Home' LOTL : December 2005 Contents 43
By Dr Ann
QAn American friend told me she’s been diagnosed with ovarian
cancer. She said you can be screened for this and now I’m
worried that it’s something I should have done. Should I see my
doctor about getting tested?
AMy advice when patients mention the word screening is the same
as the words on the cover of The Hitchhiker’s Guide To The
Galaxy: DON’T PANIC! When we receive news of a friend’s illness
the second thought after “Oh no, how awful for them!” is inevitably “My
god, what if that happened to me?” What can follow is a cascade of
panicked thoughts about health checks. Take a moment to breathe and
learn a few facts about ovarian cancer – you might find it helpful not only
in calming your nerves, but in your ability to be supportive to your friend
in a more informed way.
Ovarian cancer is a disease where a tumour develops in one of your
ovaries, the organs that release ova, or eggs, to your uterus each month.
It is the fourth most common cancer in women and 1 in 90 women will
be at risk of developing it in their lifetime. 90% of cases of ovarian cancer
occur in women over 40. 50% of cases occur in women over 65. At the
time of diagnosis, most of the cases are in the advanced stages of the
disease, which is why the mortality rate from it is so high.
Risk factors for ovarian cancer include living in an industrialised country
such as Australia or America. There have been theories about causes
such as talcum powder contact on genitals, a high fat diet, and mumps,
but none of these have been proven. There is an association between the
disease and hysterectomy and tubal ligation (removal of the uterus and
tube-tying surgery). Other risk factors are: Ashkenazi Jewish descent, a
history of one or more first-degree relatives with ovarian cancer, having
breast, colon or endometrial cancer (carrying genes associated with
breast cancer), bearing no children, starting your periods early in life,
starting menopause after 50, having your first child after 30…
But strangely, even though all these increase your risk of developing
ovarian cancer, 95% of cases have none of these risk factors. And many
women with these risk profiles do not develop ovarian cancer.
Symptoms of ovarian cancer can be similar to symptoms for a host of
other problems, which is why it is often detected late. No one symptom
is a definite signpost. Sudden weight loss or gain, a feeling of abdominal
bloating, pelvic pain, pain on penetration, abnormal vaginal bleeding,
lower back ache, persistent digestive problems…all of these could be
reported by someone who is found to have ovarian cancer. But don’t
panic: these symptoms don’t automatically equal ovarian cancer.
Just as there is no one symptom that signals ovarian cancer, there is
no single test that rules it out. While pelvic examination, blood tests,
ultrasound and CT scan can be used to investigate, the ultimate
diagnosis comes from biopsy, which is done when a lump on the ovary
is surgically removed and examined. This plus confirmation with CT scan
as to how far the tumour may have spread, will be used to classify the
cancer into early or late stages.
Treatment consists of surgery and chemotherapy, depending on the
stage of the cancer and where it lies in the body. Survival rates are
much better for those tumours detected early, with 80-100% of women
with early ovarian cancer surviving more than 5 years. For later stage
tumours, survival rate can be as low as 20%.
What your friend needs most at the moment are people to support her
during her illness. Your knowing more about the disease is invaluable
for understanding what she is going through. As for your own health,
while research is being done, there is no routine test available which will
provide a 100% accurate answer. If you are concerned about risk factors
or any current symptoms, see your GP. In the meantime, read more about
ovarian cancer at www.ocrf.com.au, and about support for your friend at
www.ovca.org and www.cancercouncil.com.au.
Dr Ann is a doctor at a Sydney metropolitan area hospital. The opinions
expressed in this column are those of the author and are not intended as
a substitute for medical advice. If you have concerns about your health
please consult your health practitioner.
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