Information about ovarian cancer.
What is ovarian cancer?
Ovarian cancer is a tumour of the ovaries (where eggs form and oestrogen and progesterone are made). The term is sometimes also used to include tumours of the fallopian tube (which connect the ovary to the uterus) and peritoneum (lining of the abdomen). These last two have similar symptoms and treatment to ovarian cancer but they are not the same cancer.
There are more than thirty different types of ovarian cancer however over 90% come from the cells on the outside of the ovary (epithelial). The next most common are from the cells that make the eggs (germ cell) and the tissue that provides support within the ovary (stromal).
Who can be affected by ovarian cancer?
Ovarian cancer is most often found in people who have been through menopause but it can also be found in younger people. Ovarian cancer can occur in anyone born with ovaries, including trans-men and non-binary people. Ovarian cancer is slightly more common in Māori and Pacific peoples.
Anything that can increase your risk is called a risk factor. Having one or more of these risk factors does not mean that you will develop ovarian cancer. Even if you have no risk factors you can still develop ovarian cancer.
- Never been pregnant or first child after 35
- Early start of periods (before 12 years old)
- Late menopause (after 55 years old)
- Use of hormone therapy after menopause
- Family history of ovarian cancer
- Having a family cancer syndrome also linked to breast, bowel, prostate and pancreatic cancer
- Personal history of breast cancer
Signs and Symptoms
There are very few symptoms in the early stages of the disease. Most, but not all people, experience at least one symptom before they are diagnosed.
Symptoms may include:
- Increase in tummy size or bloating
- Abdominal or pelvic or back pain
- Needing to urinate (wee) more often or more urgently
- Bowel habit changes
- Eating less and feeling fuller
- Painful intercourse
- Abnormal bleeding from the vagina
- Unexplained weight change
Although these symptoms are usually caused by conditions other than cancer it is important if any last for two weeks or longer (particularly if the symptoms are new, unusual or getting worse) to get them checked by your doctor as soon as possible.
Examination including a pelvic exam.
Blood tests including measuring CA-125. CA-125 is a protein that can be elevated in ovarian cancer, but also other non-cancerous conditions. CA125 can be normal in early ovarian cancer, and younger people with ovarian cancer.
Ultrasound, both transabdominal and trans-vaginal. Transabdominal is through your abdominal wall but to get the best assessment of the ovaries the person who does the scan (an ultra-sonographer) will also insert the ultrasound probe into the vagina (trans-vaginal).
If these tests are positive, then the extent of the cancer will be assessed by other radiological imaging e.g. CT scan, MRI scan, or PET scan. In order to confirm the diagnosis, a sample of the tumour will be removed through surgery.
If you are suspected to have ovarian cancer, you will be referred to a specialist called a gynaecologist. A team of health professionals with expertise and experience with ovarian cancer will look after your care.
The treatment for ovarian cancer depends on the type and stage (how far it has spread), the severity of your symptoms and your preferences.
If the cancer is found early, then surgery to remove your ovaries and fallopian tubes may be the only treatment that is required. If the cancer is not found early surgery may include removing your uterus (womb), omentum (the fatty layer that sits on the surface of your organs), lymph nodes, part of the large bowel and your appendix.
Other treatment may include chemotherapy (medicines to destroy cancer cells) which can be given before or after surgery. There are many different types of drugs and what is recommended for you will depend on your tumour and its stage. Some women may also have to have radiotherapy (radiation treatment).
Many types of ovarian cancer have high recurrence rates and poor long-term survival. But this varies depending on the specific type and stage of ovarian cancer and it is worth noting that a few types of ovarian cancer can be cured even if diagnosed at an advanced stage. Prompt investigation of symptoms is important to ensure ovarian cancer is diagnosed and treated as early as possible.