Survivors Teaching Students Saving Womens Lives SM Introduction

Survivors Teaching Students: Saving Women’s Lives. SM

Introduction • Part of national program OVCA National Alliance – called “Ovarian Cancer Teaching Program, Survivors Teaching Students” – STS is over 9 years old • Here to tell our stories – illustrate difficulty in getting an early diagnosis – illustrate our experiences after diagnosis – put face & voice on the disease • 40 schools across the country to 3 rd year medical students in gynecology rotation • with us today are 3 survivors • goal is to increase awareness of early symptoms of OVCA in order to provide early diagnosis and treatment”

Ovarian Cancer (OVCA) Overview Definition: Cancer that forms in tissues of the ovary (one of a pair of female reproductive glands in which the ova, or eggs, are formed). Most ovarian cancers are either ovarian epithelial carcinomas (cancer that begins in the cells on the surface of the ovary) or malignant germ cell tumors (cancer that begins in egg cells). • OVCA most lethal of all gynecological cancers – 1 out of every 5 reasons for cancer death in women • Annually, 22, 000 American women are diagnosed & ~15, 000 die • Median age for diagnosis = 63 • Majority are advanced stages – 10 year survival rate = 39% • No reliable screening test for early diagnosis – < 20% of ovarian cancer patients are diagnosed early • When it is detected, changes of survival are greatly improved • OVCA has symptoms even in early stages

Ovarian Cancer Statistics A woman’s lifetime risk of: • developing invasive ovarian cancer = 1 in 71. • risk of dying from invasive ovarian cancer = 1 in 95.

Ovarian Cancer Risk Factors • Personal or family history of breast, colon or ovarian cancer • Increasing age, over 55 • BRCA genes – 5 -10% of all OVCAs – Ashkenazi Jewish descent @ high risk for these genes • • Started menstruating at an early age (before 12) Had her first child after 30 Lynch Syndrome (hereditary colorectal cancer) Never being pregnant (nulligravida) Factors associated with a decreased risk of ovarian cancer include: – – using oral contraceptives having and breastfeeding children having a bilateral tubal ligation or hysterectomy having a prophylactic oophorectomy

Ovarian Cancer Symptoms • • Bloating Pelvic or abdominal pain Difficulty eating or feeling full quickly Urinary symptoms (urgency or frequency) • Additional signs – – – – Fatigue Indigestion Feeling the need to urinate often Back pain Pain with intercourse Constipation Menstrual irregularities If symptoms persist for > 3 weeks, consider that it could be OVCA

Survivor Stories

You as a future provider face obstacles • No screening/testing of general public • 80 -90% have no OVCA family history • Women don’t have general awareness – women accept these symptoms as part of the physiological cycle • When have negative Pap smear, everything is ruled out when it shouldn’t be • Symptoms are not specific – most providers look at other conditions that are less serious especially if the women are young • Fact that women are diagnosed & die shortly after is NOT true • 50% of OVCAs had negative CA 125 readings which also can be elevated in other malignancies

Conclusion • We hope that you will remember us • Dangerous situation when diagnosis is not made until the illness reaches an advance stage – Lack of provider awareness – Lack of women’s awareness – Non-specific symptoms • Although the diagnosis is often not good, each experience is unique – You can provide hope when you communicate