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Ovarian Cancer Awareness Month

Author: Neil Fearn  Bullet  Dated: 18/03/2015

Ovarian Cancer is the 5th most common cancer in women and its incidence is rising.

Ultrasound

It is also called the ‘silent killer’ because the symptoms are often difficult to recognise in the early stages because the symptoms are similar to those of less serious conditions such as irritable bowel syndrome (IBS), ovarian cysts, polycystic ovary syndrome (PCOS) and pre-menstrual syndrome.

NICE states that the outcome for women with this cancer is generally poor, with an overall five-year survival rate of less than 35%. This is because most women are only diagnosed when the disease is advanced, even though many women have symptoms months before, and also because of delays between when they first go to the doctor with symptoms and when referral is made for specialist investigations and treatment.

Symptoms of Ovarian Cancer

Three main symptoms to look out for are:

  1. Increased abdominal size and persistent bloating
  2. Persistent pelvic and abdominal pain
  3. Difficulty eating and feeling full quickly, or feeling nauseous

If you’re regularly experiencing these symptoms on most days it’s important to talk to your GP to get checked out. It would also be helpful to maintain a symptoms diary, which can be found here: Ovarian Cancer Action Symptoms Diary.

Other symptoms to be aware of that are most likely the result of other conditions in the pelvic area, but may be present in some women with ovarian cancer are:

  • Back pain
  • Needing to pass urine more frequently than usual
  • Changes in your bowel habits (diarrhoea or constipation)
  • Pain during sex
  • Feeling tired all the time

Ovarian Cancer Diagnosis

There are a number of tests that will be carried out in order to make the initial diagnosis and usually they will begin with your GP who will likely carry out an internal examination. A CA 125 blood test will be arranged. CA 125 is a protein that is a so-called tumour marker and is found in greater concentration in tumour cells than in other cells of the body.

In particular, CA 125 is present in greater concentration in ovarian cancer cells than in other cells. It is, however, important to remember that the level of CA125 in the blood can also be raised by non-cancerous conditions and by other types of cancer.

Your GP will also organise an ultrasound scan of the abdomen and pelvis to check for any abnormalities:

  • A pelvic and transvaginal ultrasound, to look for an ovarian lump
  • A pelvic or abdominal CT scan or MRI, to check for the spread of cancer

Hospital Referral

Under NICE guidelines you should then be referred to hospital within two weeks, to be seen by a gynaecologist, and a specialist multidisciplinary cancer team who would investigate further.

Several tests may be needed to help confirm the diagnosis and to stage the disease. The aim of staging is to find out:

  • How much the cancer has grown
  • Whether the cancer has spread to local lymph glands
  • Whether the cancer has has spread from the place where it first started to another place in the body (metastasised)

The stages of ovarian cancer are as follows:

  • Stage 1 - involving the ovaries
  • Stage 2 - the cancer has spread outside the ovaries but not outside the pelvis
  • Stage 3 - the cancer has spread outside the pelvis but not involved other areas of the body
  • Stage 4 - the cancer has spread to other parts of the body such as the liver and lungs

Tests that are used may include one or more of the following:

  • CT scan of the lower abdomen to look at the structure of the internal organs
  • A chest X-ray to see if the cancer has spread to your lungs
  • Blood tests to assess whether the cancer has affected the function of your liver or kidneys
  • If you have symptoms such as constipation or urinary frequency you may need scans of the bowel or urinary tract to see if the cancer has spread to these areas
  • Aspiration of fluid from the abdomen
  • X-ray controlled biopsy
  • Laparoscopy which is a surgical procedure to look inside your abdomen to check the ovaries and other internal organs and to obtain samples small samples to be examined under the microscope to detect and confirm cancer cells


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