October is Breast Cancer Awareness Month

During the month of October I will be featuring various information on breast cancer. Next to skin cancer, it is the second most common cancer among American women. There are many diffrent kinds of breast cancer and I will be spotlighting them during the month.

Here are the most common kinds of breast cancer:

Ductal carcinoma. The most common kind of breast cancer. It begins in the cells that line the milk ducts in the breast, also called the lining of the breast ducts.

• Ductal carcinoma in situ (DCIS). The abnormal cancer cells are only in the lining of the milk ducts, and have not spread to other tissues in the breast.
• Invasive ductal carcinoma. The abnormal cancer cells break through the ducts and spread into other parts of the breast tissue. Invasive cancer cells can also spread to other parts of the body.

Lobular carcinoma. In this kind of breast cancer, the cancer cells begin in the lobes, or lobules, of the breast. Lobules are the glands that make milk.

• Lobular carcinoma in situ (LCIS). The cancer cells are found only in the breast lobules. Lobular carcinoma in situ, or LCIS, does not spread to other tissues.
• Invasive lobular carcinoma. Cancer cells spread from the lobules to the breast tissues that are close by. These invasive cancer cells can also spread to other parts of the body.
  

Low Back Pain

According to the National Institutes of Health, about 80% of the population develops back problems at some time in their lives. Since many of us will cry out, "Oh my aching back!" at one time or another, I thought I'd provide some links to some helpful information on the prevention and treatment of low back pain.

Low Back Pain: Tips on Pain Relief and Prevention (American Academy of Family Physicians) - This is an excellent resource.

Low Back Pain Fact Sheet from the National Institute of Neurological Disorders and Stroke

Back Exercises an interactive tutorial (Patient Education Institute)

Housework: Back Pain Prevention (American Chiropractic Association)

Infertility

Since infertility affects many couples (about 10% of couples according to the American College of Obstetricians and Gynecologists), I thought I’d share some information and links that will explain infertility and the treatments available. Infertility means not being able to get pregnant after a year of trying. Contact your doctor if you think you may have an infertility problem. For men, a sperm test is often the first step in the diagnosis process. For women, your doctor will run tests to see if your ovaries are functioning properly.

For women, it is harder to get pregnant after the age of 30 so if you are over 30, you may not want to wait a full year to contact your doctor if you have not gotten pregnant after trying.

Most infertility cases (85 to 90 percent) can be treated conventionally with drug therapy or surgical repair of the reproductive organs. For the other cases, in vitro fertilization is available

For more in depth information on infertility, check out these links:

Infertility: An Overview (American Society for Reproductive Medicine)

Infertility (Mayo Foundation for Medical Education and Research)

Treating Infertility (American College of Obstetricians and Gynecologists)

Lead Hazards and Poisoning

Even though the threat of lead poisoning has been greatly reduced since the banning of lead paint and gasoline, the threat still exists, especially for those who live in a home that was built before 1978. Children can eat the dust or chips from lead paint in an older home so it is important to make sure your home is safe if you live in an older home.

To reduce your child’s risk of lead exposure, get your child checked, get your home checked and fix any hazards that may be present.

A simple blood test can detect lead in the body, so talk to your pediatrician for advice on testing. Blood lead levels increase the fastest from 6-12 months and peak at 18-24 months. (From the U.S. Environmental Protection Agency (EPA))

The EPA suggests these things for your home:

You can get your home checked in one of two ways, or both:

1. A paint inspection tells you the lead content of every different type of painted surface in your home. It won't tell you whether the paint is a hazard or how you should deal with it.

2. A risk assessment tells you if there are any sources of serious lead exposure (such as peeling paint and lead dust). It also tells you what actions to take to address these hazards.

Have qualified professionals do the work. There are standards in place for certifying lead-based paint professionals to ensure the work is done safely, reliably, and effectively. Contact the National Lead Information Center (NLIC) for a list of contacts in your area.

Trained professionals use a range of methods when checking your home, including:
1. Visual inspection of paint condition and location.
2. A portable x-ray fluorescence (XRF) machine.
3. Lab tests of paint samples.
4. Surface dust tests.

Things you can do to protect your family:

If you suspect there are lead hazards in your home, you can take these steps:

1. If you rent, notify your landlord immediately if you see peeling or chipping paint.
2. Clean up pain chips immediately.
3. Clean window sills and frames, floors and other surfaces on a weekly basis (you can use an all-purpose cleaner or one made especially for lead)
4. Rinse mops and sponges after cleaning dirty or dusty areas
5. Wash your child’s hands frequently
6. Keep play areas clean
7. Keep children from chewing on paint near window sills and other painted surfaces.

You should permanently remove the lead hazards, but you should not do this yourself. You must hire a certified lead "abatement" contractor, who specializes in lead paint removal. They will know how to remove, seal or enclose the lead-based paint so it is no longer a hazard.

The EPA has some great publications on lead. For basic information, check out Lead in Paint, Dust, and Soil, Basic Information . This publication provides comprehensive information on lead facts, health effects of lead and much more. It also has links to more information like Lead in Your Home: A Parent’s Guide, Finding a Qualified Lead Professional for Your Home, and more.

Here are some other links for more information:

Lead Poisoning (Mayo Foundation for Medical Education and Research)

Lead Test (American Association for Clinical Chemistry)

Lead Poisoning Prevention Tips (Centers for Disease Control and Prevention)

Cataracts

A cataract is a clouding of the lens of the eye that affects your vision. Cataracts are more common in older people. By the age of 80, about half of all people will either have a cataract or have had cataract surgery. Cataracts cannot spread from one eye to another but some people will get cataracts in both eyes.

The lens of the eye lies behind the iris and the pupil. (For a great interactive diagram of the eye, check out this link from the National Eye Institute (http://www.nei.nih.gov/health/eyediagram/) . The lens is the part of the eye that focuses the light onto the retina in the back of the eye where the image is recorded. This is very similar to the way a camera lens works. The lens of the eye is made up mostly of water and protein. As we age, the protein thickens into clumps that can cloud parts of the lens. As the cataracts get larger, they get cloudier, making it harder to see.

Some ways to protect your vision:

Wear sunglasses and wide-brimmed hats when out in the sun since long exposure to bright sunlight is one of the risk factors. Smoking is also a risk factor so if you smoke, stop! (Smoking can lead to a host of other health problems, also.) Researchers also believe that a good diet can help prevent cataracts and they recommend eating such things as green leafy vegetables, fruit, and other foods containing antioxidants.

These are some of the common symptoms of cataracts:

Blurry vision
Colors that seem faded
Glare
Not being able to see well at night
Double vision
Frequent prescription changes in your eye wear

The National Eye Institute lists these tests for the diagnosis of cataracts:

Visual acuity test. This eye chart test measures how well you see at various distances.

Dilated eye exam. Drops are placed in your eyes to widen, or dilate, the pupils. Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of damage and other eye problems. After the exam, your close-up vision may remain blurred for several hours.

Tonometry. An instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test.

TREATMENT

Early cataracts can be treated with such things as anti-glare sunglasses, magnifying lenses, and new eyeglasses. If these things don't help, then surgery becomes the only other option. Surgery is usually only done when the cataracts get bad enough to interfere with normal daily activities like driving a car, reading or watching television. You need to talk to your eye care professional in order to make the appropriate decision.

For more comprehensive information on cataracts, check out these links:

Facts about Cataracts from the National Eye Institute

Facts & Myths about Cataracts from Prevent Blindness America

Cataract Surgery from the Mayo Foundation for Medical Education and Research

Cholesterol

Somehow with all the health observances the month I missed the fact that it is Cholesterol Education Month. Cholesterol is a waxy, fat-like substance that occurs naturally in all parts of the body. Your body needs some cholesterol to work properly. But if you have too much in your blood, it can stick to the walls of your arteries. This is called plaque. Plaque can narrow your arteries or even block them. This can lead to heart disease, including heart attacks.

If you have trouble remembering which cholesterol is good (HDL) and which is bad (LDL), I'll share with you how I learned which was which. In HDL, I associated the "H" with "healthy" and in LDL, I associated the "L" with "lousy." That should help you to remember which is which.

Here are some tips from the FDA for things that you can do to lower your cholesterol:

- Cut back on foods with lots of fat such as fatty meats, fried foods, whole milk, fatty cheeses, butter, margarine, oils, lard, and creams.
- Cut back on food with lots of cholesterol, such as egg yolks and whole eggs.
- Eat more fruits and vegetables.
- Cut back on fatty snacks and desserts, such as candy, cookies, doughnuts, muffins, pastries and pies.
- Exercise at least 30 minutes most days.
- If you are overweight, try to lose weight. Try to lose weight by cutting back on the amount that you eat. Even a small amount of weight loss can help lower your bad cholesterol, and you will also help your health in other ways.
- Ask your doctor if you need to take medicine to help lower your cholesterol. Triglycerides are another form of fat in your blood. They can also raise your risk for heart disease. Levels that are borderline high (150-199 mg/dL) or high (200 mg/dL or more) may need treatment.

I found some great links about cholesterol that I'd like to share. Keeping your cholesterol under control is very important, so check these out:

About Cholesterol (American Heart Association)

High Blood Cholesterol (National Heart, Lung, and Blood Institute)

Managing Cholesterol (Interactive Tutorial) (Patient Education Institute)

Osteoporosis

Osteoporosis makes your bones weak and brittle and this increases the risk of them breaking. Anyone can develop osteoporosis, but it is more common in older women. This means 44 million Americans are at risk. As many as one half of all women and a quarter of men older than 50 will break a bone due to osteoporosis.

Risk factors for osteoporosis include:

- Getting older
- Being small and thin
- Having a family history of osteoporosis
- Taking certain medicines
- Being a white or Asian woman
- Having osteopenia, which is low bone mass

Osteoporosis is a silent disease, meaning that most people don’t know they have it until they break a bone. You can protect your bones by eating a balanced diet that is rich in calcium and vitamin D and by getting regular exercise. If your doctor feels you are at risk for osteoporosis, he or she may order a bone density test to see how dense your bones are and whether or not you have osteoporosis. It can also tell you what the chances are that you could break a bone. The results of the test can help your doctor decide what kind of prevention or treatment program you need.

TREATMENT:
There are a number of medications available for the prevention and treatment of osteoporosis. These include bisphosphonates; estrogen agonists/antagonists (also called selective estrogen receptor modulators or SERMS); parathyroid hormone; estrogen therapy; hormone therapy; and a recently approved RANK ligand (RANKL) inhibitor.

In men, reduced levels of testosterone may be linked to osteoporosis. Men who have abnormally low levels of testosterone may be prescribed testosterone replacement therapy to help slow bone loss.

Something to keep in mind: both excessive sodium and protein increase our need for calcium by excreting it in our urine, so it is important to take both in moderation in your diet.

Reducing the risk of falling:
You can significantly reduce your risk of falling by engaging in activities that help increase your balance, flexibility and strength.

Activities recommended by the NIH Osteoporosis and Related Bone Diseases - National Resource Center:

Walking
Strength training
Dancing
Tai chi
Stair climbing
Hiking
Bicycling
Swimming
Gardening

Here are a couple safety checklists, also from NIH:

Indoor safety checklist
- Use nightlights throughout your home.
- Keep all rooms free from clutter, especially the floors.
- Keep floor surfaces smooth but not slippery. When entering rooms, be aware of differences in floor levels and thresholds.
- Wear supportive, low-heeled shoes even at home. Avoid walking around in socks, stockings, or floppy slippers.
- Check that all carpets and area rugs have skid-proof backing or are tacked to the floor, including carpeting on stairs.
- Keep electrical cords and telephone lines out of walkways.
- Be sure that all stairways are well lit and that stairs have handrails on both sides. Consider placing fluorescent tape on the edges of top and bottom steps.
- Install grab bars on bathroom walls beside tubs, showers, and toilets. If you are unstable on your feet, consider using a plastic chair with a back and nonskid leg tips in the shower.
- Use a rubber bathmat in the shower or tub.
- Keep a flashlight with extra batteries beside your bed.
- Add ceiling fixtures to rooms lit only by lamps, or install lamps that can be turned on by a switch near the entrance to the room.
- Use at least 100-watt light bulbs in your home.

Outdoor safety checklist
- In bad weather, consider using a cane or walker for extra stability.
- In winter, wear warm boots with rubber soles for added traction.
- Look carefully at floor surfaces in public buildings. Many floors are made of highly polished marble or tile that can be very slippery. When floors have plastic or carpet runners in place, try to stay on them whenever possible.
- Use a shoulder bag, fanny pack, or backpack to leave hands free.
- Stop at curbs to check height before stepping up or down. Be cautious at curbs that have been cut away to allow access for bikes or wheelchairs. The incline may lead to a fall.


Links for more information on Osteoporosis:

Bone Health for Life: Easy-to-Read Information for Patients and Families from the National Institute of Arthritis and Musculoskeletal and Skin Diseases

Handout on Health: Osteoporosis from the National Institute of Arthritis and Musculoskeletal and Skin Diseases

Osteoporosis from the American College of Rheumatology

Ovarian Cancer Research

Since I have been posting occasional information in observance of Ovarian Cancer Awareness Month, I thought I'd do one more post with some information on what's going on with research in ovarian cancer treatment.

Here are some links to information on ovarian cancer research:

Modified Chemotherapy Regimen Effective in Advanced Ovarian Cancer
Women with advanced ovarian cancer lived longer and without their tumors growing after receiving a modified regimen of a standard chemotherapy drug combination, Japanese researchers have reported. In a large phase III clinical trial, the researchers randomly assigned women to receive six cycles of carboplatin and paclitaxel (Taxol) every 3 weeks (standard regimen) or six cycles of carboplatin every 3 weeks and a lower dose of paclitaxel (Taxol) once a week (dose-dense regimen). Women in the dose-dense group had a 29 percent reduction in the risk of progression and a 25 percent reduction in the risk of death after 3 years of follow-up. The results were published online September 18, 2009, in The Lancet.

Ovarian Epithelial Tumors Traced to Fallopian Tubes
Researchers at Dana-Farber Cancer Institute in Boston, Mass., have found that the source of disease in many cases of the most aggressive form of ovarian cancer, serous carcinoma, may not be the ovary at all, but rather the fimbria of the fallopian tube. Dr. Keren Levanon reported these findings at the American Association for Cancer Research annual meeting on April 14, 2008.

Ultrasound Expertise Important in the Diagnosis of Ovarian Cancer
Improving the quality of diagnostic ultrasound scans could significantly reduce unnecessary surgeries in women with suspected ovarian cancer who, in fact, have benign disease, according to a study by British researchers.

From the American Cancer Society: What’s new in ovarian cancer research and treatment?

Finding Health Information on the Internet

One of my first posts when I started this blog was about how to evaluate the quality of the health information you find online. In this day and age virtually anyone can post anything on the Internet so it's important that you evaluate the information you find. Since that original post was many months ago, I thought I'd revisit the subject.

My goal with this blog is to provide links to quality information on a wide range of subjects so you don't have to wonder about the quality of the information. Over the 22 years I was a medical librarian, I gained a lot of insight and knowledge about quality health information.

Do not use Google to search about your diagnosis! Google is a great search engine, but it does not distinguish between what is good information and what is garbage. Like I said, anyone can post anything so beware! Those of you who have been reading my blog from the beginning know that I provide a lot of links from MedlinePlus, a service of the National Library of Medicine (National Institutes of Health). (I will provide links below for all web sites I mention.) MedlinePlus is probably the best place to start when you need to look up information. They have over 800 health topics with information from over 1,000 organizations, databases for drugs and supplements and much more. You can be confident that any information you find on MedlinePlus is quality information.

Other things to consider when evaluating a web site:

Who developed the web site? Is the author clearly identified? Are the credentials of the author listed? Since anyone can post information, it is vital that you check to make sure the person giving the information is qualified to give that information. If the site does not identify the author, then that information is suspect.

Does the page show when it was last updated? Are the links to other resources still active? Many people post information on the Internet having no intention of keeping it up-to-date. That's why it's important to check for a date to be sure the information is current.

Is contact information provided so that you can e-mail, call, or write the author? If there is no contact information, then it is difficult to ascertain the validity of the information and the authority of the author.

What is the purpose of the information? Assess the reason for the information provided. Are they trying to sell you something or persuade you to do something or is the information provided for informational purposes only? If the page is designed for commercial purposes only, then there may be conflict of interest with the information provided. It is best to stick with non-commercial sites.

Can the information be verified in other sources? If a web site is not well documented, it is especially important to verify the information in other sources. If you ever find a difference in the information, it is important you check with a health care provider for clarification.

Some great resources for health information:

MedlinePlus from the National Library of Medicine.

Top 100 List: Health Websites You Can Trust (from the Consumer and Patient Health Information Section of the Medical Library Association)

NOAH: New York Online Access to Health (organization composed of a number of New York City Libraries)

Heed Early Warning Signs of Ovarian Cancer

Since I've been spotlighting ovarian cancer this month, I thought I'd share a little news item I found from the American Cancer Society called Heed Early Warning Signs of Ovarian Cancer. Ovarian cancer is hard to diagnose because many times there are no symptoms or the symptoms, such as bloating and pelvic or abdominal pain, are common to other less serious problems. Sadly, only 20% of ovarian cancers are diagnosed at an early stage when it is easier to treat.

Besides the information from the American Cancer Society, be sure to check out the MedlinePlus health topic on Ovarian Cancer for links to information on all aspects of ovarian cancer.

Type 2 Diabetes

Diabetes is a disease where your blood glucose (sugar) levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that the body produces that helps the glucose get into the cells in your body to give them energy. In Type I Diabetes, your body does not make insulin at all. These are the diabetics that must take insulin injections or receive insulin through a pump for the rest of their lives. In Type 2 Diabetes, the most common kind, your body doesn’t make or use insulin well so the glucose stays in your blood.

Having too much glucose in your blood can cause many problems over time. Over time, you can develop problems with your eyes, kidneys, and nerves. Diabetes can lead to blindness, kidney problems that necessitate dialysis, nerve problems with the limbs in your body that may get bad enough that they need to be amputated. Diabetes can also lead to heart disease and stroke.

Some of the risk factors for type 2 diabetes are older age, obesity, a family history of diabetes, lack of physical activity, and certain ethnicities. About 80% of the people with diabetes type 2 are overweight. Type 2 diabetes is increasingly being diagnosed in children and adolescents, especially among African American, Mexican American, and Pacific Islander youth.

Symptoms of type 2 diabetes include excessive thirst, fatigue, weight loss, vision problems, and frequent urination. Some people may not have any symptoms, which can lead to a delay in the diagnosis of the disease.

A fasting blood glucose test, preferably done in the morning, is the most accurate way to diagnose diabetes. However, the following tests results can also be used to diagnose diabetes:

- A blood glucose level of 126 milligrams per deciliter (mg/dL) or higher after an 8-hour fast. This test is called the fasting blood glucose test.
- A blood glucose level of 200 mg/dL or higher 2 hours after drinking a beverage containing 75 grams of glucose dissolved in water. This test is called the oral glucose tolerance test (OGTT).
- A random—taken at any time of day—blood glucose level of 200 mg/dL or higher, along with the presence of diabetes symptoms.

These test results should be confirmed by retesting on a different day.

PRE-DIABETES:

Pre-diabetes is a condition where the blood glucose is higher than normal, but not high enough to be considered diabetes.

Pre-diabetes is also called impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), depending on the test used to diagnose it. Some people have both IFG and IGT.

- IFG is a condition in which the blood glucose level is high—100 to 125 mg/dL—after an overnight fast, but is not high enough to be classified as diabetes. The former definition of IFG was 110 mg/dL to 125 mg/dL.
- IGT is a condition in which the blood glucose level is high—140 to 199 mg/dL—after a 2-hour OGTT, but is not high enough to be classified as diabetes.

(Above information on test results is from the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health)

Treatment options for type 2 diabetes include insulin, metformin, and a number of other drugs. Along with the medicines, it is important to develop a meal plan and stick to it, get enough exercise and control your weight. The more you change your lifestyle, the more effective your treatment will be.

For more information on treatment options for diabetes, the National Institute of Diabetes and Digestive and Kidney Diseases, has a great resource called What I Need to Know about Diabetes Medicines. This resource provides detailed information on the types of insulin and other medicines that your doctor might prescribe.

Consumer Reports has a two-page supplement to their Best Buy Drugs publication that lists all the different medicines. Besides the effectiveness and safety information, they provide very useful information on the costs of the different medicines so you can compare prices for each one. Here is the publication: The Oral Diabetes Drugs: Comparing Effectiveness, Safety, and Price

Other links to check out:

Diabetes Overview from The National Institute of Diabetes and Digestive and Kidney Diseases

Take Steps to Prevent Type 2 Diabetes from the Office of Disease Prevention and Health Promotion

For those interested in alternative therapies:

Diabetes and CAM: A Focus on Dietary Supplements

Complementary and Alternative Medical Therapies for Diabetes

Prostate Cancer Awareness

I didn't realize that September is also Prostate Cancer Awareness Month. I thought that since I'm highlighting ovarian cancer awareness for the women, that it would be a good idea to do a little something for the men. Last month I posted some information on the symptoms of prostate cancer and the various tests done to diagnosis the disease (http://healthtalk-margie.blogspot.com/2010/08/prostate-cancer.html). The National Cancer Institute has a very informative publication called What You Need to Know about Prostate Cancer that is definitely worth checking out. Make sure you are familiar with the signs and symptoms of prostate cancer.

A Day of Remembrance

As I've been watching the coverage of all the 9/11 remembrances, I decided that I'd like to do a special tribute to all the brave men and women who lost their lives on 9/11 while trying to rescue people. First responders rush in when everyone else rushes out. I know some people whose loved ones were affected in one way or another by what happened on that day in New York City, so this is my tribute to them.

The Firefighter's Prayer
When I am called to duty, God, whenever flames may rage;

Give me strength to save some life, whatever be its age.

Help me embrace a little child before it is too late

Or save an older person from the horror of that fate.

Enable me to be alert and hear the weakest shout,

And quickly and efficiently to put the fire out.

I want to fill my calling and to give the best in me,

To guard my every neighbor and protect his property.

And if, according to my fate, I am to lose my life;

Please bless with your protecting hand my children and my wife.

Total number killed in attacks (official figure as of 9/5/02): 2,819
Number of firefighters and paramedics killed: 343
Number of NYPD officers: 23
Number of Port Authority police officers: 37

Thank you to all the brave men and women who are first responders and who rush in when others rush out. Thank you!

Maintain Your Brain Today

I came across a really great web page from the Alzheimer's Association on Brain Health. Their Maintain Your Brain Today page provides all kinds of information on how we should take care of our brain as we age by urging people to make brain-healthy life choices. There are links called: Stay Physically Active, Adopt a Brain-Healthy Diet, Remain Socially Active and Stay Mentally Active, plus other information as well. It's definitely worth checking out. If you want more information from the Alzheimer's Association, their home page is at www.alz.org.

Dietary Supplements

If you're like me, at some point in your life you've gone into a drug store or any store that sell dietary supplements and have walked down aisles of bottles with claims that they can cure this or that disease or prevent this or that illness. Most dietary supplements are not regulated, so the manufacturers can claim just about anything.

You might be looking for a particular supplement and when you find it, there could be dozens of choices just for one type of supplement. The National Library of Medicine has an excellent database called the Dietary Supplements Labels Database. The Dietary Supplements Labels Database offers information about label ingredients in more than 4,000 selected brands of dietary supplements. It enables users to compare label ingredients in different brands. Information is also provided on the "structure/function" claims made by manufacturers. It is a site that you should bookmark and refer to whenever you're buying any kind of supplement.

The Mayo Clinic staff has written a very helpful article called Dietary supplements: Nutrition in a pill? that provides some very helpful tips for what to look for when you are shopping for supplements. Make sure you know what you're buying so you don't waste your money on something that is worthless.

National Ovarian Cancer Coalition

I thought I'd pass on another link regarding ovarian cancer. If you know someone who is battling ovarian cancer (or lost a battle with the disease) and you want to get more involved with the cause, the National Ovarian Cancer Coalition (http://www.ovarian.org/) has a great web site with some very helpful information. They list news and events around the country. They also have sections for the newly diagnosed, survivors, and caregivers. There is a lot more information there, so make sure you take a look at it.

SEPTEMBER IS OVARIAN CANCER AWARENESS MONTH

Periodically throughout the month of September I will be featuring information on ovarian cancer since it is a very difficult cancer to diagnose.

The following information is just an overview of ovarian cancer. For more complete information, check out the links at the end of this article.

Ovarian cancer usually affects women over the age of 50, although it also affects younger women. It is a very hard cancer to diagnose since there may be no symptoms or the symptoms may be vague and hard to distinguish from less serious health issues.

SYMPTOMS:

The symptoms of ovarian cancer include:

- Heavy feeling in pelvis
- Pain in lower abdomen
- Bleeding from the vagina
- Weight gain or loss
- Abnormal periods
- Unexplained back pain that gets worse
- Gas, nausea, vomiting, or loss of appetite

RISK FACTORS:

Doctors can’t always explain why one women gets ovarian cancer and another doesn’t, but studies have shown there are certain risk factors for ovarian cancer:

- Family history of cancer: Women who have a mother, daughter, or sister with ovarian cancer have an increased risk of the disease. Also, women with a family history of cancer of the breast, uterus, colon, or rectum may also have an increased risk of ovarian cancer.

If several women in a family have ovarian or breast cancer, especially at a young age, this is considered a strong family history. If you have a strong family history of ovarian or breast cancer, you may wish to talk to a genetic counselor. The counselor may suggest genetic testing for you and the women in your family. Genetic tests can sometimes show the presence of specific gene changes that increase the risk of ovarian cancer.
-Personal history of cancer: Women who have had cancer of the breast, uterus, colon, or rectum have a higher risk of ovarian cancer.
- Age over 55: Most women are over age 55 when diagnosed with ovarian cancer.
- Never pregnant: Older women who have never been pregnant have an increased risk of ovarian cancer.
- Menopausal hormone therapy: Some studies have suggested that women who take estrogen by itself (estrogen without progesterone) for 10 or more years may have an increased risk of ovarian cancer.

If you experience any of the symptoms of ovarian cancer, talk to your doctor. Your doctor will talk to you about your medical history and may order one or more of the following tests: a physical exam, pelvic exam, blood tests, ultrasound, or biopsy.

STAGING:
If you are diagnosed with ovarian cancer, your cancer needs to be staged so your doctor knows the best treatment to use. It is important to know if the cancer has spread. Tests that may be ordered include CT scan, chest x-ray, barium enema x-ray, or colonoscopy.

These are the stages of ovarian cancer:

- Stage I: Cancer cells are found in one or both ovaries. Cancer cells may be found on the surface of the ovaries or in fluid collected from the abdomen.
- Stage II: Cancer cells have spread from one or both ovaries to other tissues in the pelvis. Cancer cells are found on the fallopian tubes, the uterus, or other tissues in the pelvis. Cancer cells may be found in fluid collected from the abdomen.
- Stage III: Cancer cells have spread to tissues outside the pelvis or to the regional lymph nodes. Cancer cells may be found on the outside of the liver.
- Stage IV: Cancer cells have spread to tissues outside the abdomen and pelvis. Cancer cells may be found inside the liver, in the lungs, or in other organs.

TREATMENT:

Cancer treatment can affect cancer cells in the pelvis, in the abdomen, or throughout the body:

Local Therapy: Surgery and radiation therapy are local therapies. They remove or destroy ovarian cancer in the pelvis. When ovarian cancer has spread to other parts of the body, local therapy may be used to control the disease in those specific areas.

Intraperitoneal chemotherapy: Chemotherapy can be given directly into the abdomen and pelvis through a thin tube. The drugs destroy or control cancer in the abdomen and pelvis.

Systemic chemotherapy: When chemotherapy is taken by mouth or injected into a vein, the drugs enter the bloodstream and destroy or control cancer throughout the body.

It is important that you discuss all treatment options with your doctor. You may want to get a second opinion and you probably have a lot of questions.

For more detailed descriptions of this information, check out What You Need to Know about Ovarian Cancer from the National Cancer Institute.

What Is Ovarian Cancer? from the American Cancer SocietyOvarian Cancer Interactive Tutorial from the Patient Education Institute

For links to more information on all aspects of ovarian cancer, visit the MedlinePlus Ovarian Cancer health topic