Ovarian cancer

“ Our Nation is committed to fighting ovarian cancer, finding its cure, and providing hope and healing to those who are affected by it.
While ovarian cancer remains one of the leading causes of cancer-related death among women in our country, scientists have made significant progress in understanding the factors associated with it. Women of all ages can develop this cancer, but studies have shown risk increases with age. Other factors associated with ovarian cancer include family history, obesity, use of fertility drugs, and a prior occurrence of certain cancers. ”

“ The National Institutes of Health has invested more than $120 million this year in ovarian cancer research and expects to invest more in 2005. Through the National Cancer Institute's Ovarian Cancer Prevention and Early Detection Study, scientists are following women at increased risk for the cancer to assess how preemptive surgery and screening methods affect ovarian cancer occurrence and quality of life. The Centers for Disease Control and Prevention's Ovarian Cancer Control Initiative will also focus on factors related to early detection and treatment. ”

“ When the disease is diagnosed in advanced stages, the chance of 5- year survival is only about 25 percent. Currently, 50 percent of women diagnosed with ovarian cancer die from it within 5 years. Among African-American women, only 48 percent survive 5 years or more. ”

“ I commend the strength and courage of the women who persevere in the face of this serious illness, and I encourage our scientists and researchers to redouble their efforts to find more effective prevention, diagnostic, and treatment strategies to combat ovarian cancer. ”

“ I call upon government officials, businesses, communities, health care professionals, educators, volunteers, and all people of the United States to continue our Nation's strong commitment to preventing and treating ovarian cancer. ”

“ During my 29-year career as an obstetrician and gynecologist, too often I had to sit down with patients and give them a very bad diagnosis. It might have been a young mother of three whose three babies I delivered, now with metastatic breast cancer, or perhaps another woman with advanced cervical or ovarian cancer, all of which have very challenging prognoses. ”

“ Ovariotomy in carcinoma of the ovary. When an operation is undertaken for the removal of solid or semi-solid tumours of the ovary, and especially when bilateral and accompanied by vomiting, it is incumbent on the surgeon to make a careful examination of the gastro-intestinal tract, for in many of these cases cancer will be found either at the pylorus, or in the cæcum, or the colon, and particularly in the sigmoid flexure. In such circumstances the ovarian masses are secondary to the cancerous focus in the gastro-intestinal tract. ”

“ Our most effective weapon in the battle against ovarian cancer is early detection. Subtle but recognizable symptoms, such as bloating, vague abdominal pain and discomfort, gastrointestinal problems, back pain, and fatigue can also be symptoms of other less serious illnesses, but women who are experiencing such early warning signs should consult their doctors immediately for appropriate tests. ”

“ Occasionally the passage of a fœtus is barred by tumours growing from the uterus, especially a large cervix fibroid, or a fibroid growing from the lower segment of the uterine wall. An ovarian cyst, especially a dermoid incarcerated by the uterus, may render this operation necessary. The rarest causes are cancer of the neck of the uterus and cancer of the rectum. ”

“ At the time of the menopause there is also an increased liability to the occurrence of cancer of the ovaries. Numerous statistical data have been published regarding the frequency with which carcinoma of the uterus occurs at various periods in women’s lives, and, notwithstanding all variations, one fact stands out clearly, namely, that this disease occurs most frequently in the fourth and fifth decennia, and above all during the climacteric period. ”

“ A good broad rule to remember is, that when the womb is gravid the cervix is as soft as one's lips; when it is empty the cervix is as hard as the tip of one's nose. In all doubtful cases any operation should be postponed until time has revealed the true condition of things. Of course the introduction of the sound will settle the question of pregnancy, but this procedure is not to be thought of when any doubt exists, and it is therefore useless as a diagnostic agent. An ovarian tumor may coexist with pregnancy, and may have to be tapped or be extirpated before the delivery of the woman. ”

“ If the woman sits up or lies on either side, the relation between the areas of flatness and resonance is unaltered in the case of an ovarian cyst, while, as is well known, if the fluid be free it will gravitate to the most dependent portion of the abdomen.
Auscultation reveals nothing of importance in regard to ovarian tumors. It is of value in enabling one to make a differential diagnosis between an ovarian tumor and pregnancy. ”

“ The difficulty of making a differential diagnosis is well illustrated by many cases that have been recorded, in which it was impossible to determine the true nature of the tumor even after the abdomen had been opened.
It is of the greatest importance to exclude pregnancy. Many women have been subjected to the operation of celiotomy because the pregnant uterus was mistaken for an ovarian tumor. Women themselves often intentionally mislead the physician, especially if the pregnancy is illegitimate. ”

“ It occasionally happens that a woman may go through her pregnancy and labour with an unrecognized ovarian tumour in her abdomen; during the puerperal period it may cause symptoms which lead to its recognition, because in the course of the labour the cyst may burst, undergo axial rotation, or suppurate. When a puerperal woman possesses an ovarian tumour which gives rise to unfavourable signs, ovariotomy should be resorted to without delay. The operation in these circumstances is comparatively simple, and such adhesions as may be present are usually recent and easily overcome. ”

“ Meanwhile, however, surgery has opposed itself not only to cancers but to all kinds of tumors, until danger from these sores has been greatly lessened. The removal of internal tumors such as the ovarian, is no longer, except in complicated and neglected cases, a matter of serious import. Such work is performed in almost every country town, and the amount of human life thus rescued from impending death is very great. ”

“ Our reputation for successful operations increases; and the request is often made by patients that no men shall be present.
An old lady of seventy-nine years, the prolongation of whose life depended upon the immediate removal of a large ovarian tumor—an accidental fall having caused inflammation—insisted upon having even no consultation with men, nor any men present at the operation, saying, “I am old enough anyway to die, only I don’t want to suffer as I do now; and if the women can save my life for a while longer, I shall be grateful.” ”

“ The patient was a woman of twenty-eight whose abdomen at the umbilicus measured 69 inches in circumference and 47 inches from the sternum to the pubes. Before the operation the great tumor hung down as far as the knees, the abdominal wall chafing the thighs. Figure 263 shows the appearance of a large ovarian cyst weighing 149 pounds. The emaciation of the subject is particularly noticeable. Reifsnyder describes a native Chinese woman affected with an ovarian tumor seen at the Margaret Williamson Hospital at Shanghai. She was four feet eight inches in height, and twenty-five years of age. ”