Ovarian cancer refers to malignant growth arising from different parts of the ovaries. The ovaries are part of a woman’s reproductive system, where the eggs are developed. Most ovarian cancers are classified as “epithelial” and arise from the surface (epithelium) of the ovary. Other types arise from the egg cells (germ cell tumour) or supporting cells (sex cord/stromal).
Risk factors associated with ovarian cancer include:
- Late pregnancy
- Early onset of menstruation
- Late menopause
- Never had children
- History of breast cancer
- Genetic predisposition
Ovarian cancer is known to run in some families where family members may have increased risk of getting ovarian, breast and endometrial cancer (e.g. BRCA gene abnormalities) or increased risk of getting endometrial cancer, colorectal cancer in addition to ovarian cancer (Lynch syndrome). In women who have a sister or mother with this disease, the risk of developing ovarian cancer is increased twenty-fold. Ovarian cancer also runs in certain families with a history of breast and colon cancers. There is now evidence to suggest that certain genes are involved in causing these diseases.
Early ovarian cancer rarely has symptoms or signs. Symptoms tend to develop only when the cancer is advanced.
These symptoms include:
- Abdominal swelling and discomfort
- Persistent indigestion, gas or nausea
- Changes in bowel habits, such as constipation
- Loss of appetite
- Back pain
You may have an internal ultrasound (known as a transvaginal ultrasound), where the ultrasound probe is inserted into your vagina. Or you may have an external ultrasound, where the probe is put next to your stomach. The image produced can show the size and texture of your ovaries, as well as any cysts that may be present.
CA 125 Blood Test
CA 125 is a protein found on the surface of ovarian cancer cells and some healthy tissue. CA-125 is raised in about 80% of patients with epithelial ovarian cancers. However, it is not always accurate and not adequate for diagnosis of ovarian cancer as it is also raised in non-cancerous conditions, such as endometriosis and appendicitis.
PET CT or CT Scan
These imaging scans of the abdomen, chest and pelvis help to look for signs of cancer in other areas of the body.
These are useful in detecting whether other areas of the body such as the lungs are affected.
Surgery or Biopsy
Ultimately an operation or biopsy is required to prove that the cells affected are cancerous and originated from the ovaries.
To determine the actual extent of the cancer, surgical exploration or staging is required. During the procedure, the doctor will examine the peritoneum, which is the inner lining of the abdomen. Fluid within the abdomen is sent for assessment which involves analysis under a microscope. Besides determining the stage of the cancer, the aim of surgery is to remove as much of the cancer as possible. Often this includes removing ovaries, the uterus and its surrounding lymphatics.
Additional treatment following surgery will be determined by the stage of the disease, the grade of the disease and the type of cancer.
For very early stage disease and non-aggressive types, further treatment may not be required. For more advanced and aggressive types of cancers, chemotherapy is the treatment of choice.
Prognosis of Ovarian Cancer
Ovarian cancer in the early stage has high chance to cure while those in the late stage of the cancer, permanent cure may be difficult.
CanHOPE is a non-profit cancer counselling and support service provided by Parkway Cancer Centre, Singapore. CanHOPE consists of an experienced, knowledgeable and caring support team with access to comprehensive information on a wide range of topics in education and guidelines in cancer treatment.
- Up-to-date cancer information for patients including ways to prevent cancer, symptoms, risks, screening tests, diagnosis, current treatments and research available.
- Referrals to cancer-related services, such as screening and investigational facilities, treatment centres and appropriate specialist consultation.
- Cancer counselling and advice on strategies to manage side effects of treatments, coping with cancer, diet and nutrition.
- Emotional and psychosocial support to people with cancer and those who care for them.
- Support group activities, focusing on knowledge, skills and supportive activities to educate and create awareness for patients and caregivers.
- Resources for rehabilitative and supportive services.
- Palliative care services to improve quality of life of patients with advanced cancer.
The CanHOPE team will journey with patients to provide support and personalised care, as they strive to share a little hope with every person encountered.