Ovarian cancer

Ovarian cancer accounts for about 5% of cancers in women. 95% of cancers affecting the ovaries are benign (non-cancerous).

Risk factors for ovarian cancer

Your chances of developing ovarian cancer are higher:

  1. If you are over 40 years, especially over 50.
  2. If you have never had children.
  3. If you started menstruating early and had a late menopause.
  4. If there is a history of ovarian cancer in your family. However, 9 out of 10 women who develop ovarian cancer do not have any family history.
  5. If you have used fertility drugs e.g. Clomid.

Your chances are reduced:

  1. If you are less than 40 years.
  2. If you’ve been pregnant before – the more pregnancies you’ve had, the more you’re protected.
  3. If you have used oral contraceptives (the pill) before.

Early symptoms and signs of ovarian cancer

The popular misconception is that ovarian cancer does not cause any symptoms in the early stages. Unfortunately, many women have early symptoms that they or their doctor ignore. These include:

  • abdominal bloating
  • abdominal pain
  • constipation
  • indigestion
  • frequent urination

These early symptoms of ovarian cancer are non-specific (do not necessarily point to a specific disease) and are very easy to ignore. They are also easy to misdiagnose.

Symptoms and signs of advanced ovarian cancer

  • weight loss
  • swelling of the abdomen
  • tiredness
  • vaginal bleeding is not common with ovarian cancer, but may occur if :
    1. the tumor has spread to the uterus
    2. the tumor in the ovary produces estrogen which causes the lining of the uterus to thicken, this gets shed irregularly leading to bleeding
    3. difficulty in breathing
    4. varicose veins and/or swelling of the ankles .

Diagnosis of ovarian cancer

Your doctor will order some tests which will usually include an ultrasound scan of your pelvis and abdomen. A laparoscopy may be carried out. If the tumor is very large, an abdominal operation may be carried out to determine how large the tumor is and how far it has spread.

Ovarian cancer treatments

Treatment for ovarian cancer may involve:

  1. removal of the tumor (or as much of it as possible if the tumor is very widespread), through surgery. This may involve removing the uterus, fallopian tubes and bowel depending on the extent of the tumor.
  2. chemotherapy using anticancer drugs
  3. radiotherapy using a form of x-ray.

A combination of these is often used.

Outlook in ovarian cancer

Ovarian cancer responds much better to treatment in the early stages. If the tumor has not grown outside the ovary, chances of survival for up to 5 years after treatment are 60%. This drops to 20% if the tumor has already spread. It is important to take vague, non-specific symptoms seriously.

Early detection is the most important factor when it comes to survival rates. In spite of the various methods being investigated for use in early detection of ovarian cancer, a yearly transvaginal ultrasound scan remains the best option.

Postmenopausal hormone therapy and ovarian cancer- again!

HRT, Postmenopause, ovarian cancerWomen with moderate to severe menopause symptoms often consider hormone therapy to help ease them through various problems like hot flashes (flushes), night sweats and sore/tender breasts and nipples amongst others. If you’re considering this, the usual advice is to weigh the advantages and disadvantages before starting HRT (hormone replacement therapy).

New research published in the Journal of the American Medical Association suggests that women who are on hormone replacement therapy or have used HRT in the past are more likely to develop ovarian cancer.
Over 900,000 Danish women aged 50-79 years were followed up for 8 years. Women on hormone replacement therapy were found to have a 38 -44% increase in their chances of developing ovarian cancer compared to women who had never used HRT. For women who had come off hormone replacement 2 years earlier, the increased in risk was about 22% compared to women who had never used HRT.

The interesting thing was that after being off hormone therapy for 2-4 years, the risk for users of HRT dropped drastically and became equal to that of women who had never had any hormone replacement. The duration of hormone therapy and the type of hormone combination taken did not have any impact on the results.
Ovarian cancer is a rare disease but a very deadly one with low survival rates especially if diagnosed late. Because of its rarity, this increase in risk is very small when you consider the number of women that will actually develop the disease in their lifetime.

The fact remains that, like any other health care choices you make, taking hormones after menopause should be a decision you take based on the best information you can get and considering your personal and family health history.

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