A woman with her hands on her groin (Photo: ShutterStock)
Many women are aware of the great importance of performing periodic screening tests for the early diagnosis of breast cancer, because it is the most common cancer among women in Israel and around the world.
Along with the welcome awareness of this type of disease, it is important to recognize and raise awareness of other types of cancer as well - those that may in some cases be dangerous and aggressive and unfortunately are discovered in an advanced and metastatic stage.
The incidence of ovarian cancer in Israel is not high.
According to the data of the National Center for Disease Control in the Ministry of Health, it is in tenth place on the list of common malignant diseases among women.
At the same time, unfortunately, it ranks highest in terms of mortality rates in gynecology.
On the occasion of World Ovarian Cancer Awareness Day, starting today (8.5) it is important to debunk some common myths that have developed around the disease over the years.
1. "Ovarian cancer is diagnosed with routine screening tests, such as Pap / HPV"
The HPV/Pap (cervical pap smear) screening test is intended for the early detection of cervical cancer only and not for ovarian cancer.
Today, unfortunately, there are still no routine screening tests in Israel or in the world to detect ovarian cancer.
The diagnosis of this disease is mainly carried out with the help of a combination of several tests - vaginal ultrasound, pelvic tests and blood tests to identify unique proteins which, in combination, can raise the suspicion that any ovarian finding is a cancerous tumor.
However, even with the help of these tests, the diagnosis is still not always unequivocal and sometimes only surgery and taking tissue from the tumor (biopsy) will make it possible to definitively determine if it is indeed ovarian cancer.
Pap test is intended for early detection of cervical cancer only and not for ovarian cancer. (Photo: ShutterStock)
2. "Everyone who is at high risk of the disease is already aware of this"
Generally, it is thought that if we had a case of cancer of any kind in our family, we too can and may be at risk of this type of cancer.
This assumption is true in some cases, but definitely not in all, in a minority of cancer cases a distinct hereditary factor can be identified.
Any woman, from any background, can get ovarian cancer.
Women who have a family history of dealing with ovarian cancer and sometimes breast cancer as well, are indeed defined as being at a higher risk.
In addition, women who carry genetic defects (mutations) in the BRCA1, BRCA2 genes are also at a significantly increased risk of breast and ovarian cancer and other types of cancer depending on the specific mutation.
Today, in the health basket in Israel, every woman of Ashkenazi origin is entitled to undergo a test to detect unique mutations in BRCA.
3. "If the BRCA test results are negative - I am protected"
Not exact.
In the initial phase, it is customary to start a BRCA test for common mutations.
The test is performed on a normal blood sample and includes dozens of more common mutations in Israel.
If no mutations were found in the test, in some cases and in consultation with a genetic counselor, it is recommended to perform an extended panel that includes full sequencing of the gene to identify the possible mutations.
It is important to emphasize that mutations in the BRCA genes are mostly common among Jewish women of Ashkenazi origin (one in forty), but the genetic defects can also appear in women of any background and origin.
It is also important to remember that there are many women who have been diagnosed with ovarian cancer even though they are not carriers of BRCA mutations.
4. "Ovarian cancer can only be diagnosed in advanced stages"
In most cases, ovarian cancer is detected in stages 3 and 4, which are considered the most advanced, but in cases where the disease is detected at an earlier stage, it is easier to treat it.
Unfortunately, the symptoms of ovarian cancer in its early stages are vague and more general such as - abdominal pain, bloating, discomfort in the digestive system and the like.
That is why many women do not attach any importance to these sensations, and do not turn to testing and diagnosis until an advanced stage.
It is important to be alert for symptoms such as unusual abdominal pain that does not go away, pelvic pain, swelling, unexplained weight gain or loss, or extreme chronic fatigue.
5. "Removing ovarian cysts can prevent cancer"
Most of the cysts that are detected in routine tests in the ovary are harmless and are expected to pass by themselves without a surgical procedure.
In most cases, especially during childbearing years, these cysts are benign and not malignant, meaning that they do not indicate cancer.
Cysts usually do not need to be removed if they do not cause an unusual sensation, but in some cases we will recommend removing them if they cause pain or if they grow and change in appearance.
Of course, each case individually.
In any case of an ovarian cyst, it is important to be under medical supervision to make sure that a considered and responsible decision is made.
6. "A hysterectomy reduces the risk of ovarian cancer"
Women who have had a complete hysterectomy (uterus + cervix) or a subtotal hysterectomy (uterus without cervix), usually for benign reasons, do not thereby reduce the risk of ovarian cancer.
Today it is customary to perform a tubal resection in such a case as well, to reduce the risk of cancer from this source (which is closely related to ovarian cancer).
In benign cases at an age that is less than the age of menopause, it is not customary today to remove the ovaries due to the positive effect that their activity has on women's health.
If the ovaries were surgically removed anyway, the risk of developing ovarian cancer decreases considerably, but it still exists.
The reason for this is that there is a possibility (unlikely, but still real) that before the ovaries were removed, ovarian cells "migrated" to other areas of the pelvis and at some stage became or will become cancerous cells or a tumor similar in nature to the ovarian tumor arising from the peritoneum (the inner lining of the abdominal cavity and abdominal organs) .
Unfortunately, ovarian cancer is still considered a violent and dangerous disease, and a reliable screening test has not yet been found.
That is why it is always important to be attentive to your body, recognize signs of unusual activities and contact a medical professional to find out the reasons whenever such a suspicion arises.
True, in most cases it will not be a malignant disease, but much simpler problems, but early detection will allow, if indeed it is cancer, to adapt treatment that will dramatically improve the chances of recovery and the quality of life while fighting the disease.
In addition, it is recommended that every woman of Ashkenazi origin (even partial) contact the health services under which she is insured and perform a test to detect mutations in the BRCA genes.
This test is free in the health basket and may save lives.
The author is the chairman of the Israeli Society for Gynecology Oncology and the director of the Women's Division and the Gynecology Oncology Unit at the Shamir Medical Center (Assaf Harofeh)
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