Mar 01, 2013

Ovarian cancer - the not-so-silent as we thought disease

Ovarian cancer is the fifth most common cancer among UK women, with about 7,000 women diagnosed a year. Survival rates have been much lower than for other cancers, mostly because ovarian cancer tends to be diagnosed at a fairly late stage, often after it has spread to other parts of the body. But it doesn't always have to be a death sentence - if caught at stage 1, when the cancer hasn't spread outside the ovaries, long-term survival rates are over 90%.

Worryingly, far too many women are not yet aware that although ovarian cancer sometimes is indeed 'silent' until it's quite advanced, there are symptoms to look out for. Research in the last few years has shown that women with ovarian cancer can get four key symptoms:

  • Persistent stomach or pelvic pain
  • Persistent bloating or increased stomach size (not the kind that comes on after a big meal and settles within a couple of hours)
  • Feeling full quickly after eating, or having problems eating
  • Needing to pass water more often

All these symptoms are common, but the key to a connection with ovarian cancer is their persistency - they don't come and go and they occur on most days. In addition, warning bells should sound if these symptoms are new for you, having started within the last year or so.

Every woman needs to be aware of these symptoms, and they need to be prepared to speak to their GP about them. But don't panic - in the vast majority of cases, the cause is much less worrying. It's important to realise that your GP may have good reason for reassuring you. We hear a lot in the newspapers from women who were convinced they had ovarian cancer, and who were repeatedly 'fobbed off' by their GP before finally getting a diagnosis.

But for every one of these cases, there are hundreds women who are convinced they have cancer and who, as their GP predicted, don't have anything wrong - these stories never make headlines.

If you're worried your symptoms might be due to ovarian cancer, tell your GP what your concerns are - because the vast majority of patients with these symptoms don't turn out to have a serious cause, they may not have considered the possibility. If they tell you that you don't need tests, ask them why. These days, most GPs will welcome the opportunity to have an adult discussion about how they've reached their conclusions and the possible next steps.

A new survey by the charity Ovarian Cancer Action suggests that two thirds of women aren't aware of any of the possible warning symptoms of ovarian cancer. The same research has highlighted how few women realise that their family history could affect their risk. Although 95% of cases of ovarian cancer aren't linked to an inherited faulty gene, a strong family history of ovarian or breast cancer may need to be checked out with genetic testing. If two or more women on your mother or father's side of the family have been affected by breast or ovarian cancer, your doctor needs to know.

For now, there is no routine screening test for ovarian cancer - possible candidates, including a blood test called Ca125, and an ultrasound scan, are still being investigated. It's crucial to gather all the information about the possible risks of screening, including possible over-diagnosis and over-treatment which might result. Recent research revealing that while the national breast screening programme is estimated to save 1,300 lives a year in the UK, 4,000 women a year are over-treated as a result has taught us that. Until we know enough about the risk and benefits of ovarian screening, it's up to you to help your doctor out.


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