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Ovarian cancer symptoms and warning signs

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Ovarian cancer symptoms and warning signs

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Ovarian cancer is a type of cancer that impacts the female reproductive system. 

The risk of developing ovarian cancer in a woman’s lifetime is 1 in 87, according to the American Cancer Society (ACS). 

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It’s most commonly seen in older women, particularly over age 63. 

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Ovarian Cancer Awareness Month is recognized every September. During the month and all year round, it’s important to spread awareness about ovarian cancer and donate to organizations that conduct vital research regarding the disease. 

Below is more information about ovarian cancer. 

  1. What is ovarian cancer?
  2. How is ovarian cancer usually detected?
  3. What are early warning signs of ovarian cancer?
  4. What should I do if I think I have symptoms?
  5. What should I know about risk reduction of ovarian cancer?
  6. What should I know about risk factors for ovarian cancer?
  7. Is ovarian cancer curable?
  8. What age is ovarian cancer most common?

September is recognized as Ovarian Cancer Awareness Month. (iStock)

1. What is ovarian cancer?

Ovarian cancer is a cancer diagnosis specific to women. The type of cancer is found when abnormal cells form in the ovaries or fallopian tubes.

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The female reproductive system has two ovaries, one on each side of the uterus. The ovaries produce eggs and also release estrogen and progesterone.

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When the cells, specifically in the ovaries, start to grow in an uncontrolled way, this is when ovarian cancer is usually detected. 

2. How is ovarian cancer usually detected?

There is no screening test for ovarian cancer.

The ACS says efforts to develop a comprehensive screening test have not yielded “much success so far.” 

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The organization, however, provides two options in lieu of a comprehensive screening test: a transvaginal ultrasound (TVUS) and a CA-125 blood test.

Doctor holding a model of female reproductive organs

Ovarian cancer impacts a woman’s reproductive organs. (iStock)

A TVUS “uses sound waves to look at the uterus, fallopian tubes and ovaries by putting an ultrasound wand into the vagina.” Though the test can detect tumors in the ovaries, it is unable to detect whether the tumor is benign or not.

The CA-125 blood test measures the amount of the CA-125 protein in the blood. While researchers have found elevated levels of the protein in women with ovarian cancer, the ACS advises that high levels of the protein have also been found in women with “common conditions such as endometriosis and pelvic inflammatory disease” while further noting that not all women with ovarian cancer test for high levels of CA-125.

3. What are early warning signs of ovarian cancer?

There are not any specific signs of early stage ovarian cancer, Dr. Michael Worley, a surgical gynecological oncologist with Brigham and Women’s Hospital in Boston, previously told Fox News Digital.

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Ovarian cancer symptoms are often vague, Worley said. 

One symptom is losing or gaining weight.

Other symptoms may include abdominal bloating; bowel changes like diarrhea or constipation; bladder changes such as an increase in frequency or urgency; abdominal discomfort and pressure; and a sense of feeling full, Dr. Jamie Bakkum-Gamez, a gynecologic oncologist with the Mayo Clinic in Rochester, Minnesota, previously told Fox News.

4. What should I do if I think I have symptoms?

Often, symptoms associated with ovarian cancer can be difficult for women to spot as a lot of the symptoms are similar to those of a period or menopause. 

If symptoms persist, a woman should see a medical provider for a pelvic ultrasound, Bakkum-Gamez said, adding that women diagnosed should see a gynecologic oncologist.

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Going to an OB-GYN “is a good place to start,” Worley said, explaining that an ultrasound or a CT scan may sometimes be ordered.

Woman with cramps

Signs of ovarian cancer are very similar to those that come with a period or menopause. (iStock)

5. What should I know about risk reduction of ovarian cancer?

For middle-aged women with the BRCA-1 gene, it is recommended they get their fallopian tubes tied and ovaries removed, per the CDC.

It is also recommended for women with the BRCA-2 gene, with different age guidelines.

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Other aspects that may reduce a woman’s risk of ovarian cancer include giving birth, having a tubal ligation, having a hysterectomy, breast-feeding and using birth control pills, Bakkum-Gamez said.

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Oral birth control is “by far the easiest way” to reduce risk, Worley said. 

The method, he explained, also “works relatively well for people with BRCA mutations,” noting there’s conflicting data about it increasing the risk of breast cancer and that these women should speak to their doctors.

Those who take oral birth control for five or more years have about a 50% lower risk of developing the cancer, according to the ACS. That being said, the pills come with other risks and side effects. Therefore, it is important to talk with your doctor about the risks before making your decision. 

Birth control pills

Taking oral birth control is one way to reduce your risk for ovarian cancer. (iStock)

Risk reduction from a hysterectomy “is a little more controversial,” Worley said, explaining that old data said the procedure didn’t reduce risk, while new data says it’s helpful. Just removing the uterus reduces ovarian risk, he said.

Furthermore, living a healthy lifestyle can help reduce your risk. This includes regular exercise, a healthy diet and avoiding smoking.

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6. What should I know about risk factors for ovarian cancer?

One of the biggest risk factors for ovarian cancer is age, since it is typically found in older women.

Family history, not having children and an endometriosis diagnosis are among the risk factors for ovarian cancer, according to the CDC. 

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Others include having the BRCA-1 or BRCA-2 gene, which are linked to ovarian and breast cancer.

Additionally, Caucasians are more likely to be diagnosed with ovarian cancer. 

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Early onset of menses and late menopause are also risk factors, according to Worley.

Women with a family history of ovarian, fallopian tube cancer and breast cancer “should really be thinking about seeing a genetic counselor,” Bakkum-Gamez said. “It may lead to potential prevention.”

Cancer in uterus

One of the biggest risk factors associated with ovarian cancer is age. (iStock)

7. Is ovarian cancer curable?

The earlier ovarian cancer is diagnosed in a woman, the more treatable the disease is. Typically, ovarian cancer is treated through surgery to remove the tumor and/or chemotherapy.

The life expectancy for someone with ovarian cancer is based on averages and also differs depending on the type of cancer that is present. 

The ACS outlines relative survival rates for ovarian cancer based on women diagnosed between 2012 and 2018. The five-year survival rates are broken down between the type of ovarian cancer, invasive epithelial, stromal or germ cell tumor, and also are sorted based on the stage of cancer, localized, regional and distant. 

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For someone with localized ovarian cancer, the cancer has not spread outside the ovaries. In regional ovarian cancer, it has spread outside but near the ovaries. Lastly, in distant ovarian cancer, it has spread to more distant parts of the body, such as the liver or the lungs.

The ACS says the five-year survival rate of all three stages combined in invasive epithelial ovarian cancer is 50%. This means that women with this type of ovarian cancer are 50% as likely as women who don’t have the cancer to live for at least five years after they are diagnosed.

A woman getting an ultrasound

Early detection is vital in treating ovarian cancer. (iStock)

The survival rate for ovarian stromal tumors of all three stages combined is 89%, according to the source, and the survival rate for germ cell tumors of the ovary, all stages combined, is 92%. 

Lastly, the five-year survival rate for fallopian tube cancer of all three stages combined is 55%.

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8. What age is ovarian cancer most common?

One of the main factors that increases the risk of developing ovarian cancer is age. 

For women under the age of 40, their risk of ovarian cancer is rare. Half of all ovarian cancers are found in women 63 and older, according to the ACS.

 

Most commonly, ovarian cancer develops after a woman reaches menopause.

Andy Sahadeo and Zoe Szathmary contributed reporting.

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Federal judge orders EPA further regulate fluoride in drinking water due to concerns over lowered IQ in kids

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Federal judge orders EPA further regulate fluoride in drinking water due to concerns over lowered IQ in kids

It has been added to municipal water for decades, but a federal judge in California has ordered the Environmental Protection Agency (EPA) to further regulate fluoride because high levels could pose “an unreasonable risk” to the intellectual development of children.

U.S. District Judge Edward Chen ruled Tuesday that the scientific evidence of fluoride’s health risks when ingested at current prescribed levels requires stricter regulation under the 2016 Toxic Substances Control Act (TSCA). The act provides a legal pathway for citizens to petition the EPA to consider whether an industrial chemical presents health risks.

Chen, in his 80-page ruling, wrote there is “little dispute” over whether fluoride is hazardous and ordered the EPA to take steps to lower that risk, but didn’t say what those measures should be.

“Indeed, EPA’s own expert agrees that fluoride is hazardous at some level of exposure,” the judge said. “And ample evidence establishes that a mother’s exposure to fluoride during pregnancy is associated with IQ decrements in her offspring.”

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“Between 1981 and 1984, fluoride’s association with adverse effects including osteosclerosis, enamel fluorosis, and psychological and behavioral problems was contested,” Chen said.

At the same time, he wrote that the court’s finding “does not conclude with certainty that fluoridated water is injurious to public health,” Chen said. “Rather, as required by the Amended TSCA, the Court finds there is an unreasonable risk of such injury, a risk sufficient to require the EPA to engage with a regulatory response.

“This order does not dictate precisely what that response must be. Amended TSCA leaves that decision in the first instance to the EPA. One thing the EPA cannot do, however, in the face of this Court’s finding, is to ignore that risk,” Chen added. 

“If the Court finds anew that the chemical at issue presents an unreasonable risk, it then orders the EPA to engage in rulemaking regarding the chemical,” the judge said. “The EPA is afforded in the first instance the authority to respond; regulatory actions can range from requiring a mere warning label to banning the chemical.”

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An EPA spokesperson, Jeff Landis, told The Associated Press that the agency was reviewing the decision but offered no further comment.

It’s the first time a federal judge has made a determination about the neurodevelopmental risks to children of the recommended U.S. water fluoride level, said Ashley Malin, a University of Florida researcher who has studied the effect of higher fluoride levels in pregnant women.

She called it “the most historic ruling in the U.S. fluoridation debate that we’ve ever seen.”

Currently, more than 200 million Americans, or about 75 percent of the population, drink fluoridated water.

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In 1950, federal officials endorsed water fluoridation to prevent tooth decay, and they continued to promote it even after fluoride toothpaste brands hit the market several years later. In 1945, Grand Rapids, Michigan became the first city in the world to fluoridate its water supply. 

Critics have long said that washing teeth with fluoride is not comparable to the risks posed by ingesting fluoride, with the latter potentially triggering harmful neurotoxic effects. 

Since 2015, federal health officials have recommended a fluoridation level of 0.7 milligrams per liter of water. For five decades before that, the recommended upper range was 1.2 “after evidence increasingly established fluoride’s connection to adverse effects, including severe enamel fluorosis, risk of bone fracture, and potential skeletal fluorosis,” the judge wrote. Skeletal fluorosis is a potentially crippling disorder which causes weaker bones, stiffness and pain.

The World Health Organization has set a safe limit for fluoride in drinking water of 1.5. Separately, the EPA has a longstanding requirement that water systems cannot have more than 4 milligrams of fluoride per liter of water. 

The case was brought by Food and Water Watch, an advocacy organization which petitioned the EPA to investigate lowered IQs in children allegedly caused by fluoride. The EPA denied the group’s 2016 petition calling for the agency to ban or limit the fluoridation of drinking water. 

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Food & Water Watch and several co-petitioners subsequently sued the EPA to compel action citing the mounting scientific evidence of toxicity when fluoride is ingested.

“Today’s ruling represents an important acknowledgment of a large and growing body of science indicating serious human health risks associated with fluoridated drinking water,” the group said in a statement.

water treatment fluoride

A water utility foreman at a plant where fluoride is added to the drinking water in Healdsburg, California. (Michael Macor/The San Francisco Chronicle via Getty Images)

“This court looked at the science and acted accordingly. Now the EPA must respond by implementing new regulations that adequately protect all Americans – especially our most vulnerable infants and children – from this known health threat.”

Tuesday’s ruling cited a review of 72 human epidemiological studies and available literature by the U.S. National Toxicology Program which concluded that fluoride is connected to reduced IQ in children.

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“Notwithstanding recognition by EPA’s expert that fluoride is hazardous, the EPA points to technicalities at various steps of the risk evaluation to conclude that fluoride does not present an unreasonable risk,” Chen said. “Primarily, the EPA argues the hazard level and the precise relationship between dosage and response at lower exposure levels are not entirely clear. These arguments are not persuasive.”

The Associated Press contributed to this report. 

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