Ovarian cancer easily missed
By Dr Brighton Chireka
Ovarian cancer is notorious of mimicking other conditions. This makes it difficult to diagnose. A delayed diagnosis of a life threatening condition such as ovarian cancer is one of the most feared events in a doctor’s career. Failing to diagnose ovarian cancer can bring guilt and at times the doctor may not recover from the incident. The patient may also lose their lives due to delayed diagnosis. This article is about ovarian cancer and I hope that at least one life will be saved by reading this article.
Ovarian cancer is the fifth commonest cause of cancer-related deaths among women worldwide. It accounts for 4% of all cancer deaths in women. Death from ovarian cancer is strongly related to disease stage. Stages 1 and 2 are associated with survival rates of more than 70%. Stages 3 and 4 are associated with survival rate of 0% – 20%. In most patients, diagnosis of ovarian cancer is made at an advanced stage. This is because of its non-specific clinical symptoms.
Let’s look at the organ called the ovary.
The ovaries are a pair of small organs in the female reproductive system that contain and release an egg once a month. This is known as ovulation. The egg is one of the many things that is needed together with sperm from the male for pregnancy to take place. Every time an egg is released into the reproductive system, the surface of the ovary breaks to let it out. The surface of the ovary is damaged during this process and needs to be repaired. Each time this happens, there’s a greater chance of abnormal cell growth during the repair which can result in ovarian cancer. This may be why the risk of ovarian cancer decreases if you take the contraceptive pill or have multiple pregnancies or periods of breastfeeding. It’s because at these times, eggs aren’t released and the ovary is not damaged.
What causes ovarian cancer?
The exact cause of ovarian cancer is unknown. There are certain things thought to increase a woman’s risk of developing the condition. This includes age ( Ovarian cancer can affect women of any age but is most common in women who have been through menopause usually over the age of 50.), the number of eggs the ovaries release as explained above and whether someone in your family has had ovarian or breast cancer in the past. However, only 1 in 10 cases of ovarian cancer has a genetic link.
Women who take hormone replacement therapy ( HRT) for example to treat menopausal symptoms , have been shown to have a small increased risk of developing ovarian cancer. However, if HRT is stopped, after five years the risk is reduced to the same level as women who’ve never taken HRT.
Endometriosis may also increase your risk of ovarian cancer. In endometriosis, the cells that usually line the womb grow elsewhere in the body.
Symptoms of ovarian cancer
The symptoms of ovarian cancer can be difficult to recognise. This is particularly in its early stages as there are the same with conditions such as irritable bowel syndrome or pre- menstrual syndrome.
We have three main symptoms that are more frequent in women diagnosed with ovarian cancer. There are given below and to remember them we use the word BEAT.
B- stands for bloating . This is persistent bloating not the one that comes and goes. It is also associated with increased size of the tummy.
E – stands for Eating difficulties and feeling full quickly or feeling nauseous (kuda kurutsa)
A – stands for Abdominal ( tummy) pain and pelvic pain . This pain is persistent in the lower tummy area.
T – stands for Talking to your doctor if you have the above symptoms
Other symptoms such as back pain, needing to pass urine more frequently than usual, and pain during sex may be the result of other conditions in the pelvic area. However, they may be present in some women with ovarian cancer. Other symptoms include unexplained weight loss fatigue or changes in your bowel habits, such as diarrhoea or constipation. The challenge is that these symptoms are very common and can be caused by several conditions. It requires good doctor patient relationship to tease out the symptoms pointing to a possible ovarian cancer.
Diagnosing ovarian cancer
I advise you to see your doctor if you have any of the symptoms mentioned in this article.
Your doctor will gently feel your tummy (abdomen) and ask you about your symptoms, general health and whether there’s a history of ovarian or breast cancer in your family.
They may carry out an internal examination and may have a blood test to look for a protein called CA125 in your blood. CA125 is produced by some ovarian cancer cells. A very high level of CA125 may indicate that you have ovarian cancer. You may be referred for an ultrasound scan of your lower tummy area.
If needed, you may also be referred to a specialist (a gynaecologist or gynaecological oncologist) at a hospital.
How can you help your doctor to diagnose your problem?
If you have any of these types of symptoms, try keeping a diary to record how many of these symptoms you have over a longer period. Please remember that ovarian cancer is rare in women under 40 years of age. More than 8 out of 10 cases of ovarian cancer occur in women who are over 50 years of age.
Go and see your doctor if you have these symptoms regularly (on most days for three weeks or more). Although it’s unlikely they’re being caused by a serious problem, it’s best to check.
If you’ve already seen your doctor and was reassured but now the symptoms are continuing or getting worse, you should go back and explain this. You know your body better than anyone. You should explain that you are worried about ovarian cancer so that your doctor can rule it out. The earlier the ovarian cancer is diagnosed the better as the survival rate is high in early stages.
Treating ovarian cancer
The treatment you receive for ovarian cancer will depend on several things, including the stage of your cancer and your general health. Chemotherapy is the main treatment for ovarian cancer. This treatment will usually involve a combination of surgery and chemotherapy.
As with most types of cancer, the outlook for ovarian cancer will depend on the stage it’s at when diagnosed – that is, how far the cancer has advanced. The best is to get it early before it has spread anywhere. I hope this article will help at least one person to have their diagnosis not delayed.
You may want to read about other common cancers in women.
Feel free to share with friends and relatives and also send me your comments. I look forward to reading your inputs .
This article was compiled by Dr. Brighton Chireka who is a GP and a Health Commissioner in South Kent Coast in the United Kingdom. You can contact him at: firstname.lastname@example.org and can read more of his work on his blog at Dr Chireka Health Talks
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Dr Chireka has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. Views expressed here are personal and do not in any way , shape or form represent the views of organisations that Dr Chireka work for or is associated with.