s very treatable in early stages but it’s rarely found early.
Q: So no truly effective early screenings or straightforward symptoms?
A: No. That’s why awareness and keeping current regarding latest findings is crucial. Incidentally, a leading spokesperson about ovarian cancer and advocates for early detection and using the tools available was the late actress Gilda Radner who developed ovarian cancer, fought it and eventually succumbed. There’s a new film released this September on her and her battle with ovarian cancer called “Love, Gilda.” It’s playing in Atlanta now, so in a way, she’s still speaking out.
Q: You say awareness and using the available tools, what are some of them?
A: Well, for instance, something Radner tried to increase awareness about and asked doctors to use, was the CA 125 test as a screening for ovarian cancer. In some cases, it may be used to look for early signs in those at high risk. It’s useful but the problem is it isn’t very specific or sensitive to ovarian cancer. There are falsely diagnosed cases and missed cases. It’s a very good tumor marker and means of monitoring certain cancers during and after treatment, but not perfect for diagnosing. But it is a tool.
A: If someone has a family history of ovarian cancer, they should certainly run out and be checked. It’s recognized there are certain genetic factors and gene mutations to look for. Mutations in BRCA genes are responsible for the disease in nearly half of families with multiple cases and 13 percent of women worldwide who have ovarian cancer are found to be BRCA 1/BRCA 2 positive. Insurance should pay for testing. By knowing, you have a head start toward preventing it by being proactive and getting a total abdominal hysterectomy. But let me add, these genetic tests need to be done in a doctor’s office, not with off-the-shelf genetic tests from places like Walmart. Also, I might add there’s a class-action lawsuit concerning possible relation between ovarian cancer and talcum powder.
Q: How about symptoms?
A: First, ovarian cancer is rare in younger women. But otherwise, a lot of women will go to their doctor saying they have pelvic abdominal pain, increased bloating, get full quickly when they eat. There may be shortness of breath due to fluids. If certain indicators add up a doctor can justify tests. But often, ovarian cancer is discovered accidentally while having a test — a CAT scan or some other procedure — while looking for something else. Going to your gynecologist every year is important in general and but can also lead to discovering ovarian cancer.
Q: Treatment when found?
A: We treat with a combination of surgery and chemotherapy. We don’t use a lot of radiation with it. Most often it’s surgery, then you might come to someone like me whose specialty is in chemotherapy for further cleanup. It varies, but it’s important to be seen by your gynecologist which would lead to seeing a gynecological oncologist and treatment.
Q: Central Georgia Cancer Care sees patients already diagnosed with cancer and referred by their physicians. How about yourself? Your background and time with the practice?
A: I was born in Jacksonville, Florida, and, as a preacher’s kid, moved around a lot. I am a proud graduate of Georgia Tech and my medical training was in Augusta at the Medical College of Georgia. I came to Middle Georgia in 2001 to Central Georgia Cancer Care where I’ve been ever since. Our website is www.centralgeorgiacancercare.net.
Q: So how would you summarize this about ovarian cancer?
A: I suppose the takeaway is early detection is crucial, but it’s difficult. The strongest known factor and indicator is family history. See your doctor, your gynecologist, regularly. A Pap smear is not a test for ovarian cancer. If ovarian cancer is in question, there are other things that can be looked at and used, even the fact most gynecologists can do in-office ultra-sounds which could spot a tumor along with certain physical exams where a tumor could be felt. With 22,000 new cases a year, it’s not the most prevalent of cancers but it is certainly something to pay attention to.
Answers may have been edited for length and clarity. Compiled by Michael W. Pannell. Contact him at firstname.lastname@example.org.