Ovarian cancer

Ovarian cancer is a leading cause of cancer deaths in women women and has the highest mortality of any of the gynaecologic cancers. Over three decades, there has been little improvement in the long-term survival of women with ovarian cancer. Early, curable ovarian cancer produces no symptoms, and three-fourths of cases are not diagnosed until the cancer has spread beyond the ovarian capsule. As a result, two thirds of women with ovarian cancer have advanced disease at the time of diagnosis. Once this stage is reached, fewer than 10% of women are cured.

To date, there are no ideal screening tools: pelvic examinations are not nearly sensitive enough to detect small ovarian tumours; ultrasound cannot distinguish a cancer from a harmless cyst; and the commonest blood test misses half of early ovarian cancers and often reads positive for other reasons, including other kinds of cancer and certain benign conditions. The biggest risk factor is heredity, and in some families a strong susceptibility seems to be inherited through a gene or group of genes to a woman by her mother; there is also suggestion that transmission can occur through a woman's father.

Ovarian cancer affects only one woman in 70, but it is the leading cause of death from gynaecological cancers and the fourth-leading cause of cancer deaths in women (after cancers of the lung, breast and colon). It most commonly strikes women from 40 to 70 and is most common in women over age 60. There is an increased chance of an ovarian tumour being malignant at older ages and after menopause. In 1993, it was estimated that 22,000 new cases would be diagnosed in the USA and 13,300 women would die of the disease in that year. In fact, it accounted for around 26,600 new cases and 14,500 deaths in 1995. The overall 5-year survival rate is at least 75% if the cancer is confined to the ovaries and decreases to 17% in women diagnosed with distant metastases.

The lifetime risk of dying from ovarian cancer in the USA is 1.1%. Each of the following factors approximately doubles the average woman's risk of ovarian cancer: never having had a baby, having used talcum powder on the perineal area for many years, being infertile (and perhaps having taken fertility drugs) and having had breast cancer. A diet high in meat and animal fats also plays a role. In Japan, as daily fat consumption increased from 10.6 grams to a still-low 84.5 grams, incidence of ovarian cancer nearly doubled. The other important risk factor is afamily history of ovarian cancer. Less than 0.1% of women are affected by hereditary ovarian cancer syndrome, but these women may face a 40% lifetime risk of developing ovarian cancer.

The male condom is now suspected of helping cause cancer and infertility. The problem being that talcum powder is used by some manufacturers as a dry lubricant. Talcum powder has been shown to cause ovarian cancer and fibrosis on the fallopian tubes in women, leading to infertility. The US Food and Drug Administration had banned the use of talc on surgical gloves but not on condoms (as of 1995).