Worried you may have ovarian or cervical cancer? To know more, Dr Timothy Lim, Head and Senior Consultant from the Department of Gynaecological Oncology at KK Women's and Children's Hospital, gives detailed answers to your questions.
Ovarian cancer and cervical cancer are among the top 10 most common cancers in females in Singapore. Persistent bloating is a symptom of ovarian cancer while abnormal vaginal bleeding may be a sign of cervical cancer. Catching these cancers early improves the chance of recovery.
Dr Timothy Lim, Head and Senior Consultant from the Department of Gynaecological Oncology at KK Women's and Children's Hospital, gives detailed answers to your questions.
Question by rsim
Hi Dr Lim, Besides persistent bloating symptom, what are other symptoms of ovarian cancer?
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
Ovarian Cancer does not present with specific symptoms, but the majority of patients do complain of swelling of the abdomen, early satiety, pressure symptoms such as urinary frequency or constipation, abdominal or pelvic discomfort/pain. Some women may even feel a lump in the abdomen or experience irregular menses or vaginal bleeding. Women should be aware of these symptoms and seek medical help if the symptoms persist for more than two weeks.
Question by Chai
Dear Dr Lim, What are the preventive measures available for ovarian cancer?
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
Prevention of ovarian cancer is difficult. However research has shown that women on contraceptive pills have a 50% lesser risk of getting ovarian cancer if taken for five years or more. Other factors associated with a reduced risk include pregnancy, breastfeeding, hysterectomy and tubal ligation. Prophylactic removal of ovaries in women at high risk of ovarian cancer e.g. BRCA carriers have also been shown to reduce ovarian cancer risks.
Question by pocoyosky
Hi Dr Lim, What are the causes of ovarian cancer?
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
The exact cause is unknown but we do know that there are some risk factors which pre-dispose some women to develop ovarian cancer. Post-menopausal women above 55 years of age have a higher risk of developing ovarian cancer. Women with a strong family history of breast and ovarian cancer also have an increased risk. In fact, hereditary factors account for about five to ten percent of all ovarian cancers, especially in women who are carriers of the breast cancer genes BRCA 1 and 2. Research has also shown that women who are obese, infertile, nulliparous or have endometriosis are at an increased risk of developing ovarian cancer.
Question by mrina
Dear Dr Lim, What are the chances of recovery if we catch ovarian cancer at early stage? Will there be a relapse again?
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
Ovarian cancer can be cured if detected at an early stage. The five-year survival of stage one is about 76 to 93%. However, there is always a chance of a cancer relapse.
Question by esim
Dear Dr Lim, What are the treatment options for cervical cancer? Is heavy menses flow a sign of cervical cancer?
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
The treatment options for cervical cancer depend on the stage of the disease. In very early stages, usually surgery alone would suffice. However, in advanced disease, surgery is not an option and radiotherapy with or without chemotherapy is the treatment of choice.
The most common symptom would be post coital bleeding, which is bleeding after sex. Other symptoms include irregular prolonged bleeding, inter-menstrual bleeding, postmenstrual bleeding as well as abnormal vaginal discharge.
Question by sch
Dr Lim, How can we detect ovarian cancer early? Is stomach scan the detection test?
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
In general there is no effective method of screening for early ovarian cancer currently in the general population. Even yearly ultrasound scans of the ovaries may miss interval development of ovarian cancer. The routine use of blood tumor markers for screening is also not recommended because it can be abnormal in many other non-cancer conditions and lead to unnecessary interventions and anxiety.
However, in women who are at high risk of ovarian cancer e.g. BRCA carriers, screening with ultrasound scan of the pelvis and blood tumor markers such as CA 125 may help to detect early cancers. Awareness of the symptoms of ovarian cancer is important and may lead to early detection in some women.
Question by dsim
Dr Lim, Is it true that single female has lesser risk to ovarian cancer than married with kids female because they did not experience childbirth?
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
On the contrary, women who have not given birth are at an increased risk of developing ovarian cancer.
Question by ireneneo
Dear Doc,
What are the chances of getting ovarian cancer with a recurrent growth of ovarian cyst over a period of time?
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
It depends on the type of ovarian cysts. In fact most ovary cysts are non-cancerous in nature and will not become cancer. However, women with endometriotic cysts are at an increased risk of ovarian cancer.
Question by mosmos
Dear Dr Lim, Does a small tumour found on the vaginal and not removed, lead to ovarian cancer and cervical cancer in the future? Thanks.
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
It depends on the nature of the tumor in the vagina. If it is a non-cancerous growth, it will not lead to cancer of the ovary and cervix.
Question by octane
Hi Dr Lim, Does a family history of cancer add to the increase risk of getting ovarian cancer and cervical cancer?
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
Yes, women with a strong family history of breast and ovarian cancer have an increased risk. In fact, hereditary factors account for about five to ten percent of all ovarian cancers, especially in women who are carriers of the breast cancer genes BRCA 1 and 2.
Question by janey
Does having taken hormonal tablets such as Clomid at an earlier age make a woman at higher risk of any cancer like ovarian cancer?
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
Women who take infertility medication such as clomid or have undergone infertility treatment such as In-Vitro Fertilisation (IVF) have a slightly increased risk of ovarian cancer.
Question by leelianhuay
Dear Dr Timothy
i perceive if a normal healthy person who decides not to have any more babies removes her ovaries & womb, she will not catch the ovarian cancer. Is this true ? Thank you.
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
Yes, prophylactic surgical removal of ovaries in women at high risk of cancer (i.e. BRCA gene carriers) has also been shown to reduce the risk of ovarian cancer. But this is not recommended for the general population as removal of ovaries means stopping the body’s production of estrogen which causes surgical menopause and menopausal symptoms like bone loss, increased risk of heart diseases and osteoporosis may happen.
Question by anggielow
What are the symptoms of ovarian cancer? Are there any tests that can be carried out to see if one has ovarian cancer?
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
Ovarian Cancer does not present with specific symptoms and the majority of patients complain of swelling of the abdomen, early satiety, pressure symptoms such as urinary frequency or constipation, abdominal or pelvic discomfort/pain. Some women may even feel a lump in the abdomen or experience irregular menses or vaginal bleeding. Women should be aware of these symptoms and seek medical help if they experience any of these for more than two weeks or if they are recurrent.
The use of serum blood markers or ultrasound scan of the pelvis may help to diagnose ovarian cancer. But generally there is no proven cost effective method of screening for ovarian cancer currently in the general population.
Question by aejdr
Hi Doctor,
Can removing ovaries prevent ovarian or cervical cancer? Will there be any post health issues after the removal?
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
Yes, removal of the ovaries mean stopping the body’s production of estrogen which causes surgical menopause and menopausal symptoms like bone loss, are at increased risk of heart diseases and osteoporosis may happen. However, it does not mean she will age earlier than those in her age group.
Question by miiow
Good day,
Dr Lim! If a woman were to remove her uterus and ovaries, is it to say she's reached menopausal stage and losing estrogen which will cause her to age earlier than those at her age group?
Thank you for your precious time!
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
Yes, removal of the ovaries mean stopping the body’s production of estrogen which causes surgical menopause and menopausal symptoms like bone loss, are at increased risk of heart diseases and osteoporosis may happen. However, it does not mean she will age earlier than those in her age group.
Question by laipc08
Dr. Lim, Is Ovarian cancer only related to married woman and not affected to single? Can single woman opt from yearly test even when they growth old? Thks
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
No, in fact women who are single are at risk too. Women who do not have children or are infertile are at an increased risk of ovarian cancer. A single woman can opt for yearly tests though this is not scientifically proven.
Question by elgasg
Hi Doctor,
Can you kindly advise what are the screening methods available for early detection of these cancers?
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
There is no proven method of screening for ovarian cancer currently. Even yearly ultrasound scans of the ovaries may miss interval development of ovarian cancer. The routine use of blood tumor markers for screening is also not recommended because it can be abnormal in many other non-cancer conditions and lead to unnecessary interventions and anxiety.
However, in women who are at high risk of ovarian cancer e.g. BRCA carriers, screening with ultrasound scan of the pelvis and blood tumor markers such as CA 125 may help to detect early cancers. Awareness of the symptoms of ovarian cancer is important and may lead to early detection in some women. For cervical cancer, pap smear tests have been shown to be effective in early detection.
Question by evefarrashid
hi, i have a question/s that ive longed wondered. googled in numerous times and breakdown most of the time. i am 24 yrs old and i have problems with my discharge and periods. my first period when i was 14 and i got 4-6 times per year. and subsequently 5-7 times per year. ive skipped the 5mnths the longest. i went to the doctor and she keep telling me "why are you worried? you are scared to be pregnant right?" i was 17 at that time and i did not have any sexual contact and that was the rudest remark i ever heard. till then, i was afraid to visit any doctor. so i let my period cycle be and it is still irregular at this age.. so lately this year. i was infected with yeast infection. i visit the doctor and the gave me the pill to be inserted into my vagina. it cleared and i got it again two months later. i did papsmear and it came back normal but yeast infection was detacted. ive heard that we shouldn't get the infection more than 2-4 times per year. and i tink i will get it in few months time. im so afraid if the period and infections related to any form of ovarian or cervical cancer. im so so afraid. i don't know where to start. from my diet? hygiene? or my my body mind and soul. So doctor, why am i dealing with this things? are they related? how can i prevent all of this?
p/s: to add, i do have bloating at certain time of the month and my bleeding comes and goes.. and it smells. ive been finding ways to eliminate all these things wish me luck to find the answer :( its very embarrasing
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
We are sorry but we are not able to share medical advice or recommendation through this platform. I would recommend you seek an expert opinion of a gynaecologist to address your concern.
Question by jennifer_aw02
Hi Dr Lim, Just wonder does large blood clot during menses (happen on 2nd day only) eventually turn out to be ovarian or cervical cancer?
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
We are sorry but we are not able to share medical advice or recommendation through this platform. I would recommend you seek an expert opinion of a gynaecologist to address your concern.
Question by motjan
Dear Dr Lim, can pap smear detect early stage of cervical cancer and ovarian cancer?
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
A pap smear can detect early stage cervical cancer but it is not used for screening of ovarian cancer.
Question by xxxxx674j
I am worried about ovarian cancer n breast cancer. My mother had breast cancer n died at 44. How do I ascertain my risk? What kinds of check up do i go for. I am age 40. Recently i been having prolonged menses is it a cause for worry.?
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
You would first need to consult a gynaecologist to address your menstrual problem and ascertain your risk of ovarian and breast cancer. At the age of 40, it is advisable to go for a yearly mammogram.
Question by rjasmin
hi Dr Lim, I had my womb and my left ovary removed in 2012 due to endometriosis and fibroid. What are the chances of me getting ovarian cancer now that am left with one ovary and had endometriosis before. Are there any diet that i should practise to maintain a healthy ovary. I'm in my late 40s and has never given birth before. Thank you
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
Women with endometriosis and women who have never given birth before are at an increased risk of ovarian cancer. You should continue to see your gynaecologist for follow-up.
Question by chu
Dear Dr Lim, HPB website mentioned that HPV vaccination is recommended for women who are below 26 years old. Does it mean the effect of the vaccine is greatly reduced/or does not work for women beyond the age?
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
Yes, the effect of the vaccine is reduced for women above 26 years old but as long as a woman has not been exposed to or been infected with any of the vaccine types of HPV, they will benefit from vaccination. After immunisation, it is important to remember that the vaccination only provides 70% protection. All sexually active women must continue with regular Pap smears, at least once every three years.
Question by ivee
A good day to you! I have these symptoms:
- a lump which doctors said is just a scar from my C-section about 8 years ago. During my monthly period it feels swollen and bigger.
- sometimes I feel some pricking pains in my abs that last about 2-4 secs, but I also feel this sometimes in my chest/stomach/abs
- my abs feels bloated/hard most of the time and painful when got bump
- I had a pap smear, can this check for ovarian and cervical cancer?
Thank you!
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
We are sorry but we are not able to share medical advice or recommendation through this platform. I would recommend you seek an expert opinion of a gynaecologist to address your concern. Pap smears can help detect early cervical cancer but there is no cost effective method of screening for ovarian cancer currently.
Question by evelynyee
Dear Dr Lim,
Does our regular pap smear test done sufficient enough to detect both Ovarian Cancer as well as Cervical Cancer? Or do we need any other type of tests to check & prevent both Cancers?
Thks so much fr yr kind advice.
Evelyn
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
A pap smear can detect early stage cervical cancer but it is not used for screening for ovarian cancer. There is no cost effective method of screening for ovarian cancer currently. Yearly ultrasound scans of the ovaries may miss interval development of ovarian cancer.
The routine use of blood tumor markers for screening is also not recommended because it can be abnormal in many other non-cancer conditions and lead to unnecessary interventions and anxiety. However, in women who are at high risk of ovarian cancer e.g. BRCA carriers, screening with ultrasound scan of the pelvis and blood tumor markers such as CA 125 may help to detect early cancers. Awareness of the symptoms of ovarian cancer is important and may lead to early detection in some women.
Question by medfem
What follow-up is needed for one who has the following symptoms: early satiety, swelling tummy, constipation and feeling the need to go to urinate regularly throughout the day in recent months?
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
Please seek medical help if you experience any of these symptoms for more than two weeks or if they are recurrent.
Question by Babe Babe
Hi there, Confusion!!
I have 2 ovarian cysts which located at the right side and did consult the Private and Gov doc but the statement eventually is not equal.
Private advice to be ops but when come to Gov doc says not for the time being have to do a scan 6 months later and see how the results show.
Im confused as do not know which I should take even those the size area of the cyst is about 2.2 x 1.7 x 2.1cm, but if need to be remove still have to remove it soon or have to wait and have the 3rd scan?
Report show as below
:- Within the right ovary, there is a complex echogenic cyst containing smaller anechoic cystic area measuring 2.2 x 1.7 x 2.1cm.
No evidence of venous vascularity is seen within the cyst.
This may represent an ovarian dermoid / haemorrhagic cyst.
So based on the above what should I do? Shall I go to the 3rd opinion?
Look forward to your reply soon.
Babe Babe
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
We are sorry but we are not able to share medical advice or recommendation through this platform. I would recommend you seek an expert opinion of a gynaecologist to address your concern.
Question by wendyngbc
Hi there, What is the chances of single lady contracted Ovarian cancer or cervical cancer, as clinic or hospital stated that they are not recommended to do PAD SMEAR TEST, if they are not sexual intercourse?
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
Women who are single are at risk too Research has also shown that women who are obese, infertile, nulliparous or have endometriosis are at an increased risk of developing ovarian cancer.
Cervical cancer is attributed to a sexually transmitted virus called the Human Papilloma Virus (HPV). This virus is said to account for 99.7% of all cervical cancers. Most sexually active women will have been exposed to this virus. If you have not had any sexual intercourse, you may want to consider taking the HPV vaccine to protect you from cervical cancer. Vaccination provides 70% protection and all sexually active women must continue with regular Pap smears, at least once every three years.
Question by labbit87
Hi Dr Lim, I know that there are 2 versions of HPV vaccinations: Gardasil and Cervarix. From talks on cervical cancer, I know that Gardasil protects against HPV 6, 11, 16, 18 whereas Cervarix protects against HPV 16 and 18. HPV 6 and 11 are for causing genital warts, whereas 16 and 18 for cervical cancer. 1) Gardasil also states that it protects against other cancers like vaginal and anal cancers. But does Cervarix protects against such other cancers as well? 2) Some evidence shows that the cross-influence of other HPV strands that cause cancer are better in Cervarix (but not significantly clear), is this true? 3) If I had the Cervarix vaccination, will it be better to also get the Gardasil vaccination to guard against genital warts? Or is Cervarix against cancers sufficient? 4) If a person is sexually inactive for her whole life (eg. a special child), she does not need to get the HPV vaccination? Thank you very much.
Answered by Dr Timothy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
Both vaccines are scientifically proven to be highly effective in preventing cervical cancer . The Merck Vaccine (Gardasil) offers protection against genital warts as well.
The protection against other cancers like vaginal cancer are shown in the Gardasil vaccine studies
There is some suggestion of cross protection against some other strains of HPV but the significance is unclear since the vaccine study was not designed to look specificallyy Lim Head, Pre-Invasive Disease & Screening Unit Department of Gynaecological Oncology KK Women’s and Children’s Hospital
Women who are single are at risk too. Women who do not have children or are infertile are at an increased risk of ovarian cancer.
Ref: S13
