gynecology and obstetrics
Ovarian, Fallopian Tube, and Peritoneal Cancer
Key Points
Ovarian cancer affects mostly postmenopausal and perimenopausal women; nulliparity, delayed childbearing, early menarche, delayed menopause, and certain genetic markers (BRCAmutations) increase risk. Symptoms (eg, dyspepsia, bloating, early satiety, gas pains, backache) are nonspecific. If cancer is suspected, do ultrasonography first (sometimes followed by CT or MRI) and measure tumor markers (eg, CA 125). Typically, treatment is surgical staging (including hysterectomy, bilateral salpingo-oophorectomy, pelvic washings, and peritoneal biopsy) and cytoreductive surgery followed by chemotherapy (eg,carboplatin,paclitaxel, andbevacizumab). Effective screening is not available for average-risk women; screen women at high risk (eg,BRCAmutation carriers) with ultrasonography and/or CA 125. 