The ovaries are the primary reproductive glands found in cisgender women. The body has two ovaries (one on either side of the uterus), producing two hormones known as estrogen and progesterone. These hormones play an essential role in developing breast tissue, body hair, and body shape, as well as in fertility and menstruation.
So, what happens if cancerous tissue finds itself in these ovarian glands? Let's look deeper at ovarian cancer and integrative therapies that can be used alongside conventional ovarian cancer treatment.
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What is Ovarian Cancer?
As a quick review: cancer arises when a cell or group of cells starts to get out of control. If you picture a cell as a car on a city street, a "law-abiding" cell stops at the red lights, slows down at the yellow lights, and drives through the green lights. However, a cancer cell disregards the stoplights and drives straight through the green, yellow, and red lights. As one can imagine, this reckless cell can cause great destruction and damage along the way. A key differentiator between a normal cell and a cancer cell is a cancer cell disregards the body's stoplights. The body has innate mechanisms to ensure cells don't grow uncontrollably (i.e., stop lights). However, cancer cells can override these mechanisms.
When cells in the ovaries, fallopian tubes, or peritoneum disregard the red lights and continue to multiply, they can form masses that begin to invade nearby healthy tissue. This is what is known as ovarian cancer.
Ovarian Cancer Symptoms
It can be tricky to diagnose ovarian cancer as it doesn't always produce noticeable symptoms. Sometimes the symptoms of ovarian cancer can be mistaken for gut or urinary issues. Several of the symptoms or signs that may present with ovarian cancer include:
- A feeling of fullness after meals
- Bloating or distention of the abdomen
- Fatigue
- Urinary changes - increase in frequency or urgency
- Constipation or changes in bowel movements
- Pelvic pain or discomfort
If you're experiencing some of these symptoms, don't panic. First, seek a thorough workup to assess the origin of your symptoms. Remember, various pathologies can cause the symptoms listed above and are not specific to ovarian cancer. Your PCP, or primary care physician, is a great first stop to ensure you get the proper workup.
What Causes Ovarian Cancer?
The pathogenesis of ovarian cancer is multifactorial. However, about 10% of ovarian cancers have a known genetic component. This includes BRCA1, BRCA2, Lynch syndrome, and others. There's an increased risk of developing ovarian cancer in individuals having a family history of ovarian, breast, or colon cancer. Women with endometriosis or who use hormone therapy (estrogen and/or progesterone) after menopause are more likely to develop ovarian cancer. The risk status of a person can also be higher for those who have never carried a pregnancy to term or who have had their first full-term pregnancy after age 35.
Low zinc levels have also been assessed in ovarian cancer patients suggesting that there may be an association between circulating zinc levels and ovarian cancer risk. Sedentary behavior can also increase your risk for ovarian cancer.
Functional Medicine Labs to Help Aid in Ovarian Cancer Treatment and Recovery
Currently, there's no screening test for ovarian cancer. However, there are ways to assess whether you're at an increased risk of eventually developing ovarian cancer. Some of these labs may also be helpful when making treatment decisions.
Genetic Testing
If there's a known family history of breast or ovarian cancer, it can be beneficial to pursue genetic testing to determine if you have a BRCA1 or BRCA2 mutation. These mutations are responsible for most inherited ovarian cancers. If your parent has a BRCA1/2 mutation, there is about a 50% chance of inheriting this mutation. Those of Ashkenazi Jewish descent are more likely to have a BRCA mutation. For those with a BRCA1 mutation, the estimation is that the risk of developing cancer in the ovaries is between 35% and 70%. By testing to see if you have the BRCA1 mutation, you can be proactive about prevention and surveillance exams.
The risk of developing ovarian cancer throughout the lifespan (lifetime risk) in those with BRCA2 mutations is between 10% and 30%. To put it in perspective, the average lifetime risk for women in the US of developing ovarian cancer is less than 2%. Therefore genetic testing is helpful when navigating treatment options because if you do have a BRCA mutation, you may be more likely to choose a more aggressive treatment approach.
Micronutrients testing
Testing the body's micronutrient levels can unveil underlying nutrition deficiencies. Low circulating zinc levels may play a role in ovarian cancer and, therefore, should be evaluated. The Micronutrient Test by SpectraCell Laboratories offers comprehensive testing of 31 nutrients.
Hormone Testing
Infertility, endometriosis, and the use of hormones post-menopause have all been shown in research to increase the risk of ovarian cancer. If you are currently experiencing infertility or endometriosis, it may be helpful to do a comprehensive look at your hormones to assess the root cause. The complete DUTCH test can be an excellent starting point since it will give you an overview of your hormones and show any imbalances.
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Integrative Medicine Approach to Recovery and Treatment of Ovarian Cancer
Integrative oncology is an approach that combines conventional medicine with evidenced-informed functional medicine to increase the quality of life, decrease side effects, and improve overall survival in cancer patients. When it comes to recovering and treating ovarian cancer, an integrative approach can provide several benefits to patients. Here are several of the most commonly recommended therapies:
Nutrition and Dietary Considerations for Ovarian Cancer Treatment and Recovery
Adherence to a Mediterranean diet correlates with reduced cancer and mortality risk. The Mediterranean diet looks like plenty of vegetables, fruits, beans, lentils, nuts, and whole grains accompanied by healthy fats (like extra virgin olive oil or "EVOO"). Fish, red meat, and dairy are consumed in moderate amounts. Sugary drinks, alcohol, and sweets are avoided or kept to a minimum. Following this lifestyle can be beneficial in reducing overall cancer risk and is helpful during active treatment to ensure you are consuming a well-balanced and nutrient-dense diet. There is currently research underway to see if this lifestyle can also increase the length of survival without the return of cancer (also known as progression-free survival).
Supplements and Herbs For Ovarian Cancer Treatment and Recovery
Phytomedicines (or botanical medicines) can be helpful alongside treatment and post-treatment. Let's look closer at the most commonly prescribed supplements.
Green Tea
Green tea consumption has been linked to decreased ovarian cancer occurrence and better prognosis. There is ongoing research to see if a compound found in green tea, called EGCG (epigallocatechin gallate), is anti-cancer. In cell studies, it is clear that green tea does have an inhibitory effect on ovarian cancer cells.
Indole-3-Carbinol
Indole-3-Carbinol is a component found in vegetables such as broccoli, Brussels sprouts, cabbage, collards, cauliflower, kale, and mustard greens. In cell studies, it has been shown to synergistically sensitize ovarian cancer cells to a specific type of treatment known as bortezomib. One of the most exciting uses of indole-3-carbinol is in conjunction with EGCG as a maintenance therapy in ovarian cancer patients.
Multivitamins
Vitamins (like vitamins C and E) can have a protective effect on ovarian cancer and, therefore, can be beneficial to take regularly. If mineral levels, like zinc, are low, taking a multivitamin to help correct this nutrient deficiency can be helpful.
Complementary and Integrative Therapies for Treatment and Recovery of Ovarian Cancer
Improving your overall quality of life can be a game-changer if you are actively going through treatment. Many integrative therapies can complement treatment and help reduce side effects.
Yoga
Like breast cancer, yoga can be helpful during and after treatment. In ovarian cancer patients, yoga improved cognitive function after treatment, specifically with the use of restorative yoga. This type of yoga encompasses more meditative practice and uses minimal physical exertion.
Acupuncture
Chemotherapy can result in the decrease of white blood cells. This is known as neutropenia. If you are severely neutropenic during treatment, you may have to stop or delay chemotherapy to give your white blood cells time to rebound. Acupuncture is helpful for chemotherapy-induced neutropenia (CIPN) and allows you to get through treatment without any unnecessary breaks or pauses.
Massage
Massage therapy in gynecological malignancies can improve quality of life. A study looking at Amna therapy, a type of Japanese massage, significantly reduced physical complaints in those who were considered survivors of gynecological cancers.
Summary
Integrative medicine alongside ovarian cancer treatment is safe and effective. Ovarian cancer can be challenging to diagnose, so be proactive if you are concerned about your family or medical history. Check in with your PCP (primary care physician) regularly and be sure that, if necessary, you are getting the appropriate genetic testing. Find a physician trained in integrative oncology to help support you alongside your medical oncology team.
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