Ovarian Cancer

What is ovarian cancer?

Ovarian cancer is the 2nd most common gynaecological cancer in the western world and the 10th most common cancer in women in Australia. Ovarian cancer can affect women in any age group but is most diagnosed between the ages of 50 and 65. 

There are different types of ovarian cancers. The most common type is  epithelial ovarian cancer. A similar type of cancer can start in the fallopian tubes or lining of the abdomen called peritoneum.

What are the symptoms of ovarian cancer?

Symptoms of ovarian cancer can be vague like abdominal bloating, altered bowel habits, loss of appetite or increase in dress size. In some cases, an abdominal lump may be felt or be picked up on an ultrasound.

How do you diagnose ovarian cancer?

Ovarian cancer may be suspected based on findings of an ultrasound or a CT scan. Tumour markers like CA 125 may be raised. The only way to be certain about the diagnosis of ovarian cancer is on pathological examination of tissue obtained either through surgery or by a biopsy under image guidance.

How is ovarian cancer staged?

Determining the stage or the spread of ovarian cancer is done surgically. Imaging with a CT scan or PET scan prior to surgery can help in establishing the likely extent of the disease and guide treatment decisions. 

Most women diagnosed with ovarian cancer have Stage III ovarian cancer. This means that the disease involves abdominal organs beyond the ovaries.

How is ovarian cancer treated?

For the vast majority of women, the treatment of ovarian cancer requires a combination of surgery and chemotherapy.

Some women benefit from upfront surgery followed by six cycles of chemotherapy. The other option is to start chemotherapy and carry out surgery halfway through the six cycles. 

The choice of the treatment depends on multiple factors including the extent of the disease, your ability to tolerate surgery and the presence of fluid in the abdomen, called ascites. 

The outcome of the treatment is the same regardless of the treatment choice. You may require a biopsy first if the treatment starts with chemotherapy.

What is the role of genetic testing after diagnosis of ovarian cancer?

Most women diagnosed with ovarian cancer are referred for genetic testing to check for a gene defect/mutation (BRCA1, BRCA2, Lynch Syndrome) that may have started the cancer. Some of the cancers associated with genetic mutations respond to targeted therapies. 

Additionally, genetic testing allows opportunity for testing other family members for inheritable gene defects and for them to seek appropriate advice of reducing their risk of cancer in the future.

Are you a member of a multidisciplinary team?

Yes, Dr Vivek Arora believes in a multidisciplinary approach for the best possible outcome. He discusses your diagnosis and consults with the Gynaecological Oncology Multidisciplinary Team at the Royal Hospital for Women in Randwick.

What questions should I ask the specialist?

We encourage you to ask any questions you may have during your diagnosis and treatment.

You may have questions regarding the stage of the cancer, treatment options, fertility preservation, seeking a second opinion, risks of treatment, involvement in trial therapies, impact on sexual function or where to seek further information.

Where can I find more information?

Cancer Council has some helpful factsheets on ovarian cancer. You can access them here: https://www.cancercouncil.com.au/ovarian-cancer/.

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