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ALL ABOUT OVARIAN CANCER

Ovarian cancer is the sixth most common cancer in women in the UK; more than 7000 women are diagnosed each year. It causes around 4000 deaths a year – that’s one woman dying every two hours. This makes ovarian cancer the most deadly gynaecological cancer. Despite these statistics, the disease is not as well-known as some of the other more common cancers, and the awareness of signs and symptoms is low.

This article was included in issue 70  (autumn 2016) of The Menopause Exchange newsletter.

One of the reasons for poor awareness is that, until 2011, the NHS didn’t officially recognise symptoms that pointed to the disease. So it was often diagnosed far too late for there to be a successful outcome. But the good news is that it’s now known that there are four main symptoms to look out for.

Symptom check

The four main symptoms of ovarian cancer are: persistent bloating; persistent stomach pain; difficulty eating/feeling full very quickly; and needing to wee more often. These symptoms would usually be out of the ordinary for the women experiencing them and may have only occurred within the last 12 months. These symptoms will also occur frequently – more than 12 days in a month.

Other possible symptoms of ovarian cancer that women may experience include: back pain, changes in bowel habit (going more frequently, or much less frequently) and extreme tiredness for no obvious reason. As with the four main symptoms, these will be persistent, frequent and out of the ordinary.

If you’re worried that you may be experiencing symptoms of ovarian cancer, you may find it useful to keep a symptoms diary. This will help you to chart what’s going on – and enable your GP to have a better understanding of your symptoms and when they occur.

A common misconception is that the cervical screening test looks for ovarian cancer too. Unfortunately though, this is not the case. There is no national screening programme for ovarian cancer. So the best way to make sure it’s diagnosed early is to know your body and be aware of any changes or symptoms.

Getting diagnosed

Ovarian Cancer Action’s advice to any woman who’s experiencing any possible symptoms of ovarian cancer is to see their GP as soon as possible. Generally, the cause of these symptoms is unlikely to be something as serious as ovarian cancer, but if it is, then early diagnosis is the key to better outcomes and survival.

If you have possible ovarian cancer symptoms, your GP should refer you for a CA125 blood test. CA125 is a protein that all women have in their blood. Higher CA125 levels are often associated with ovarian cancer. If levels are found to be higher than normal, a GP should arrange for a pelvic ultrasound to be carried out at a local hospital. The aim of the ultrasound is to detect any abnormalities and decide if you need a referral to a gynaecological oncologist. If ovarian cancer is found, treatment would start as soon as possible. If you think you might need a CA125 test, don’t be afraid to ask.

What’s your risk?

You can get ovarian cancer at any age but your risk does increase as you gets older. Eighty percent of cases are seen in women over 50. Other risk factors include being overweight or obese, smoking, having a long menstrual history (e.g. starting your periods at a young age, not having children and/or going through a later menopause), endometriosis and using oestrogen-only HRT.

If you have a family history of either breast or ovarian cancer, you may have a higher risk of developing ovarian and breast cancer. This is because you may have inherited a faulty gene known as a BRCA1/2 mutation. Everyone carries BRCA1/2 genes, but those with a mutation in one of the genes are more likely to get breast and/or ovarian cancer. Mutated BRCA1/2 genes are rare, with around one in 400 people carrying them. Those from Ashkenazi Jewish, Dutch, Icelandic, Norwegian, Pakistani, Polish and Swedish populations are more likely to have a BRCA1/2 gene mutation than some other populations.

Having a BRCA1/2 gene mutation increases your risk of developing ovarian cancer by 10-60%, and increases breast cancer risk by 45-85%. Ovarian Cancer Action encourages women to be aware of their family history and to make an appointment with their GP to discuss genetic testing if they know of a history of ovarian or breast cancer. BRCA1/2 gene mutations are hereditary and can be carried by both men and women. If a person carries a mutation, there is a 50% chance that they will pass it to their children.

Risk reduction

If you have a BRCA1/2 gene mutation, there are steps you can take to help reduce your risk of ovarian and breast cancer.

Surgery to remove your ovaries and fallopian tubes will reduce your risk of developing ovarian cancer to 5%, as well as reducing your risk of developing breast cancer by 50%. This can trigger the immediate onset of the menopause due to abrupt hormone changes. For this reason, it’s important to take care when deciding whether or not to have risk-reducing surgery. Women with a BRCA1/2 gene mutation should be supported by their GP and a genetics counsellor to ensure that they’re fully informed of the impact of whatever they decide to do.

Effective treatment

Treating ovarian cancer usually requires a combination of surgery and chemotherapy. Each woman’s situation and experience is unique, and the oncologist will advise a treatment plan suited to the individual.

Sometimes you may have surgery first to try to remove as much of the tumour as possible. Depending on the exact location of the tumour, and whether it has spread, one or both ovaries may have to be removed, along with the uterus and fallopian tubes. Once as much of the tumour has been removed as possible, chemotherapy may follow in an attempt to destroy what is left of the tumour.

Record your symptoms

Visit the Ovarian Cancer Action website (www.ovarian.org.uk) for information on ovarian cancer and a symptoms diary. You can also search ‘ovarian cancer action’ in your phone’s app store to record your symptoms on the go.

This article was written by Ross Little, Ovarian Cancer Action.

Created autumn 2016

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