About 1 in 10 women have endometriosis, a condition where tissues in the lining of the uterus migrate and grow outside of the uterus, often creating painful cysts and lesions that swell during menstruation. As common as endometriosis is, many women don’t know they have it. But getting diagnosed is important for many reasons – not least of all because it’s linked to an increased risk of ovarian cancer.
According to a recent study, those who have endometriosis are 4.2 times more likely to develop ovarian cancer than those who don’t have endometriosis. Those with certain types of endometriosis, like deep infiltrating endometriosis, are 9.7 times more likely to develop ovarian cancer.
“Endometriosis produces inflammatory hormones called cytokines,” says Ahmad Awada, M.D., a gynecologic oncologist at Henry Ford Health. “When cells move outside of their natural habitat, it creates a lot of inflammation. Chronic inflammation, coupled with cellular changes and eventual DNA damage or genetic mutations, can lead to the development of cancer. Those with deep infiltrating endometriosis have an increased risk of ovarian cancer because deep infiltrating tissue cause more extensive inflammation and cellular activity.”
If you have endometriosis, however, it doesn’t mean you will get ovarian cancer. “About one in a thousand people with endometriosis will get ovarian cancer,” says Dr. Awada. “Still, it’s a good idea to be vigilant about your risk.”
Symptoms Of Endometriosis & Getting A Diagnosis
Symptoms of endometriosis include, but are not limited to, painful periods, pain during intercourse and irregular or heavy menstrual bleeding. Endometriosis is also a known cause of female infertility. In some cases, it can lead to the formation of ovarian cysts, known as "chocolate cysts" (or endometriomas).
Hormonal birth control is the main method of treatment. Birth control prevents ovulation, suppresses ovarian hormone production and slows down endometriosis-associated inflammation. Unfortunately, however, there’s usually a delay in confirming a diagnosis and starting treatment.
“Imagine a young woman consulting multiple doctors for years before finally hearing, ‘I think you have endometriosis,’” says Dr. Awada. “It’s important to keep seeking care until you receive a proper diagnosis. Today, there are many specialists in endometriosis, and numerous resources are available to help guide you. Continue advocating for your health until your concerns are addressed.”
Most commonly, patients are provided with a ‘presumed diagnosis’ of endometriosis based on the above symptoms, along with imaging (like ultrasound) and a physical exam. “However, when symptoms are severe and fail to respond to initial treatment with hormonal birth control, or when large endometriomas are present, we often recommend surgery to confirm the diagnosis and/or surgically treat the endometriosis,” he says.
Lowering Your Risk for Ovarian Cancer
Being on birth control not only helps relieve symptoms of endometriosis, but it also decreases your risk of ovarian cancer (if you’re on it for at least five years) since it suppresses ovulation, says Dr. Awada. Pregnancy and breastfeeding are also protective against ovarian cancer, as they also suppress ovulation.
You can also abide by general, healthy lifestyle guidelines to lower your risk for cancer: eat a nutritious diet, exercise, maintain a healthy weight and don’t smoke.
“It’s also incredibly important to look at your family history,” says Dr. Awada. “God forbid your mom, sister, grandmother or aunt had ovarian cancer. This increases your risk for ovarian cancer. You can get genetic testing to see if you have mutations that predispose you to it, in which case we can take a proactive approach to decreasing your risk.”
Being proactive is especially important because ovarian cancer is often a silent disease. “Symptoms of ovarian cancer can be very vague: dull, abdominal pain, nausea, bloating,” says Dr. Awada. “They’re symptoms you could chalk up to indigestion, constipation, stress, ovulation. That’s why three out of four patients with ovarian cancer present at an advanced stage. Any symptoms that last beyond a few weeks should be taken seriously.”
Reviewed by Ahmad Awada, M.D., a gynecologic oncologist who sees patients at Henry Ford Cancer – Detroit and Henry Ford West Bloomfield Hospital.
