Ovarian
Ovarian cancer is cancer of the ovary and surrounding tissues. It has the highest mortality of all female cancers and survival rates have not decreased for over 30 years. Each year worldwide there are 250,000 women affected and 150,000 who die. In the UK, there are over 7000 new cases per year and over 4000 deaths in the 2012. It is referred to as the silent killer as it is difficult to detect until it is quite advanced, which results in a lower survival rate.
Causes and risk factors:
Age – over 85% of cases are over 50 years
Family history including BRCA1 and BRCA2 mutations (but only 1 in 10 cases has a genetic link)
Northern European or Ashkenazi Jewish descent
Starting periods before aged 12 with a late menopause
Never having had children
Infertility and infertility treatment
First child after 30 years
Never having taken oral contraceptives
Using oestrogen only hormone replacement therapy (HRT)
Symptoms are:
Abdominal bloating
Abdominal pain or swelling
Feeling bloated
Back ache
Eating problems including feeling full after eating, difficulty eating, indigestion, nausea, vomiting
Frequent or urgent urination
Constipation
Fatigue
Menstrual changes
Pain during intercourse
Ascites are often present. This is a build up of fluid in the peritoneal cavity and are secondary to cancer. They are common in women with advanced disease. This makes women feel unwell and they describe ascites as the worst experience of the cancer journey. Over 70% of women with ovarian cancer have ascites.
Screening and diagnosis:
Unfortunately there are currently no screening methods for ovarian cancer but the Gynaecological Cancer Research Centre at University College London, headed by Professor Usha Menon, is coordinating a large multi-centre trial focused on screening and early detection of ovarian cancer called the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). It was designed to determine how many lives could be saved by screening for ovarian cancer and the latest results show that an annual blood test could reduce the number of women dying by 20% but the study is ongoing.
If you have any of the above symptoms, you should see your doctor as soon as possible. A diagnosis is made by a physical examination to check for lumps in the abdomen, including a vaginal examination, blood tests to check for CA125 (a cancer marker), imaging and ultrasound scans, CT or PET scan or a colonoscopy. A firm diagnosis can only be made after a biopsy. NICE have produced guidelines to help GPs recognize ovarian cancer.
There is an ovarian symptoms diary app aimed to help women keep track of their symptoms so they can discuss this with their doctor more effectively.
FIGO have classed four grades of ovarian cancer.
Stage I – cancer confined to ovaries – 10 year survival is 73%
Stage II – cancer spread to the pelvis
Stage III – cancer spread to the abdominal cavity including liver, pelvis, inguinal para-aortic lymph nodes or bowel
Stage IV – cancer spread to liver, lung, and other sites – 10 year survival less than 10%
Treatment:
Surgery is undertaken to remove as much of the tumour as possible. There is a correlation between the amount of tumour left after the surgery and the outcome. After surgery, chemotherapy is used. If the cancer is very widespread, chemotherapy might be used before surgery.
Outcome:
Unfortunately a very small number are caught early. If caught early a woman’s chance of 5 year survival will be over 90%. But 75% of ovarian cancer is diagnosed at an advanced stage and will have a poor outcome – a 5 year survival of 30%.
Ovarian cancer charities:
There are several charities in the UK working on ovarian cancer and there are probably charities in your country: Ovacome, Ovarian Cancer Action, Target Ovarian Cancer, and The Eve Appeal.
March 2016 is ovarian cancer awareness month. Find out more about ovarian cancer month here. #startmakingnoise
Read More:
http://www.ovacome.org.uk/
http://www.targetovariancancer.org.uk/
http://www.targetovariancancer.org.uk/about-ovarian-cancer/what-ovarian-cancer
https://www.eveappeal.org.uk/
