Ovarian cancer: the silent killer
We get to grips with the symptoms, causes and treatment of ovarian cancer – one of the least understood diseases…
With almost 7,000 women diagnosed with ovarian cancer each year in the UK, it is the fifth most common cancer in women. However, two in three sufferers will not survive beyond five years after diagnosis.
Women have two ovaries, one on either side of the womb. One function of the ovaries is to make eggs and in fertile women, they release one egg a month into the fallopian tube, to be fertilised by sperm. They also produce the hormones oestrogen and progesterone, which work to regulate a woman’s menstrual cycle.
Ovarian cancer occurs when the cells in the ovaries grow abnormally, causing tumours and secondary cancer elsewhere in the body.
Incredibly, ovarian cancer claims four times as many lives as cervical cancer. The reason for this, according to the charity Cancer Research (www.cancerresearchuk.org), is that the smear test saves many people with cervical cancer by detecting early changes in the cervix, meaning early treatment can be more effective.
Now it is hoped a simple procedure can do the same for ovarian cancer. The National Institute for Health and Clinical Excellence (NICE, www.nice.org.uk) is calling for GPs to carry out a blood test to measure levels of the CA125 protein in women, particularly the over-50s, to detect ovarian cancer earlier. The test is available on the NHS for those suspected of having the disease, but NICE says offering it sooner would improve patients’ survival rates.
The guidelines have received a positive response from Gilda Witte, chief executive of charity Ovarian Cancer Action. She commented: ‘We welcome the publication of NICE’s guideline on recognising and managing ovarian cancer. If it is detected when it is still contained in the ovary, women have a 90% chance of surviving.’
Understanding the symptoms
Ovarian cancer has been dubbed ‘the silent killer’ because it is widely thought the symptoms don’t present themselves until the cancer is at an advanced stage. However, this is not always the case. Many women do have the symptoms, but they are commonly confused with those of irritable bowel syndrome (IBS), which affects one in five womenor the side-effects of hormone replacement therapy (HRT).
Ovarian cancer can produce the following symptoms:
- Constant or persistent pelvic or stomach pain.
- Persistent bloating in the abdomen and a possible increase in the size of the abdomen.
- Difficulty eating and a feeling of getting full quickly.
- The desire to pass urine more frequently.
- Changes in bowel habit, such as constipation or diarrhoea.
- Back pain
Since many of these symptoms are commonly experienced by women who don’t have the disease, the charity suggests that medical attention should be sought if the symptoms are present on most days, or if you develop any of the symptoms suddenly.
Ovacome, the ovarian cancer support network, has launched a website (www.beatonline.info) to help women keep track of their symptoms. It features an online symptom tracker that can be used to record what a woman is experiencing. It then generates a report to help your doctor decide if tests or scans are necessary.
Factors that influence risk
Age Some 80% of cases occur in those aged over 50, although women in their 20s and 30s can also be affected. In younger women, the symptoms can be mistaken for fibroids and endometriosis, meaning diagnosis isn’t always made as speedily as it should be.
You have a greater chance of developing the disease if you have two or more close relatives who have had ovarian or breast cancer. Risk factors are also increased if you are of Jewish, Icelandic, Norwegian, Dutch, Pakistani and Polish descent. However, 90% of all cases of ovarian cancer have nothing to do with genetic predisposition.
Losing excess weight will help to reduce your risk – obese women who’ve been through the menopause are up to 80% more likely to get ovarian cancer, according to a study conducted in the US. Taking the combined oral contraceptive pill for five or more years reduces the risk by nearly 30%, with benefits lasting up to 30 years afterwards. After 15 years of taking the pill, risk is reduced by half, says Cancer Research UK. The reason for this is that the pill stops a woman from ovulating and it is thought ovulation may damage the lining of the ovaries. Similarly other factors such as having children, breastfeeding for longer and hitting the menopause earlier – all of
which reduce the number of times a woman ovulates during her lifetime – can all lower the risk of a woman developing ovarian cancer.
Getting a diagnosis
If you suspect you have ovarian cancer, you are likely to experience the following in order to reach an accurate diagnosis:
- An examination by a doctor, where he or she may be able to feel an enlarged ovary or other abnormality. But, says Ovacome, this method is only useful for detecting large ovarian tumours and not those at an early stage.
- An ultrasound scan where a scanner will be placed on your stomach and soundwaves will create images of structures inside your body. A small probe may be placed inside the vagina to get a detailed picture of the ovaries from another angle.
- A blood test that detects the presence of protein called CA125. The level of CA125 is high in 80% of women with advanced ovarian cancer and around 50% of those in the early stages of the disease.
Options for treatment include surgery, chemotherapy and, occasionally, radiotherapy. The treatment advised in each case depends on factors such as the stage and grade of the cancer, as well as the patient’s general health.
- Surgery: Most women with ovarian cancer will need to have surgery. If the cancer is at a very early stage and just confined to the ovary, an operation to remove the affected ovary and associated fallopian tube may be all that is needed. But if the cancer has grown into other nearby structures or has spread, a more extensive operation to remove the womb and other affected areas may be necessary.
- Chemotherapy: This is where drugs are used to destroy the cancer cells or stop them from multiplying. Chemotherapy is sometimes given before surgery to reduce the size of the cancer, making surgery easier and raising the chances of it being more successful.
- Radiotherapy: This is a treatment that uses high-energy beams of radiation to kill cancer cells or stop them from multiplying. Radiotherapy is rarely used to treat ovarian cancer, but it is sometimes used after surgery to kill cancer cells that may have been left behind after the operation. Radiotherapy can also be helpful in shrinking secondary tumours that have developed elsewhere and are causing pain or other symptoms.
‘I’m battling through’
Trish Mills, 48, self-diagnosed ovarian cancer from a newspaper article…
‘I used to feel sick, bloated and very full after a small meal, but when I went to my GP, I was told that I had gastric problems. A consultant then diagnosed irritable bowel syndrome (IBS) – but I knew it was more serious than that.
‘I became very anxious and depressed that no one could help me, then during time off over the Christmas period in 2009, a friend came to visit me and he brought a copy of the Daily Mail with him.
‘He asked me to read an article he’d seen in it because the woman in the news story had similar complaints to myself and had also been turned away from her GP.
‘After a rollercoaster ride, tests confirmed that I had stage 3 ovarian cancer. Following chemotherapy and a hysterectomy, I hope to find out soon if I have beaten the illness and am in remission.
‘I‘ve been battling cancer for two years now, but I hope to be fit to take part in the Great North Run at the end of the year.’
at home’s celebrity editor backs cancer awareness campaign
Lorraine Kelly is helping to raise awareness of ovarian cancer by urging the British public to join the Eve Appeal’s Make Time for TEA campaign. Lorraine is an ambassador for the charity, which hopes to raise £150,000 through the campaign for research into ovarian cancer.
The aim of the campaign is to raise funds and encourage those who take part to talk about their health issues over tea and cakes. Those taking part in an event will then be entered into a competition that will see one lucky winner enjoy afternoon tea with Lorraine at a top London hotel in June .
‘I do a lot of work with the Eve Campaign to raise funds and awareness about ovarian cancer’, says Lorraine. ‘It is called the silent killer because it is often difficult to detect early warning symptoms. The good news is that we are on the verge of a real breakthrough in diagnosis, with a single blood test being able to detect any signs of ovarian cancer.
‘The quicker it is discovered and treated, the greater chance women have of surviving. Unfortunately, awareness of gynaecological cancers is still pretty low in the UK,’ says Lorraine. ‘What better way to raise awareness and donate to a very worthwhile cause and have fun with your girlfriends at the same time?’
For more information visit www.eveappeal.org.uk or call 020 7299 4430.
Where to go for help
Ovacome, tel: 0845 371 0554, web: www.ovacome.org.uk
Target Ovarian Cancer Organisation, tel: 020 7923 5470, web: www.targetovariancancer.org.uk
Ovarian Cancer Action Charity, tel: 0300 456 4700, web: www.ovarian.org.uk
Macmillan Cancer Support Centre, tel: 0808 800 1234, web: www.macmillan.org.uk
Cancer Research UK, tel: 0800 800 4040, web: www.cancerhelp.org.uk
This article was first published in at home with Lorraine Kelly in May 2011. [Read the digital edition here]