Ovarian cancer
The ovaries are two small organs in the pelvis whose main function is to store and release eggs in the monthly cycle that can help pregnancy occur in women of child-bearing age. Because of this they have little use after menopause.
Cancer can develop in an ovary and this type of cancer particularly affects women over 50 years old. Sadly, ovarian cancer is often diagnosed late, which means it carries a higher chance of death than some other cancers. It is the eleventh most common cancer in women in the US, occurring in about 1 in 87 women, and around half of these are over the age of 65.
There are a number of types of ovarian cancer, distinguished from each other by the type of cell the cancer occurs in. These include epithelial ovarian cancer (that causes around 90% of cases), germ cell cancer that arises from the egg-making cells and stromal ovarian cancer which is rare.
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What symptoms should I look for?
Ovarian cancer is often diagnosed late as symptoms can be subtle and mistaken for other conditions. Abdominal bloating that does not come and go but remains constant, sometimes with an increase in belly size, is often one of the first symptoms. Others include pain or pressure in the pelvis and feeling full quickly.
It can cause non-specific symptoms like weight loss, fatigue, pain when having sex, and back pain, but numerous causes exist for these symptoms. It can also cause a change in bowel habits or an increased frequency of urination. Again, these don’t lead directly to thinking of ovarian cancer, so it’s worth seeing your doctor if you experience any of these.
What causes ovarian cancer?
Age is the biggest risk factor for ovarian cancer. Certain genes increase your risk of developing ovarian cancer, including BRCA 1 and BRCA 2, which you may have heard of in relation to breast cancer risk.
You are at higher risk if a family member has had cancer of the ovary, if you've had endometriosis, or if you are overweight or obese.
The fewer the number of times you ovulate (release an egg each month) appears to reduce the risk of developing ovarian cancer – such as with taking the contraceptive pill or breastfeeding – which means having a late menopause or not having children can slightly increase the risk.
What will my doctor do?
Your doctor will ask about your symptoms, any medication, and relevant family history. They will examine your abdomen and pelvis by feeling on the top and – with your consent - perform an internal examination with a gloved finger passed inside the vagina. This allows them to feel for any lumps, bumps, or certain pain points.
Blood tests can help indicate your overall general health, but a specific test called CA-125 is a blood tumor marker indicating ovarian cancer.
If you are suspected of ovarian cancer, your doctor will urgently refer you to a gynecologist.
If you have a family history of breast or ovarian cancer, your doctor may refer you to a geneticist who will test for certain inherited genes. This will help formulate a management plan for you going forward.
Treatment for ovarian cancer depends on the type of ovarian cell that has become cancerous, how advanced it is, and whether it has spread to lymph nodes or other organs, but the usual treatments are surgery and chemotherapy.
Survival will depend on multiple factors, such as the type and stage of cancer, overall health, and age.
How can I prevent ovarian cancer?
There are ways to reduce your risk, such as taking birth control pills. Birth control pills reduce the risk of ovarian cancer, but it’s important to discuss the risks vs. benefits of taking them with your doctor.
With certain inherited genes that increase your risk, you may be offered surgery to remove your ovaries early, reducing your risk of developing cancer in the future.
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