February is Ovarian Cancer Awareness Month - this type of cancer affects roughly 1400 people in Australia each year, and is the eighth most common female cancer. Therefore, it’s important to be aware of the signs and symptoms so you know when to seek help from a doctor.
Types of ovarian cancer
There are three different types of ovarian cancer:
Epithelial: this is the most common type of ovarian cancer and accounts for around 90% of cases. It appears on the cells on the outside of the ovary and usually occurs in those over the age of 60.
Germ Cell: this less common type of ovarian cancer accounts for around 4% of cases, and occurs in the cells that produce eggs. It usually occurs in adolescents or those under the age of 40.
Stromal: this is the rarest type of ovarian cancer and comes from the hormone-producing cells around the ovary. It can result in the over-production of oestrogen and occurs mostly in those aged 40 - 60.
Ovarian cancer symptoms
Unfortunately, ovarian cancer symptoms are very similar to the symptoms of many other conditions, which makes them very difficult to recognise or differentiate. Furthermore, most people don’t experience symptoms during the early stages of ovarian cancer. This means it has usually progressed by the time of diagnosis and has become more difficult to treat.
Some key symptoms to be aware of include:
- Bloating and/or pain and discomfort in the pelvic area
- Loss of appetite and/or feeling full quickly
- Constipation or diarrhoea
- More frequent urination
- Indigestion and/or nausea
- Unexplained weight loss or gain
- Changes in your menstrual cycle or bleeding after menopause
- Pain during sex
- Bleeding during or after sex
If you are experiencing these symptoms for a number of weeks, keep track of them and see your GP for further investigation. Ovarian Cancer Australia has created a handy symptom tracker which you can download from their website. Always keep in mind that these symptoms can be experienced with a number of different conditions and are not always associated with ovarian cancer. Don’t be alarmed - always speak to your GP to determine if there is cause for concern.
Causes of ovarian cancer
Ovarian cancer has a strong genetic link. In fact, up to 20% of epithelial type ovarian cancers are believed to be the result of a defective gene inherited from either your mother or father’s side of the family. If you have a history of ovarian, breast, colon or endometrial cancer on either side of your family, it is particularly important to be aware of the signs and symptoms of ovarian cancer. Those from Ashkenazi Jewish descent are also believed to be at greater risk.
However, keep in mind that most people who are diagnosed with ovarian cancer do not have a family history.
The exact cause of ovarian cancer is not known; however, it is shown to be linked with:
- Having previously experienced breast cancer, diabetes or endometriosis
- Ageing - the risk of ovarian cancer increases with age, particularly in those over 50
- Not having children or those who have children after the age of 35
- Starting your period before the age of 12
- Experiencing late menopause
- Being overweight
- Taking oestrogen-only hormone replacement therapy or fertility treatments
How do you get diagnosed?
In order to diagnose ovarian cancer, your doctor will need to run a number of tests. These may include:
- A pelvic exam: this is where your doctor feels for any masses or lumps in the abdomen. This is done externally and internally, by inserting their fingers into the vagina and rectum.
- CA125 blood test: your doctor may request this blood test to check for the proteins produced by cancer cells, also known as tumour markers. The level of CA125 may be higher in those with ovarian cancer, but may also be elevated due to other health issues such as ovulation, menstruation, irritable bowel syndrome, liver or kidney disease, endometriosis or fibroids. If you are diagnosed with ovarian cancer, this blood test may be repeated throughout your treatment to monitor the effectiveness of the treatment.
- Biopsy: sample cells are taken from the area of concern and examined under a microscope to check for abnormalities.
- Pelvic ultrasound: an abdominal (external) and transvaginal (internal) ultrasound may be performed to view the uterus and ovaries and identify any abnormalities.
- Colonoscopy: this procedure is used during the diagnostic process to rule out whether any symptoms are resulting from issues within the bowel.
Ovarian cancer treatment options
Ovarian cancer is treated with surgery to remove any tumours or cancerous cells and is usually followed by chemotherapy. In some cases, like early-stage epithelial ovarian cancer or borderline tumours, chemotherapy may not be required following surgery. Treatments options vary case to case and your doctor will be able to recommend the best course of treatment for you.
If you or someone you love is dealing with ovarian cancer or any other type of cancer, support is available. Contact The Cancer Council on 13 11 20 for confidential phone support, or call the Ovarian Cancer Helpline on 1300 660 334.