Throwing a spotlight on ovarian cancer

With symptoms that can at first be waved away as “nothing serious”, ovarian cancer tends to sneak by initial health check-ups.

Search for ovarian cancer articles on any news website and you will quickly see a common theme: misdiagnosed or undiagnosed cases. Although ovarian cancer is the second most common gynaecological cancer (endometrial cancer takes the dubious top prize), it is notoriously difficult to diagnose due to its nonspecific symptoms and a lack of reliable screening programmes.

There are three types of ovarian cancer with epithelial ovarian cancer representing more than 90% of ovarian cancer diagnoses. The majority of these are high-grade serous carcinomas that usually originate in the fallopian tubes. High-grade serous carcinomas grow quickly and spread early, which is why they are usually diagnosed at a late stage where prognosis is poor.

Early detection is more likely in females with other subtypes of epithelial ovarian cancer where growth is slower. The two other types of ovarian cancer are sex cord-stromal tumours – more likely to present in women over 40 – and malignant germ cell tumours which are most common in women aged in their 20s.

Diagnosis relies on recognising and investigating suspicious symptoms but due to the vagueness of ovarian cancer symptoms, it is often mistaken for less serious issues like irritable bowel syndrome, constipation or a urinary tract infection.

That’s why it’s important to be familiar with the signs and “know your normal” when it comes to bowel and urinary movements, menstrual cycles, how you feel after eating and what your pelvic region generally feels like. If you have any uncertainty or an inkling that something could be wrong it’s time to see your GP.

Like most cancers, diagnosis at an early stage provides better chances of recovery. With greater awareness comes more accurate diagnosis and the chances of providing timely treatment increase for everyone.

Symptoms may present as manageable to start with to cause discomfort after some time, which is why any new symptoms should be checked out by a gynaecologist.

Possible symptoms of ovarian cancer

Some of the most common symptoms of ovarian cancer include:

Bloating
Eating less but feeling fuller
Abdominal, pelvic or back pain
Needing to urinate more often and with more urgency
Changes in bowel motion habits
Fatigue

Be wary of...

Less common symptoms include:

Indigestion
Abnormal vaginal bleeding or discharge
Unexplained weight changes
Painful sex

Risk factors

As ovarian cancer tends to occur more regularly in women who have had a greater number of ovulatory cycles over their lifetime, early onset of periods, late menopause, or not having birthed children can all be risk factors
Women from the Pacific region have a higher instance of ovarian cancer than wahine Māori and European/pakeha women
Those with a family history of breast cancer, ovarian cancer or pancreatic cancer could be more prone to developing ovarian cancer

How is ovarian cancer diagnosed?

Testing for ovarian cancer generally begins with a pelvic examination, during which the doctor will insert two gloved fingers into your vagina while pressing down on your abdomen to feel for any lumps and bumps. While this may be slightly uncomfortable, it should not be painful and is a necessary step to determining if there is cancer present.

If the doctor does feel something, you will then be sent for a pelvic and/or transvaginal ultrasound. If there are no lumps present, you should still be sent for more testing to determine what is causing the symptoms.

A CA125 blood test is a key step, as this checks the levels of a specific protein in your blood, which is often elevated in people with this form of cancer. This test will help determine how quickly you are seen for an ultrasound. Again, if this blood test comes out normal but your symptoms persist, it is important to return to your doctor for further testing. It’s also important to let them know if your symptoms change or worsen while you are waiting for tests.

Where to go for more information

February is Ovarian Cancer Awareness Month, with the Ovarian Cancer Foundation holding their Step Up for Ovarian Cancer drive across the country. The foundation’s website is a great place to find information, and our doctors will always be happy to answer any questions you may have. Remember, in the case of ovarian cancer, it pays to err on the side of caution, so book in a check up if you have any symptoms or suspicions.