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Understanding ovarian cancer |
Despite being the sixth most common cause of cancer death and claiming the lives of some 800 Australian women each year, ovarian cancer is often overshadowed by its more famous cousins – breast and cervical cancer.
It's not surprising then that there is a distinct lack of knowledge about ovarian cancer among Australians.
A recent survey commissioned by the National Breast Cancer Centre (NBCC) found that half of all Australian women incorrectly assumed a pap test could detect ovarian cancer.
The results showed that even more women were unable to correctly name any of the signs or symptoms of the disease.
More alarming is the fact that women aged 50 years and over – those most at risk of developing ovarian cancer –
are most commonly getting it wrong.
For Dr Jacinta Halloran, if the results of this survey teach us anything, it's that much more needs to be done to increase ovarian cancer awareness among Australians.
"That so many women are in the dark about ovarian cancer is really concerning," says Jacinta.
"There's clearly a lot of work to be done to raise awareness of this important and deadly disease."
The NBCC estimates that ovarian cancer – cancer of the ovaries – affects about 1200 women each year.
The disease is difficult to detect because there is no specific screening test and the symptoms are vague and common.
"For this reason, seven out of 10 women are diagnosed at an advanced stage when the cancer is difficult to treat,"
says Jacinta, "and the five-year survival rate is only 42 percent."
But it's not all bad news.
"If you know what symptoms to look out for, know your risk factors and see your GP if you notice anything unusual, you can dramatically improve your odds."
So who's at risk?
Some women have a higher than average risk of the disease, says Jacinta. These include women:
- With a family history (mother, daughter or sister) of ovarian cancer
or cancer of the breast, uterus,
colon or rectum
- With a personal history of cancer of the breast, uterus, colon or rectum
-
who started menopause after the
age of 50
-
who are aged over 55 (the average
age at time of diagnosis is 62 years)
-
who are older and have never
been pregnant
Jacinta is quick to advise that just because you have one or even several risk factors, this does not mean you
will necessarily go on to develop
ovarian cancer.
"But if you do have some risk factors,
you need to pay special attention to
health and body for any warning signs or symptoms."
No clear signs
Part of the reason that ovarian cancer
is often diagnosed at a late stage is that there are very few symptoms early on.
As the cancer progresses symptoms
can include:
- pressure in the abdomen, pelvis,
back, or legs or on the bladder
or bowel
- a swollen or bloated abdomen
and weight loss or gain
- nausea, indigestion, gas,
constipation, or diarrhoea
- feeling very tired all the time
Less common symptoms include:
- pain
- shortness of breath
- unusual vaginal bleeding
Again, Jacinta warns that just because you experience some of these symptoms does not mean you have cancer. What it does mean is that you should keep an eye on things and see your doctor if the symptoms are unusual or persistent.
How is it treated?
Jacinta says that most women with ovarian cancer will be advised to have surgery to remove their uterus and ovaries.
"During the operation, the surgeon –
usually a gynaecologist who specialises in cancer treatment – will examine the abdomen and pelvis for any evidence that the cancer has spread. This allows for the removal of any other tumours and allows the surgeon to work out what stage the cancer is at."
After surgery almost all women will need a six-month course of chemotherapy, says Jacinta. About 75 percent of women can expect a positive outcome.
Sadly however, most women with advanced ovarian cancer will relapse and will most likely need a second course of chemotherapy.
Radiotherapy to the abdomen is also used occasionally in women with earlier cancers.
Should I be screened for ovarian cancer?
The only screening tests currently available for ovarian cancer are the transvaginal ultrasound and the
CA-125 blood test. However, because of the limitations of the CA-125 blood test, researchers are working hard to develop new
blood tests for the early detection of ovarian cancer.
Jacinta also points to a large study in the UK involving 200,000 women that is investigating if routine ultrasounds or three-monthly CA-125 tests can improve survival rates.
"The results of the UK study aren't due for another couple of years, so it is not currently recommended
that all Australian women be regularly screened.
"However women with a strong family history of ovarian cancer and who have been tested and found to have the cancer gene are advised to have six or 12-monthly CA-125 tests and ultrasounds.
"Many of these women may also decide to have their ovaries and uterus removed once they have finished having children."
It's in your genes
If several women in a family have ovarian or breast cancer, especially at a young age, this is considered a strong family history.
If you have a strong family history of ovarian or breast cancer, you may benefit from speaking to a genetic counsellor. The counsellor may suggest you undergo genetic testing to look for the presence of a specific gene that increases the risk of ovarian cancer.
The Centre for Genetics Education advise that a genetic counsellor may be able to help you:
- clarify your chance of developing ovarian and breast cancer based on your family history
- answer any questions you might have about your family history
of cancer
- discuss what medical check-ups are appropriate
- discuss the limitations and potential benefits of genetic testing.
Your GP will be able to help you find a genetic counsellor.
Donna's Story
Donna Mathieson was an active 29 year old when she started to feel tired, bloated and noticed that despite her healthy lifestyle, she had begun to put on weight. Like many others, she didn't think anything of these symptoms and only went to the doctor when she started experiencing severe stomach pains.
"My doctor sent me for an ultrasound, which picked up the tumour," says Donna. "It all happened so fast. Within a week, I'd been diagnosed with ovarian cancer and had the tumour removed.
"Six weeks after my operation, I started a six month course of chemotherapy and had to have two further operations to remove two other tumours. Luckily they were both benign but my doctors didn't want to take any chances.
"All up, it took about 12 months for the doctors to give me the all clear. Of course I still have to have regular tests and check-ups to ensure the cancer doesn't come back."
Donna's story serves as a good reminder that if you don't feel 100 percent, you should think about visiting your doctor. "We all know our own bodies and we all know when something is not right. My advice to others would be to go
and see your doctor if you feel sick.
"And if you're not happy with the outcome, don't be scared to seek a second opinion. After all, we're talking about your life, and nothing is more important than that."
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