Alyssa* was not sure what was wrong, but she knew something was not quite right. Six months after Alyssa's gynecologist dismissed her increasingly severe symptoms as nothing that a little bed rest couldn't cure, she drove herself to the emergency room and refused to leave until someone told her what was wrong. What was wrong was that Alyssa had Stage IIIC ovarian cancer (Stage IV is the most severe).

The American Cancer Society estimates 23,000 women will be diagnosed with ovarian cancer this year and 14,000 women will die, making ovarian cancer the deadliest of the gynecologic cancers. Raising awareness of ovarian cancer symptoms is crucial in decreasing these startling statistics.

Common symptoms are:

These symptoms are not unique to ovarian cancer, but it is critical for women to take action if symptoms are unusual for them and persist. If ovarian cancer is suspected, experts recommend a vaginal/rectal pelvic exam, a transvaginal sonogram, and a CA-125 blood test. Also, research has shown that outcomes are better if a gynecologic oncologist, a physician who has been trained specifically to deal with gynecologic cancers, has performed the surgery.

All women are at risk for ovarian cancer and should be aware of factors that put them at higher risk. These factors include: increasing age; having a family history of ovarian, breast or colon cancer; and not bearing children.

The fact that lower percentages of lesbians have conceived and birthed a child, as compared to heterosexual women, places them at a higher risk for ovarian cancer. Also, although oral contraceptives do not prevent ovarian cancer, their use is associated with a 5% to 10% reduction in risk for each year of use. Lesbians generally do not use oral contraceptives, and therefore do not receive this risk reduction benefit. Tubal ligation, hysterectomy, and removal of the ovaries has also been associated with a reduction in risk.

In addition to the risk factors mentioned above, lower utilization of healthcare system, lower likelihood or regular cancer screening, and insurance limitations contribute to increased risk of many cancers for lesbians. Moreover, although use of fertility drugs has not been definitively linked to ovarian cancer and more research is needed, it is important to be aware of this potential association.

It is crucial for lesbians to learn about ovarian cancer and act as their own health advocates. Regular check-ups and persistence can make a huge difference. More than two-thirds of all ovarian cancer cases are detected when the cancer has spread beyond the ovaries and when the five-year survival rate is only 25 percent. Early detection increases the survival rate to more than 90 percent. Until there is a definite screening tool for the ovarian cancer, having knowledge about this disease and educating other women about it is the only way to stop the deadliest of all gynecological cancer from taking more lives.

For more information about ovarian cancer, contact the Ovarian Cancer National Alliance at 202/331-1332, , www.ovariancancer.org. *Name changed to protect the patient's privacy.