By Jennifer Garam
This post has been created in partnership with AstraZeneca. Some links will take you to third-party websites not maintained, sponsored, or reviewed by AstraZeneca.
As an ovarian cancer survivor, Ovarian Cancer Awareness Month in September has a lot of personal significance for me. This year, I’m excited to be partnering with AstraZeneca to share crucial information about the signs and symptoms of ovarian cancer, what you need to know about genetic and biomarker testing, and why it’s essential to stay on top of your routine annual medical check-ups.
Below, I share my personal experience and what I’ve learned from going through an ovarian cancer diagnosis and treatment. But note: Only a healthcare professional can diagnose the disease and give medical advice on treatment options — you should always talk to your doctor if you have any questions about the signs, symptoms, and biomarker testing options for ovarian cancer.
Delays in Cancer Screenings and Diagnoses Due to COVID
In addition to the obvious devastating effects of the COVID-19 pandemic, there has been another disturbing consequence: During the pandemic, cancer screenings declined dramatically — and cancer diagnoses and treatments were disrupted and delayed. According to one study, while the impact of these delays could vary depending on the cancer type and extent of the delay, this could lead to “presentation at more advanced stages, with potentially poorer clinical outcomes.”
But, as the saying goes, “early detection is the best prevention,” and for many diseases, an early diagnosis could vastly improve the prognosis. With ovarian cancer, for example, if diagnosed in Stage I, the five-year survival rate is approximately 90%. When diagnosed in Stage III, the five-year survival rate drops to approximately 39%. And diagnosed in Stage IV, that figure drops even further, to approximately 17%. And, because ovarian cancer symptoms are so vague and nonspecific — and therefore easy to miss, minimize, or dismiss, especially in the early stages — the majority of cases (80%) are diagnosed when the disease has already progressed to the later stages.
It’s understandable that during the height of the pandemic, people might have been wary of venturing into a healthcare setting for a routine check-up or to ask about a new health concern. But now that the pandemic is easing up, if you haven’t already returned to regularly going to your annual doctor appointments, as well as any applicable cancer screenings based on your age and risk factors, now is the time to do it.
Scheduling Your Annual Check-Ups
Scheduling and taking time out for doctor appointments may sometimes feel like an inconvenience. But deprioritizing your own health and well-being and putting off your regular check-ups could lead to much worse problems down the line. As a BRCA1-positive ovarian cancer survivor, I have a ton of appointments and screenings I need to stay on top of. Here are some of my tips for making this process more manageable:
- Space it out. Some people like to group all their annual appointments into a short time span — say, a one-week period — to get them over with. Personally, I like to space out all my routine appointments over the course of the year for two reasons: First of all, it’s easier to take time off work when you space out your appointments. And secondly, spreading out my appointments ensures that I don’t go too long without being seen by some kind of medical provider. So, for example, you could schedule your annual check-up with your primary care provider (PCP) every year in January and your annual gynecologic appointment in July, and book any relevant screenings, like a mammogram or colonoscopy, sometime between those check-ups. Of course, for any urgent symptoms, don’t wait for your annual appointment to get it checked out!
- Find doctors you like. You might not really like your providers, and if you only see them once or twice a year, you may be tempted to just let it slide. But if you ever have a more serious health issue, having excellent medical providers you like and trust, and who are responsive to your questions and concerns, is going to make a huge difference. It also makes going to the doctor less dreadful — and even enjoyable. I love my healthcare team, which means I actually look forward to seeing them at my appointments!
- Work can wait. Probably one of the biggest reasons people put off going to the doctor is feeling too busy with work or personal responsibilities. Even if you have a demanding job with a crushing to-do list, it’s important to try to find time to take care of your health. As someone who has been through treatment for advanced ovarian cancer, as well as other preventative surgery, trust me: The most important thing is your health. You deserve to take a couple of hours off a few times a year to go to your regular medical appointments and screenings and get any concerns checked out.
Ovarian Cancer: Knowing the Signs and Symptoms
Ovarian cancer, the fifth leading cause of cancer deaths among women, accounts for more deaths than any other gynecologic cancer. It’s known as the “silent killer” with symptoms that “whisper.” This is because the symptoms are vague and nonspecific, meaning they are often common disturbances that are easy to minimize, dismiss, or attribute to something a lot less serious. A Pap test does NOT screen for ovarian cancer, and there is currently no reliable routine screening test for ovarian cancer, so it’s especially important to know what the signs and symptoms are. According to the American Cancer Society, some of the most common symptoms of ovarian cancer include (but are not limited to):
● Bloating
● Pelvic or abdominal pain
● Trouble eating or feeling full quickly
● Urinary symptoms such as urgency (having to go very badly) or frequency (having to go often)
● Fatigue
● Upset stomach
● Back pain
● Pain during sex
● Constipation
● Changes in menstrual period, such as heavier than normal or irregular bleeding
As you can see, taken individually, many of these symptoms can be written off as “normal.” That’s why it’s crucial to know what is normal for you and your body, so if any symptoms are different or more severe than what’s normal for you, you should get it checked out. And it’s advised to see a doctor right away if you experience any of these symptoms consistently for two weeks or longer.
What You Need to Know About Genetic and Biomarker Testing
Genetic Testing
If you do receive an ovarian cancer diagnosis, there’s something else you need to know about that could have a significant impact on your treatment and outcome: genetic and biomarker testing.
Shortly after being diagnosed with ovarian cancer, my doctor ordered genetic testing for me to determine if I had an inherited gene mutation that contributed to me being at risk for and developing ovarian cancer. When I got the results, I learned that I’m BRCA1-positive. A BRCA mutation — BRCA1 or BRCA2 — is a change that takes place in the BRCA gene and can increase an individual’s risk of developing several types of cancer, as well as affect their eligibility for certain treatment options. About 20% of ovarian cancer patients have an inherited BRCA1 or BRCA2 mutation. Knowing my BRCA status affected my treatment plan, in that it gave me the option of a targeted therapy based on my specific type of disease.
Genetic testing is becoming the standard of care for certain cancers, and knowing if you have an inherited genetic mutation is critical for determining treatment options and guiding decisions about your care. Therefore, genetic testing should be done as soon as possible after an ovarian cancer diagnosis. And it’s important to do this test in a clinical setting, versus using an at-home, direct-to- consumer ancestry DNA test. Medical-grade genetic testing that’s conducted via a simple blood or saliva test in your doctor’s office or cancer center is FDA-approved and administered by a clinically certified lab. Having it done in a medical setting rather than using an at-home test will give you a more comprehensive picture of any inherited genetic mutations you may have, actions you’ll need to take as a result, and treatment options this information may provide.
If you’ve been diagnosed with ovarian cancer and your doctor hasn’t mentioned genetic testing to you, ask your provider if you’re a good candidate for it. And if you haven't been diagnosed with ovarian cancer but want to know if you may have one of the gene mutations associated with an increased risk for the disease, you may want to consider talking to your doctor about genetic testing too. For instance, if you have a family history of close relatives who’ve had breast or ovarian cancer, you might be at risk and want to undergo genetic testing to determine if you have an inherited mutation like BRCA.
However, don’t let the absence of a family history of cancer give you a false sense of safety. With no known family history of breast or ovarian cancer, I was blindsided by my diagnosis. After learning that I’m BRCA1-positive, my family members underwent genetic testing too. And, while BRCA mutations are often (incorrectly) only associated with women, it was my father who has the mutation. Although men with BRCA mutations do have a higher risk of developing certain types of cancer, the cancer risk for BRCA-positive men is much lower than that of their female counterparts. My father has never had cancer, leading to the BRCA mutation “hiding in men” in my family, as I call it.
Many of us are walking around with incomplete knowledge about our family medical history, and as a result, incomplete information about our potential cancer risk. So it’s important to talk to your family members and put together the most complete medical history you can, and also speak to your doctor about any potential risk factors that could make you a good candidate for genetic testing. And remember that men can be carriers of BRCA mutations too, so be sure to look into your father, his side of the family, and any other close male relatives as well when you’re investigating your family medical history.
Biomarker Testing
Another type of test to ask about when diagnosed with ovarian cancer is biomarker testing. Biomarkers are biological molecules present in blood or tissue, and they can serve as an indicator of a condition or disease. Biomarker testing is important because it can identify specific “drivers” in an individual's cancer that affect how it grows and spreads. The way biomarkers are expressed by cancer varies from person to person, which is why biomarker testing is so crucial: It can provide your medical team with more information about your specific type of disease that, similar to genetic testing, could also inform and affect treatment options and decisions.
For instance, one biomarker is homologous recombination deficiency, or HRD. HRD impairs the ability of cells to properly repair DNA damage, and about 50% of ovarian cancer cases are associated with being HRD-positive. Doing biomarker testing as early as possible after an ovarian cancer diagnosis can be critical for getting you on the optimal treatment plan for your specific type of disease. The more information you and your medical team can gather about your relevant genetic and biomarker makeup, the more informed decisions you can make about your treatment plan.
Take Control of Your Health
Before my ovarian cancer diagnosis, I wasn’t very proactive or informed about my health. I kept up with some of my annual check-ups and screenings, but not all of them. At doctor appointments, I didn’t ask a lot of questions, and I didn’t always understand the reasons certain tests were being done or what their outcomes were.
That all changed when I was diagnosed: I’m now on top of my check-ups and screenings, and I ask a ton of questions and make sure I always understand my doctors’ answers, as well as any test results.
Be proactive and stay on top of your annual check-ups with your PCP and gynecologist, and if you haven’t scheduled them in a while, do it now. And if you have any concerning symptoms, like the ones mentioned above for ovarian cancer, and they’ve persisted for a period of two weeks, see a doctor right away.
Because ovarian cancer symptoms can be so vague and nonspecific, and easily confused with issues that are a lot less serious, it is crucial to advocate for yourself. There are countless stories of women who were experiencing ovarian cancer symptoms and their concerns were dismissed for months or longer because they were “too young for ovarian cancer.” (This isn’t true — while the median age for an ovarian cancer diagnosis is 63, women get diagnosed decades younger. I was diagnosed on the young side at 43, and I know women who were much younger than I was when they were diagnosed with ovarian cancer.)
Or, women presenting with these symptoms can be thought to just have run-of-the-mill gastrointestinal distress. After experiencing concerning symptoms such as abdominal pain and bloating for one week, I was initially misdiagnosed with gastritis or colitis. Luckily, I was correctly diagnosed with ovarian cancer very quickly, the next day.
Many women are not so lucky, and in the time it takes to receive a correct diagnosis the disease spreads and becomes more advanced. So if you have concerning symptoms, and they are persistent, do not stop until your concerns are taken seriously, you’re correctly diagnosed, and you can receive the appropriate treatment.
And if you are diagnosed with ovarian cancer, talk to your doctor about genetic and biomarker testing and how they can help inform and guide your treatment decisions. Knowing this information could possibly make a difference in your treatment options — and potentially improve your outcome.
This post was sponsored by AstraZeneca. I received some materials and information from AstraZeneca. All opinions are my own.