Do you know?
· ovarian cancer is the eighth most common cancer and also eighth most common cause of death from cancer in women worldwide. In
· In India, Ovarian cancer is the leading cause of death among the gynecological cancers and is the third most common cancer and fourth most common cause of death in women with a mean age-adjusted incidence and mortality rate of 6.7 and 4.8 per 100,000 women respectively (GLOBOCAN 2020)
· In western countries, the median age of diagnosis is 63 years, whereas in India, the median age of diagnosis has been reported to be < 50 years.
· Only 20% of all ovarian cancer cases are diagnosed at the early stage and curable ( 5 year survival rates 80-90% )and nearly 80% women are diagnosed in advanced stage ( 5 year survival reported 40 %
· The Pap test only screens for cervical cancer and DOES NOT cover ovarian cancer.
Risk Factors
· The risk of ovarian cancer increases with age, and is high around the time of menopause.
· A family history of ovarian cancer, colon cancer, stomach cancer, uterine cancer, prostate cancer, premenopausal breast cancer or a personal history of premenopausal breast cancer places women at heightened risk of ovarian cancer.
· BRCA gene mutation in self or any close family member.
· Endometriosis
· Infertility and not bearing children are risk factors
Risk reducing factors
· Pregnancy
· Oral contraceptive pills significantly reduce the risk when taken for 5 years
· Breastfeeding
· Removal of fallopian tubes (Female sterilization)
Consult for these symptoms
· Persistent Bloating (swelling or feeling of fullness in the abdomen )
· Difficulty eating or feeling full quickly
· Dyspepsia for more than 3 weeks
· Pelvic or abdominal pain
· Abdominal distension
· Urinary symptoms- urgency or frequency
Women who have these symptoms almost daily for more than a few weeks should see their doctor to consider ovarian cancer as the possible cause, although it most likely won’t be.
How is ovarian cancer diagnosed?
Confirmatory diagnosis of ovarian cancer is made on histopathology after the surgical excision of ovarian mass in early stages of cancer. In advanced stages, diagnosis is made by cytological examination of ascitic fluid (fluid in the abdomen) for ovarian cancer cells or diseased omental / peritoneal biopsy before commencement of treatment.
Clinical examination, abdominal ultrasound, CT scan and MRI, PETCT aid in the assessment of the obvious spread of the disease and defining the treatment line. Tumour marker - CA125 levels in the blood also adds to the information.
How is ovarian cancer treated?
The treatment of ovarian cancer is decided based on the existing standard guidelines in order to offer the best results. Usually surgery includes specialized surgical procedures.
Surgery is the main stay of treatment for early stage disease where fertility sparing surgery can be offered in selected cases. Surgery and chemotherapy are the cornerstones in the management of advanced ovarian cancer & recent advancement of HIPEC (heated intraperitoneal chemotherapy) has added to the survival in advanced ovarian cancer. Recent addition of the targeted maintenance therapy offer survival benefits in these patients based on the status of BRCA mutation.
Guidelines, recommend such cases being best surgically managed by experienced Gynae-oncologist for the best possible results in terms of survival and quality of life.
Act in time
· Unfortunately, there is no effective specific screening test for ovarian cancer. Therefore, women need to understand the risk and symptoms and take up check ups as per the advice.
· If you have any of the aforementioned symptoms that are frequent, persistent or new to you, ask your doctor to consider ovarian cancer as a possible cause.
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