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ALL ABOUT OVARIAN CANCER

Ovarian cancer affects around 7000 people each year in the UK. The lifetime risk of developing this cancer is one in 50, meaning it’s a less common cancer. Breast cancer is a common cancer, with a lifetime risk of one in seven.

This article was included in issue 87 (winter 2020/21) of The Menopause Exchange newsletter.

The main risk factor is age – like most cancers – and this can affect anyone with ovaries. More than 80% of cases of ovarian cancer in England and Wales occur in women over 50. People sometimes mistake the signs and symptoms of the disease for menopausal symptoms, so it’s important to know your body, be aware of ovarian cancer and know when to be checked by your GP.

What causes ovarian cancer?
The answer is we don’t know. For most people, there’s no particular reason why the cancer occurs. Some risk factors have been identified. Being at higher risk means you may be more likely to develop the cancer, so it’s useful to know the risk factors and talk to your GP if you’re worried.

A small number of ovarian cancers are caused by a faulty gene that runs in families. It’s important to tell your doctor if close family members have had breast, ovarian, prostate or pancreatic cancer because an inherited gene fault may be affecting your family. If you know your family has a history of faulty BRCA genes, Lynch syndrome or Peutz-Jeghers syndrome, discuss genetic screening a counselling with your GP

The International Agency for Research on Cancer (IARC) and World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) identified the following risks as having sufficient or convincing evidence (2018):

  • asbestos exposure
  • using HRT (oestrogen-only)
  • Smoking (for some rarer types of ovarian cancer)
  • being tall
  • being overweight
  • not having ever been pregnant

They identified the following risk factors as having limited evidence:

  • talc-based body powder used on vulva/genitals
  • x-radiation, gamma radiation exposure

A history of endometriosis or diabetes can also increase the risk.

The IARC/WCRF/AICR identified sufficient or convincing evidence for the use of oestrogen-progestogen containing contraceptives as reducing the risk of ovarian cancer. Having children and breastfeeding can also reduce the risk. The risk is ovulation, so anything that reduces ovulation is theoretically risk reducing.

Know the signs and symptoms
As ovarian cancer occurs most often in the years leading up to the menopause and after the menopause, it’s important to be aware of any body changes and discuss them with your GP if you’re worried. Ovarian cancer most commonly occurs after the menopause, usually in people over 63.

Ovacome runs a campaign to raise awareness of the signs to look out for and make them easy to remember. This is our BEAT campaign:
B is for bloating that doesn’t come and go
E is for eating difficulty and feeling full more quickly
A is for abdominal and pelvic pain you feel most days
T is for toilet changes in urination or bowel habits

Other symptoms include:

  • vaginal bleeding
  • indigestion
  • weight loss
  • feeling unusually tired
  • pain during sex
  • pain or lumps in your pelvic area

Symptoms of ovarian cancer can vary from woman to woman. It’s far more likely that these symptoms will be due to something less serious than ovarian cancer but if they’re new for you and don’t stop, talk to your doctor. You can use the Ovacome symptom diary at www.ovacome.org.uk/symptoms-tracker to keep a record to show your doctor.

Ovarian cancer can be mistaken for irritable bowel syndrome (IBS). IBS rarely occurs for the first time in people over 50. The guidance for GPs is that if a woman over 50 reports having these symptoms on a persistent or frequent basis, she should have tests to rule out ovarian cancer.

Because ovarian cancer signs and symptoms can be mistaken for signs of much less serious conditions, such as IBS or menopause symptoms, the diagnosis is often made when the cancer has spread and is more difficult to treat.

How is it diagnosed?
Currently ovarian cancer is diagnosed using a blood test to measure levels of CA125, a protein in your blood that can rise with ovarian cancer. CA125 levels over 35 suggest that ovarian cancer may be present and further tests are needed. Ultrasound scans or CT scans are then used to look for the cancer. These are painless tests that create images of the inside of your body.

How is it treated?
There are two main treatments – surgery and chemotherapy. If you have ovarian cancer, you’ll probably be offered one of these treatments or a combination of both.

Most people need surgery. This aims to remove as much of the tumour as possible without damaging any of the surrounding organs. The surgeon will aim to do a hysterectomy (remove the uterus (womb) and cervix), a bilateral salpingo-oophorectomy (remove the ovaries and fallopian tubes) and remove the omentum (a fatty layer in the abdomen).

Very early stage ovarian cancer, stage 1a or 1b, which is low grade (slow to spread) and borderline tumours can sometimes be cured with surgery alone. In other cases, treatment usually involves a combination of chemotherapy and surgery. Chemotherapy is also recommended for ovarian cancer that’s come back.

About Ovacome
Ovacome is the national UK charity focused on providing support and information to anyone affected by ovarian cancer. Visit www.ovacome.org.uk or call
the support line on 0800 008 7054 (Monday to Friday 10am to 5pm) or email support@ovacome.org.uk.

Created Winter 2020

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