Ovarian Cancer

What is ovarian cancer?

Ovarian cancer occurs when cells in one or both ovaries grow abnormally and become cancerous tumours.

This cancer can be hard to diagnose as symptoms are often dismissed or attributed to other issues.

Ovarian cancer is the fifth most common cancer in Singapore.1

Ovarian cancer can be one of three types: 1

  • Epithelial– Most ovarian cancers arise from the surface epithelium of the ovary
  • Germ cell – These tumours occur in egg producing cells of the ovary
  • Stromal tumour – These develop in the oestrogen and progesterone producing tissue that holds the ovary together

Is ovarian cancer hereditary?

In some cases ovarian cancer is due to mutations in the genes BRCA 1 (Breast Cancer 1) and BRCA 2 (Breast Cancer 2). Mutations in these genes are also involved in the increased risk of breast cancer.

Approximately 15% of ovarian cancers can be explained by these gene mutations. 6

Stages of ovarian cancer

Ovarian cancer is typically staged using the FIGO (International Federation of Gynaecology and Obstetrics) system.9  There are four stages of ovarian cancer ranging from Stage I to Stage IV, which gives an indication of how little (Stage I) to how much (Stage IV) the cancer has progressed. 8

The stages of the FIGO system are: 13

  • Stage ICancer has been found in either one or both ovaries.
  • Stage IIThe cancer has spread beyond one or both ovaries to other nearby organs such as the uterus or bladder.
  • Stage IIIThe cancer has spread beyond the ovaries and nearby organs to the lining of the abdomen or lymph nodes.
  • Stage IVThe cancer has spread to other areas of the body such as the lung.

Within each stage (I-IV) there are sub-stages, listed from A through to D which describe the extent of the tumour.13

As the staging of ovarian cancer can be complex, it is important to discuss your individual diagnosis and stage with your specialist.

Signs and symptoms of ovarian cancer

Currently there is no screening test to diagnose ovarian cancer. Typically a blood test to test for CA125 – a common marker for ovarian cancer can be done, along with a physical examination and scans.9 However only a biopsy can clinically diagnose ovarian cancer.

Therefore knowing your body and being aware of any changes and symptoms is important.8

Some common symptoms to be aware of include:

Pain

in the abdomen or pelvic area

Changes in urinating

more frequent or urgent need to pass urine

Bleeding

between periods or after menopause

Bloating

or an extended abdomen

Tiredness

Reduced appetite

or a feeling of being full after small meals

Changes in bowel habits

such as constipation or diarrhoea

Weight gain or loss

that can’t be explained by diet and exercise-related factors

Whilst these symptoms may be due to other causes besides ovarian cancer, it is always important to see your doctor.

Treatment

Frequently asked questions

What causes ovarian cancer?

Whilst there is no one cause of ovarian cancer, risk factors include: 1

  • Women with few pregnancies or who have never been pregnant
  • A family history of the disease
  • A high-fat diet
  • Early menarche and late menopause.
What can I do to decrease my risk of ovarian cancer?

Whilst the exact cause of ovarian cancer is not known, there are some factors that can reduce your risk for developing ovarian cancer, such as:

  • Pregnancy, breastfeeding and taking birth control reduce the frequency of egg production (ovulation) which is thought to decrease the risk of developing cancer of the ovary.4
  • Tubal ligation (cutting and tying the fallopian tubes) as well as hysterectomy (removal of the uterus) are also thought to reduce the risk of ovarian cancer, through the reduction of cancer-causing substances reaching the ovaries. 4
  • Maintaining a healthy weight – Maintain a healthy weight within the normal BMI (Body Mass Index)* range of 18.5 – 24.9kg/m25

References

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