Iowa Health Book: Cancer Center
National Cancer Institute
Peer Review Status: Externally reviewed by the
National Cancer Institute
This booklet was written and published by the National Cancer Institute (NCI), 9000 Rockville Pike, Bethesda, MD 20892.
The NCI is the U.S. Government's main agency for cancer research and information about cancer. The NCI's publications are free. They may be copied or reproduced without written permission.
Contents
What You Need to Know about Ovarian Cancer
Each year, more than 22,000 women in the United States learn they
have ovarian cancer. This National Cancer Institute (NCI) booklet
will give you some important information about the symptoms,
diagnosis, and treatment of this disease. This booklet also has
information to help you deal with ovarian cancer if it affects you or
someone you know. Other NCI booklets are listed at the end of this
file. Our materials cannot answer every question about ovarian
cancer. They cannot take the place of talks with doctors, nurses, and
other members of the health care team, but we hope our information
will help with those talks.
Researchers continue to look for better ways to diagnose and treat ovarian cancer, and our knowledge is growing. For up-to-date information, call the NCI-supported Cancer Information Service (CIS) toll free at 1-800-4-CANCER (1-800-422-6237).
The Ovaries
The ovaries are a pair of female reproductive organs. They are
located in the pelvis, one on each side of the uterus. Each ovary is
about the size and shape of an almond. The ovaries have two
functions: they produce eggs and female hormones.
Each month, during the menstrual cycle, an egg is released from one ovary. The egg travels from the ovary through a fallopian tube to the uterus.
The ovaries are the main source of female hormones (estrogen and progesterone). These hormones control the development of female body characteristics, such as the breasts, body shape, and body hair. They also regulate the menstrual cycle and pregnancy.
What Is Cancer?
Cancer is a group of more than 100 different diseases. They all
affect the body's basic unit, the cell. Cancer occurs when cells
become abnormal and keep dividing and forming more cells without
control or order.
Like all other organs of the body, the ovaries are made up of many types of cells. Normally, cells divide to produce more cells only when the body needs them. This orderly process helps keep us healthy.
If cells keep dividing when new cells are not needed, a mass of tissue forms. This mass of extra tissue, called a growth, or tumor, can be benign or malignant:
In women under age 30, most ovarian growths are benign, fluid-filled sacs called cysts. Cysts may occur during a woman's monthly cycle and often go away without any treatment. If a cyst does not go away, the doctor may suggest removing it, especially if it is causing problems or seems to be changing. In some cases, the doctor may decide to wait and watch for changes with ultrasonography or other tests.
There are several types of ovarian cancer. Most ovarian cancers are epithelial carcinomas, which begin in the lining of the ovary. (Other types of ovarian cancer are rare and are not discussed in this booklet.)
When cancer spreads, the new tumor has the same kind of abnormal cells and the same name as the original (primary) tumor. For example, ovarian cancer that spreads to the colon is metastatic ovarian cancer. It is not colon cancer, even though the new tumor is in the colon.
Symptoms
Ovarian cancer is hard to find early. Often there are no symptoms in
the early stages and, in many cases, the cancer has spread by the
time it is found. The cancer may grow for some time before it causes
pressure, pain, or other problems. Even when symptoms appear, they
may be so vague that they are ignored.
As the tumor grows, the woman may feel swollen or bloated, or may have general discomfort in the lower abdomen. The disease may cause a loss of appetite or a feeling of fullness, even after a light meal. Other symptoms may include gas, indigestion, nausea, and weight loss. A large tumor may press on nearby organs, such as the bowel or bladder, causing diarrhea or constipation, or frequent urination. Less often, bleeding from the vagina is a symptom of ovarian cancer.
Ovarian cancer may cause swelling due to a buildup of fluid in the abdomen (ascites). Fluid also may collect around the lungs, causing shortness of breath.
These symptoms may be caused by cancer or by other, less serious conditions. Only a doctor can tell for sure.
Diagnosis and Staging
To find the cause of any of these symptoms, the doctor asks about the
woman's medical history and does a careful physical exam, including a
pelvic exam. The doctor feels the vagina, rectum, and lower abdomen
for masses or growths. A Pap smear (a common test for cancer
of the cervix) is often part of the pelvic exam, but it is not
a reliable way to find or diagnose ovarian cancer. The doctor may
also order other tests:
Often, the doctor orders a blood test to measure a substance in the blood called CA-125. This substance, called a tumor marker, can be produced by ovarian cancer cells. However, CA-125 is not always present in women with ovarian cancer, and it may be present in women who have benign ovarian conditions. Thus, this blood test cannot be used alone to diagnose cancer.
The only sure way to know if cancer is present is for a pathologist to examine a sample of tissue under the microscope. Removing tissue from the body for this examination is called a biopsy. To obtain the tissue, the surgeon does an operation called a laparotomy. If cancer is suspected, the surgeon removes the entire ovary (oophorectomy). This is important because, if the problem is cancer, cutting through the outer layer of the ovary could allow cancer cells to escape and cause the disease to spread. If cancer is found at this time, the surgeon proceeds with surgery.
During surgery, the surgeon removes nearby lymph nodes, and takes samples of tissue from the diaphragm and other organs in the abdomen. The surgeon also collects fluid from the abdomen. All of these samples are examined by a pathologist to check for cancer cells. This process, called surgical staging, is needed to find out whether the cancer has spread. Staging is important in the planning of follow-up treatment.
Treatment
Treatment for ovarian cancer depends on a number of individual
factors, including the stage of the disease and the woman's age and
general health. Treatment for ovarian cancer is best planned by
doctors who specialize in the diagnosis and treatment of this
disease.
Most people with cancer want to learn all they can about their disease and their treatment choices so they can take an active part in decisions about their medical care. The doctor is the best person to answer their questions. When talking about treatment choices, the patient may want to ask the doctor about taking part in a research study. Such studies, called clinical trials, are designed to improve cancer treatment.
When a person is diagnosed with cancer, shock and stress are natural reactions. These feelings may make it difficult to think of every question to ask the doctor. Also, patients may find it hard to remember everything the doctor says. But they do not need to ask all their questions or remember all the answers at one time. They will have other chances for the doctor to explain things that are not clear and to ask for more information.
Often it helps to make a list of questions to ask the doctor. Also, to help remember what the doctor says, patients may take notes or ask the doctor whether they may use a tape recorder. Some patients also want to have a family member or friend with them to take part in the discussion, to take notes, or just to listen.
Here are some questions a woman may want to ask her doctor before treatment begins:
Getting a Second Opinion
Treatment decisions are complex. Sometimes, it is helpful for
patients to have more than one doctor's advice about the diagnosis
and treatment plan. There are several ways to find a doctor who can
give a second opinion:
Methods of Treatment
Ovarian cancer may be treated with surgery, chemotherapy, or
radiation therapy. The doctor may use just one method or combine
them.
Surgery for ovarian cancer usually involves removal of the ovaries, the uterus, and the fallopian tubes. This operation is called hysterectomy with bilateral salpingo-oophorectomy. (If a woman has a very early, slow-growing tumor and wants to remain able to have a child, the doctor may remove only the affected ovary.) If the cancer has spread, the surgeon removes as much of the cancer as possible in a procedure called tumor debulking. Tumor debulking reduces the amount of cancer to be treated with chemotherapy or radiation therapy.
Here are some questions a woman may want to ask her doctor before surgery:
Chemotherapy for ovarian cancer often involves a combination of drugs. Anticancer drugs are usually given by injection into a vein or by mouth. Either way, chemotherapy is called systemic therapy because the drugs travel all through the body in the bloodstream.
Chemotherapy is usually given in cycles: a treatment period followed by a recovery period, then another treatment period, and so on. A woman may receive chemotherapy as an outpatient at the hospital, at the doctor's office, or at home. Depending on which drugs are used, how they are given, and her general health, a woman may need to stay in the hospital while receiving chemotherapy.
Doctors are studying another way of giving anticancer drugs called intraperitoneal chemotherapy. In this approach, the drugs are put directly into the abdomen through a catheter. In this way, drugs reach the cancer directly. This treatment is given in the hospital.
Here are some questions a patient may want to ask the doctor before chemotherapy:
Radiation therapy (also called radiotherapy) is the use of high-energy rays to damage cancer cells and stop them from growing. Radiation may come from a machine (external radiation) or from radioactive material placed into or near the tumor (internal radiation). Like surgery, radiation therapy is local therapy; it affects cancer cells only in the treated area.
For external radiation therapy, the patient goes to the hospital or clinic each day. Usually, the treatments are given 5 days a week for about 5 weeks.
Some women receive a type of internal radiation called intraperitoneal irradiation. Radioactive liquid is put into the abdomen through a catheter. A short hospital stay may be necessary for this treatment.
Here are some questions the patient may want to ask her doctor before radiation therapy:
Clinical Trials
Many patients with ovarian cancer are treated in clinical trials
(treatment studies). Doctors conduct clinical trials to find out
whether a new treatment is both safe and effective and to answer
scientific questions. Patients who take part in these studies may be
among the first to receive treatments that have shown promise in
laboratory research.
Some patients may receive the new treatment while others receive a standard approach. In this way, doctors can compare different therapies. Patients who take part in a trial make an important contribution to medical science and may have the first chance to benefit from improved treatment methods.
Various trials for ovarian cancer patients are under way. Doctors are studying new drugs, new drug combinations, and different treatment schedules. They also are exploring drugs designed to make radiation therapy more effective, and other ways of combining different types of treatment. Biological therapy, the use of substances that boost the immune system's response to cancer or protect the body from some of the side effects of treatment, is under study in patients with recurrent or advanced ovarian cancer.
A woman with ovarian cancer who is interested in participating in a trial should talk with her doctor. The National Cancer Institute booklet What Are Clinical Trials All About? explains the possible benefits and risks of treatment studies.
One way to learn about clinical trials is through PDQ, a computerized cancer information resource developed by the National Cancer Institute. PDQ contains information about cancer treatment and about clinical trials in progress all over the country. The Cancer Information Service can provide information from PDQ to doctors, patients, and the public.
Side Effects of Treatment
It is hard to limit the effects of therapy so that only cancer cells
are destroyed. Because treatment often damages healthy cells and
tissues, it can cause unpleasant side effects.
The side effects of cancer treatment vary, depending on the type of treatment. Also, each woman reacts differently. Doctors try to keep side effects to a minimum, but problems may occur. The National Cancer Institute booklets Radiation Therapy and You and Chemotherapy and You have helpful information about cancer treatment and coping with side effects.
Surgery
Surgery for ovarian cancer is a major operation. For several days
after surgery, the patient may have difficulty emptying her bladder
and having normal bowel movements. Drugs may be given to relieve pain
and to prevent or treat infection. A woman should ask the doctor or
nurse for medicine to relieve pain. For a period of time after the
surgery, some of the woman's normal activities are limited to let
healing take place.
In younger women, when the ovaries are removed, the body's natural source of estrogen is lost and menopause starts. Symptoms of menopause are likely to appear soon after the surgery. Hormone replacement therapy is commonly used to ease such symptoms as hot flashes and vaginal dryness in menopausal women. However, the use of hormone replacement therapy has not been studied in women who have had ovarian cancer. Deciding whether to use it is an individual matter; ovarian cancer patients should discuss the possible risks and benefits of hormone replacement therapy with their doctor.
Chemotherapy
The side effects of chemotherapy depend mainly on which drugs the
patient receives. In addition, side effects vary from patient to
patient. In general, anticancer drugs affect rapidly dividing cells.
These include blood cells, which fight infection, cause the blood to
clot, and carry oxygen to all parts of the body. When blood cells are
affected by anticancer drugs, women are more likely to get
infections, bruise or bleed easily, and have less energy. Cells in
hair roots and cells that line the digestive tract also divide
rapidly. As a result, women may lose their hair and may have other
side effects, such as nausea, vomiting, or mouth sores. Usually the
doctor can suggest diet changes or medications to ease these
problems. Most side effects of chemotherapy gradually go away during
the recovery period or after treatment stops.
Certain drugs used in the treatment of ovarian cancer can cause kidney damage. To help protect the kidneys while taking these drugs, patients are given large amounts of fluid. These drugs also may cause tingling in the fingers or toes, ringing in the ears, or difficulty hearing. These problems may continue after treatment stops.
Radiation Therapy
Patients are likely to become very tired during radiation therapy,
especially in the later weeks of treatment. Resting is important, but
doctors usually advise patients to try to stay as active as they can.
It is also common for the skin in the treated area to become red, dry, tender, and itchy. There may be permanent darkening or "bronzing" of the skin in the treated area. This area should be exposed to the air as much as possible, but protected from sunlight. Patients should avoid wearing clothes that rub the treated area. The radiation therapist or nurse will give advice about keeping the skin clean. Patients should not use any lotion or cream on their skin without checking with the doctor or nurse.
Radiation treatment to the lower abdomen may cause nausea, vomiting, diarrhea, or urinary discomfort. Usually the doctor can suggest diet changes or medicines to ease these problems.
Radiation therapy for ovarian cancer also can cause vaginal dryness and interfere with intercourse. Women may be advised not to have intercourse during treatment. However, most women are able to resume sexual activity a few weeks after radiation treatment ends.
Biological Therapy
The side effects caused by biological therapy vary with the type of
treatment. Often, these treatments cause flu-like symptoms, such as
chills, fever, muscle aches, weakness, nausea, vomiting, and
diarrhea. Sometimes patients get a rash, and they may bleed or bruise
easily or have bone pain. These problems can be severe, and patients
may need to stay in the hospital during treatment.
Nutrition for Cancer Patients
Some patients find it hard to eat well. In addition to loss of
appetite, the common side effects of therapy, such as nausea,
vomiting, or mouth sores, can make eating difficult. For some
patients, food tastes different. Also, people may not feel like
eating when they are uncomfortable or tired.
Eating well means getting enough calories and protein to help prevent weight loss and regain strength. Patients who eat well during cancer treatment often feel better and have more energy. In addition, they may be better able to handle the side effects of treatment.
Doctors, nurses, and dietitians can offer advice for healthy eating during cancer treatment. Patients and their families also may want to read the National Cancer Institute booklet Eating Hints, which contains many useful suggestions.
Followup Care
In some cases, doctors recommend "second-look" surgery after
chemotherapy is complete. This allows the doctor to examine the
abdomen directly and take fluid and tissue samples to see whether the
treatment has been successful. If cancer is found, additional
treatment is needed.
When treatment is over, regular checkups generally include a physical exam, as well as a pelvic exam and Pap smear. Sometimes doctors also order chest x-rays, a CT scan of the abdomen, and laboratory tests such as urinalysis, a complete blood count, and the CA-125 assay. Often the CA-125 level in a patient's blood is high before surgery and returns to normal within several weeks after the tumor has been removed. If the CA-125 level begins to rise again, it may mean the cancer has come back.
Depending on the drugs she has received, a woman treated for ovarian cancer with chemotherapy may have an increased risk of developing leukemia later in life. However, it is important to keep in mind that the benefits of receiving treatment for ovarian cancer far outweigh the risks of future disease.
Women should carefully follow their doctor's advice on health care and checkups, and should report any problem to the doctor as soon as it appears.
Support for Cancer Patients
Living with a serious disease is not easy. Cancer patients and those
who care about them face many problems and challenges. Coping with
these difficulties is easier when people have helpful information and
support services. Several useful booklets, including Taking Time:
Support for People With Cancer and the People Who Care About Them,
are available from the Cancer Information Service.
Cancer patients may worry about holding their job, caring for their family, or keeping up with daily activities. Concerns about tests, treatments, hospital stays, and medical bills are also common. Doctors, nurses, and other members of the health care team can answer questions about treatment, working, or other activities. Meeting with a nurse, social worker, counselor, or member of the clergy can be helpful to patients who want to talk about their feelings or discuss their concerns about the future or about personal relationships.
Friends and relatives can be very supportive. Also, many patients find it helps to discuss their concerns with others who have cancer. Cancer patients often get together in support groups, where they can share what they have learned about coping with cancer and the effects of treatment. It is important to keep in mind, however, that each patient is different. Treatments and ways of dealing with cancer that work for one person may not be right for another-even if they both have the same kind of cancer. It is always a good idea to discuss the advice of friends and family members with the doctor.
Often, a social worker at the hospital or clinic can suggest groups that can help with rehabilitation, emotional support, financial aid, transportation, or home care. For example, the American Cancer Society has many services for patients and their families. Local offices of the American Cancer Society are listed in the white pages of the telephone directory.
Information about other programs and services is available through the Cancer Information Service. The toll-free number is 1-800-4-CANCER.
The public library has many books and articles on living with cancer. Cancer patients and their families and friends also can find helpful suggestions in the booklets listed at the end of this pamphlet.
What the Future Holds
Patients and their families are naturally concerned about what the
future holds. Sometimes they use statistics to try to figure out
whether the patient will be cured or how long she will live. It is
important to remember, however, that statistics are averages based on
large numbers of patients. They cannot be used to predict what will
happen to a particular patient because no two cancer patients are
alike; treatments and responses vary greatly. Patients should talk
with the doctor about their chance of recovery (prognosis).
When doctors talk about surviving cancer, they may use the term
remission rather than cure. Even though ovarian cancer can be
cured, doctors use these terms because the disease can return. (The
return of cancer is called a recurrence.)
The Promise of Cancer Research
Scientists at hospitals and medical centers all across the country
are studying ovarian cancer. They are trying to learn more about what
causes this disease and how to prevent it. They are also looking for
ways to detect it earlier and to treat it more effectively.
Cause and Prevention
About 1 in every 70 women in the United States will develop ovarian
cancer during her lifetime. Most cases occur in women over the age of
5O, but it can also affect younger women. The disease is more common
in white women than in black women, but doctors do not know why.
Scientists do not know what causes ovarian cancer. It is clear, however, that this disease is not contagious; no one can "catch" ovarian cancer from another person.
By studying large numbers of women all over the world, researchers have found certain risk factors that increase a woman's chance of developing ovarian cancer. However, studies also show that most women with these risk factors do not get ovarian cancer, and many women who do get the disease have none of the risk factors we know about.
The following are some of the known risk factors for ovarian cancer:
Recent research raises the question of whether infertile women who take fertility drugs and do not become pregnant may be at increased risk of developing ovarian cancer. But this possible link has not been proven. Further research is under way to see whether ovarian cancer is related to infertility and/or to the use of fertility drugs.
Women who think they may be at risk for developing ovarian cancer should discuss this concern with their doctor, who can plan an appropriate schedule of checkups.
Early Detection
Most health problems respond best to treatment when they are found
early. Women who have regular pelvic exams increase the chance that,
if ovarian cancer occurs, it will be found before the disease causes
symptoms. However, pelvic exams often cannot find ovarian cancer at
an early stage. Scientists are trying to find better ways to detect
ovarian cancer earlier, when treatment may be more successful. For
example, they are exploring the usefulness of measuring the level of
CA-125 in the blood. Other ways of detecting the disease, such as new
ultrasound techniques, also are under study.
Women over age 60 are taking part in a nationwide study of CA- 125 and transvaginal ultrasound. In this study, scientists are trying to learn whether these tests can detect early ovarian cancer (in women who have no symptoms of the disease) and reduce the number of deaths from this disease. The Cancer Information Service can provide information about this study.
Definitions of Terms
Abdomen (AB-do-men): The part of the body that contains the pancreas, stomach, intestines, liver, diaphragm, and other organs.
Adjuvant therapy (AD-joo-vent): Treatment that is given following the primary treatment, such as chemotherapy after surgery.
Ascites (a-SYE-teez): Abnormal buildup of fluid in the abdomen.
Benign (be-NINE): Not cancerous; does not invade nearby tissue or spread to other parts of the body.
Biological therapy (by-o-LOJ-i-kul): Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also called immunotherapy.
Biopsy (BY-op-see): The removal of a sample of tissue that is then examined under a microscope to check for cancer cells.
Bladder: The organ that stores urine.
Bowel: The intestine.
Cancer: A term for the more than 100 diseases in which abnormal cells divide without control.
Catheter (KATH-e-ter): A flexible tube that is placed in a body cavity to insert or withdraw fluids.
Cervix (SIR-viks): The lower, narrow end of the uterus.
Chemotherapy (kee-mo-THER-a-pee): Treatment with anticancer drugs.
Clinical trials: Medical research studies conducted with volunteers. Each study is designed to find better ways to prevent, detect, or treat cancer and to answer scientific questions.
Colon (KO-lon): The section of the large intestine above the rectum.
CT (or CAT) scan: A series of detailed pictures of areas inside the body created by a computer linked to an x-ray machine. Also called computed tomography or computed axial tomography.
Cyst (sist): A sac or capsule filled with fluid.
Diaphragm (DYE-a-fram): The muscle that separates the chest from the abdomen.
Epithelial carcinoma (ep-i-THEE-lee-ul kar-si-NO-ma): Cancer that begins in the cells that line an organ.
Estrogen (ES-trojin): A female hormone.
Fallopian tubes (fa-LOPE-ee-en): The pair of tubes, one on each side of the uterus, through which an egg travels from the ovary to the uterus.
Gynecologist (guy-ne-KOL-o-jist): A doctor who specializes in treating diseases of the female reproductive organs.
Hormones: Chemicals produced by glands in the body. Hormones control the way certain cells or organs function.
Hysterectomy (hiss-ter-EK-to-mee): An operation to remove the uterus and cervix.
Intraperitoneal (in-tra-per-i-to-NEE-al): Within the abdominal cavity.
Intravenous pyelogram (in-tra-VEE-nus PYel- o-gram): An x-ray of the urinary tract. Also called IVP.
Laparoscopy (lap-a-RAH-sko-pee): A surgical procedure in which the doctor uses a lighted instrument to look at organs inside the abdomen through a small opening (incision).
Laparotomy (lap-a-ROT-o-mee): An operation to open the abdomen.
Local therapy: Treatment that affects only cells in a tumor and the area close to it.
Lymph (limf): An almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease.
Lymph nodes: Small, bean-shaped organs located along the channels of the lymphatic system. Bacteria or cancer cells that enter the lymphatic system may be found in the nodes. Also called lymph glands.
Lymphatic system (lim-FAT-ik): The tissues and organs (including the bone marrow, spleen, thymus, and lymph nodes) that produce and store cells that fight infection. The channels that carry lymph also are part of this system.
Malignant (ma-LIG-nant): Cancerous; can invade nearby tissues or spread to other parts of the body.
Menopause (MEN-o-pawz): The time of a woman's life when menstrual periods permanently stop; also called "change of life."
Menstrual cycle (MEN-stroo-al): The hormone changes that lead up to a period (menstruation). For most women, one cycle takes about 28 days.
Metastasis (meh-TAS-ta-sis): The spread of cancer from one part of the body to another.
Oncologist (on-KOL-ojist): A doctor who specializes in treating cancer. A gynecologic oncologist specializes in cancer of the female reproductive organs.
Oophorectomy (oo-for-EK-to-mee): The removal of one or both ovaries.
Ovaries (O-va-reez): The pair of female reproductive organs that produce eggs (ova) and hormones. They are located in the lower abdomen, one on each side of the uterus.
Pap smear: Microscopic examination of a sample of cells collected from the cervix; used to find cancer of the cervix.
Pathologist (path-OL-ojist): A doctor who identifies diseases by studying cells and tissues under a microscope.
Pelvis: The lower part of the abdomen cased between the hip bones. Organs in the female pelvis include the uterus, vagina, ovaries, fallopian tubes, bladder, and rectum.
Progesterone (pro-JES-ter-own): A female hormone.
Prognosis (prog-NO-sis): The probable outcome of a disease; the chance of recovery.
Radiation therapy (ray-dee-AY-shun): Treatment with high-energy rays from x-rays or other sources to kill cancer cells. Also called radiotherapy.
Remission: Disappearance of the signs and symptoms of cancer. When this happens, the disease is said to be "in remission." A remission can be temporary or permanent.
Risk Factor: Something that increases a person's chance of developing a disease.
Salpingo-oophorectomy (sal-PING-go-oofor- EK-to-mee): Removal of the fallopian tubes and ovaries.
Staging: The tests and exams needed to stage, or describe, the cancer by learning such things as its size, its exact location, and whether it has spread.
Surgery: An operation.
Systemic therapy (sis-TEM-ik): Treatment that reaches and affects cells all over the body.
Tissue: A group or layer of cells that performs a specific function.
Transvaginal ultrasound: Sound waves sent out by a probe inserted in the vagina. The waves bounce off the ovaries, and a computer uses the echoes to create a picture called a sonogram. Also called TVS.
Tumor: An abnormal mass of tissue.
Tumor debulking: Surgically removing as much of the tumor as possible.
Tumor marker: A substance in blood or other body fluids that may suggest that a person has cancer.
Ultrasonography: A test in which sound waves (called ultrasound) are bounced off tissues and the echoes are converted into a picture (sonogram).
Ureters (yoo-REE-ters): The tubes that carry urine from each kidney to the bladder.
Uterus (YOO-ter-us): A small, pear-shaped, muscular organ in the pelvis of females where the unborn child develops until birth. Also called the womb.
Vagina (va-JYE-na): The muscular canal extending from the cervix to the outside of the body.
Resources
Information about cancer is available from many sources, including
the ones listed below. You may wish to check for additional
information at your local library or bookstore and from support
groups in your community.
Cancer Information Service
The Cancer Information Service, a program of the National Cancer
Institute, is a nationwide telephone service for cancer patients,
their families and friends, the public, and health care
professionals. The staff can answer questions in English or Spanish
and can send free National Cancer Institute booklets about cancer.
They also know about local resources and services. One toll-free
number, 1-800-4-CANCER (1-800-422-6237), connects callers with the
office that serves their area.
American Cancer Society
The American Cancer Society is a voluntary organization with a
national office and local units all over the country. It supports
research, conducts educational programs, and offers many services to
patients and their families. To obtain free booklets about cancer and
information about services and activities in local areas, call the
Society's toll-free number, 1-800-ACS-2345 (1-800-227-2345), or the
number listed under American Cancer Society in the white pages of the
telephone book.
Other Booklets
National Cancer Institute printed materials, including the booklets
listed below, are available free of charge by calling 1-800-4-CANCER.
Booklets About Cancer Treatment
Booklets About Living With Cancer
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