Ovarian cancer, a deadly disease, is on the rise globally, and Ireland is no exception with over 600 new cases diagnosed each year and around 400 women losing their lives annually. Dr. Claire Thompson, a Consultant Gynaecological Oncologist at the Mater Misericordiae University Hospital and Rotunda Hospital, is raising awareness. She highlights common misconceptions about ovarian cancer – notably that many women mistakenly believe cervical screenings can prevent or detect it, which they cannot.
“This is why it’s so important for women to be aware of the symptoms of ovarian cancer, and to not ignore them.” Despite ovarian cancer’s symptoms being somewhat nebulous, Dr. Thompson emphasises the importance of vigilance. BEAT – an acronym to help recall the pivotal indicators: Bloating, Eating difficulty, Abdominal pain, and Toilet changes – was established by medical experts and charities.
Dr. Thompson strongly advises women experiencing these signs to consult their GP without delay and stresses the importance of not simply attributing them to conditions like endometriosis or IBS, reports RSVP Live.
As well as causing observable cysts or masses in the ovaries, ovarian cancer can lead to ascites – fluid accumulation within the abdomen, and impact additional organs such as the bowel and the peritoneum, the abdominal wall’s protective lining. If an individual presents with symptoms, a blood test to examine CA125 levels and an ultrasound scan will be conducted. Depending on the results, they may be referred to gynae-oncology teams for further investigation through CT or MRI scans.
A biopsy, which involves taking a tissue sample for cancer testing, can also be performed. “The biopsy can be performed in the X-ray department, or sometimes we bring a lady to theatre and do a procedure called a laparoscopy, where we have a look around the tummy to see what’s going on and take a biopsy at the same time,” explains Dr. Thompson.
Treatment:
“Treatment usually involves surgery and chemotherapy. Sometimes we do surgery first, followed by chemo. Other times, we do chemo first, then surgery, then more chemo. This is done if we can’t operate immediately or if the lady isn’t well enough.” Dr. Thompson adds that due to the nature of ovarian cancer and the fact that three out of four women are diagnosed when the cancer has already spread, it often tries to return.
Many of the newer, targeted treatments aim to keep this cancer at bay for longer. These include drugs that affect the blood supply to the cancer. “We use a drug called Avastin for that. There’s another drug called a PARP inhibitor, which acts on how cancer cells build themselves genetically. Those drugs are particularly useful in ladies with the BRCA gene.”
Research into the potential of immunotherapy in treating ovarian cancer is currently underway, she adds. When considering all stages of ovarian cancer, the five-year survival rate stands at approximately 40 percent. However, Dr. Thompson emphasises that early detection significantly improves prognosis, stating: “The treatments are continually improving too, cancers are being kept away for longer.”
Fertility:
High-grade serous is the most prevalent type of ovarian cancer and it has the potential to spread to other organs. “The surgery we have to do in that case involves removing both ovaries and the womb. That’s a hugely difficult thing to go through, especially for young women. There is a different type of cancer that very young women in their teens and 20s tend to get. It’s called a germ cell tumour, which presents as a big cyst on the ovary.
They respond very well to chemo and sometimes we can preserve their fertility, we can do things like egg retrievals. Unfortunately, the vast majority of ladies won’t have this option, as it’s totally dependent on the type of cancer.” If a woman’s ovaries and womb are removed, this results in her entering menopause, which brings its own set of challenges. Dr. Thompson explains that these women’s bone health must be monitored and traditional hormone replacement therapy isn’t an option due to the nature of ovarian cancer.
“Thankfully we have non-HRT drugs that can help with menopause symptoms. We are also setting up clinics for women who are experiencing menopause after cancer so they can get specialist help.”