Ovarian cancer begins in the ovaries, the organs that produce eggs and hormones. It is often called a “silent killer” because symptoms may be vague until the disease is advanced. One of the aggressive ovarian cancer, high grade serous ovarian carcinoma often develops from serous tubal intraepithelial carcinoma (STIC) lesions, considered to be precursor lesions in fallopian tubes, usually seen BRCA mutation carriers. Early detection of ovarian cancer can improve outcomes.
Causes & risk factors
- Genetic Mutations: Inherited mutations in BRCA1/BRCA2 genes or Lynch syndrome increase risk.
- Age: Most common in women over 50.
- Reproductive History:
- Never having been pregnant.
- Early menstruation (before 12) or late menopause (after 50).
- Family History: A close relative with ovarian, breast, or colorectal cancer.
- Other Risks: Obesity, hormone replacement therapy (long-term use), endometriosis.
Symptoms
- Abdominal bloating or swelling.
- Pelvic or abdominal pain.
- Feeling full quickly or difficulty eating.
- Frequent urination or urgency.
- Unexplained weight loss, fatigue, or changes in bowel habits.
Prevention
- Genetic Counselling: For those with a family history of ovarian/breast cancer.
- Birth Control Pills: Long-term use may reduce risk.
- Pregnancy and Breastfeeding: Linked to lower risk.
- Surgical Options: Prophylactic removal of ovaries/tubes (for high-risk individuals only).
- Healthy Lifestyle: Maintain a healthy weight and avoid smoking.
Screening
- Routine Screening: Unlike cervical cancer, there is no reliable screening test for average-risk individuals.
- High-Risk Patients:
- Regular transvaginal ultrasound, HE4 and CA-125 blood tests (though not foolproof).
- Genetic testing for BRCA mutations or Lynch syndrome.
Diagnosis & Treatment
- Diagnosis:
- Pelvic Exam: To check for lumps or irregularities.
- Imaging: Ultrasound, CT, or MRI scans.
- Blood Tests: HE4 and CA-125 (a tumour marker, though not definitive).
- Biopsy: Usually done during surgery or image guided to confirm cancer.
- Treatment Options:
- Surgery: Removal of ovaries, fallopian tubes, uterus, and nearby lymph nodes (debulking).
- Chemotherapy: Often used after surgery.
- Targeted Therapy: PARP inhibitors (e.g., Olaparib) for BRCA-mutated cancers.
- Immunotherapy: Emerging option for some cases.
Discuss fertility preservation before treatment if desired.
Frequently Asked Questions
Q: Is ovarian cancer linked to HPV?
A: No—unlike cervical cancer.
Q: Can a cervical smear test detect it?
A: No. Smear tests screen for cervical cancer only.
Q: What’s the survival rate?
A: Depends on stage:90% 5-year survival if caught early (Stage I). However, this can be less than 30% for advanced stages (III/IV).
Q: Does it run in families?
A: 10–15% of cases are hereditary.
Q: Can it recur?
A: Yes, recurrence is common; follow-up care is vital
eGynaecologist Advice:
- Symptoms of potential ovarian cancer are often subtle and easily confused with other conditions. You must consult a gynaecologist if you have persistent symptoms.
- Symptom awareness is critical for early detection of ovarian cancer and better overall survival. You must consult a gynaecologist for investigations and potential early treatment.
- You should discuss fertility sparing treatment with your gynaecologist if you desire to achieve pregnancy.
- If you are considered high risk for developing ovarian cancer and have completed your family, you must consult gynaecologist for risk reducing surgery.
- Regular follow up checks after treatment with your gynaecologist are important to monitor your health and prevent complications of recurrence of cancer.
