Ovarian cancer: Risk factors and treatment

Women can reduce their chances of ovarian cancer by having more babies and breastfeeding them.

Q My mother has just been diagnosed with ovarian cancer.

What is ovarian cancer?

What treatment will my mother need?

What can I do to prevent ovarian cancer from happening to me?

A Ovarian cancer is the most common gynaecological cancer in women.

Ovaries are part of the female reproductive organs.

They are where egg cells are produced by a process called ovulation.

They are also responsible for secreting hormones, including oestrogen, progesterone and testosterone.

Ovarian cancer is a cancer that originates in the ovary.

When the cells in the ovaries turn cancerous, they do not usually cause any obvious signs such as lumps, or symptoms such as pain, as the ovaries are very small organs and situated deep in the pelvis.

Symptoms tend to be vague, but they become more noticeable as the cancer progresses.

These symptoms, which may include bloating, pelvic pain, abdominal swelling, and a change in bowel habits, can sometimes be confused with those of colon cancer.

As the cancer cells spread to other organs, patients may complain of symptoms such as breathlessness and loss of appetite.

Common areas to which the cancer may spread to include the lining of the abdomen, lining of the bowel and bladder, lymph nodes, lungs and liver.

As a result of the lack of symptoms in the early stage and the lack of effective screening tests, a large number of ovarian cancer cases are detected at a later stage.

The risk for ovarian cancer is related to the amount of time a woman spends in ovulation.

Thus, not having children is a risk factor for ovarian cancer, likely because ovulation is suppressed by pregnancy.

Obesity and hormone replacement therapy also raise the risk.

In contrast, events that stop ovulation such as breastfeeding, oral contraceptive use with oestrogen/ progesterone combination pills, multiple pregnancies, and pregnancy at an early age, all decrease the risk of ovarian cancer.

A positive family history of ovarian cancer is a risk factor.

People with hereditary nonpolyposis colorectal cancer (Lynch syndrome) are at increased risk of many types of cancer.

Women with this disorder have a high risk of cancer of the ovaries and lining of the uterus (the endometrium).

Those with BRCA1 and BRCA2 genetic abnormalities are also at increased risk.

There is a genetic test available commercially for BRCA genes testing for individuals who have strong risk factors such as having a family history of both breast and ovarian cancers.

The treatment for ovarian cancer depends on the stage of the cancer.

Generally, for early-stage ovarian cancer, treatment involves surgery to remove the ovaries, fallopian tubes and uterus.

Chemotherapy can be used after surgery to reduce the risk of cancer recurrence.

Chemotherapy could also be given before surgery to reduce the size of the tumour.

This could make it easier for surgeons to remove the tumour.

Chemotherapy can also be used in a more advanced disease to reduce the symptoms and to prolong life.

Women can reduce their chances of ovarian cancer by having more babies and breastfeeding them.

  • Director and senior medical oncologist at The Harley Street Heart & Cancer Centre

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This article was first published on February 2, 2016. Get a copy of The Straits Times or go to straitstimes.com for more stories.