The short answer? Not very common.
“It is, overall, a very uncommon disease in young women,” says Katherine Mager, MD, Associate Professor of Oncology in the Department of Gynecologic Oncology at Roswell Park Comprehensive Cancer Center. “Among ovarian cancer cases, only about 10% are diagnosed in women under 40.” But this low risk of an ovarian cancer diagnosis does not mean it’s something young adults should ignore.
What are the signs of ovarian cancer?
Some common signs and symptoms of this disease in patients of all ages include new onset pelvic or abdominal pain, bloating, changes in urinary and bowel function or changes in appetite.
“It can be challenging to differentiate between these and normal menstrual symptoms,” says Dr. Mager. “Because ovarian cancer is so uncommon in young adults, more often than not these symptoms are part of a normal physiologic process.” It is always recommended to check with your doctor or gynecologist for further evaluation if these symptoms persist or become worse.
If these symptoms do lead to a diagnosis of ovarian cancer, fertility-sparing treatment options are available in many different forms. “Sometimes it means doing surgery where we’re able to preserve the uterus, cervix, ovary or fallopian tube to allow a young woman to go on to carry a pregnancy,” says Dr. Mager. “It can also involve working closely with a fertility team to look at ways we can preserve fertility, even if we need to remove one or both of the ovaries and the uterus.”
Roswell Park’s Oncofertility Program recognizes how important fertility preservation can be to patients in their 20s and 30s. “There are a lot of options and it’s important to work with a specialist who has familiarity with fertility-sparing approaches,” Dr. Mager emphasizes.
Screening and preventive measures
Many women will begin screening for cervical cancer at the age of 21-25; a Pap test, performed by your gynecologist collects cervical cells for observation of any abnormal changes. This is a quick and effective way to monitor and prevent the growth of cervical cancer cells but not an effective means for ovarian cancer screening.
“We recommend annual visits with your gynecologist for a pelvic exam and to help assess any changes in symptoms or pelvic masses,” says Dr. Mager. Knowing your body and being familiar with your normal menstrual symptoms can help to catch these out-of-the-ordinary symptoms.
Another important aspect of detecting ovarian cancer is knowing your family health history. “If you have a strong family history of cancer of any kind, it’s a good idea to touch base with your doctor about the option of genetic testing,” Dr. Mager advises. “We know inherited susceptibility represents a portion of ovarian cancer cases, but at this point it is not the majority.”
Dr. Mager also references the importance of cancer research. “As we learn more about how ovarian cancer arises, we will hopefully be able to pinpoint more of these genes that might make a woman more susceptible to the development of ovarian cancer.”
Ovarian cysts and other misconceptions
“Ovarian cysts are incredibly common in young women. As part of the menstrual cycle, women are generally forming one or multiple cysts every month,” says Dr. Mager. “We call these functional cysts.” Many cysts that develop are benign (noncancerous) and do not make a patient more likely to develop a malignant (cancerous) cyst later on in life.
“There are some cysts which we call borderline tumors, that can have a risk of transformation into a low-grade cancer,” says Dr. Mager “These are cysts that should be removed, and patients should be followed closely after removal. But that is a very small exception.”
Another frequent misconception Dr. Mager hears often from patients are the effects of birth control on a woman’s risk of developing cancer — while some may think ovarian cancer development is associated with the use of birth control pills, the opposite is actually true.
“Birth control is one intervention that we do know is associated with a decreased risk of the development of ovarian cancer,” Dr. Mager says. Combined oral contraceptives (containing both estrogen and progesterone) or any other specific medication will not lead to an increased risk of cancer.