Ovarian Cancer by Mr David Ireland, Consultant Gynaecologist
Each year, around 6,800 women in the UK are diagnosed with ovarian cancer, making it the fifth most common female cancer, and the biggest gynaecological killer. In comparison to other cancers, such as breast cancer - which affects 50,000 people each year - it is however relatively uncommon. In fact, it is estimated that the average GP sees only one case of ovarian cancer every five years.
It predominantly affects older women, with 80% of cases occurring in women over the age of 50, particularly those who have reached the menopause. In addition, women with a strong family history of breast or ovarian cancer are also at increased risk and should be more vigilant about any symptoms.
‘Unfortunately most patients we see with ovarian cancer are at an advanced stage of the disease’ explains Consultant Gynaecologist Mr David Ireland from the Nuffield Hospital in Leicester. ‘Many women with very early ovarian cancer have no symptoms at all and don’t know they are suffering from the disease. Symptoms tend to be vague and often mistaken for other less serious disorders. The good news however, is if it is caught early the outcome is good. The 5 year survival rate in patients with early stage cancer is almost 90%’.
Unlike smear tests, which routinely screen for cervical cancer, there is currently no widespread screening available for ovarian cancer so it is important to be alert to the symptoms and seek advice if concerned.
‘Symptoms to watch out for are lower abdominal pain, bloating and swelling of the abdomen’ explains Mr Ireland. ‘There may be bowel or urinary changes as well as loss of appetite and weight loss with more advanced disease.’
Even though it’s very unlikely to be ovarian cancer, it is important to get checked out by your GP, especially if you experience a number of symptoms. ‘You should also remember to mention any family history of breast or ovarian cancer, especially in a close relative such as a mother or sister’ suggests Mr Ireland ‘As about one in 10 cancers are caused by an inherited genetic disorder, including BRCA1 and BRCA 2 genes which also increases the risk of breast cancer’.
As well as the genetic link, you might be more at risk of ovarian cancer if you started menstruating at a young age or have a late menopause. Women who haven’t had children are also at greater risk, as well as those who suffer from other gynaecological conditions such as endometriosis, ovarian cysts or infertility. Having a body mass index (BMI) above 30 or taking HRT are also thought to slightly increase your risk of developing the disease.
If your symptoms don’t go away or get worse, it is advisable to go back to your GP and ask to be re-examined. You know your body better than anyone. If you need further investigations, you will be referred to a gynaecologist where under NHS guidelines you should be seen within 2 weeks, or ask to be referred privately to your local Nuffield Hospital to see a consultant usually more quickly.
Tests for ovarian cancer may include an internal examination by your doctor, blood tests, various scans and possibly a laparoscopy, where, under general anaesthetic, a surgeon will make a small incision in your abdomen and look inside with a camera.
‘The treatment of ovarian cancer varies and depends on the stage and extent of the disease’ explains Mr Ireland. ‘Treatment is also tailored to each particular patient, and may include a combination of surgery and chemotherapy. Some patients start with the chemotherapy first followed by surgery, while in others surgery is the initial treatment followed by chemotherapy’.
Ovarian cancer was historically known as the ‘silent disease’ due to the lack of symptoms, but over the last 35 years the survival rate has improved significantly, due to better diagnosis, treatment and awareness. Even though it is relatively uncommon, ovarian cancer still accounts for more deaths than all other gynaecological cancers put together, and around 4,400 women die from the disease each year – that’s one every 2 hours. These statistics emphasise the need to seek medical advice if you have any symptoms of ovarian cancer or are at all worried. On a positive note, the survival rate in women diagnosed at stage 1 cancer is actually around 90% and the younger you are, the better the chances of successful treatment. Early diagnosis and treatment could well save your life.