Media fact sheet
Summary sheet for journalists
Ovarian cancer- The facts
Ovarian cancer is the second most common gynaecological cancer in the UK and is diagnosed in over 7,000 women a year. This page provides information about ovarian cancer in the UK.
Cancer can occur in the ovary at any age, although the most common type of ovarian cancer (epithelial) tends to occur in post-menopausal women. 90 per cent of cases occur in those over the age of 45.
Cervical screening tests – sometimes known as smear tests – will not detect ovarian cancer, only cervical cancer.
There is currently no screening programme for ovarian cancer.
Symptoms and diagnosis
The good news about ovarian cancer is that if diagnosed at an early stage, the outcome is good. However, because some of the symptoms of ovarian cancer are similar to those seen in more common conditions, it can be difficult to diagnose. Most women are not diagnosed until the disease has spread, which is why it is important that women know about the symptoms, so that they can seek advice as early as possible.
The three most common symptoms of ovarian cancer are:
- Bloating that is persistent and does not come and go
- Difficulty eating and feeling full more quickly
- Abdominal or pelvic pain that is experienced most days
These symptoms are frequently experienced by women, however when they are experienced frequently, persistantly and severely the likelihood of ovarian cancer increases. Other symptoms such as urinary symptoms, changes in bowel habit, extreme fatigue or back pain may also be experienced. Again, it is most likely that these symptoms are not ovarian cancer, but could still indicate the disease.
Ovacome has an online symptom tracker: www.ovacome.org.uk/symptom-checker.aspx
There are several ways that women are diagnosed. CA125 is a tumour marker; a protein found in the blood. It is not 100% specific or sensitive. This mean it may come back negative, but some ovarian cancers do not cause a rise in CA125, the result may be positive, but in fact no cancer is present. Other conditions will cause a rise in CA125 such as endometriosis, appendicitis, stress, flu etc. Sometimes an ultrasound scan or CT scan shows a tumour, other times the cancer is found during surgery.
Ovarian cancer- The risks
Most causes of ovarian cancer occur for unknown reasons, but about 10 per cent of ovarian cancers are thought to be caused by a faulty gene inherited from either parent. Researchers have also found that close relatives of women with ovarian cancer are slightly more likely to develop it themselves.
The two genes involved in familial breast cancer, BRCA1 and BRCA2, are also involved in familial ovarian cancer and many families are looking for information on the possibility of genetic testing for ovarian cancer. Around 10 per cent of ovarian cancer cases are thought to be genetic.
Genetic testing is a complex process. The two genes involved in ovarian cancer are BRCA1 and BRCA2, which are very long genes. Faults can occur at any points along the length and different families have different faults. The first step is to take a blood sample from a family member with ovarian or breast cancer and identify the fault from that sample. Genetic testing can then be offered to other family members if they want to know whether they have inherited the fault.
If you have a faulty BRCA1 or BRCA2 gene you are also at increased risk of breast cancer, and again the options are similar: You may be offered screening, a regular mammography to pick up any early breast cancer. You may also be offered surgery: a bilateral mastectomy to remove both breasts to prevent the development of breast cancer.
Types of ovarian cancer
There are many different kinds of ovarian cancer. The ovary has lots of different types of cells in it, each doing different jobs. It is when one of these cells ‘goes wrong’ that cancer starts. Mostly, the type of ovarian cancer is determined by which type of cell went wrong.
The majority of ovarian cancers are epithelial ovarian cancer. The epithelium is the surface of the ovary. There are many other, less common types of ovarian cancer including Clear cell, Germ Cell, and Borderline ovarian cancer. Borderlines are a slow growing type of ovarian cancer, and quite different.
For more information please visit: www.ovacome.org.uk/types-of-ovarian-cancer
The treatment and prognosis of ovarian cancer depends on several things. The type is one, but importantly, the stage of the cancer will determine the treatment given. The stage describes the spread of the cancer at the time of diagnosis and this should be established at the initial operation/scans.
Stage 1 The cancer is confined to the ovary, and has not spread.
Stage 2 The cancer is found in other sites in the pelvic organs
Stage 3 The cancer has spread to other areas of the abdomen
Stage 4 The cancer has reached more distant sites.
The stages are then further classified, a, b and c. These distinctions give a further indication of the particular state of the cancer at the time of diagnosis.
For more information please visit: www.ovacome.org.uk/staging-and-grades
There are two main treatments for ovarian cancer, surgery and chemotherapy. If a diagnosis of ovarian cancer has been made using scans, a surgeon will look closely at the results and discuss which options are best for the woman affected.
The object of surgery is to remove as much tumour as possible without causing any damage to the surrounding organs. For this reason, it is not always possible to remove 100% of the tumour. Where possible, the surgeon will do a hysterectomy (removal of the womb, or uterus) and a Salpingo-oophrectomy (Removal of the ovaries and fallopian tubes).
Some surgeons like to do the operation first, whilst other believe that it is better to try to reduce the tumours with Chemotherapy, and operate later. Following surgery most women are in hospital for a week, and will need several weeks of convalescence at home. Heavy lifting and driving are to be avoided for 4-6 weeks.
In some cases chemotherapy will be advised, either to kill any remaining cancer cells left after surgery, or to prepare for surgery.
Chemotherapy is a type of drug which kills cancer cells. It is prescribed by a doctor, called an Oncologist. There are many different types of chemotherapy, and the oncologist will discuss the various options available. Most chemotherapy’s for ovarian cancer are given as an intravenous infusion, at the hospital. The side effects of the different chemotherapy’s vary.
You can find our more information about treatments and side effects on our website: www.ovacome.org.uk/treatment
About remission and relapse
Survival in ovarian cancer is particularly poor. 5 year survival for the disease varies from 30 – 40% (depending on your datasource) Survival is different for different types and stages, with stage 4 disease having a 5 year survival rate of 4%.
In most cases the chemotherapy is able to shrink the tumour till there is no evidence of active cancer left. This is called a complete remission. Sometimes a small amount is still left at the end of treatment, and this is called a partial remission. In a small number of cases, the cancer cells resist the chemotherapy, and the disease does not improve. If this happens, the oncologist will change the type of chemotherapy. After completing treatment, women will be closely monitored, and attend the hospital at regular intervals to check that the cancer has not come back. The frequency of these checks lessens, but the oncologist will always be happy to see someone if they have concerns in between appointments.
Although ovarian cancer is frequently controlled by chemotherapy (that is, put into remission) very often it will come back. This is called a relapse, or recurrence. It is difficult to predict how long the benefits of the chemotherapy will last, for some women only a few months, for others remission continues for over 5 years, and they are considered cured.
If the cancer returns after the initial (first line) chemotherapy, the oncologist will suggest another course (second line). The aim here is to achieve as long a remission as possible. Some women go on to have successful third and fourth line treatment sometimes more. At all times, the treatment options and decisions will be made taking the woman’s aims and wishes into account.
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