From Dené C. Wrenn, MD, MS, gynecologic oncologist with OHC

January 4, 2019

As we learn more about the female organs and how cancer develops, a surprising source of many cases of ovarian cancer has come to light: the fallopian tubes.

Many primary peritoneal cancers and some ovarian cancers start in the fallopian tubes and not the ovaries. These cancer cells break loose and stick to the ovaries or the cavity lining (peritoneum) of the abdomen. For reason still unknown, they tend to grow more quickly in these new locations. Armed with this knowledge, we are evaluating a new option for the prevention of ovarian cancer, especially for women at high risk.

Removing the ovaries at a younger age can cause medical problems, including cardiovascular disease, early onset of menopause, and bone loss. So, instead of removing the ovaries, we consider removing the fallopian tubes only, and then later removing the ovaries when the woman is older. This will allow her ovaries to work longer.

Of course, every woman is different, and what may be ideal for some women might not be a good approach for others. That’s why we meet with each patient for a comprehensive review of her situation and together decide what’s best for her and her family.

Another villain behind ovarian cancer is its ability to go undetected. The potential symptoms of ovarian cancer can very easily be symptoms of something else. For that reason, they often go unchecked and the cancer isn’t caught until a later stage. The most common symptoms of ovarian cancer include bloating, pelvic or abdominal pain, trouble eating or feeling full quickly, and always feeling like you have to urinate or having to go often.

It’s critically important that you know your body. You know better than anyone when something “isn’t right.” And when that something persists, it’s important to contact your doctor right away.

Take, for example, a woman in Georgia who was experiencing pain on the right side of her stomach that she said felt like “bad gas.” After three days, she decided to see her doctor. After an exam, her doctor sent her to the emergency room where X-rays revealed a tumor on her ovary.

Another woman, an OHC patient who lives here in West Chester, was playing soccer when she felt a sharp pain in her right side. Her initial reaction was to just shake off, like many athletes. The pain persisted so she went to the emergency room where once again, tests revealed an ovarian tumor. After treatment from my colleague, Dr. Marcia Bowling, gynecologic oncologist with OHC, the woman was cured. The fact that she sought treatment immediately meant the cancer was caught early, when survival rates can be as high as 90 percent.

To recap, here are important steps you can take to prevent or detect ovarian cancer:

  1. Know your body. Know what feels “right,” and when something feels “wrong,” don’t ignore it or wait. Contact your doctor to make sure it isn’t something serious.
  2. Talk with your doctor about your medical history as well as your family’s medical history. At OHC, we have a program led by experts who help people determine if genetic testing is right for them, and then we discuss the results and make recommendations.
  3. If you have tested positive for the BRCA genes, you can meet with an OHC doctor to discuss your results, your medical history and your options, including the removal of your fallopian tubes.
  4. As always, eat a healthy, well-balanced diet, exercise, don’t smoke, and limit alcohol.

In the meantime, researchers are continuously working on prevention, early detection and treatments for ovarian cancer. The experts at OHC are up-to-date on the latest advancements and offer clinical trials to help you keep the villains at bay.

Dené C. Wrenn, MD, is a gynecologic oncologist with OHC who is highly experienced with the newest treatments, including the use of robot-assisted surgery and immunology, for female cancers and complex gynecologic conditions.

OHC (Oncology Hematology Care) has been fighting cancer on the front lines for more than three decades. We are the region’s leading experts in the treatment of nearly every form of adult cancer and complex blood disorder. OHC offers the latest medical, gynecologic and radiation therapy, and is always seeking better treatment options through participation in clinical trials. OHC is certified by the American Society for Clinical Oncology in the Quality Oncology Practice Initiative Certification Program, is an accredited Oncology Medical Home, and is one of only 179 practices nationally to be accepted into the Medicare Oncology Initiative. At its heart, our approach to cancer care is simple – to surround you with everything you need so you can focus on what matters most: beating cancer. For more information about services and careers at OHC, call 1-888-649-4800 or visit

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