Ovarian Cancer

Who is the ideal person for this information?

– Patient with diagnosis of ovarian cancer

– Partner, family member or relative of ovarian cancer patient

This information includes common symptoms, type, diagnosis of ovarian cancer and treatment you may be offered. Being diagnosed with ovarian cancer is distressful for patient and her close relatives; our team will guide and support you throughout cancer journey. This leaflet is to supplement the support you will get.

What is ovarian cancer and how common is it in India?

Cancer is a disease of cells in the body that don’t have control over their growth. Normal cells grow and multiply in a systematic manner. The new cells are made only when they are needed. Due to changes in this normal process, cells don’t have control and they grow & multiply too quickly. As they grow more & more, they damage normal tissue and organs of the body.

Ovarian cancer occurs when normal cells in the ovary change into abnormal cells and grow disproportionately without any control. Ovarian cancer occurs most commonly in 50-60 years of age group, but can happen in younger (<20 years) or older women. Ovarian cancer is the 3rd most common female cancer in India. Sometimes ovarian cancer can be hereditary.

There are three types of ovarian cancer. Below information is for epithelial ovarian cancer which is most common (90%).

What are the protective factors for ovarian cancer?

– Oral contraceptive pills

– being pregnant or breastfeeding

What are the factors responsible for ovarian cancer?

In most cases, the reason behind ovarian cancer is unknown. However, there are factors that can be responsible for ovarian cancer (Not having risk factors doesn’t mean that you won’t get cancer or having risk factors doesn’t mean that you will get cancer).

– Older age

– Female relatives with ovarian or breast cancer

– Known close relative with BRCA gene mutation (mother, sister, daughter, aunty)

– History of infertility

– No children (minimal possibility)

– Early menarche or late menopause

What are the symptoms of ovarian cancer?

Symptoms of ovarian cancer can include:

• distended abdomen or feeling bloated
• Lower abdominal pain
• Change in appetite, feeling full quickly or having trouble in eating
• Feeling to urinate often or urgently
• Loss of weight

These symptoms are common feelings. Conditions other than ovarian cancer might also cause these. But if you start feeling these symptoms and if they continue for more than a day or two, you should tell your doctor.

Many women don’t have symptoms of ovarian cancer, but they come to know when a growth is found.

How is it diagnosed?

These Investigations are used commonly to detect or suspect ovarian cancer.

• Ultrasound or other imaging tests–These tests generate images of the inside of the body and can display abnormal growths.
• Blood tests–There is no blood test that can confirm if a woman has ovarian cancer. Increased CA 125 level in blood is associated with an increase in chance of ovarian cancer. However, there are multiple conditions which elevate CA 125 level in blood.
• CT (computed tomography) scan: this imaging test done to assess abdomen and pelvis in detail. Sometimes you may be advised to have a biopsy.

Final diagnosis of ovarian cancer can be done by histo-pathological examination of ovarian tissue specimen only.

What is cancer staging?

Cancer staging is a way in which doctors look at how far a cancer has spread. This is done by doing surgery.

How is ovarian cancer treated?

Surgery and chemotherapy are essential pillars for ovarian cancer treatment and generally both are given in majority patients. For most women, surgery to remove cancer is the first treatment which is followed by chemotherapy if needed. Other women might need first treatment with chemotherapy followed by surgery according to the spread of ovarian cancer. Chemotherapy is a medical term for medicine that kills cancer cells and stops their growth.

What if I want to get pregnant after cancer treatment?

If you want to have a baby after cancer treatment, tell your doctor at the time of diagnosis of cancer and before cancer treatment planning. Usually women with ovarian cancer are unable to get pregnant after treatment, but for some women it may be possible to plan treatment so that pregnancy is still possible.

What happens after ovarian cancer treatment?

After treatment, we will check you every 3-month interval for the first 2 years after treatment. This close follow-up visit intended to see if the cancer comes back. Follow-up visits usually include blood tests, examination and imaging tests. If you have symptoms similar to the time of diagnosis, then tell your doctor.

What happens if the ovarian cancer comes back or spreads?

If the cancer comes back or spreads, you might require more surgery, chemotherapy or targeted therapy. Your doctor will give you more information and suitable option for treatment in this situation.

Can ovarian cancer be prevented or diagnosed early?

If ovarian, breast, prostate or pancreatic cancer runs in your family, talk to your doctor. There might be things you can do to keep from getting cancer or early diagnosis. Experts recommend ovarian cancer screening for patients with high risk for ovarian cancer.

What else should I do and ask my doctor?

It is important to follow all your doctors’ instructions about visits and tests. It’s also important to talk to your doctor about any side effects or problems you have during treatment. It is important to inform your doctor about any symptoms or side effects to follow his/her instructions carefully. Always express your expectations and feelings about treatment with your doctor. Anytime you are offered treatment plan, it is better to ask:

• What are the benefits of this cancer treatment? Will it reduce or relieve my symptoms?
• What are the side effects to this treatment?
• What other treatment is there beside this plan?
• What happens if I do not wish to have this treatment?