What is ovarian cancer?

The ovary is the organ which produces eggs in women. These eggs then travel to the uterus through the fallopian tubes during ovulation. Sometimes epithelial cells or germ cells inside the ovaries multiply excessively, generating a tumour mass inside the ovary itself.

There are several kinds of ovarian cancer:

• benign tumours: for example, ovarian cysts
• epithelial ovarian tumours: these represent more than 90% of ovarian malignancies and are arise from the epithelial cells surrounding the ovaries;
• germinal tumours: this type of cancer comes from germ cells. These tumours make up for 5% of malignant ovarian cancers and almost exclusively affect children and young people;
• stromal tumours: these are generally less dangerous and account for 4% of malignant ovarian tumours. This kind of cancer is derived from the gonadal stroma and it causes an uncontrolled hormone production (both male and female).

What are the symptoms of ovarian cancer?

The symptoms of ovarian cancer can be difficult to recognise, particularly early on, since in the early stages this kind of tumour is asymptomatic, and symptoms are similar to a number of other conditions. Symptoms can include:

• bloating
• loss of appetite
• feeling the need to urinate frequently.

How is it diagnosed?

The most common tests to make a diagnosis are:

• transvaginal ultrasound (TVU)
• abdominal computed tomography (CT) scan
• barium enema X-rays
• magnetic resonance imaging (MRI)

What causes ovarian cancer?

It is not clear yet what exactly causes ovarian cancer, but the following factors may increase your risk of getting ovarian cancer:

• increasing age (especially after menopause)
• never having carried a pregnancy to full term;
• early menarche (first menstrual cycle)
• late menopause
• genetic predisposition: this affects 7-10% of women diagnosed with ovarian cancer and may cause the tumour to grow in younger women. If there have been several cases of breast cancer or ovarian cancer in your family, it may be helpful to see a genetic counsellor in order to know whether you’ve inherited a faulty gene.

How can it be prevented?

Compared to the general female population, women who have had children, women who have breastfed and women who take the combined contraceptive pill have a lower risk of getting this kind of cancer.

Although you cannot prevent ovarian cancer, the best way to minimise the impact of the condition if it develops is to get an early diagnosis. If you think you may be at a higher risk of ovarian cancer, an annual gynaecological check-up may increase your chances of detecting it early on.

How can it be treated?

The most common treatments for ovarian cancer are:

• surgery
• chemotherapy
• radiotherapy: this is a palliative treatment aimed at relieving the pain from the cancer symptoms

Which doctor should I talk to?

You’ll see a gynaecologist for your first examination. If you are diagnosed with ovarian cancer, the doctor will advise you to see an oncologist.