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Early Detection Is The Key To Fighting Ovarian Cancer, Expert Explains

It is essential that women are educated about the risk factors, signs and symptoms of ovarian cancer for early detection which improves overall survival.

Early Detection Is The Key To Fighting Ovarian Cancer, Expert Explains

Ovaries are a pair of reproductive organs located by the side of the uterus

Ovarian cancer is one of the most lethal gynaecological cancers, ovarian cancer is a silent killer with around 46,000 new cases every year in India (GLOBOCAN 2020)1. Unlike breast & cervical cancer, there is no successful screening tool for detecting ovarian cancer in general population, leading to delays in diagnosis and initiation of treatment. It is therefore essential that women are educated about the risk factors, signs and symptoms of ovarian cancer for early detection which improves overall survival.

Ovaries are a pair of reproductive organs located by the side of the uterus. Ovaries produce eggs and hormones such as oestrogen & progesterone etc. Majority of ovarian cancers are epithelial ovarian cancers, which arise from the covering cells of ovaries, or fallopian tubes. Recent research suggests that epithelial ovarian cancers mostly originate from fallopian tubes. Ovarian epithelial cancers, fallopian tube cancers & primary peritoneal cancers form in the same type of tissues and are managed similarly. The cancerous cells can migrate to other parts of the body known as metastasis leading to the advanced stage of the cancer.

Risk factors that can increase the likelihood of developing ovarian cancer include age, being overweight or obese, not having given birth, strong family history of breast & ovarian cancer, personal history of breast cancer, genetic mutations like BRCA1 or BRCA2, and medical conditions like endometriosis. Having one or two risk factors does not necessarily mean that a women will develop ovarian cancer. Most often, women are likely to get it even without any risk factors. Lifetime risk of ovarian cancer in general population is about 1-2%.2 Awareness helps women at high risk to consult their doctors to seek timely preventive measures. For e.g. genetic counselling and testing for women with a strong family history of ovarian or breast, cancer can help to identify potential genetic mutations like BRCA 1 & 2. It is estimated that the lifetime ovarian cancer risk for women with a BRCA1 & BRCA 2 mutation is estimated to be between 35% - 40% and 10-30% respectively, by the age of 70 years.2 Women at high risk of ovarian cancer may be offered to undergo prophylactic surgery to remove their ovaries and fallopian tubes as a preventive measure.

While the exact cause of ovarian cancer is unknown, reducing modifiable risk factors can help lower the chances of developing the disease. Lifestyle modifications and maintaining a healthy weight, engaging in regular physical activity, and eating a balanced diet can reduce the risk of developing various cancers, including ovarian cancer. Other measures that help include the use of oral contraceptives with the long-term use of birth control pills lowering the risk of ovarian cancer by 30% to 50%.

Symptoms of ovarian cancer can be vague making it difficult to detect in its early stages. Common symptoms include abdominal pain, bloating, difficulty eating or feeling full quickly, unexplained weight loss, frequent urge to pass urine and changes in bowel habits like constipation. These symptoms are often overlooked or attributed to other conditions. Mere presence of these symptoms does not indicate that a woman has ovarian cancer, but it is necessary to carry out further diagnostic tests after consultation with your doctor if the symptoms are persistent beyond 2 weeks. It's important to note that screening tests for ovarian cancer can sometimes produce false positive results, which can be concerning for patients. The CA125 test is one such screening tool, but it is not recommended for routine screening as it could be raised in other non-cancerous conditions as well. Instead, other diagnostic tools such as transvaginal ultrasound and CT scans may be recommended for women who are at a higher risk of ovarian cancer. When it comes to ovarian cancer, early detection is the key to effective treatment.

Diagnosing ovarian cancer is challenging, as it is mostly asymptomatic in its early stages. By the time symptoms appear, the cancer may have already spread to other parts of the body. Earlier the stage, the disease is diagnosed, better are the chances of survival. This further emphasises the need for educating women on signs & symptoms of ovarian cancer. If ovarian cancer is caught early, it can be treated with surgery by gynaecologic surgeons with speciality training in gynaecological oncology. Depending on the type of the cancer tissue, chemotherapy and/or radiation therapy may be offered. The type of treatment used depends on the stage of the cancer and the overall health of the patient.

For advanced cases of ovarian cancer where surgery is not feasible or other options have exhausted, palliative care may be necessary to help manage symptoms and improve the quality of life. This type of care focuses on providing relief from symptoms such as pain, fatigue, and difficulty eating or sleeping. Palliative care can be given alongside other treatments or on its own, depending on the patient's needs.

Ovarian cancer is a growing concern in India and it is vital that we raise awareness about this disease to reduce its impact on women's lives. Through education and awareness campaigns, we can empower women to recognize early symptoms, seek timely medical help, and take preventive measures. With early detection, prevention, and the support of loved ones and healthcare professionals, we can make a difference in the lives of thousands of women in India!

(Dr Sravanthi Nuthalapati, Consultant Gynaecologic Oncologist, Karkinos Healthcare)

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