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Q. Where are the ovaries?
A. The ovaries are above the womb and connected to it by
two short tubes (the Fallopian tubes). This means that they
are below and to either side of the navel.
Q. How common is ovarian cancer?
A. In the year 2000 (the most recent for which figures are
available) there were 6,734 cases of ovarian cancer diagnosed
in the UK. In the USA the estimated 2004 incidence is 25,500
cases. Overall about one woman in 50 will get ovarian cancer
at some time during her life.
Q. How dangerous are ovarian cancers?
A. In 2002, 4,687 women in the UK died of ovarian cancer,
making it a more common cause of death than cervical and
uterine cancer combined. In the USA it is estimated that
16,000 women will die from ovarian cancer in 2004.
Q. What are the risk factors for ovarian cancer?
A. Like most cancers it is more common with increasing age.
The other risk factor is if you carry certain genes (see
below). Having children reduces the risk: women with three
or four children have only half the risk of a childless
woman. Infertile women (ie women who cannot conceive despite
trying for several years) appear to have an even higher
risk than other childless women. Taking the contraceptive
pill reduces the risk of ovarian cancer by somewhere between
a third and a half, depending on how long it is taken for.
Although the effect of hormone replacement therapy (HRT)
on ovarian cancer risk has been studied, the results are
unclear. Some studies have found an increased risk, but
analysis of all the published research shows conflicting
results.
There have been some reports claiming that using talc in
the genital area increases the risk of ovarian cancer. However,
most of the research conducted on this has not produced
reliable findings and there is no good evidence to support
these claims.
Q. Does the diet affect the risk of ovarian cancer?
A. There is some evidence that being overweight can increase
your risk of ovarian cancer. Some research has suggested
that beta-carotene in the diet can reduce the risk of this
cancer, although this finding has not yet been confirmed.
Q. Does ovarian cancer run in families?
A. There are several genes, which are known to carry increased
risks of various cancers, which can run in families. The
BRCA1 and BRCA2 genes were originally discovered because
they cause an increased risk of breast cancer, but we now
know that they also substantially increase the risk of ovarian
cancer. The HNPCC gene was discovered because it increases
the risk of colon cancer, but women with this gene also
have a greater chance of getting ovarian cancer. Overall,
if you have one close relative (mother, sister or daughter)
who has had ovarian cancer, your risk goes up about 4-fold.
If you have two cases amongst close relatives, your risk
goes up 10-fold or more.
Q. Can we screen for ovarian cancer?
A. There is no reliable method of screening for ovarian
cancer. However, both the CA125 blood test and vaginal ultrasound
are currently being tested as possible methods for screening
women for ovarian cancer.
Q. What are the symptoms of ovarian cancer?
A. There are few clear symptoms of ovarian cancer. Typically
it can cause pain in the abdomen, a feeling of being bloated,
fatigue, weight loss, or problems with urination. However,
these can all be caused by a number of other diseases. This
makes it difficult to diagnose ovarian cancer by symptoms
alone.
Q. How is ovarian cancer diagnosed?
A. If ovarian cancer is suspected, two main tests are used
to make the diagnosis. First, an ultrasound scan of the
abdomen is performed. Sometimes the scan is taken from inside
the vagina. The second test is to measure the level of the
CA125 marker in the blood. Neither of these tests gives
a definite diagnosis of ovarian cancer, but if both tests
are positive, the patient is usually referred to a surgeon
who will operate to see if the ovaries show any signs of
cancer.
Q. How is ovarian cancer treated?
A. The treatment used will depend on how advanced the cancer
is and how old the patient is. For younger patients with
early cancer, limited surgery is used to preserve their
fertility. For older patients with more advanced cancers,
the ovaries and the womb are usually removed. If the cancer
has spread, further tissue may need to be removed to get
out as much of the cancer as possible. Chemotherapy is normally
used after the surgery to kill any remaining cancer cells.
Sometimes it is also used before the surgery to shrink the
tumour and make it easier to remove completely.
Q. How effective are the treatments?
A. Overall, only about two out of every five women with
ovarian cancer can be cured. Like all other cancers, the
stage at which ovarian cancer is diagnosed determines how
easily it is to cure. If diagnosed and treated while the
cancer is still confined to the ovaries, nearly 75% of women
can be cured. However, once it has spread into the pelvic
cavity, the cure rate drops to one third. If it has spread
further, only one quarter to on sixth of patients can be
cured. For these figures 'cured' is defined as surviving
for five years after the first diagnosis.
http://www.aicr.org.uk/
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