Ovarian Cancer
What is Ovarian Cancer?
The ovaries contain primitive cells, which are cells that go on to become eggs, and epithelial cells. Primitive cells that become cancerous are called germ cell tumours. Epithelial cell cancers of the ovary are more common than germ cell cancers. Names of different types of epithelial ovarian cancers include mucinous or serous cystadenocarcinoma, clear cell carcinoma and endometrioid carcinoma of the ovary. Not all tumours of the ovary are cancerous as some are benign.
How common is Ovarian Cancer?
Ovarian cancer is the 6th commonest cancer in Singapore. It is the second commonest female genital tract cancer.
Age of Onset
Epithelial ovarian cancer is a disease of older women while germ cell cancers of the ovary occurs more frequently in younger women.
Risks and Causes
Risk factors associated with ovarian cancer include:-
- late pregnancy
- early onset of menstruation
- late menopause
- never had children
- genetic predisposition
Ovarian cancer is known to run in families. In women who have a sister or mother with this disease, the risk of developing ovarian cancer is increased twenty-fold. Ovarian cancer also runs in certain families with a history of breast and colon cancers. There is now evidence to suggest that certain genes are involved in causing these disease.
Symptoms and Signs of Ovarian Cancer
Among female genital tract cancers, epithelial ovarian cancers are the most difficult to prevent or cure because they rarely have early symptoms or signs. Symptoms tend to develop only when the cancer is advanced. These symptoms include abdominal swelling and discomfort, bloating or wind, pain, change in bowel habits and unexplained loss of weight.
Diagnostic Tests
A marker in the blood, called CA-125, is raised in about 80% of patients with epithelial ovarian cancers. However, it is also raised in non-cancerous conditions, such as endometriosis and appendicitis. The result of elevated CA-125 must therefore be interpreted in the light of other clinical findings. Pelvic ultrasound can detect ovarian cancer and also show if other areas of the region are involved. Computerised scans (CT) of the region and chest x-rays are also useful.
To determine the actual extent of the cancer, surgical exploration or staging is required. During the procedure, the doctor will examine the peritoneum, which is the inner lining of the abdomen. Fluid within the abdomen is sent for assessment which involves analysis under a microscope.
Treatment of Ovarian Cancer
Besides determining the stage of the cancer, the aim of surgery is to remove as much of the cancer as possible. Often this includes removing ovaries, the uterus and its surrounding fat.
Additional treatment following surgery will be determined by the stage of the disease, the grade of the disease (aggressiveness) and the type of cancer.
For very early stage disease and non-aggressive types, further treatment may not be required. For the more advance and aggressive types of cancers, often chemotherapy is the treatment of choice.
Prognosis of Ovarian Cancer
Ovarian cancer in the early stage can potentially be cured while those in the late stage of the cancer, permanent cure maybe difficult.
Frequently Asked Questions about Ovarian Cancer
1. Is there a screening test for ovarian cancer?
There is currently no widely accepted and effective screening test for ovarian cancer. However, if there is strong family of history of ovarian cancer, it may be appropriate for that woman to go for regular gynaecological assessment.
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