A B C D E F G H I J K L M N O P R S T U V W

CANCER OF THE OVARY

What is Cancer of the Ovary ?

There are two ovaries, one on either side of the womb. The normal ovary measures approximately 4 centimetres. After the menopause the ovary shrinks and in old age may become very small. The ovary is relatively free in the abdominal cavity and can enlarge considerably before pressing on other organs. This is why growths of the ovary may not become apparent until quite advanced. The symptoms of ovarian cancer are rather vague and this is another reason for late diagnosis. These symptoms include a general feeling of malaise and tiredness. Indigestion, loss of appetite and weight loss also occurs.

There may be shortness of breath, abdominal swelling and some swelling of the legs. Abdominal pain may occur but usually as a dull and vague discomfort. The abdominal discomfort is usually due to a fluid secreted by the growth called ascites. It may be so great that clothes no longer fit. It may press on the rectum causing diarrhoea or constipation. There may be an increased desire to pass urine. All these symptoms are caused by the increasing size of the tumours. Both ovaries are usually involved. As the tumour spreads inside the abdomen more structures are affected. The tumour may spread to the lungs causing difficulties with breathing. However, many ovarian growths are in fact benign and are cured completely by surgery.

How does Cancer of the Ovary occur ?

Ovarian cancer is more likely to affect women who have never had children. It is most common in women age 50-70 and rarely affects women under the age of 35. Some ovarian growths are due to cells which have lodged in the ovary from another growth elsewhere in the body. For example, tumours of the breast and bowel may spread to the ovaries. It may be the enlargement of the ovary, which is the first indication of a tumour elsewhere.

Why does Cancer of the Ovary occur ?

In most cases the cause of ovarian cancer is not known. A small proportion (about 1 in 100) of cases occur in families with a strong history of ovarian or breast cancer. This may due to a defective gene called BRCA that can be inherited. This only applies where several close relatives have ovarian or breast cancer however. A woman who has a strong family history of ovarian cancer should talk to her GP about this. He may suggest referral to a specialist cancer genetics clinic. Most women who have a single other family member affected by ovarian cancer are not at risk of inheriting the condition. Women who use the contraceptive pill are less likely to get ovarian cancer. The longer the pill is used the greater the degree of protection. Taking hormone replacement at the time of menopause does not increase the risk of getting ovarian cancer.

Treatment Involved for Cancer of the Ovary

This can be a difficult diagnosis to make. It is not always possible to tell if the growth is benign or malignant until it is removed. If your doctor suspects a growth in the ovary you will be referred for an urgent specialist opinion. Patients with ovarian cancer are referred, where possible, to hospitals which have cancer "teams" including surgeons, oncologists and nurses who specialise in the care of gynaecological cancers. The investigations will include blood tests, chest x-ray and scans of the abdomen and pelvis. It is important to establish whether the growth is secondary to a growth elsewhere. If this is the case it will be the primary growth that needs treating. The final diagnosis may not be made until an operation to remove the growth.

SURGERY an operation will be recommended to remove the growth. This will usually include removal of both ovaries, the womb (hysterectomy) and some of the fatty tissue attached to the bowel (omentum). Samples from any fluid in the abdomen and from lymph glands at the back of the abdomen may also be taken. The operation may be quite straightforward or quite long and complicated. Sometimes all the growth cannot be removed but it is still worth removing as much as possible. This means there is less growth to be treated by drugs or radiotherapy later.

CHEMOTHERAPY this means treatment with drugs, which kill rapidly growing, cells. This is exactly what a tumour is a collection of fast growing cells. Chemotherapy has improved the treatment of ovarian growths dramatically in recent years. There are different drugs, which may be used. They have nasty side effects, which include nausea, anaemia, tiredness and possibly loss of hair. These symptoms go when the treatment has finished and hair grows back, often better than before. Many people are afraid of chemotherapy but it is well worth doing if the doctor suggests it. Most chemotherapy is given in an intravenous drip for a few hours. The gap between treatments varies from a few days to a few weeks. Treatment is given for some months.

RADIOTHERAPY X-ray treatment is also used in ovarian growths in some centres but this is uncommon in the UK.

During Treatment of Cancer of the Ovary

The surgery of ovarian growths can be very extensive. Even so most patients will be up and about after a few days and ready for discharge after a week. This is not always the case. Chemotherapy will be started within a few weeks of the operation. The specialist, using regular blood tests at the time of each treatment very closely supervises all patients having chemotherapy. The doctor will prescribe drugs to help the nausea if that is a problem.

After Treatment of Cancer of the Ovary

Patients who have had ovarian tumours are usually followed up very regularly. This follow-up usually be for 5 years. Scans and x-rays may also be a regular part of the follow-up. If the cancer comes back treatment may be given using different variations in the drugs used for chemotherapy.

If Cancer of the Ovary is Left Untreated

Ovarian cancer continues to grow and spread if not treated. Benign ovarian growths can undergo twisting, bleeding, or rupture. All these complications would need an operation.

Effects on Family of Cancer of the Ovary

The treatment of this disease can be very wearing and depressing. You and your family will need a lot of support. You will be much too fatigued to undertake housework while under treatment. If the family cannot help, then home helps should be organised.