Ovarian cancer

What is ovarian cancer?

The ovaries are part of the female reproductive system and store eggs. They are almond-shaped organs and there’s one located on each side of the uterus (womb).

Ovarian cancer is one of the most common types of cancer in women. It’s caused by changes inside the ovaries. It mainly affects women over the age of 50 who’ve been through the menopause. But in certain cases it can affect younger women too.

Ovarian cancer symptoms

Common ovarian cancer symptoms are:

• A constant feeling of being bloated

• A swollen tummy (abdomen)

• Pain in the pelvis or abdominal area

• Needing to urinate frequently

• Feeling extremely full after small meals

In certain cases, other ovarian cancer symptoms may be experienced, like:

• Regular indigestion

• Nausea

• Pain during sex

• A change in your bowel habits

• Pain in your back

• Persistent tiredness

• Unintentional weight loss

As the symptoms of ovarian cancer are similar to common conditions like irritable bowel syndrome (IBS), they’re not always easy to recognise.

If you feel bloated more than 12 times a month, you’re having ovarian cancer symptoms that won’t go away or you have a family history of ovarian cancer, you should go and see a GP.

What causes ovarian cancer?

One abnormal cell can cause a cancerous tumour to form in the ovaries. The exact reason why this happens is still unknown, but there are certain factors which may increase your risk of developing ovarian cancer:

• Age – Especially if you’re over the age of 50

• Genes – If you’ve a family history of ovarian or breast cancer

• Having hormone replacement therapy (HRT)

• If you have gone through the menopause

• Having endometriosis – This is where the tissue that lines the womb (endometrium) also grows outside the womb in organs such as the ovaries, bowel, bladder, rectum or vagina. This condition can also cause blood-filled cysts to grow

Reducing your risk of ovarian cancer

There are some steps you can take to reduce your risk of ovarian cancer:

• Losing weight

• Eating a healthy, balanced diet

• Giving up smoking

• Exercising regularly

Diagnosis of ovarian cancer

If you think you’re having ovarian cancer symptoms, you should go and see a GP straight away. Some tests they might recommend are:

• An ultrasound scan, using a probe that’s placed inside your vagina and one that’s moved over your abdomen

• A blood test to check for a protein called CA125, which is produced by some ovarian cancer cells

• Physical examination of your abdomen (tummy)

In some cases, the GP may refer you to a specialist called a gynaecologist for further tests like:

• A CT scan of your ovaries

• An X-ray of your chest to see whether the cancer has spread to your lungs

• A biopsy – where a needle is passed into your tummy and a sample of ovary cells or fluid from around the ovaries is checked for cancer

What is the best treatment for ovarian cancer?

If you’re diagnosed with ovarian cancer, a multidisciplinary team will work together to provide your care. Specialist doctors involved in your treatment may include:

• Pathologist - Specialises in diseased tissue

• Gynaecologist - A surgeon who focuses on the female reproductive system

• Clinical oncologist: A chemotherapy and radiotherapy specialist

• Radiologist: Specialises in using imaging techniques to detect disease

The treatment you have will depend on whether your ovarian cancer has spread.

Treatment options may include:

• Laparoscopy – This is a type of keyhole surgery that is performed under general anaesthetic. The surgeon will make small cuts in your abdomen, and gas will be blown into your pelvis to allow access to your ovaries. A small, tube-shaped microscope with a light on the end (called a laparoscope) will then be passed into your abdomen so that the tumour can be removed and the cuts closed with dissolvable stitches.

• Surgery - To remove the fallopian tubes, both ovaries and your womb (hysterectomy). Following surgery, you may be advised to avoid having sex for a few weeks to allow your wound to heal properly.

• A course of chemotherapy - Special medicine is usually given by a drip into a vein in order to kill the cancerous cells

• Radiotherapy - High-energy beams of radiation are targeted at your ovarian cancer tumours to kill the cancerous cells

• Targeted therapy – This is where a medicine called olaparib (Lynparza) or niraparib (Zejula) is given to try and stop the ovarian cancer growing and spreading

Fertility and pregnancy

Having ovarian cancer and receiving treatment can affect your fertility. If your treatment has triggered an early menopause, you may no longer be able to have children.

It’s important to talk about your fertility needs before treatment starts, if possible, in order to help you, your partner and the medical team plan the most appropriate treatment.

If you’re only having one ovary removed, doctors may be able to preserve your fertility by keeping your uterus (womb) intact. But chemotherapy treatment may harm your remaining ovary or increase your risk of early menopause.

The doctor will discuss your options with you and can refer you to fertility counselling or other fertility services.

What is the outlook with ovarian cancer?

If you’re diagnosed with ovarian cancer, your outlook depends on how far it’s spread and your general health. The earlier your tumour is found, the better the chance of making a good recovery.

If your ovarian cancer is at an advanced stage, the doctor will refer you to a palliative care team, who will be able to discuss your options for pain relief and provide practical help and support to you and your family.

Living with ovarian cancer

It can feel scary living with an ovarian cancer diagnosis. It’s important to find ways to cope with your feelings.

Some things that may help are:

• Find someone to talk to – Sharing your feelings with a friend or loved one may help, or you may want to get in touch with a support group and meet others in the same boat

• Be kind to yourself – Don’t try to do too much. Try to relax, eat well and get plenty of rest to help with any stress, fatigue or side effects from treatments

• Psychological support – Your diagnosis may make you feel anxious or depressed. Speaking to a doctor or counsellor may help. You may benefit from prescribed antidepressant medication if you’re suffering from depression