Ovarian cancer is the fifth most common cancer in Singaporean women. It’s the second most common female genital tract cancer (after endometrial cancer), averaging about 317 cases annually, according to the Singapore Cancer Registry 2008-2012.

Here's what every woman needs to know when it comes to ovarian cancer.

Although a woman’s chance of getting ovarian cancer may not seem very alarming – about 1 in 71 – up to 80 per cent of cases are only diagnosed at an advanced stage due to a lack of early symptoms.

Diagnosing ovarian cancer at an early stage is crucial as it is associated with a cure rate of up to 90 per cent. However, once the disease has spread beyond the ovary, the 5-year survival rate drops to as low as 20 to 25 per cent (for stage 4).

Causes of ovarian cancer

Women have two ovaries, one on each side of the womb, which produce eggs and female hormones during a woman’s reproductive life.

According to the gynaecological cancer team at the Depa​rtment of Obstetrics & Gynaecology, Singapore General Hospital (SGH), a member of the SingHealth​ group, ovarian cancer occurs when ovarian cells begin to grow in an uncontrolled manner and produce tumours in one or both ovaries.

One in 10 ovarian cancers is caused by an inherited faulty gene.​ Your risk of getting the disease is increased four-fold if your sister or mother has it. Furthermore, ovarian cancer is known to run in families with a history of breast cancer, uterine and colorectal cancer. There are means to test for such mutations to help counsel patients on prevention.

Types of ovarian cancer

The three basic types of ovarian tumours include:

  • Epithelial tumours: This is the most common, making up 85 to 90 per cent of ovarian cancers. It develops from one of the cells that surround the exterior of each ovary.
  • Germ cell tumours: These tumours occur in the egg-producing cells of the ovary and generally occur in younger women.
  • Stromal tumours: These start from cells that hold the ovary together and produce female hormones.

Ovarian cancer symptoms

Ovarian cancer symptoms have three characteristics:

  • Frequent - they usually happen more than 12 times a month (3 times per week)
  • Persistent - they don't go away
  • New to the patient- they've started in recent months or weeks

They include the following:

  1. Persistent pelvic or abdominal pain
  2. Increased abdominal size / persistent bloating (not bloating that comes and goes)
  3. Difficulty in eating, and feeling full quickly
  4. Urinary symptoms (urgency / frequency)

Risk factors for ovarian cancer

Factors that put you at an increased risk of developing ovarian cancer include:

  1. Inherited gene mutations – Having an inherited mutation in genes called breast cancer gene 1 (BRCA 1) and breast cancer gene 2 (BRCA 2), which are linked to about 5 to 10 per cent of ovarian cancers.
  2. Age – Ovarian cancer tends to develop after menopause, but younger women can get it too.
  3. Childbearing status – Your risk increases if you’ve never had children or been pregnant.
  4. Having other cancers – If you or a first-degree relative (mother, daughter, sister) have had breast cancer, colon (colorectal) cancer or cancer of the uterus (womb), your risk of getting ovarian cancer may increase.
  5. Obesity in early adulthood – Women obese at the age of 18 have an increased risk of developing ovarian cancer before menopause.
  6. Long use of hormone replacement therapy (HRT) – Use of HRT for five or more years has been shown to significantly increase the risk of ovarian cancer.

Ovarian cancer has been known as the "silent killer" as the symptoms are non-specific. However, recent studies have shown that patients tend to have symptoms with particular characteristics, which can be identified.

These symptoms are red flags for ovarian cancer:

  1. abdominal or pelvic pain,
  2. increased abdominal size or bloating,
  3. urinary frequency or urgency, and
  4. early satiety, which ar​e frequent (on average at least three times a week), persistent, and new to the patient (starting in recent months or weeks).

Read on to learn how ovarian cancer can be prevented and t​​reate​d​.

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​Ref: P16