‘The family history has an important role’ – Early signs and symptoms of ovarian cancer

Sophie Collins

Knowing the symptoms is key for early detection and improved outcomes

Dr. Patricia Pantilie, a Surgical Registrar and Fellow in Endometriosis under Mr. Waseem Kamran at Beacon Hospital, spoke to Her.ie on the importance of recognising ovarian cancer during March, Ovarian Cancer Awareness Month.

Despite being less discussed than other cancers, ovarian cancer presents a significant health concern, particularly in Ireland.

It currently ranks among the highest incidences in Europe, with 390 new diagnoses every year and approximately 269 deaths each year.

Understanding Ovarian Cancer

Ovarian cancer originates in the ovaries, which are essential components of the female reproductive system, responsible for ovulation.

When abnormal cells begin to proliferate within the ovaries, they form tumours.

While the exact cause remains unknown, Dr. Patricia Pantilie said that certain risk factors are associated with increased susceptibility, such as:

age
family history of cancer (especially breast or ovarian cancer)
obesity, hormone replacement therapy (HRT)
fertility treatments
genetic predispositions like BRCA1 and BRCA2 mutations

“The family history has an important role, and the risk of developing ovarian cancer increases with every member diagnosed with breast or ovarian cancer.

“Defective genes that have been liked to both breast cancer and ovarian cancer are BRCA1 and BRCA2. Several other gene changes are known to increase the risk of ovarian cancer, including gene changes associated with Lynch syndrome.

“Also, an Eastern European (Ashkenazi) Jewish background and a previous diagnosis of endometriosis are also considered risk factors.”

Recognising Symptoms

Early-stage ovarian cancer often presents no noticeable symptoms, making detection challenging.

As the disease progresses, symptoms may include bloating, abdominal discomfort, nausea, changes in bowel habits, fatigue, and irregular bleeding.

However, these symptoms are non-specific and may mimic other conditions, underscoring the importance of regular check-ups and awareness.

Dr. Pantilie went on to say: “Assess your own personal risk factors – Family history of breast or ovarian cancer is very important when assessing your own personal risk of developing cancer.

“You should discuss this with your doctor as you may require a referral to a genetic counsellor who can advise you if genetic testing will be required in your case.”

Diagnosis and Treatment

Dr. Pantilie said that diagnosing ovarian cancer typically involves imaging tests such as ultrasound, CT scans, MRI scans, and blood tests to assess tumour markers like CA125.

However, there are no standardised screening tests for ovarian cancer.

If abnormalities are detected, further diagnostic procedures such as biopsies or surgeries may be necessary, Dr. Pantilie said.

Treatment options also vary depending on factors like tumour size, stage, and grade, often involving a combination of surgery, chemotherapy, and radiotherapy, the Surgical Registrar explained.

“There are 4 stages of the disease,” Dr. Pantilie explained, “and they are used to reflect, from 1-4, if the cancer is only limited to the ovaries (1), has it spread to nearby organs and tissues (2), has it spread to the rest of the abdomen, (3) lungs, liver or other lymph nodes in the chest, neck or armpits (4).”

Prognosis and Prevention

Despite the challenges, advancements in treatment have improved survival rates.

According to statistics, the survival rate for ovarian cancer patients surpasses 50% at the five-year mark post-diagnosis.

While there are no foolproof methods for preventing ovarian cancer, certain measures may mitigate risk, including:

maintaining a healthy weight
considering oral contraceptives (with careful consideration of associated risks)
undergoing genetic testing, especially for those with a family history of cancer or known genetic mutations

Raising awareness about ovarian cancer is crucial for early detection and improved outcomes.

By understanding the symptoms, risk factors, and diagnostic procedures associated with ovarian cancer, individuals can take proactive steps toward prevention and timely intervention.

Through ongoing research, education, and advocacy efforts, we can strive to reduce the burden of ovarian cancer and improve the quality of life for affected patients.