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Ovarian Cancer

  • What is Ovarian Cancer?

    ovarian cancer

    Ovarian cancer refers to malignant growth arising from different parts of the ovaries. The ovaries are part of a woman’s reproductive system, where the eggs are developed. Most ovarian cancers are classified as ‘epithelial’ – arising from the surface of the ovary. Other types arise from the egg cells (germ cell tumour) or supporting cells (sex cord/stromal).

    What Causes This Cancer and Who are at risk?

    The risk factors of ovarian cancer include:

    • Late pregnancy
    • Early onset of menstruation
    • Late menopause
    • Never had children
    • History of breast cancer
    • Genetic predisposition
    • Endometriosis, where tissue that normally lines the inside of the uterus grows outside instead

    Ovarian cancer is the 5th most common cancer among women in Singapore. There were a total of 1,506 cases diagnosed from year 2007 to 2011 based on the Singapore Cancer Registry Annual Registry Report. It is the second most common female genital tract cancer.

    Age of Onset

    Epithelial ovarian cancer usually affects older women although it can also happen to younger women. Germ cell cancers of the ovary occur more frequently in younger women.

    Ovarian cancer is known to run in some families with BRCA gene abnormalities or Lynch syndrome. Families with BRCA gene abnormalities may have increased risk of getting ovarian, breast and uterine cancer. Families with Lynch syndrome may have increased risk of getting ovarian, uterine and colorectal cancer. In this case, women with a sister or mother with Lynch syndrome are 20 times more likely to develop ovarian cancer. 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 diseases.

  • Ovarian Cancer Signs & Symptoms

    Early ovarian cancer rarely has symptoms or signs. Symptoms tend to develop only in the advanced stages of ovarian cancer, they include:

    infographic of ovarian cancer symptoms
    • Abdominal swelling and discomfort
    • Bloating
    • Persistent indigestion, gas or nausea
    • Changes in bowel habits, such as constipation
    • Loss of appetite
    • Back pain
  • Ovarian Cancer Diagnosis & Assessment

    ovarian cancer diagnosis using ultrasound

    CA 125 Blood Test

    CA 125 is a protein found on the surface of ovarian cancer cells and certain healthy tissue. The level of CA 125 is raised in about 80% of patients with epithelial ovarian cancers. However, it is not always indicative of ovarian cancer and not adequate for its diagnosis as the level of CA 125 can also be raised in conditions such as endometriosis and appendicitis.

     

    Ultrasound Scan

    You may have an internal ultrasound (known as a transvaginal ultrasound), where the ultrasound probe is inserted into the vagina. There is also the option of an external ultrasound, where the probe is put next to your stomach. The ultrasound image can show the size and texture of the ovaries, as well as any cysts that may be present.

    Pelvic Examination

    The doctor can inspect the genitals (vulva), vagina, uterus and ovaries for unusual changes.

    CT Scan / MRI Scan

    These imaging scans of the abdomen, chest and pelvis help to look for signs of cancer in the body.

    Chest X-rays

    These are useful in detecting whether other areas of the body such as the lungs are affected by the cancer.

    Surgery / Biopsy

    An operation or biopsy is required to prove that affected cells are cancerous.

  • Treatment & Care for Ovarian Cancer

    What treatment is offered?

    To determine the actual extent of the cancer, surgical exploration or ‘staging’ of the cancer is required. To do so, the doctor conduct surgery to 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. 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 the ovaries, the uterus and its surrounding lymphatics.

    chemotherapy

    Additional treatment following surgery will be determined by the stage of the disease, the grade of the disease and the type of cancer.

    For very early stage or non-aggressive cancer, further treatment may not be required. For more advanced and aggressive cancer, chemotherapy may be the treatment of choice.

    Prognosis of Ovarian Cancer

    Treatment tends to be highly effective for ovarian cancer in the early stage, and very difficult in the late stage of the cancer. However, survival has increased in the last 10-20 years due to better chemotherapy.