DURATION: Up to 30 minutes.
ANAESTHESIA/PAIN RELIEF: None normally required for blood test/imaging. Biopsy – local anaesthetic. Rarely a laparoscopy – general anaesthetic – is required.
RECOVERY TIME: None
SPECIAL REQUIREMENTS: None.
SUITABLE FOR: Women who are concerned they may have ovarian cancer or have a family history of this condition.
Ovarian cancer describes any form of cancer that can originate in the ovaries, the fallopian tubes or the lining of the abdomen.
As the organs responsible for producing and storing a woman’s eggs, the ovaries are one of the most important parts of the female reproductive system and play a crucial role in a woman’s ability to have a baby.
No longer useful after the menopause, the ovaries are perhaps more vulnerable to playing host to mutated cells once periods have come to an end – this is evidenced by ovarian cancer being more common in women over the age of 50. It should be noted, however, that it is possible to develop ovarian cancer at any age.
The cause of ovarian cancer is unknown and its development is quite often not influenced by any sort of genetic link. In fact, up to 90% of ovarian cancers occur in women with no known risk factors or family history of this condition. After diagnosis of ovarian cancer a BRCA gene mutation analysis will be performed, some women are subsequently found to either have this mutation in the ovarian cancer or actually be found to carry the BRCA gene mutations in there normal cells.
What is ovarian cancer?
Ovarian cancer is a cancerous growth arising either from the ovaries, fallopian tubes or the lining of the abdomen (peritoneum).
Like all other types of cancer, ovarian cancer occurs when abnormal cells begin to grow out of control infiltrating healthy surrounding tissues leading to the formation of tumours. Put simply, ovarian cancer can describe any type of cancer that has its roots in the ovaries and, although devoid of a definite cause, can be said to be influenced by a number of factors. Approximately 10% of ovarian cancer is a hereditary condition, which makes those with a family history of the disease more prone to its development.
There is also evidence to suggest that lifestyle factors such as smoking and obesity can have a bearing on the emergence of ovarian cancer, with those in possession of an underlying health condition such as endometriosis also potentially more at risk.
What are the symptoms of ovarian cancer?
It may surprise you that the leading early symptoms of ovarian cancer are not necessarily confined to the vaginal and pelvic region. Although abnormal bleeding and pain in the reproductive areas are common symptoms, seemingly unshakeable bouts of bloating, a frequently swollen stomach and changes to your appetite could all be signs of ovarian cancer. Owing to the nature of these symptoms, they can commonly be confused with those of irritable bowel syndrome, or IBS. This really drives home the importance of seeking medical attention to pursue further testing in this area.
Symptoms of ovarian cancer can include:
- Feeling very full when eating
- Persistent pain or discomfort in the pelvis
- Abdominal pains
- A swollen tummy
- Needing to urinate more frequently
- Loss of appetite
- Unexplained weight loss
- Altered bowel habit
Screening for ovarian cancer
Screening for ovarian cancer in low-risk individuals has not been proven to be effective.
UKCTOCS, the largest ovarian cancer screening study to date for low risk women (with no symptoms), demonstrated that, although there were some benefits to use of both USS and Ca125 blood testing to determine the presence of this cancer at an earlier stage, the long term follow up data published in the Lancet 12/05/21 demonstrated this has not been beneficial to long-term survival.
However, in high-risk women with a strong family history of this illness, this type of ovarian cancer screening may be advantageous and support discussion regarding timing of preventative surgery which is recognised as the most effective method of preventing ovarian cancer.
When you visit Mr Gardner for ovarian cancer screening, you will be asked to undergo a blood test and an ultrasound scan. In some situations, there may also be a need to drain a small amount of fluid from within the abdomen. This can usually be completed without any form of anaesthetic.
In cases where a biopsy is required, this will normally take place whilst you are awake. A local anaesthetic will be administered to the skin and a fine needle used to take a sample of tissue from the appropriate area.
If it is necessary for you to undergo a laparoscopic assessment, this will be performed under general anaesthetic. It should be noted that this is not a common method of ovarian cancer screening and will only be considered if other forms of investigation have been unsuccessful.
It should be mentioned that treatment for ovarian cancer will normally involve a combination of surgery and chemotherapy, as well as targeted therapy.
Mr Francis Gardner
Over many years of practising many advanced forms of gynaecology, Mr Francis Gardner has established himself as a respected medical practitioners in his field. He is a dual-accredited gynaecologist, specialising in both gynaecology and gynaecological oncology.
Since qualifying in 1992, he has developed his skills in the fields mentioned above and has spent the last 28 years working tirelessly to provide all of his patients with an exceptional standard of care.
To book in for your ovarian cancer screening test, contact Mr Gardner today.
The symptoms of ovarian cancer are very non-specific and may be confused with the symptoms of conditions such as irritable bowel syndrome (IBS). However, if you are concerned about these symptoms or they start to become more aggressive, it is always advisable to book in for a screening to rule out the presence of ovarian cancer.
Although ovarian cancer predominantly affects women who have gone through the menopause, it can also occur at any age.
This is critical to the long-term outcome of the disease. If this is detected at stage 1, the patient will likely make a full recovery with 93% of women surviving 5 years. Treatment for post-menopausal women diagnosed with stage 1 ovarian cancer usually involves a full hysterectomy, with removal of the ovaries and fallopian tubes and also the omentum (a fat pad in the stomach.
If ovarian cancer is detected at stage 3 or higher, treatment becomes more complex and will often comprise surgery, chemotherapy and targeted therapy. The recovery rate for those diagnosed with stage 3 ovarian cancer sits at around 56%.
After undergoing an ultrasound scan, it may be possible to give a clinical impression of whether an underlying problem may be present. The results of a CA125 blood test and any further imaging tests may take a few days to come back. These things will be able to determine both the presence of ovarian cancer and how far this has progressed.
Fluid from the abdomen or a biopsy will be taken to confirm a diagnosis.
Ovarian cancer can only be confirmed with analysis of tissue or fluid showing ovarian cancer cells.
Initial screening is with a Ca125 blood test and an ultrasound scan. If there is a concern raised at this point then further imaging tests with CT or MRI will be required. A decision is then made with the support of a Multi-disciplinary team (MDT) discussion as to whether an operation is indicated with the information available or whether an ultrasound guided biopsy is indicated to confirm the diagnosis. Either way tissue will be obtained which will confirm or refute the diagnosis.
Fortunately on many occasions an abnormally raised Ca125 blood test is linked to other conditions including common conditions such as endometriosis in young women and liver conditions and heart failure in elderly women. Furthermore the majority of complex ovarian masses seen on ultrasound are also due to benign conditions so although they may require an operation they may not be linked to a final cancer diagnosis.