Cancer / 28 May, 2020

Why finding ovarian cancer early is so important

Dr Lau Pik Onn

What is ovarian cancer?

Ovarian cancer refers to a malignant (cancerous) growth arising from different parts of the ovaries. The ovaries are the part of a woman’s reproductive system where eggs are developed.

Ovarian cancer is the fifth most common cancer in Singapore, with more than 300 cases diagnosed yearly.1

90% of ovarian cancers are ‘epithelial’, meaning they arise from the surface (epithelium) of the ovary. Epithelial ovarian cancers tend to occur more in older women. The remaining 10% of ovarian cancers arise from the egg cells (germ cell tumour) or supporting cells (sex cord-stromal tumour). Germ cell cancers of the ovary occur more frequently in younger women.

What are the signs and symptoms of ovarian cancer?

Early stage ovarian cancer usually does not cause obvious symptoms and is often known as the ‘silent killer’.

Signs and symptoms of early stage ovarian cancer may also be mild or vague and often ignored, leading to diagnosis at an advanced stage.

These include:

  • Abdominal swelling, bloating or wind
  • Feeling full easily when eating
  • Loss of appetite or weight
  • Discomfort or pressure in the abdomen, pelvis, back or legs
  • Change in bowel or urinary habits, such as a frequent need to urinate

If you experience any of these symptoms, it is important that you consult your doctor.

Risk factors

It is not clear what causes ovarian cancer. However, there are some risk factors. These include:

  • Family history – This is the greatest risk factor for ovarian cancer.
  • Personal history of breast cancer
  • Having your first pregnancy at an older age
  • Early onset of menstruation
  • Late menopause
  • Never having children
  • Having a genetic predisposition including inherited gene mutations*
  • Endometriosis – A condition where tissue that normally lines the inside of the uterus grows outside instead

(*Note: Families with BRCA gene defects have increased risk of ovarian, breast and uterine cancer. Families with Lynch syndrome have higher risk of ovarian, uterine and colorectal cancer)

Screening for ovarian cancer

The two common screening tests used for ovarian cancer, in addition to a detailed medical history and pelvic examination are:

  • Blood test for CA125 marker – CA125 is a protein found on the surface of ovarian cancer cells and certain healthy tissues. CA125 levels are raised in 80% of patients with epithelial ovarian cancer. However, CA125 is insufficient as a sole indicator of ovarian cancer as levels can also be raised in non-cancerous conditions (e.g. endometriosis and appendicitis).
  • Ultrasound of the pelvis (including the ovaries and uterus) – An ultrasound scan will be conducted to check the size and texture of the ovaries and to detect the presence of any abnormal ovarian cysts.

A CT scan or MRI of the abdomen and pelvis may also be conducted to identify any abnormal growths.

Often a diagnosis of ovarian cancer can only be accurately determined after surgery or biopsy.

At Icon Health Screening, our screening packages provide a comprehensive option for women concerned about ovarian cancer. For more information on our screening options, click here.

Why is screening important?

Early detection of ovarian cancer is important as treatment can be highly effective in the early stages of cancer. Unfortunately, ovarian cancer is often undetected until an advanced stage as the signs and symptoms can be vague and hard to spot.

While pap smears are used to screen for cervical cancer and abnormal cells in the cervix, they do not detect ovarian cancer. You should speak to your doctor regarding an annual pelvic examination and ultrasound of the pelvis to help ensure ovarian cancer is found early, giving you the best possible chance at a successful treatment outcome.

References

For a full list of references,
  1. Health Promotion Board. (2015). Singapore Cancer Registry Annual Registry Report 2015. Retrieved on 26 May 2020 from https://www.nrdo.gov.sg/docs/librariesprovider3/Publications-Cancer/cancer-registry-annual-report-2015_web.pdf?sfvrsn=10
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