Ovarian cancer is the fifth most common cancer affecting women in Singapore. The Department of Obstetrics & Gynaecology at Singapore General Hospital (SGH), a member of the SingHealth group, shares what are the risk factors that put women at risk of this 'silent killer'. (iStock photo)
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.
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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).
Ovarian cancer occurs when ovarian cells begin to grow in an uncontrolled manner and produce tumours in one or both ovaries. Although it usually occurs in postmenopausal women over the age of 50, it can be diagnosed at a younger age, sometimes even during infancy.
One in 10 ovarian cancers is caused by an inherited faulty gene. Your risk of getting the disease is also 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.
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Types of ovarian cancer
The three basic types of ovarian tumours include:
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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
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Germ cell tumours: These tumours occur in the egg-producing cells of the ovary and generally occur in younger women
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Stromal tumours: These start from cells that hold the ovary together and produce female hormones
Risk factors for ovarian cancer
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.
Age – Ovarian cancer tends to develop after menopause, but younger women can get it too.
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Childbearing status – Your risk increases if you've never had children or been pregnant.
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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.
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Obesity in early adulthood – Women obese at the age of 18 have an increased risk of developing ovarian cancer before menopause.
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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.
Although ovarian cancer is known as a 'silent killer' as the symptoms are non-specific, recent studies have shown that there are red flags for the condition such as:
- Abdominal or pelvic pain
- Increased abdominal size or bloating
- Urinary frequency or urgency, and
- Early satiety, which are frequent (on average at least three times a week), persistent, and new to the patient (starting in recent months or weeks)
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