Updated: Jun 6, 2021
Dr Kathryn Hillarby I NHS Cheltenham General Hospital I 28 March 2021
Ovarian cancer is often known as the silent killer, as it frequently goes undiagnosed until it has spread. The symptoms are often vague and there is a large overlap with symptoms of less serious conditions, such as irritable bowel syndrome (IBS).
Affecting approximately 7000 women in the UK each year, it predominantly affects women who have gone through the menopause (usually over the age of 50) and in most cases affects women with no strong family history of this.
The ovaries are two small organs located in the pelvis, each measuring about the size of a grape in women who have gone through the menopause. Prior to the menopause they are responsible for producing the hormones oestrogen and progesterone, as well as releasing an egg every month.
The most common symptoms are:
Bloating that doesn’t come and go.
Eating difficulties and feeling full more quickly.
Abdominal and pelvic pain felt on most days.
Toilet changes – in urination or bowel habits.
Other symptoms can include:
Extreme tiredness or fatigue.
If you have any of these symptoms or are worried, please speak to your Doctor. The majority of women with these symptoms will not have ovarian cancer, but it is important to rule this out. If you do have family members who have had cancer of the ovary, breast, prostate or pancreas, do make sure you tell your Doctor about this as it may be that you carry an inherited gene that may make you more susceptible to ovarian cancer.
Your Doctor may want to see you and examine you and may arrange a blood test called a CA125, which is a marker for ovarian cancer. Your doctor may also arrange an ultrasound scan for you. If your Doctor is worried, they may refer you to see a gynaecologist as a rapid referral to be seen within 2 weeks.
The earlier the cancer is diagnosed, the easier it is to treat. Treatment usually involves a combination of surgery to remove as much of the cancer as possible, as well as chemotherapy to kill the cancer cells.
In Gloucestershire we have a specialist cancer treatment centre for women diagnosed with ovarian cancer and we have some of the best survival data in the UK for women diagnosed and treated with this condition.
Most women who are found to have ovarian cancer do not have any risk factors, but 5-15% of women may carry a faulty gene called the BRCA 1 or BRCA 2 gene. If you carry a faulty version of these genes you may also be at an increased risk of developing breast cancer.
Other risk factors for developing ovarian cancer include:
Previous breast cancer, especially in women diagnosed at a younger age and with oestrogen receptor negative (ER negative) breast cancer.
Using hormone replacement therapy (HRT) – women who use HRT have a small increase in risk of developing ovarian cancer.
A past history of endometriosis.
Being overweight or obese.
However, some factors reduce your risk of developing ovarian cancer:
Taking the combined oral contraceptive pill – evidence shows that the longer you take the pill for, the greater the protection.
Having children – the more children you have the greater the reduction in risk.
Breast feeding also reduces the risk of developing ovarian cancer.
Having been sterilised.
If you are worried about ovarian cancer please talk to your GP. If you would like any more information about ovarian cancer, you may find the following websites helpful:
Kathryn Hillaby is a Consultant Gynaecologist and Consultant Gynaecological Oncologist. She specialises in diagnosing and treating women with ovarian cancer, as well as other gynaecological conditions. She works as an NHS consultant at Cheltenham General Hospital, Gloucestershire Royal Hospital and Worcester Royal Hospital.
She is also a member of the Gynaecology Group (www.thegynaecologygroup.co.uk ) - a group of experienced gynaecologists working throughout the Cotswolds – working at the Nuffield Hospital in Cheltenham.