The ovaries are two small organs in the pelvis whose main function is to store and release eggs in the monthly cycle that can cause pregnancy to occur in women of child-bearing age. Because of this they have little use after the 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 sixth most common cancer in women in the UK, affecting around 7,000 women each year, 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.
Ovarian cancer is often diagnosed late as the symptoms linked to it can often 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 also cause non-specific symptoms like weight loss, fatigue, pain when having sex and back pain, but there can be numerous causes for these. It can also cause a change in bowels habits or increased frequency of urination. Again, these symptoms sometimes don’t lead to thinking of ovarian cancer, so it’s worth seeing your doctor if you experience any of these.
Age is the biggest risk factor but certain genes increase your risk of developing ovarian cancer, and these include BRCA 1 and BRCA 2, which you may have heard of in relation to breast cancer risk.
You are also at higher risk if a member of your family has had cancer of the ovary, if you've had endometriosis or 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.
Your doctor will ask about your symptoms, any medication and relevant family history. They will then examine your abdomen and pelvis by pressing on it 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 also help review your overall general health, but a specific test called CA-125 is a blood tumour marker that indicates ovarian cancer, along with other positive test results. If there is any suspicion of ovarian cancer, your doctor will refer you urgently to a gynaecologist – a specialist in this area.
If you have a strong 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 far 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 type and stage of cancer, your overall health and your age. Overall, 7 in every 10 women survive beyond the first year, and almost half survive to five years or more after diagnosis.
Ovacome and Target Ovarian Cancer are two charities in the UK offering information and support for those affected by ovarian cancer.
There are ways to reduce your risk such as considering 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, and therefore reduce your risk of developing cancer in the future.
Read about: Ovarian cyst
Read about: Pelvic pain
Read about: PCOS
Read about: Heavy periods
Read about: Endometrial cancer
Read more about: Cancer
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