01/03/2012 12:00

Focus on ovarian cancer

Six thousand five hundred women are diagnosed with ovarian cancer every year. To mark Ovarian Cancer Awareness Month, we've got the lowdown on the fifth most common type of female cancer.


Doctor and patient (© Getty Images)

Many people aren't aware of the symptoms of ovarian cancer, but knowing them is key to early diagnosis. "The symptoms of ovarian cancer are persistent pelvic and stomach pain, increased abdominal size, persistent bloating that comes and goes, and difficulty eating and feeling full quickly," says Tania Pearson at Ovarian Cancer Action. "Occasionally other symptoms such as urinary problems, changes in bowel habit, extreme fatigue or back pain may also be experienced on their own or at the same time as those listed above. If a woman experiences any symptoms that are unusual, she should ask her GP to investigate."

The location of the ovaries means that symptoms are often related to the menstrual cycle. "Because the ovaries are intimately associated with menstruation this type of cancer can also cause irregular periods or bleeding and possible discomfort during sex," says Bill, a nurse specialist at Macmillan. "The position of the ovaries near the pelvis also means that that they can affect other body functions if a tumour or swelling presses on the other organs nearby. That kind of pressure might show up as constipation, back pain or difficulty with passing water."

Early diagnosis is crucial when it comes to ovarian cancer. "Ovarian cancer is a very challenging disease to treat, primarily because most women (75%) are diagnosed once the disease has spread," explains Alex at Target Ovarian Cancer. "Treatment for ovarian cancer includes surgery and usually chemotherapy. In this sense it's not dissimilar to other cancers. Radiotherapy is not generally used except to relieve certain symptoms. However, whilst other cancers have seen improvements in treatments, there have been no new life-extending treatments in ovarian cancer in over 20 years."

While it's true that women who take the pill are less likely to develop ovarian cancer, there's a bigger picture to consider. "Long-term use of the oral contraceptive pill lowers the risk of a woman developing ovarian cancer, but it can increase the risk of other cancers," points out Alex at Target Ovarian Cancer. "For this reason, it's important that women discuss any concerns they have with their doctor. Taking the pill for five years or more does not necessarily stop you developing ovarian cancer, but it reduces the possibility."

It's thought that part of the reason for the high number of cases of ovarian cancer in the western world could be linked to the fact more and more women are having children later in life. "Having children has a protective effect against ovarian cancer," says Tania at Ovarian Cancer Action. "The fewer menstrual cycles a woman has, the less 'wear and tear' her ovaries receive over the course of her lifetime. In developed countries, women often postpone motherhood until later in adult life or choose not to have children."

As with other types of cancer, knowing about your family's medical history can make a huge difference. "Women who are known to be at high risk of developing the disease because of a family connection sometimes have their ovaries and fallopian tubes removed," says Alex at Target Ovarian Cancer. "This is known to reduce the risk by 90%. Women who have two or more family members on the same side who have had ovarian cancer and/or breast cancer are at increased risk. That's why it's important for women to understand their family history, and to seek advice if necessary."

Although ovarian cancer can affect women of any age, women over the age of 40 are most at risk, as are those where there's a family history of cancer. "Some ovarian cancers are caused by an inherited faulty gene that can be passed down family lines, through both women and men," explains Tania. "In particular, there are two faulty genes that have been identified as causes of ovarian cancer, named BRCA1 and BRCA2. These same genes are responsible for hereditary breast cancer. Consequently, there are families where a number of relatives may develop ovarian, breast or both breast and ovarian cancer. "

Many people underestimate how common ovarian cancer is but in the UK, around 6,500 cases are diagnosed each year, and survival rates are worringly low. "A recent international benchmarking study published in The Lancet showed that women in the UK are less likely than women in comparable countries to survive ovarian cancer longer than one year from diagnosis," says Tania. "In fact, survival rates of UK woman rank seventh in Europe. Only 41% of women diagnosed with ovarian cancer in the UK will survive five years."

However, if the cancer is detected early, the statistics are very different. "The evidence points to early diagnosis being key to improving UK women's survival rates for ovarian cancer," says Tania. "90% of women will survive longer than five years if diagnosed at the earliest stage of the disease. Unfortunately, there is very low awareness amongst UK women that ovarian cancer has symptoms and GPs may not always recognise the symptoms as indicative of the disease."

Although the link between diet and ovarian cancer isn't clear, it's common knowledge that being overweight increases your chances of developing cancers of the breast and womb, and can also increase your chances of developing a more aggressive type of ovarian cancer. "We do know that the incidence is lower in Mediterranean countries, compared with Nordic countries," says Dr Sean Kehoe, medical adviser to the ovarian cancer charity Ovacome. "This could be down to diet, genes, or the environment."

Ovarian Cancer Awareness Month last from 1 to 31 March. For more information and help visit www.ovarian.org.uk.

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24Comments
02/03/2012 08:28
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I'm so glad they're raising awareness of this so-called 'silent killer'. I lost my sister to ovarian cancer when she was 17 years old. It was 24 years ago, when I was 16. It only got diagnsed when she complained of pain in her legs. After being sent for physio, it was found that she she had thrombosis in both thighs. Tests were done, and were were told she had cancer, and that it was terminal. She died around 8 weeks later. Five years ago, I lost a good friend who developed secondary cancer after having ovarian cancer. If anyone reads this and thinks they have these symptoms, PLEASE go to the doctors. Don't feel that you're wasting you GP's time. It could save your life.
02/03/2012 11:44
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hi .. iv been battling this cancer now for 2 years ,,for over a year i kept telling my doctor i wasn't feeling well and was bleeding all the time sex hurt when we tried ,, i lost so much weight my doctor just didn't seem to care how i was feeling kept telling me it is nothing ,i knew there was some think wrong but the docs kept saying nothing to worry about ,, then we had a new doctor at how surgery sent me for tests straight away found out i had cancer iv had my womb taken away now , about 3 months ago just found out it as not gone ,, now iv just started radiotherapy yesterday .. i am really mad with my doctor for levering me for so long what mad it worse the doctor as never liked me or my family and makes me feel like he's just left me to die ,I'm only 33 have 2 lovely girls at 7,,10, ,,so much as happened since iv been ill the things the hospital have put me thou touching my heart with a camera leveing needles in my arm sending me home iv been thou hell because of the doctor not care in for  is thers patients so much more to say just not enough time ,,
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I lost a dear friend to this disease just before Christmas last year.

 

Please take heed of the advice here - and that goes for GP's too.  She had gone to her GP and was  dismissed as being "neurotic" as her mother had also had ovarian cancer and the GP said she was naturally worried but for no real reason.  She knew there was something not right but 18 months later when she returned to him and he finally referred her, she had 2 tumours, one the size of the grapefruit and was told she had terminal cancer.

 

This brave lady fought for over 5 years to stay as long as she could with her young family.  If you ever have any doubt, insist the GP sends you for a simple ultrasound.  It literally could mean the difference between life and death.

 

02/03/2012 13:22
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Women should also check for vulva cancer my daughter died at 31 she knew something was wrong but was misdiagnosed by doctors and nurses who didn't listen. My daughter went for smears which came back abnormal but they still did no further investigations. My daughter lived in pain for years before she was diagnosed and by the time she was diagnosed it was too late for her. Please don't let it be too late for you if you have any fears something is not right please insist on further tests and scans.
02/03/2012 12:09
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because this cancer is hard to detect i think there should be regular screening like there is for cervical cancer this would save money for the nhs in the long run as early detection is far better.
02/03/2012 18:01
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I was diagnosed with stage 1c ovarian cancer almost 3 years ago but my CA125 came back within the normal range and is not an effective or reliable screening tool. I had a full hysterectomy and 6 cycles of chemotherapy and thankfully i am now in remission. We need to raise awareness of this disease on the same scale as the Breast cancer awareness scheme then more women can be saved.
02/03/2012 11:53
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from comments I have read, there is one conclusion, it is not that women do not want to go to the doctor and tell him/her that something is not right, the problem with diagnosing this and many other types of cancer lies with doctors themselves. they are very reluctant to take what you say seriously and to refer you for further examinations or to a specialist. This is more frustrating that anything else. Even the recent campaing 'Let's be clear' seems a waste, cos when you go to the doctor they just tell you it is nothing to worry about and you just being paranoid.
02/03/2012 14:26
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To repeat the other blogs - please, please, be aware of the symptoms of ovarian cancer. Insist on tests, if you are remotely concerned, even if it is just the CA125 blood marker test. Although not conclusive, at least they will then do further tests, if you know to ask! It could just save your life. I had no idea of ovarian cancer and was being treated at a hospital for (you've guessed it) bloating and feeling full, etc. The first raised CA125 (228) was noted in May last year and nothing done, or even commented on to me. The second time the CA125 was tested was in September, by which time it  was 1600. The doctor then said he was going to refer me for a further test, but gave me no indication that anything serious could be going on. I finally got the test/referral in December, when I was diagnosed with stage 3c and CA125 was 3600. I am sooooo angry at the hospital for not picking it up sooner and mostly for not giving me a warning in September, so that I could make sure I did not wait too long for the appointment. Having recently moved, I had a lot on my plate and put tiredness & feeling out-of-sorts down to that. By the time I was diagnosed, referred to the Cancer Centre for my area and was seen, it was this February before I had the operation. If only someone had said something last May!!

I am now waiting to start Chemotherapy next week, with only a 40% chance of living for 5 years. This is not the retirement I had envisaged when I stopped working 2 years ago. I am now 66.

Please talk to any other women you know, to make them aware. Don't leave it to the doctors - look after yourself!!

02/03/2012 11:01
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My wife got ovarian cancer and although she complained to her doctor several times about the fatigue and stomach pains, the doctors did not send her further tests. It was only when the growth reached the size of  a melon that the doctors send her for tests to the hospital.

 

Is Ovarian cancer so difficult to detect ?

 

 

02/03/2012 12:53
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I agree with squif that there should be screening as with cervical smears. I've been found to have the BRAC1 gene so will automatically be sreened for ovarian and breast cancer indefinately which gives me some peace of mind and I believe I'm lucky. GP's must be re-educated and if a woman goes with the common symptons of ovarian cancer then what is the harm in referring them for a simple ultrasound & blood test that takes 10 mins instead of dismissing them. No wonder Great Britain has some of the poorest survival percentages for cancer of all types if the GP's aren't proactive.
02/03/2012 16:13
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my story is different,i went to my gp because i could feel something moving inside my abdomen when i exercised.i had all the usual bloating but put that down to bad diet and didnt mention that. My gp sent me to see a surgeon straight away,who did the ca125 test which was 188,not that high,but was acted on, i then had an urgent ct scan which showed a 16cm cyst.Before i knew it i was sent to a hospital that specialises in gynae cancers and a week later had a hysterectomy and my ovaries removed.test revealed i had stage 1a ovarian cancer,and needed no further treatment.i was extremely lucky and urge any woman to insist on a ca125 test. if she has symptoms.Its a simple blood test,its not a clear indicator but its something to go on and it could save your life.
02/03/2012 16:01
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We are all hearing the same story of failed and late diagnosis over and over from family, friends, and relatives, with the result of much time wasted in unnecessary repeat visits to GPs. Surely the demand for GP time can be reduced, and therefore the number of GPs reduced as follows: Number of generalists needs to go DOWN; number of specialists needs to go UP. Money spent on screening equipment, centres, labs, and specialist medical people (to operate that equipment and do tests in those labs) needs to go UP. Many GPs need to be retrained and reallocated into more specialist areas of health expertise, instead of being used only as generalists (who know nothing about everything) who are largely devoted to "reassuring" people that they don't need any tests. The attempt at reassurance WONT WORK if 3 neighbours or family members died in the last year due to late diagnosis, all having been similarly sent away with nothing more than reassurance. We patients already know that there may well be nothing serious wrong with us, but still we would be much better reassured and much less likely to become time wasters if the system could be rebalanced so that there was less talking and more precautionary "just in case" testing. System needds rebalancing. Much of GP time is wasted in attempts to reassure people who could be far more quickly reassured in a rebalanced health system.
02/03/2012 22:39
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In May last year I discovered a mass in my stomach and had severe abdominal pain , after a visit to the doctor he decided to treat me for constipation that was until June when i decided to change doctor as the pain was getting worse and the first doctor didn't seem worried about it  , the second doctor agreed with me that the mass wasn't normal and referred me for scans , it was only after a full hysterectomy in October to remove the mass and a biopsy that they found out I had clear cell ovarian cancer. That was in November , I was graded at stage 2c , i'm currently going through chemo just now and get my last one next friday (9th) , I see the consultant on 21st to find out whether the chemo has worked , so at the moment i'm sitting with fingers crossed hoping that i'm going to get the news i want to hear ,  That i'm in remission x 
02/03/2012 14:39
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For a guide to symptoms go to 'Target Ovarian Cancer' dot org dot uk. (I cannot put a link on here). They have a page devoted to them and a symptom tracker to use.

 

BE AWARE and tell all the women you know and ask them to pass the info on.

02/03/2012 13:10
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@Anna. YOu're right to an extent, but it took a fair bit of testing with my sister to find the cancer, probably because they couldn't believe that a 17 year old had it in her ovaries.

 

@Squif  I agree, there should be some sort of screening, but as I understand it, women will only be screened if thre's a history of breast and/or ovarian cancer within the close family. I am very aware of the symptoms of both cancers myself, because there is a history in the family, though not close enough family to warrant me being screened

 

@Michelle Harrison  I'm heartbroken to read your story, what a thing for you and your young family to have to go through! I feel your frustration and anger totally. Love and hugs x

 

@Denise. Cancer is within all of us, but there are various things that can trigger it off. The specialist who treated my sister thinks that a bank raid where she was badly traumatised triggered it in her. THat happened 6 months before she died

02/03/2012 17:15
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i went to the docs this morning with symtoms much the same he said it could be a cyst and sending me for a scan im a bit scared now :-( hope he dont take too long for my scan
02/03/2012 13:06
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The Laura Crane Youth Cancer Trust, this year is funding vital research into Ovarian and testicular cancers.

YORKSHIRE CHARITY TO RAISE FUNDS FOR RESEARCH INTO A RARE CANCER

AFFECTING YOUNG PEOPLE

     A Yorkshire charity has pledged to raise funds for research into a rare cancer, as many teenagers and young adults are potentially missing out on vital treatment due to a lack of understanding of cancer in this age group.

     As part of its ongoing fight against cancer in young people, the Laura Crane Youth Cancer Trust (LCYCT) has pledged to raise funds into research to help establish the best form of treatment for young adults with Germ Cell Tumours (GCTs). GCTs usually affect the testes and ovaries or gonads as they are collectively referred to.  Although rare, tumours in the gonads are amongst the most common cancer in adolescents.

     Unfortunately GCTs in this age group are often overlooked as medical teams focus more on children, older adults or specifically men or women, which means treatment for adolescents is poorly understood and often undertaken on wards that aren’t tailored to young patients’ needs.

     The research is being led by a team based in Leeds and Huddersfield on behalf of the NCRI Testis CSG, the Gynaecological CSG and the Teenage and Young People CSG, and also involves collaborations with laboratories and clinical teams from across the UK, as well as centres and specialists in Europe and USA.

Dr Johnathan Joffe, Consultant Medical Oncologist at Huddersfield Royal Infirmary and Leeds, is part of the team coordinating the research. He said: “The research will, for the first time, explain why these tumours behave differently in different age groups and will demonstrate the optimal way to treat and cure more patients with these cancers. It will also hopefully put an end to the separate approaches currently being used by cancer teams.”

   The charity has created a fun, but serious viral promotional film featuring Huddersfield-born Rugby League players and charity ambassadors Andy Raleigh and Keith Senior, to highlight the Trust’s pioneering funding venture.  

     To view the promotional film  on its website www.lauracranetrust.org  or text GNAD42 2 to 70070 to donate £2 and pledge your support to the campaign.



04/03/2012 00:01
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my wife had been bleeding since may 2006, went to doctors, dr said it was her hormones, even though her sister died of cervical cancer and her brother died of stomach cancer and her father died of bowel cancer, now my wife bled frequently , and the dr gave her pills to try and stop it but they never worked, then the dr put the coil in, but that never worked either, plus she was having pain in her hip , she was having to use crutches , so in november of that year the dr decided to take the coil out and while she was doing so said you are bleeding heavily, so she arranged an appointment with a gyno ,my wife went into hospital in december had a hystorectomy and found out she had cancer ,they could'nt get rid of it all ,to cut along story short , she had treatments of chemo and radiotherapy, over 3 years had to have a colostomy, was in serious pain in that time, but hard as she fought it she died in oct 2009, now why couldn't they have given her a scan when the symptons were first showing considering her family history, i miss her so much.
03/03/2012 01:35
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Thank you for that article Tamara Hinson. For far too many years we were told there were no symptoms which was why ovarian cancer was usually found when it was too late. I admit the symptoms could easily be caused by other ailments but what price a scan when lives are at stake?
03/03/2012 01:30
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I was lucky many years ago when a large ovarian cyst caused trouble and early cervical cancer was detected only when I became hospitalised. The cyst itself was benign.

I thank my then GP who thought he had felt a lump when he examined me earlier and told me to come back after the pain had subsided to complete the examination.  He could have so easily have just said come back if you get any more pain, and time would have dragged on. 

 I had a hysterectomy within four weeks later.

Angela, I am so angry too, for you and all the others who waited unnecessarily, while test results languished unattended. Whatever the final results, these delays make you feel uncared for.

I hope with all my heart that you get many good years of retirement. xx

Good luck to you too, Sharon.

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