What is Ovarian Cancer? With DR. Philippa Kaye

More women die from ovarian cancer than any other gynaecological cancer. But of the five gynaecological cancers (ovarian, womb, cervical, vaginal and vulval) it isn’t the most common, the most common gynae cancer in the UK is womb (uterine or endometrial) cancer.

Almost 7500 women are diagnosed with ovarian cancer each year in the UK, making it the sixth commonest form of cancer affecting women. The reason that it is the largest cause of gynae cancer deaths is that it tends to present late and with cancer time matters. The earlier that a cancer can be diagnosed the less likely it is to have spread; making it easier to treat and generally giving a better prognosis and outcome. Although ovarian cancer can occur at any age, it’s most common after the menopause.

Ovarian cancer risk factors

There are various factors which can increase your risk of developing ovarian cancer, some of which are in your control and some not! Getting older is something outside of your control as is having family members affected, carrying a gene such as BRCA1 or having endometriosis which all increase your risk. Being on hormone replacement therapy (HRT) also increases your risk, but only by a small amount and this needs to be balanced against the positive effects of being on HRT which include decreased risk of colorectal cancer, osteoporosis and dementia.

If you do have a strong family history for ovarian cancer your GP will be able to refer you to a genetic counsellor to discuss whether you would like testing for some of the genes which increase the risk of ovarian cancer. If you do have a gene which increases your risk, you may be offered surgery to remove the ovaries, the age at which this is offered depends on the gene involved.

You can decrease your risk by stopping smoking, trying to maintain a healthy weight and being physically active. Pregnancy, breastfeeding and the oral contraceptive pill also drop your risk.

Symptoms of Ovarian Cancer

Symptoms of ovarian cancer can include pain in your tummy or pelvis and persistent bloating (this is different from the bloating you might have with pre menstrual syndrome or irritable bowel syndrome which tends to fluctuate and come and go), or that your tummy has got bigger in size. You might notice that you find eating more difficult, that it makes you feel sick, or you feel full very quickly. You might also notice a change in your bowel habit or the need to go to the toilet to do a wee more often. There can be unintentional weight loss, where you lose weight despite not actively trying to and tiredness and fatigue. When you are examined by your doctor they may be able to feel a mass in your tummy or pelvis.

Having the symptoms described above does not definitely mean that you have ovarian cancer; rather that you have symptoms which need to be investigated further.

The reason that ovarian cancer tends to present later than some other cancers is that the symptoms can initially be mild or vague or overlap with other conditions, so it can be difficult to spot meaning that about 6 out of 10 women are diagnosed after the cancer has spread.

Ovarian Cancer Diagnosis

There’s not currently a screening programme for ovarian cancer like there is for breast or cervical cancer. There is a blood test for a marker named Ca125 which can be raised in ovarian cancer which may be used as part of the diagnosis and monitoring during treatment, but Ca125 can be raised for reasons other than ovarian cancer such as endometriosis or having pelvic inflammatory disease from a sexually transmitted infection.

You are likely to be offered the Ca125 blood test and an ultrasound scan which can be done either through your tummy (just like a pregnancy scan) or internally through the vagina. If ovarian cancer is diagnosed, further scans such as a CT scan will be offered to see if the cancer has spread to other parts of your body.

Ovarian cancer is sometimes called a ‘hidden’ cancer, referring to the fact that the symptoms can initially be vague or difficult to diagnose and that it is often diagnosed after the cancer has spread.

Ovarian Cancer Treatment

The treatment for ovarian cancer will depend on the type of cancer and if it has spread and how far it has spread around the body as well as your general health. Treatment is most often surgical where the surgeon cuts the cancer out, removing it from your body. This tends to involve removing both ovaries but also the fallopian tubes and uterus. Depending on the spread part of the colon, other structures may also be surgically removed.

Chemotherapy may be another treatment that involves using medication to treat the cancer and can be done before surgery, in order to shrink the cancer to allow a smaller surgery and/or after the surgery to treat any remaining cancer.

About 1 in 2 women diagnosed with ovarian cancer will survive 5 years after their diagnosis. The earlier that ovarian cancer can be diagnosed the better, so if you have any of the symptoms mentioned here, are worried, or have a family history of ovarian cancer please see your GP.

If you are looking for more information on ovarian cancer, any gynaecological cancer or would like to raise awareness of ovarian cancer, or funding for research and patient support please head over to The Eve Appeal