Understanding Ovarian Cancer & The Importance of Second Opinions
- Alex Macgillivray is urging others to pay attention to their symptoms after she initially dismissed her ovarian cancer symptoms as back pain caused by “tight” hips.
- Ovarian cancer is called the cancer that whispers because symptoms can be vague and sometimes similar to regular menstrual cycle fluctuations.
- Our advice to readers is simple: Talk to your doctor if you feel like something is off.
- If you’re worried about your risk of developing ovarian cancer, speak with your doctor. One of our experts urges “all women to discuss their family history and individual risk factors with their doctors and ask whether there are risk-reducing options available to them.”
- Oncologists encourage people diagnosed with cancer to seek second opinions. You won’t be offending your doctor if you wish to consult another expert.
Before her shocking diagnosis, Macgillivray, who resides in southwest Great Britain, decided to take up yoga to help with the pain she was enduring, thinking stretching would alleviate any tightness in her body.
Read MoreAs Macgillivray is now going through chemotherapy, she explained in her recent interview with Kennedy News & Media, “I’ve always known my hips are tight so I get lower back pain. It was an ache in my lower back, then I’d randomly get a stabbing pain in my lower groin on the right side.
“When I got to June I started to experience severe bloating, which is really odd for me. My stomach was distended, I looked and felt pregnant. Everyone was saying to me ‘oh I get bloating, it could be IBS’ but I said ‘no it’s really weird.’ I was also constipated, which I never am.”
Expert Ovarian Cancer Resources
- Is There Screening for Ovarian Cancer?
- The Anatomy of a Lung Cancer
- Genetic Testing Can Help Guide Ovarian Cancer Treatment Decisions
- Managing An Ovarian Cancer Recurrence: How The New Drug Elahere Is Providing Hope
- The Different Kinds of Ovarian Cancer
- Ovarian Cancer Symptoms Can Be Hard to Spot
- Ovarian Cancer: Symptoms, Diagnosis & Making a Treatment Plan
After noticing she hasn’t eating anything out of the ordinary, she decided to seek her doctor’s advice two days after the constipation arose, leading her to undergo testing [including CT scans and ultrasounds], which revealed ovarian germ cell tumors.
Ovarian germ cell tumors (OGCTs) are tumors that develop from immature female germ cells (the cells that develop into eggs) in one or both ovaries. They can be either non-cancerous (benign) or cancerous (malignant).
RELATED: What Is An Ovarian Germ Cell Tumor? How Do You Treat and Diagnosis This Cancer?
“Ovarian germ cell tumors account for up to 25% of ovarian tumors (benign or malignant) but only 5% are malignant ovarian neoplasms,” Dr. Eleftheria Kalogera, a gynecologic oncologist at Miami Cancer Institute, part of Baptist Health South Florida, previously told SurvivorNet.
“They tend to affect young women in the 2nd and 3rd decade of life with a mean age at presentation of 19 to 20 years old. While they account for two-thirds of the ovarian tumors in this age group, only one-third is malignant.”
Macgillivray has admitted her diagnosis, which came around the time she was engaged, has made her feel as if life was “a bit of a roller-coaster.”
She continued, “Fair play to them, [the hospital staff] they did all the scans and found it, they didn’t just send me home with laxatives. James [her 27-year-old fiance] proposed after my exploratory surgery, he had it all planned out before I got ill, I had no idea it was coming.
‘It’s been something to really look forward to and a light at the end of a tunnel.”
The Importance of Second Opinions for Ovarian Cancer Diagnosis and Treatment
Macgillivray concluded with a warning for other women, saying, “Bloating and a change in toilet habits could just be linked to monthly cycles, but I’d said to anyone to get anything unusual to them checked out.
‘I’ve been lucky, I’ve got the ‘best’ ovarian cancer you can have as it’s usually silent and people don’t get diagnosed until later on. But I would push as soon as you experience any uncommon symptoms to get them checked out.”
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Ovarian Cancer Basics
Ovarian cancer has been called the “cancer that whisper,” because women often don’t experience symptoms until their cancer has already reached its late stages. The symptoms that do appear at first are hard to identify as cancer.
The Different Kinds of Ovarian Cancer
Symptoms of ovarian cancer may include the following, according to SurvivorNet experts.
- A feeling of bloating or fullness
- Pain in the pelvis or abdomen
- Nausea
- Vomiting
- Changes in bowel habits
These can be similar to symptoms many women experience monthly with their menstrual cycle, which makes finding this cancer so difficult.
Many ovarian cancers begin in the fallopian tubes. A few cancerous cells first grow on the fallopian tubes and then, as the fallopian tubes brush over the ovary, these cells stick to the ovaries and eventually grow to form a tumor.
Expert Ovarian Cancer Resources
- Is There Screening for Ovarian Cancer?
- The Anatomy of a Lung Cancer
- Genetic Testing Can Help Guide Ovarian Cancer Treatment Decisions
- Managing An Ovarian Cancer Recurrence: How The New Drug Elahere Is Providing Hope
- The Different Kinds of Ovarian Cancer
- Ovarian Cancer Symptoms Can Be Hard to Spot
- Ovarian Cancer: Symptoms, Diagnosis & Making a Treatment Plan
A few factors might increase the risk of ovarian cancer. Having these factors doesn’t mean you will get this cancer, only that your risk is slightly higher.
Your risk for ovarian cancer may be increased if you:
- Have gone through menopause. Ovarian cancer is rare in women younger than 40.
- Have a gene mutation. The BRCA1 and BRCA2 genes help cells repair their DNA damage. Having a change, or mutation, in one of these genes increases your risk of getting ovarian cancer. These gene mutations are commonly passed down in families.
- Are overweight or obese. Being very overweight might not only affect your risk of getting ovarian cancer but also your survival if you are diagnosed.
- Had your first pregnancy after age 35, or never carried a pregnancy to full-term. Of course, this doesn’t mean that women should have children just to protect themselves.
- Have family members with cancer. Your risk might be higher if you have close family members who have had ovarian, breast, or colorectal cancer.
- Used hormone replacement therapy. Women who take estrogen and progesterone after menopause are at slightly higher risk than women who don’t use these hormones.
Should You Have Chemotherapy Before Surgery for Ovarian Cancer?
No routine screening tests are recommended for women who are at average or low risk for ovarian cancer. Since symptoms can be subtle and hard to distinguish from everyday ailments like a stomach bug, SurvivorNet’s medical experts say women need to know their family history, be vigilant for symptoms, and ask their doctor for testing if they have any unusual or persistent symptoms.
The Importance of Getting a Second Opinion
After receiving a cancer diagnosis, it’s important to remember that you can, and should, talk to other cancer specialists about your disease.
“If I had any advice for you following a cancer diagnosis, it would be, first, to seek out multiple opinions as to the best care,” National Cancer Institute Chief of Surgery Steven Rosenberg told SurvivorNet in a previous interview. “Because finding a doctor who is up to the latest of information is important.”
RELATED: Second (& Third) Opinions Matter When Deciding Between Surgery or Radiation
As we highlight in several areas of SurvivorNet, highly respected doctors sometimes disagree on the right course of treatment, and advances in genetics and immunotherapy are creating new options.
Also, in some instances the specific course of treatment is not clear cut. That’s even more reason why understanding the potential approaches to your disease is crucial.
At the National Cancer Institute, there is a patient referral service that will “guide patients to the right group depending on their disease state so that they can gain access to these new experimental treatments,” Rosenberg says.
Cancer Research Legend Urges Patients to Get Multiple Opinions
Furthermore, getting another opinion may also help you avoid doctor biases. For example, some surgeons own radiation treatment centers. “So there may be a conflict of interest if you present to a surgeon that is recommending radiation because there is some ownership of that type of facility,” Dr. Jim Hu, director of robotic surgery at Weill Cornell Medical Center, tells SurvivorNet.
Other reasons to get a second opinion include:
- To see a doctor who has more experience treating your type of cancer
- You have a rare type of cancer
- There are several ways to treat your cancer
- You feel like your doctor isn’t listening to you, or isn’t giving you good advice
- You have trouble understanding your doctor
- You don’t like the treatment your doctor is recommending, or you’re worried about its possible side effects
- Your insurance company wants you to get another medical opinion
- Your cancer isn’t improving on your current treatment
Be Pushy, Be Your Own Advocate, Says Leading Expert
Bottom line, being proactive about your health could be a matter of life or death. Learn as much as you can from as many experts as you can, so that you know that you did your best to take control of your health.
Questions for Your Doctor
If you find yourself considering seeking a second or third medical opinion, here are some questions to kickstart the conversation with your doctor:
- Is there any other testing available for the type of cancer I have?
- Are there any other treatment options available for my type of cancer?
- Why or why do you not recommend those other options?
- I would like to seek a second opinion on my diagnosis and treatment options. Is there another doctor or facility you recommend?
- Do you want the second opinion to be sent to you?
- Can I have a copy of all my records that I can share with this second physician?
Ovarian Cancer: Getting a Second Opinion
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.