It’s Ovarian Cancer Awareness Month. And the state’s health department reports that fewer women are being diagnosed with the illness in Missouri.
Dr. Heidi Miller, chief medical officer for the Missouri Department of Health and Human Services believes that’s due to two reasons: Less use of hormone replacement therapy after menopause and an increased use of oral contraceptives before menopause. Both reduce the total estrogen volume that impacts and stimulates the ovaries.
Being on birth control can reduce a woman’s chance of developing ovarian cancer, Miller said. And, while being on hormone replacement therapy can increase the risk for ovarian cancer, she said women shouldn't automatically rule out using it.
Decades ago, she said, many women who went through menopause would be put on hormone replacement therapy. But concerns about cancer and heart disease risks saw its use dramatically drop, according to Miller. More recently, she said, doctors realized that they had to individualize the approach — to look at one patient at a time.
"I want to emphasize that it doesn’t mean that a woman should never be on hormone replacement therapy," she said, "we just have to make sure that the benefits outweigh those potential risks.”
While the number of ovarian cases is down in Missouri, ovarian cancer remains one of the leading causes of death in women diagnosed with gynecological cancers and the second most common gynecologic cancer across the U.S. And, in 2021, the latest year for which data is available, 293 Missouri women died from the disease, according to the Centers for Disease Control and Prevention.
Miller said a woman can reduce her risk of ovarian cancer by maintaining a healthy weight, exercising and avoiding smoking. She advises anyone with a family history of ovarian cancer to ask their doctor about genetic testing. Miller said if a woman knows she’s at higher risk, she can ask her doctor about more intensive monitoring and screening. And she said it's important that women need to know the symptoms of ovarian cancer.
"Some of the symptoms for ovarian cancer could include abdominal bloating, pelvic or abdominal pain, trouble eating, feeling full quickly, urinary symptoms such as, like, needing to rush to urinate or having urinary frequency, unexplained weight loss, unexplained weight gain, fatigue or unexplained bowel changes,” said Miller.
Those symptoms can also be caused by other illnesses, she said. But if a woman has any of those symptoms almost daily for more than a few weeks, she needs to see her healthcare provider. The sooner ovarian cancer is diagnosed, the greater the chances for a positive outcome, according to Miller.
"As a primary care doctor myself," she said, "I really encourage my patients to let us know when things don't feel normal."
Learn more about ovarian cancer here.
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