Health
Ovarian Cancer Awareness Month
Around 7,300 women are diag- nosed with ovarian cancer in the UK each year and less than half are alive five years later, often due to late diagnosis. Yet early diagnosis can increase the five-year survival rate to over 90%.
Unfortunately, the symptoms of early stage ovarian cancer can be mild and easily mistaken for symptoms of other conditions, such as Irritable Bowel Syndrome (IBS) or Premenstrual Syndrome (PMS). That’s why Ovarian Cancer Awareness month, occurring every March, is so important. PROTECTING YOURSELF FROM OVARIAN CANCER
There are a few factors shown to reduce ovarian cancer risk. These are:
• Taking the contraceptive pill – the longer you take it, the more protection it offers. Protection lasts for at least 30 years after you stop.
• Having children – each child lowers your risk.
• Breastfeeding – the longer you breastfeed, the higher the pro- tection.
• Having your tubes tied (sterilisa- tion).
TYPES OF OVARIAN CANCER Epithelial ovarian cancer About 90% of ovarian tumours are epithelial (starting in the layer cov- ering the ovary).
Primary peritoneal carcinoma A few ovarian cancers are primary peritoneal carcinomas, which de- velop from the membrane around abdominal organs.
Germ cell and other rare ovarian tumours: Around 1 to 2% of ovarian cancers are germ cell cancers, formed in the egg making cells of the ovary. Benign forms of germ cell tumour also exist, sometimes called dermoid cysts or mature teratoma. Rare stromal tumours and sarcomas can also affect the ovary.
Borderline ovarian tumours Borderline ovarian tumours do not grow into the supportive tissue of the ovary (the stroma) and grow slowly. Abnormal cells can
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sometimes break away and settle elsewhere in the body, usually the abdomen, but do not usually grow into the underlying tissue. RISK FACTORS Increasing age: Most ovarian can- cer sufferers are post-menopause.
Faulty genes: Between 5 and 15% of ovarian cancers are thought to be caused by an inherited faulty gene, including BRCA1 and BRCA2, which also increase the risk of breast cancer.
Previous breast cancer: Risk is up to double in women who’ve had breast cancer and even higher if their breast cancer diagnosis was before age 40.
Being infertile or having fertility treatment: Some studies indicate that infertility raises risk, but fertility treatments are no longer believed to do so. There does seem to be an increased risk of border- line ovarian tumours in infertile women treated with IVF. Hormone replacement therapy (HRT): Less than 1% of ovarian can- cers are linked to HRT. Being overweight or tall: A BMI of 28 or over increases risk in pre- menopausal women but has no effect on risk in postmenopausal women. Taller women also have a higher risk. Endometriosis Using talc: Using talcum powder between your legs is thought to increase ovarian cancer risk due to its irritant effect. Smoking: The longer you’ve smoked, the greater the risk in- crease for certain ovarian cancers. Diet factors: There is no definitive evidence on the effect of diet on ovarian cancer risk, although some studies suggest a high fat diet may increase it. SYMPTOMS
Ovarian cancer symptoms aren’t always easy to identify and may be easily mistaken for the symptoms of conditions such as IBS or PMS in the early stages. However, if symp- toms are new, severe, frequent or persistent (occurring most days for three weeks or more), you should see your GP immediately, although often, a less serious condition is to blame. Look out for:
• Abdominal swelling and persistent bloating.
• Persistent pelvic and abdominal pain.
• Difficulty eating, nausea and feeling full unusually quickly.
• Back pain.
• Needing to urinate more fre- quently.
• Pain during sex.
Remember that ovarian cancer is rare in women under 40, but that you should be particularly cautious if you are over 50 or have a family history of breast or ovarian cancer. DIAGNOSIS
First, the GP will examine you ex- ternally and internally, checking for any lumps or swelling. They may also send you for an abdominal or transvaginal ultrasound scan and do a blood test for CA125. CA125 is a protein produced by some ovarian cancers but also other conditions, such as endometrio- sis, fibroids, pelvic inflammatory disease and pregnancy. The CA125 level is raised in about half of wom- en with early stage ovarian cancer and 90% of women with advanced ovarian cancer.
You’ll usually be referred to a spe- cialist who will examine you and order a blood test and ultrasound scan if the GP hasn’t done so. They may also order a CT or MRI scan. To assess whether any abnormality indicates cancer they use the risk of malignancy index (RMI), which combines scan results, CA125 levels and menopausal status. Women with a high score are referred to a multidisciplinary team. However, sometimes it’s impossible to diag- nose ovarian cancer definitively without surgery. TREATMENT
Most women with ovarian cancer will require surgery. If your cancer is diagnosed early enough, you may only need the affected ovary and attached fallopian tube re- moved. More advanced cancers may need more extensive surgery, and chemotherapy may be used before and after to treat cancerous cells and reduce the risk of reoc- currence.
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www.cr5.co.uk your local community website!
By Alison Runham
www.alison.runham.co.uk
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