Frequently Asked Questions About Ovarian Cancer

Here are concise answers to frequently asked questions (FAQs) about ovarian cancer. But before that, let's understand the body part affected—the ovary. 

The ovaries are glands that are small in size and shaped like an egg. They are two, located on each side of the uterus and connected by the fallopian tubes. The main function of the ovaries is to make eggs and hormones, and also to store them. 

Cancer is a medical term for a condition in which an uncontrollable division of abnormal cells occurs in the body. These abnormal cells can penetrate other body tissues, causing cancer cells to circulate throughout the body. This circulation is made possible through the lymph system and blood. 

Different types of cancer exist, one of which is ovarian cancer. 

What is ovarian cancer? 

A cancer originated in the ovarian tissue. It starts spreading from the egg cells or the cells on the top layer of the ovary.¹ Abnormal cells in the ovary grow and divide in such a way that the body cannot control.²

How common is ovarian cancer? 

Ovarian cancer is ranked in 6th place as the most common cancer found in women in Europe and 8th worldwide.³ 

In a ranking of causes of death, it is in 8th place, making it the most common cause of cancer-related death in women globally. In Europe, Australia, and North America, it is ranked in 5th place as the most common cause of cancer-related death in women.⁴

What causes ovarian cancer? 

Ovarian cancer happens when normal cells in the ovary are changed to abnormal or tumour cells through a series of processes. These changes occur when a person's genetic material interacts with external factors such as radiation, chemical contaminants, and infection.⁵

Who is most at risk of ovarian cancer? 

Risks of developing ovarian cancer include:

• Inheriting certain genes, such as the BRCA. This has been linked to an increased risk of ovarian cancer
• History of cancer of the bowel or breast
• Exposure to radiotherapy
• Disease conditions such as diabetes or endometriosis
• Young age, for example, those at the start of their menstrual period or late age (above 55) at the stop of the menstrual period (menopause) 
• Obesity
• Smoking
• Undergoing hormone replacement therapy
• Zero used hormonal birth control⁶
• Having someone in your family with ovarian cancer⁷

How can ovarian cancer be prevented? 

• Use of oral birth control pills
• Surgery that closes the fallopian tubes is called tubal ligation
• Surgery to remove the fallopian tubes, called salpingectomy
• Child bearing
• Breastfeeding up to eight to ten months
• Visiting your healthcare provider, who will conduct a risk assessment
• Maintaining a healthy weight
• Stop smoking completely⁸

What are the signs and symptoms of ovarian cancer? 

Signs and symptoms of ovarian cancer may be difficult to detect at the initial stage. But in due course, the following may occur:

• Poor appetite
• Pain in the abdomen
• Pain in the back
• Bleeding from the vagina after menopause
• Feeling bloated
• Constipation
• Feeling of tiredness
• Losing weight without a clear cause
• Increased need for urination⁹

How is ovarian cancer diagnosed? 

• Laboratory blood tests, including a test for CA125 (a type of cancer marker) 
• Ultrasonic scan
• Use of radiological scans, such as a computed tomography (CT) scan
• Physical assessment, including assessment of the pelvic region
• A tissue sampling test called biopsy¹⁰

What are the stages of ovarian cancer? 

Ovarian cancer has four stages. These are based on how the abnormal cells appear under the microscope. This means that the higher the stage, the more abnormal the cell growth. The stages also define the level of growth of the cancer and the extent of its spread to other body parts. The stages are:¹¹

• Stage one: Indicates that the cancer is confined to the ovaries only. The main treatment here is surgery, although chemotherapy may be needed for certain cases
• Stage two: Indicates that the cancer growth has extended beyond the ovaries and fallopian tubes and has now spread to the pelvic area. Treatment options include surgery and chemotherapy
• Stage three: Indicates a spread outside the pelvic region to the abdominal region or nearby lymph nodes. Treatment options include surgery, chemotherapy, and the use of targeted cancer medications
• Stage four: Indicates the cancer cells have spread to other parts of the body, like the lungs or liver. Treatment options include surgery, chemotherapy, and the use of targeted cancer medications

What are the main treatments for ovarian cancer? 

According to Cancer Research UK, ovarian cancer is treated according to the stage of the cancer. The main treatment options are:¹²

• Surgery: The goal of the surgery is to remove most, if not all, of the cancer. Your abdomen may be cut open, and the pelvic region explored to find out if there is spread of the cancer. This procedure is called laparotomy. Various tests will be carried out on you before the surgical intervention, and no pain will be felt due to anaesthesia. This procedure is usually an extensive one, and weeks of recovery in the ICU may be required. Complications that may arise due to the surgery include infection, clots formation in the blood, problem with breathing, problem with the intestines and bladder, bleeding through the vagina, and bleeding into the abdomen or pelvic region
• Use of chemotherapy: Chemotherapy uses medications that work against cancer to kill cancer cells. They are called cytotoxic or anti-cancer drugs. Chemotherapy can be administered through the blood vessels. Another method of administration is into the abdomen during a surgical procedure. This method is called hyperthermic intraperitoneal chemotherapy (HIPEC)

Chemotherapy can be administered in combination with surgery or as a single therapy. One shot is given once in three weeks and is repeated up to six times. Some of the complications include poor appetite, weight loss, loss of hair, and problems with stooling. Blood tests and scans will be needed to find out if the treatment is effective. 

• Use of targeted cancer medications: These types of medications work to either stop the continuous growth of the cancer cells or strengthen the defence system of the body to fight the cancer cells. Examples of such medications include Olaparib and Avastin
• Hormonal therapy: Hormones fuel the growth of some ovarian cancers. This makes the cancer hormone-sensitive or hormone-dependent. If your cancer is in this category, hormonal therapy is given
• Use of radiation therapy (radiotherapy): This is the use of X-rays, high in energy, to cause destruction to cancer cells in the ovaries. Radiotherapy can reduce the size of the cancer by causing it to shrink

Will I survive if I am diagnosed with ovarian cancer? 

It is difficult to estimate the number of years one can live after the diagnosis of ovarian cancer. Statistics from Cancer Research UK show that in England, of every 100 women diagnosed with ovarian cancer, 70 will survive up to one year, 40 up to five years and 35 up to ten years. At whatever stage your cancer is, the extent of spread, and how quickly it is diagnosed are factors that can affect survival.¹³

How does ovarian cancer affect daily life? 

Living with ovarian cancer can be a lot and can have an impact on your daily life. You may experience many emotions, such as feelings of sadness, anger, failure, or something entirely different. Hair loss, poor appetite, tiredness, money problems due to the cost of health care, and workplace issues are what may arise as you live with ovarian cancer. You can get support from social workers and your local community. Talk to your healthcare provider to help you navigate how you can assess this help. 

Can ovarian cancer come back after treatment? 

Yes. Your cancer can come back. When this happens, it is referred to as recurrent cancer. 

Is ovarian cancer the same as cervical cancer? 

No. Ovarian cancer affects the ovaries, while cervical cancer affects the cervix.

What symptoms should prompt a doctor’s visit?

Feeling bloated for most days up to 3 weeks or more could be a warning sign of ovarian cancer, so visit your doctor. 

What kind of doctor should I see?

When you visit the hospital, you will be directed to see a special doctor referred to as a Gynecologic oncologist. This doctor specialises in the diagnosis and treatment of cancers related to the female reproductive organs. 

Summary

Ovarian cancer affects the ovaries of the female body. Various factors increase the risk of its development. Early diagnosis and treatment positively impact the outcome. See your doctor if you have any risk factors or think you might have ovarian cancer.