Seven months after gynecologic oncologist Dr Vaagn Andikyan led a team of dedicated Western Connecticut Health Network surgeons, physicians, and medical staff in successfully resected a 132-pound benign ovarian tumor from a 38-year-old woman, he is reaching out to promote important practices in the hope of protecting women from the devastating and too often deadly diagnosis of ovarian cancer.

For Dr Andikyan, an opportunity to chat with The Newtown Bee during September — Ovarian Cancer Awareness Month — provided him a forum to stress the critical need for women to have annual examinations, and to communicate with their physicians immediately if they suspect there may be a medical issue, or are exhibiting symptoms of ovarian cancer.

Dr Andikyan is a board-certified gynecologic oncologist and assistant professor at the University of Vermont Larner College of Medicine. He earned his medical degree from I.M. Sechenov Moscow Medical Academy in Moscow, and completed residencies in obstetrics and gynecology at the Research Center for Obstetrics, Gynecology, and Perinatology of Russian Academy of Medical Sciences in Moscow and SUNY Downstate Medical Center in Brooklyn, N.Y.

He was also a research scholar at  Yale School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences in New Haven. Dr Andikyan completed a fellowship in gynecologic oncology at the Icahn School of Medicine at Mount Sinai, N.Y., and a Pelvic Reconstruction fellowship at Memorial Sloan-Kettering Cancer Center.

Certified by the American Board of Obstetrics and Gynecology, Dr Andikyan served as an attending physician and assistant professor at the Research Center for Obstetrics, Gynecology, and Perinatology in Moscow.

He said he is not only very comfortable talking about the issue because he is a physician trained to counsel patients, but because he grew up in Russia with a mother and aunt who were both physicians.

“It was very common for us to be talking about health and medical issues around the dinner table,” he said. “So I found myself naturally drawn into the field of medicine. When I was a resident, I saw the trouble and the sadness patients diagnosed with ovarian cancer were going through, and at the same time I saw the success stories.”

He told The Bee that today, almost eight in ten women are diagnosed with advanced stages of ovarian cancer, when prognosis is poor.

That is likely because ovarian cancer is difficult to detect, especially in the early stages, he said. This is partly due to the fact that the ovaries — two small, almond-shaped organs on either side of the uterus — are deep within the abdominal cavity.

“And there is no up-to-date screening for it,” Dr Andikyan said, “so unfortunately our management is based on many different symptoms and identification of groups of patients who are at risk.”

Ovarian Cancer Defined

Ovarian cancer is a disease in which, depending on the type and stage of the disease, malignant (cancerous) cells are found inside, near, or on the outer layer of the ovaries, Dr Andikyan explained.

“The ovary is a very complex organ,” he said. “It has several linings where cancer can form, and the core of the ovary contains hormonally active tissue that give rise to another type of cancer, and there are germ cell tissues as well where a cancer can grow,” he said.

According to the National Ovarian Cancer Coalition (NOCC), the following are often identified by women as some of the signs and symptoms of ovarian cancer: bloating, pelvic or abdominal pain, trouble eating or feeling full quickly, and feeling the need to urinate urgently or often.

Other symptoms of ovarian cancer can include fatigue, upset stomach or heartburn, back pain, pain during sex, constipation, or menstrual changes.

If symptoms are new and persist for more than two weeks, it is recommended that a woman see her doctor, and a gynecologic oncologist before surgery if cancer is suspected, Dr Andikyan said. When the symptoms are persistent, or when they do not resolve with normal interventions (like diet change, exercise, laxatives, rest), it is imperative for a woman to see her doctor, he added.

“Your readers should take home the most important message about communicating with your medical provider, whether it’s your OB/GYN, or your primary care physician,” he said. “We can open the window of opportunity to get them to the right doctor, get a diagnosis, and get treatment. Ovarian cancer may spread very quickly — going from Stage I to Stage III within a month.”

Persistence of symptoms is key — because these signs and symptoms of ovarian cancer have been described as vague or silent, only approximately 19 percent of ovarian cancer is diagnosed in the early stages. Symptoms typically occur in advanced stages when tumor growth creates pressure on the bladder and rectum, and fluid begins to form.

Non-Specific Symptoms

In women ages 35-74, ovarian cancer is the fifth leading cause of cancer-related deaths, and an estimated one woman in 75 will develop ovarian cancer during her lifetime.

The American Cancer Society estimates that there will be more than 22,280 new cases of ovarian cancer diagnosed this year and that more than 14,240 women will die from ovarian cancer this year.

When one is diagnosed and treated in the earliest stages, the five-year survival rate is more than 90 percent.

Due to ovarian cancer’s non-specific symptoms and lack of early detection tests, about 20 percent of all cases are found early, meaning in stage I or II. But if not caught until the tumor is measured at stage III or higher, the survival rate can be as low as 28 percent.

Dr Andikyan said due to the nature of the disease, each woman diagnosed with ovarian cancer has a different profile and it is impossible to provide a general prognosis. But he is heartened by the rapid developing genomic research going on that is helping identify risk factors ahead of a potential diagnosis in more than 25 percent of study subjects.

“If you have that gene, you could move forward with risk reducing surgery — the removal of tubes and ovaries — that will prevent the risk of ovarian cancer,” he said. “Another 75 to 80 percent have targetable mutations that we could potentially screen and place in a high risk group.”

Dr Andikyan is seeing patients at 95 Locust Avenue, Stroock Tower, second floor, in Danbury, and will be seeing patients in Norwalk. To schedule an appointment with Dr Andikyan, call 203-739-4900.