Ovarian cancer

How common is ovarian cancer?

Ovarian cancer is the seventh most common cancer in women worldwide and is most common in women over 60.

Who are more likely to get ovarian cancer?

The risk is higher for women who have not had children, for those who have had early menopause or late menopause, and for women who carry the BRCA-1 and BRCA-2 gene mutations (as in breast cancer). Other risk factors include family history, which can increase the risk by up to 15%, and obesity, which appears to increase the risk of developing cancer and the incidence of more aggressive forms. Conversely, factors that can reduce the risk are the use of contraceptive tablets (depending on years of use), childbearing, breastfeeding, exercise and maintaining a normal body weight.

Are there any symptoms indicative of ovarian cancer?

Two thirds of patients with ovarian cancer are diagnosed at an advanced stage as in the early stages the disease is usually asymptomatic. Symptoms are non-specific and may include pelvic or lower abdominal pain, loss of appetite or premature satiety, abdominal distension, pain during sexual contact, frequent urination, constipation, menstrual irregularities, back pain, easy fatigue and weight loss.

What tests does a patient with suspected ovarian cancer undergo?

The imaging test in case of suspected ovarian cancer includes ultrasound (transabdominal or transvaginal), CT and/or MRI of the abdomen.

How is ovarian cancer diagnosed?

The diagnosis of the disease is made by biopsy of the lesion in the ovary. In the case of ascites (fluid collection in the abdomen), a sample of the fluid is taken and its cytological examination may also make a diagnosis if cancer cells are detected. The CA-125 marker, often found elevated in patients with ovarian cancer, is used to assess response to treatment and is not used to diagnose the disease. The treating physician also decides whether women with ovarian cancer will need genetic testing for mutations and also guides their relatives appropriately.

What are the treatments available today?

The treatment approach for patients with ovarian cancer includes surgery, chemotherapy, radiotherapy, radiotherapy, hormone therapy and targeted therapy, either alone or more often in combination. In young women who are at an early stage, limited surgical treatment is indicated to preserve fertility. In older women and in more advanced stages, the ovaries and uterus are removed, as well as tissues infiltrated by cancer cells. Surgery is usually followed by chemotherapy to eradicate any remaining disease. Sometimes chemotherapy may precede surgery to reduce the size of the tumour so as to be removed more effectively.

Do all ovarian cancer patients receive the same treatment?

The treatment strategy to be followed in each patient is determined by the extent of the disease and the patient’s health condition and is always individualised.

What is the prognosis for patients with ovarian cancer?

As with all cancers, survival is related to the stage of the disease at diagnosis. So if cancer is detected and treated at an early stage, a complete cure is possible. More specifically, if the disease is diagnosed while the tumour is confined to the ovaries, up to 75% of patients can be completely cured. In cases where the tumour has extended into the pelvis, the chance of cure is reduced.