Ovarian cancer

Ovarian cancer is often referred to as a 'silent killer', and for good reason.

Common symptoms are similar to other conditions, imitating anything from a urinary tract infection to irritable bowel syndrome, making it difficult to detect ovarian cancer in its early stages.

While ovarian cancer is not considered common (it is the 9th most common cancer for Australian women), due to low early detection rates survival rates are also low, with a 5-year survival rate being less than 50%.¹

"Ovarian cancer is rare, and the symptoms can be caused by other, less serious conditions, but they should still be investigated," says Bridget Bradhurst, Ovarian Cancer Support and Advocacy Nurse at Ovarian Cancer Australia.

Some people with ovarian cancer will experience mild to no symptoms. However, some signs include:

• abdominal bloating
• difficulty eating or feeling full quickly
• frequent or urgent urination
• back, abdominal or pelvic pain
• constipation or diarrhoea
• menstrual irregularities
• tiredness
• indigestion
• pain during intercourse
• unexplained weight loss or weight gain.²

Having vague symptoms (such as bloating, pelvic or belly pain, loss of appetite or feeling full quickly, and changes to urination) may result in multiple doctor visits and countless tests to get to the bottom of your symptoms, but they shouldn't be dismissed.

Some factors that increase your risk for ovarian cancer include:

• age (risk increases for people over 50)
• family history of ovarian, breast or bowel cancer
• inherited BRCA1 or BRCA2 gene mutations
• being of Ashkenazi Jewish descent
• early onset of periods (before 12 years) and late menopause
• not having had children, or having your first child after the age of 35
• using oestrogen only hormone replacement therapy or fertility treatment.²

There is currently no dedicated test for ovarian cancer.

While some people assume that a cervical screening test checks for all gynaecological cancers, it does not detect ovarian cancer. Furthermore, the human papilloma virus (HPV) vaccine only provides protection against cervical cancer, not ovarian.

"There is a lot of research going on in this space to find an effective method that can detect ovarian cancer at an early stage," says Bradhurst.

"We recommend that if symptoms are unusual for you and persistent, that you see your local doctor to assist in investigating them. This may include a blood test and transvaginal ultrasound to rule out ovarian cancer."

There are things that may lower the risk of ovarian cancer.

"We know that some protective factors for ovarian cancer can include having given birth, breastfeeding and using birth control as well as risk reduction surgery (removing the fallopian tubes or ovaries) for those identified as high risk. However, these things may not be recommended for everybody," says Bradhurst.

A study in the 'Journal of the American Medical Association' reported that people with the BRCA-positive gene (which puts them at a higher risk of ovarian cancer) live longer if they have their ovaries removed. But is this an option?

"For some people at higher risk there is the surgical option to remove their ovaries."

Some studies suggest that taking oral contraception could decrease the risk.

One scoping paper, which examined the results of 55 studies, found "significant reduction in ovarian cancer incidence" in oral contraceptive 'ever-users' compared to 'never-users', and the duration of use also decreased the risk of ovarian cancer.³ So, what is it in oral contraception that seems to have this effect on ovarian cancer?

Research suggests it could be progesterone (a hormone produced in the ovaries that peaks during pregnancy and while on some forms of contraception) that is responsible for the decrease in ovarian cancer risk.⁴ Some studies have also revealed that progesterone may even destroy cancer cells.⁵

Discuss the possible risks and benefits with your doctor before beginning any new medication.

With no effective screening method there's no denying more needs to be done to be able to identify ovarian cancer earlier and to find more effective treatment options for those who are diagnosed.

Cancer Council have an online booklet for people wanting to know more about ovarian cancer risk factors and treatments.

Ovarian Cancer Australia provides support services to ovarian cancer patients and carers.