Ovarian Cancer

Ovarian cancer is notorious for causing very minimal symptoms in the early stages. Hence high index of suspicion and being aware of symptoms is important. Ovarian cancer commonly occurs after menopause (after 50 years of age) and symptoms can be non-specific such as:

• Abdominal distension and bloating
• New onset of pelvic pain
• Nausea and fullness
• Urinary frequency
• Loss of appetite and weight
• Lower abdominal lump

Please see your GP urgently if you are concerned and he/she will be able to arrange appropriate tests or referral on an urgent basis.

An ultrasound scan and a blood test (CA125) can often give a provisional diagnosis, but the diagnosis is only confirmed after biopsy (usually after removal of any ovarian lesion). An MRI scan will often give more specific and detailed information before surgery. It also helps in planning the management.

Cervical smear test will NOT detect or rule out ovarian cancer! It is aimed at detecting cervical pre-cancerous changes and is nothing to do with ovaries.

• Stage 1: cancer is limited to one or both ovaries
• Stage 2:  cancer has spread beyond ovaries but is limited to the pelvis
• Stage 3: cancer has spread to parts of the abdominal cavity beyond pelvis such as bowel, and diaphragm
• Stage 4 cancer has spread to distant organs such as lung

CA125 and ultrasound scan have also been used for screening especially in women at higher risk of developing ovarian cancer. However, these tests can be both falsely positive and negative. Benign ovarian cysts are very common and CA125 is raised in many common conditions such as fibroids and endometriosis. Also, only 50% of stage 1 and 80% of all ovarian cancer will have raised CA125. Even if we do annual screening, there is a chance of developing disease in the interim.

We can discuss and offer screening for ovarian problems.

This information can often be obtained after an MRI scan or operation and biopsy (histology).

Surgery to remove as much of the tumour and disease as possible is often the first option (though not always). If there is evidence or suspicion of spread outside the ovaries, additional chemotherapy may be recommended.

Your doctor and CNS (Clinical Nurse Specialist) would be the first point of call as they would be able to provide information specific to your circumstances. Not all the information that you read online or in leaflets will apply to you and you must not draw any conclusions unless discussed with your team. You can get general information on websites such as, Ovacome, Cancer Research UK, and Macmillan.

This often depends on your individual circumstances (such as age, medical condition, type and stage of ovarian cancer and response to treatment) and your doctor will be able to provide more specific information. It is important to ask questions (take somebody with you for consultations) and if there are no direct answers, you can always find out about best and worst possible scenarios.

Yes, a small percentage of ovarian cancers are linked to inherited genetic mutations, most commonly BRCA1 and BRCA2. If you have a strong family history of ovarian or breast cancer, you may be offered genetic counselling and testing.

Genetic testing is often recommended for anyone diagnosed with ovarian cancer, regardless of age or family history. Identifying a genetic cause can guide treatment decisions and help assess risk for other family members.

Using the contraceptive pill for several years, having children, breastfeeding, and avoiding unnecessary hormone replacement therapy (HRT) may reduce your risk. If you have a genetic predisposition, preventative surgery may also be considered.