Ovarian Cancer

Ovarian cancer is a type of cancer that originates in the ovaries. It's one of the most common types of cancer in women over the age of 50 years and is usually diagnosed when it's already advanced. There are 3 main types of ovarian cancer (and many other subtypes). The treatment and chance of cure will be different for each type of cancer and will depend on how far the cancer has spread.

Symptoms of ovarian cancer

Early-stage ovarian cancer may not cause any noticeable symptoms. As the disease progresses, women may experience:

• Indigestion, persistent bloating and nausea (feeling sick).
• A loss of appetite or feeling full early
• Unexplained weight loss
• Discomfort or persistent pressure in the pelvic area or lower back
• Changes in bladder or bowel habits such as constipation
• Feeling tired or a lack of energy.
• Postmenopausal bleeding.

If you are experiencing any of these symptoms you should seek advice from your health provider.

Risk factors

Risk factors for ovarian cancer include:

• Age: Most common in women aged 50 to 60 years. The average age to be diagnosed is 65 years old.
• Ethnicity: Ovarian cancer is slightly more common in Māori and Pasifika
• Inherited gene mutations: BRCA1 and BRCA2 genes increase the risk
• Family history of ovarian cancer
• Estrogen hormone replacement therapy: Especially with long-term use and in large doses
• Age when menstruation started and ended: Beginning menstruation before age 12 or starting menopause after age 52, or both, may increase the risk of ovarian cancer
• Lifestyle factors including tobacco smoking and alcohol use may also increase the risk.
• Being overweight or eating a high-fat diet

When to see a doctor

• If you are experiencing the symptoms outlined above.
• Persistent pelvic or abdominal pain
• Ongoing bloating
• Difficulty eating or feeling full quickly
• Urinary symptoms: Urgency or frequency

Diagnosis

Diagnosis procedures for ovarian cancer may include:

• History of symptoms
• Pelvic examination: Doctor examines the ovaries and nearby organs for lumps or other changes
• Imaging tests: Like ultrasound or CT scans to create a picture of the ovaries
• Blood tests: For cancer markers that help identify ovarian cancer
• Surgical evaluation: Sometimes including biopsy during surgery to examine tissue samples

Treatment options

Medical treatments:

The treatment offered will depend on the type and stage of ovarian cancer, as well as your general health.

• Surgery: To remove one ovary (unilateral oophorectomy), both ovaries (bilateral oophorectomy), or both ovaries and the uterus (hysterectomy)
• Chemotherapy: Uses drugs to kill cancer cells; can be administered before or after surgery
• Targeted therapy: Focuses on specific weaknesses present within cancer cells
• Radiation therapy: Uses high-energy beams to kill cancer cells, though not commonly used for ovarian cancer

Self-care and support:

• At the moment, there are no screening tests that are recommended for ovarian cancer
• Regular check-ups and staying aware of body changes. 
• Genetic testing: Women who have a family history of breast or ovarian cancer may have a higher risk of cancer themselves. Some of these women will carry a genetic abnormality called BRCA1 or BRCA2, or another type of cancer gene (which is more rare).Genetic screening for BRCA (and other cancer genes) is a lengthy and expensive process, so there are specific criteria required before testing is recommended. This can be discussed with your health provider.
• Healthy lifestyle choices: Maintaining a healthy diet and regular exercise.
• Support groups: Connecting with other women facing ovarian cancer.
• Follow-up care: Regular visits post-treatment to monitor for any recurrence.‍

Conclusion

Ovarian cancer, often diagnosed at a late stage due to subtle early symptoms, requires awareness and early detection and treatment to improve outcomes. Understanding symptoms, risk factors, and treatment options can empower women to make informed decisions about their health. If you have symptoms or concerns related to ovarian canceror ongoing abdominal or back pain, abnormal vaginal bleeding, nausea or bloating, see your healthcare provider for a check-up.

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