Ovarian cancer: Its causes and signs to look out for

By the National Health Service, UK.

Ovarian cancer, or cancer of the ovaries, is one of the most common types of cancer in women.

The ovaries are a pair of small organs located low in the tummy that are connected to the womb and store a woman’s supply of eggs.

Ovarian cancer mainly affects women who have been through the menopause (usually over the age of 50), but it can sometimes affect younger women.

The symptoms of ovarian cancer can be difficult to recognise, particularly early on.

They’re often the same as symptoms of less serious conditions, such as irritable bowel syndrome (IBS) or pre-menstrual syndrome (PMS).

-MAIN SYMPTOMS-

The most common symptoms of ovarian cancer are:

•        Feeling constantly bloated.

•        A swollen tummy.

•        Discomfort in your tummy or pelvic area.

•        Feeling full quickly when eating, or loss of appetite.

•        Needing to pee more often or more urgently than normal.

-Other symptoms-

Other symptoms of ovarian cancer can include:

•        Persistent indigestion or nausea.

•        Pain during sex.

•        A change in your bowel habits.

•        Back pain.

•        Vaginal bleeding (particularly bleeding after the menopause).

•        Feeling tired all the time.

•        Unintentional weight loss.

-When to see a general practitioner (GP)-

See a GP if:

•        You have been feeling bloated, particularly more than 12 times a month

•        You have other symptoms of ovarian cancer that will not go away – especially if you’re over 50 or have a family history of ovarian or breast cancer, as you may be at a higher risk

It’s unlikely you have cancer, but it’s best to check. A GP can do some simple tests for ovarian cancer to see if you might have it.

If you have already seen a GP and your symptoms continue or get worse, go back to them and explain this.

-CAUSES-

Ovarian cancer occurs when cells in the ovaries grow and multiply uncontrollably, producing a lump of tissue called a tumour.

It’s not clear exactly why this happens, but the following factors may increase your risk of getting ovarian cancer.

• Increasing age

The risk of ovarian cancer increases as you get older, with most cases occurring after the menopause.

About 8 in every 10 cases are diagnosed in women over 50, although some rarer types of ovarian cancer can occur in younger women.

• Family history and genes

You’re more likely to get ovarian cancer if you have a history of it in your family, particularly if a close relative (sister or mother) has had it.

Sometimes this may be because you’ve inherited a faulty version of a gene called BRCA1 or BRCA2. These increase your risk of developing both ovarian and breast cancer.

But having relatives with ovarian cancer doesn’t mean you definitely have a faulty gene.

Only around 1 in every 10 ovarian cancers is thought to be caused by one of these genes.

Ovarian Cancer Action has a tool to help you check whether your family history puts you at risk of ovarian cancer.  

Speak to your GP if you’re worried your family history may mean you’re at a higher risk of ovarian cancer. They may refer you to see a genetic counsellor, who may suggest having a test to check for faulty genes.

• Hormone replacement therapy (HRT)

It has been suggested that taking hormone replacement therapy (HRT)may increase your risk of ovarian cancer. But studies looking at this have so far had conflicting results.

It’s thought that if there is any increase in cases of ovarian cancer in women taking HRT, the risk is very small.

Any increased risk of ovarian cancer is thought to decrease after you stop taking HRT.

• Endometriosis

Research has shown that women with a condition called endometriosismay be more likely to develop ovarian cancer.

In endometriosis, the cells that usually line the womb grow elsewhere in the body, such as in the ovaries or tummy.

These cells still behave as if they were in the womb, including bleeding during periods.

But as there’s no way for the bleeding to leave the body, it becomes trapped and causes pain in the affected area.

-Other factors-

Other things that may increase your risk of ovarian cancer include:

•        Being overweight or obese – Losing weight through regular exercise and a healthy diet may help to lower your risk.

•        Smoking – Stopping smoking may help reduce your risk of ovarian cancer and many other serious health problems.

•        Using talcum powder – Some research has suggested that using talcum powder between your legs could increase your risk of ovarian cancer, but the evidence for this is inconsistent and any increase in risk is likely to be very small.

TREATMENT

The treatment for ovarian cancer depends on how far it has spread, your general health and whether you’re still able to have children.

Most people have a combination of surgery and chemotherapy.

The aim of treatment is to cure the cancer if possible. If the cancer is too advanced to be cured, treatment aims to relieve symptoms and control the cancer for as long as possible.

You’ll be cared for by a team of healthcare professionals who will come up with a treatment plan and support you throughout your treatment.

• Surgery

Surgery is the main treatment for ovarian cancer. The aim is to remove all of the cancer or as much of it as possible.

Surgery usually involves removing:

•        Both ovaries and the fallopian tubes.

•        The womb (a hysterectomy).

•        A layer of fatty tissue in the tummy (the omentum).

If the cancer is just in one or both ovaries, you may only need to have the ovary or ovaries removed, leaving your womb intact. This means you may still be able to have children.

Surgery is carried out under general anaesthetic (where you’re asleep). You’ll probably only need to stay in hospital for a few days, but it may take many weeks to fully recover.

• Chemotherapy

Chemotherapy is where medication is used to kill cancer cells. Most women with ovarian cancer have it in addition to surgery.

It may be used:

•        After surgery to kill any remaining cancer cells.

•        Before surgery to shrink the cancer and make it easier to remove.

•        If ovarian cancer comes back after initial treatment.

Chemotherapy medicine is usually given as a drip into the vein, but is sometimes given as tablets. You’ll need to come into hospital to receive the treatment, but can normally go home the same day.

Treatment is given in cycles, with a period of treatment followed by a period of rest to allow your body to recover. Most women have 6 cycles of chemotherapy, with each cycle lasting 3 weeks.

Chemotherapy can cause some unpleasant side effects, such as:

•        Tiredness.

•        Feeling and being sick. 

•        Loss of appetite.

•        Hair loss. 

•        Diarrhoea.

•        Increased risk of infections.

Most side effects can be controlled with medication from your doctor and they should pass once treatment stops.

• Radiotherapy

Radiotherapy uses carefully directed beams of radiation to kill cancer cells.

It’s not used very often to treat ovarian cancer, but may be used:

•        After surgery for early ovarian cancer, to kill any cancer cells left behind.

•        To shrink tumours and reduce symptoms if ovarian cancer has spread and can’t be cured.

Common side effects of radiotherapy include: Sore skin, tiredness and hair loss in the treated area. These should pass after treatment stops.

• Clinical trials

Research into newer and better treatments for ovarian cancer is ongoing through clinical trials.

Speak to your care team if you’re interested in participating in a trial as part of your treatment. They can let you know about any research you may be able to get involved in.

It’s important to be aware that you might not get an experimental treatment (you may be given a standard treatment that’s being compared to the new one) and there’s no guarantee that a new treatment will be more effective.