March 2016 is Ovarian Cancer Awareness Month

Here are some facts about ovarian cancer, its symptoms and signs, risk factors, investigations and treatment.

Ovarian cancer is the fifth most common cancer among women in the UK (after breast, bowel, lung and womb) and affects about 7,100 women per year.

Awareness of symptoms may make women more likely to be diagnosed and treated early.
• Increased abdominal size / always feeling bloated
• Difficulty eating/feeling full quickly – heartburn/nausea/loss of appetite.
• Abdominal or pelvic pain
• Urinary problems, bowel problems, back pain, feeling more tired than usual.

Although these symptoms are common in women and are more likely not to be due to ovarian cancer, if you get any new symptoms that are not normal for you, it is important to get them checked.

Risk factors. All women are at risk of ovarian cancer.
• Genes: Inherited conditions account for 5-15% of ovarian cancer cases; the majority of these hereditary cases are linked with BRCA1/2 mutations

• Age: Risk is strongly related to age. The older you are, the higher your risk.

• Smoking: An estimated 3% of ovarian cancer cases in the UK are linked to smoking tobacco.

• Other medical conditions: Ovarian cancer risk is 24% higher in breast cancer survivors compared with the general population, ovarian cancer risk is 20-55% higher in diabetics compared with non-diabetics, Ovarian cancer risk is 27-80% higher in women with endometriosis (endometriosis can also raise the CA125 level).

Diagnostic tests: If your doctor is worried or suspects ovarian cancer they will send you for a pelvic ultrasound test. An internal scan will usually be performed as this gives better detail. It can still be difficult to tell whether there is a cancer on the ovary or just a harmless cyst. If the ultrasound is not entirely normal further tests (MRI or CT scan) may be suggested.

Your doctor may also do a blood test to measure a protein called CA125 – although this can sometimes be falsely high in people who do not have ovarian cancer (e.g. in inflammatory conditions such as arthritis) and sometimes ovarian cancer can still be present with a normal CA125 level – only about 85 out of every 100 women with ovarian cancer (85%) have raised CA125

Unfortunately ovarian cancer is often diagnosed at a late stage. Women often delay seeking help because they think their symptoms are due to other less serious causes, e.g. irritable bowel syndrome – it is unusual to suddenly develop tummy pain, bloating and diarrhoea when you are older and you should always consult your GP

A cervical smear test will not detect ovarian cancer. This is a common misconception. It detects pre-cancerous changes within the cervix (opening to the womb).

Early diagnosis improves a woman’s chance of survival. In the UK, the overall five-year ovarian cancer survival rate is 46 per cent. But if diagnosed at the earliest stage, up to 90 per cent of women with ovarian cancer survive for five years or more.

Dr Sarah Watson


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