Understanding the link between PCOS and ovarian cancer

Polycystic ovarian syndrome (PCOS) is a hormone disorder that affects one in ten women between the ages of 15 and 44. It’s the most common cause of female infertility and is linked to an imbalance of reproductive hormones.

Ovarian cancer can also affect fertility and cause similar symptoms. Though the two share some similarities, they are very different conditions affecting the ovaries.

Understanding PCOS and ovarian cancer

The ovaries are the female reproductive glans responsible for producing eggs and distributing reproductive hormones. The hormonal imbalance that causes PCOS can show up in symptoms like:

• Irregular or absent menstrual cycles
• Excess body and facial hair or thinning hair
• Infertility
• Abnormal growths on one or both ovaries

Some women don’t experience outward symptoms and may only realize they have PCOS when they experience infertility. The cause of PCOS is unknown, but it’s believed to be genetic because women often have a family history of PCOS. PCOS has been linked to higher levels of androgen (male) hormones and higher insulin levels.

Ovarian cancer also begins in the ovaries and typically develops in older women. It’s a leading cause of cancer deaths among women because symptoms often don’t appear until the cancer is advanced, leading to late diagnoses. Symptoms are often persistent and include:

• Bloating
• Weight loss
• Pain or cramping in the abdominal area
• Back pain
• Reduced appetite
• Frequent or urgent urination

There are three types of ovarian cancer: epithelial ovarian cancer, germ cell tumors and stromal cell tumors. Epithelial is the most common type of ovarian cancer and can spread to other parts of the body. Ovarian cancer is typically diagnosed through a physical examination, blood tests and imaging. Treatment usually includes chemotherapy and surgery.

Does PCOS increase the risk of ovarian cancer?

While the causes of both PCOS and ovarian cancer remain unclear, research has not discovered a link between the two conditions. However, studies have found a link between PCOS and other types of cancer.

“Studies shows that women with PCOS are three times as likely to develop endometrial cancer when compared to women who do not have PCOS, but the risk for breast or ovarian cancers is not significantly greater among women with PCOS,” said Dr. Priya Ramshesh, MD, Oncology Medical Director of IU Health Southern Indiana Physicians Oncology-Hematology. “It’s important for all women to continue to have regular checkups and screenings with their doctors to detect any concerns as early as possible.”

Managing PCOS and cancer risks

While there is no treatment for PCOS, patients can work with a physician to reduce symptoms by:

• Eating a healthy diet
• Exercising
• Managing diabetes
• Regulating irregular menstrual cycles through medicines like birth control

The risk for developing ovarian cancer increases with age, as half of all cases are identified in women age 63 or older. Because ovarian cancer is difficult to diagnose early, it’s important to monitor your risk for developing disease. Risk factors for ovarian cancer are age, obesity, never carrying a pregnancy (or not carrying one to term), smoking and having a family history of ovarian, breast or colorectal cancers. However, some women develop ovarian cancer without any family history of the disease.

There are no reliable screening tests for ovarian cancer for women with an average risk for disease. Women with a family history or higher risk for ovarian cancer may be offered a transvaginal ultrasound or a blood test to look for proteins common in ovarian cancer, however these have not been shown to be effective means for early diagnosis because they can also detect other, more benign issues. People with family history of ovarian cancer should discuss with their care providers if genetic tests are appropriate.

Regular checkups and conversations with a physician can help women navigate concerns about PCOS and ovarian cancer by discussing risk factors and addressing concerning symptoms as soon as they appear.