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Ovarian Cancer

About the Condition

Cancer of the ovary affects more than 6,500 women in the UK each year. It is the fifth most common cancer among women, and is usually diagnosed in women who have gone through the menopause (usually over the age of 50), although it can affect women of any age*.


Ovarian cancer occurs when the genetic material of cells in the ovary become damaged or changed, producing mutations that affect normal cell growth and division. The abnormal cells then replicate, causing cancer. If undetected, the cancer can spread beyond the ovaries and move to other parts of the body. This disease is one of a group known as gynaecological cancer, all of which affect different parts of the female reproductive system.


The precise causes of ovarian cancer are unknown, but several risk factors have been identified. These include:
 

  • Family history - If you have two or more close relatives (mother, sister or daughter) who developed ovarian cancer or breast cancer, you may be at higher risk of developing the condition.
  • Fertility and egg release - Every time an egg is released into the reproductive system, the surface of the ovary has to break to let it out. As the surface of your ovary is damaged during this process, it needs to be repaired. Every time this happens, there is a greater chance of abnormal cell growth during the repair. This may be why the risk of ovarian cancer decreases if you take the contraceptive pill, or have multiple pregnancies or periods of breastfeeding, as during this time eggs will not be released.
  • Hormone replacement therapy (HRT) - Women who take hormone replacement therapy (HRT) have been shown to have a small increased risk of ovarian cancer. However, if HRT is stopped, after five years the risk is reduced to the same level as women who have never taken HRT.
  • Endometriosis - this is a condition where cells that usually line the womb grow elsewhere in the body, and cause pain, swelling and bleeding in the affected area. Endometriosis may increase the risk of ovarian cancer.

 

Symptoms

The symptoms of ovarian cancer can be difficult to recognise, particularly in early stages of the disease. This is because they are often the same as symptoms of other less serious conditions, such as irritable bowel syndrome (IBS) or pre-menstrual syndrome (PMS). However, the following three main symptoms are more frequent in women diagnosed with ovarian cancer:
 

  • increased abdominal size and persistent bloating (not bloating that comes and goes)
  • persistent pelvic and abdominal pain
  • difficulty eating and feeling full quickly, or feeling nauseous


Other symptoms, such as back pain and needing to pass urine more urgently and frequently than normal, may be the result of other conditions in the pelvic area. They are probably not ovarian cancer, but may be present in some women with the disease.


If any of these symptoms apply to you, or if you have any concerns about similar symptoms, it is essential that you see your doctor at once, as your chances of recovery are much higher if your cancer is diagnosed early.

 

Diagnosis

If you’re referred to CCL for diagnosis, your consultant or oncologist will advise you on which tests are relevant to your individual symptoms. As the symptoms of ovarian cancer can also indicate several other conditions, it is important that a variety of tests are conducted to obtain an accurate diagnosis. These will include:
 

  • A vaginal or internal examination
  • A blood test to look for a chemical called CA125 in the blood. This chemical is produced by some ovarian cancer cells. A very high level of CA125 in the blood may mean you have ovarian cancer.
  • A Computerised Tomography (CT) scan, which shows a 3D image of the area being looked at
  • An Ultrasound scan, which uses high frequency sound waves to look inside the body and produce live images on a computer display.
  • A Magnetic Resonance Imaging (MRI) scan, which is a procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body
  • A laparoscopy, which is where a small incision is made in your abdomen under general anaesthetic and a flexible camera called an endoscope is used to examine your liver
  • An Abdominal Fluid Aspiration, which is where a thin needle is passed into your abdomen to take a sample of fluid to be tested for cancer cells. 
  • An X-ray, which is when low level radiation is used to create an image of the body

 

Staging

When ovarian cancer is diagnosed, the doctors will give it a stage. This is often based on surgical findings. The stage describes the size of the cancer and how far it has spread.

Ovarian cancer has four commonly used stages:
 

  • stage 1 – the cancer only affects one or both of the ovaries
  • stage 2 – the cancer has spread from the ovary and into the pelvis or uterus
  • stage 3 – the cancer has spread to the lining of the abdomen, the surface of the bowel and the lymph nodes in the pelvis
  • stage 4 – the cancer has spread to other parts of the body such as the liver, spleen or lungs 

 

Grading

The grade of cancer refers to the appearance of cells under a microscope.
 

  • low grade – although abnormal, cells appear to be slow-growing
  • moderate grade – cells look more abnormal than low-grade cells
  • high grade – cells look very abnormal and are likely to be fast-growing

 

Treatment

At CCL, patients with ovarian cancer are usually treated by a team of different specialists, called a Multi-Disciplinary Team, or MDT. This team works together to create a treatment plan to suit the individual needs of the patient. The main treatments for ovarian cancer are:
 

  • surgery, which will probably involve removing:
    • both ovaries and the fallopian tubes (called a bilateral salpingo-oophorectomy)
    • the uterus (called a total abdominal hysterectomy)
    • the omentum, a fatty layer of tissue within the abdomen (called an omentectomy)
    • The surgeon may also remove the lymph nodes from the pelvis and abdomen. They may also take samples of nearby tissue and send it to the laboratory to see if the cancer has spread. If the cancer has spread, the surgeon will try to remove as much of it as possible. This is known as debulking surgery.
  • chemotherapy


The treatment you have will depend on the stage your cancer has reached.

 

Support Services

Cancer doesn’t just leave a physical impact on an individual, it can have a huge emotional effect as well. Cancer and its treatment can be overwhelming, causing a wide variety of emotions, and it is important to remember that there is no right or wrong response. Reactions vary hugely from person to person, and most people find that it becomes easier to cope when they’re given additional support, so that’s what we do.


At CCL we provide support that caters to both the physical and emotional needs of the patient, before, during and after treatment. We offer a wide range of services for patients, as well as their loved ones, designed to make a very difficult time as easy as possible, and to give our patients the best treatment and support possible.


Following treatment for ovarian cancer, many women have concerns about their sexual health and fertility, and may be experiencing physiological and emotional changes that can be difficult to deal with. CCL provides fertility specialists and psychosexual therapists to help women adapt and adjust to these changes.

 

 

 

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