Ovarian Cancer Awareness: Symptoms, Early Detection & Research

295,000 people are diagnosed with ovarian cancer worldwide every year and the sad truth is, ovarian cancer kills more women than the other four gynecological cancers combined (uterine, cervical, vaginal, and vulval).

We’ve seen so many inspiring stories in the past few weeks during Ovarian Cancer Awareness Month and so we want to talk about how we can prevent deaths from ovarian cancer by understanding more about this disease, its symptoms, and the need for more research.

Increasing awareness and understanding symptoms of ovarian cancer

Increasing your awareness of ovarian cancer and its symptoms means we can take quicker action against ovarian cancer because the earlier we can detect ovarian cancer, the sooner we can fight it. We need to take it upon ourselves to increase awareness and help save the lives of our friends, sisters, mothers, daughters, and even ourselves.

The best place to build awareness is by knowing what to look out for. The earlier ovarian cancer is diagnosed the better the outcome, yet Ovarian Cancer Action’s research shows that 90% of women do not know the main symptoms.

Ovarian cancer has four primary symptoms:

• Persistent stomach pain

• Persistent bloating

• Difficulty eating/feeling full more quickly

• Needing to urinate more frequently

Other symptoms might include back pain, changes in bowel habits (going more often or a lot less), and extreme tiredness for no obvious reason.

Now, these symptoms are also attributable to much less serious conditions such as IBS, ovarian cysts, and polycystic ovary syndrome - so if you are experiencing them - there is no need to worry right away.

Remember, it's all about awareness; being aware of how your body is feeling, listening to what it is telling you, and recognizing when things don't feel right. If any of the above symptoms are persistent, severe, frequent, or out of the ordinary it's best to call your doctor right away to make sure you are addressing whatever the situation is as soon as possible.

Ovarian cancer diagnoses and COVID-19

Recent research from Macmillan Cancer Support shows that in the UK during the first year of the pandemic, there were at least 50,000 “missing cancer diagnoses”, meaning that compared to previous years, 50,000 fewer people were diagnosed with cancer - and were therefore not being treated.

It’s important that you don’t let the COVID-19 pandemic prevent you from going to the doctor if you think you are experiencing any symptoms. GPs and hospitals are open and are working hard to make sure it is safe for you to attend.

Improving prevention & early detection

When we think about cancer prevention, we'd rather be one step ahead of the symptoms than experiencing them, and we can do that through preventative screening. But with ovarian cancer, this is where things get tricky. One of the biggest misconceptions about ovarian cancer is that it's screened and tested for during a routine cervical smear (or Pap smear). Unfortunately, that's not the case.

At present, there is no specific screening tool for ovarian cancer - and that's where part of the problem lies. There has been a lot of research into screening for ovarian cancer, but the success is limited. At the moment, there are 2 tests that are used the most often, in addition to a pelvic exam. These are:

1. Transvaginal Ultrasound (TVUS): this is a test that looks at the uterus, fallopian tubes, and ovaries by putting an ultrasound wand into the vagina. It can help find masses, but cannot detect whether they are cancerous or not.

2. CA-125 Blood Test: This test will measure the amount of a protein in your blood called CA-125. Some women who have ovarian cancer have high levels of CA-125. This test can be a good indicator for doctors and can be used to see if treatments for ovarian cancer are successful, but it has not been found to be effective in screening for ovarian cancer.

With a lack of screening, most women don't find out they have ovarian cancer until they have progressed into later stages of the disease, as symptoms become increasingly worse. Sadly, as with all cancers, as it progresses the chances of survival significantly drop. If a woman’s ovarian cancer is diagnosed at stage 1 she has a 90% chance of surviving for five years or more. However, only 33% of women are diagnosed at this stage. By stage 4 survival rate is as low as 4%. So how do we help fix this? Earlier detection and diagnosis. And how can we do that? Through continued research.

Why research matters for ovarian cancer prevention

Research has already uncovered an exciting and effective cancer prevention strategy that you should be aware of, and it's called BRCA testing. For a quick recap on what BRCA testing is, it's a blood test that checks for mutations in genes called BRCA1 and BRCA2, and it can help you better understand your chances of getting breast cancer and ovarian cancer. While we all have BRCA genes, some people (men and women) are born with a mutation at one of these BRCA gene locations. Now for both cancers, having a mutation at a BRCA location does not mean you will definitely develop breast or ovarian cancer, it just means that you are at a higher risk for these diseases.

So, while it's not a complete screening tool for ovarian cancer, it has important implications for this disease. A recent study, led by the University of Melbourne in Australia and in conjunction with 18 other countries across the world, followed nearly 10,000 women with BRCA1 and BRCA2 gene mutations for up to 20 years. They produced results that give a clearer idea of when women with BRCA1 and BRCA2 gene mutations are most likely to develop breast and ovarian cancer - something that could prove to be life-saving for so many women worldwide.

To give you the numbers, the study found that by the age of 80, BRCA1 gene mutation carriers had on average a 72% chance of developing breast cancer and a 44% chance of getting ovarian cancer. For BRCA2 mutation carriers, the risk is 69% for breast cancer and 17% for ovarian cancer by the age of 80. The study also showed that cancer risk increases rapidly at a younger age, peaking in the 30s for BRCA1 mutations carriers, and 40s for BRCA2 mutation carriers. Risk then remains high until a woman reaches her 80s, and not her 60s as previously thought.

It was found that a woman’s risk is higher where there are more cases of breast and ovarian cancer in her family history, compared to those women with few cases. This is interesting new information that can help women identify when they are going to be most at risk, and allow them to make more informed decisions about screening and when to have risk-reducing surgery. This is particularly important when thinking about things such as when to start a family as those who carry the faulty gene have a 50% chance of passing it on to their children and, if undiscovered, consequences can be devastating (read more on BRCA gene mutation). It also shows the importance of BRCA gene mutation carriers being aware of their family history of breast and ovarian cancer so they know if they are more at risk.

What all of this research hopefully encourages you to do is to take your health into your own hands by examining your family history and discussing with your doctor whether BRCA testing may be beneficial to you.

The need for more research on ovarian cancer

While recent research findings are incredibly promising and starting to make a change - we still need more research and more awareness. Despite what's been uncovered with BRCA testing, in 2017, charity Ovarian Cancer Action found that 29% of women diagnosed with ovarian cancer were not being offered BRCA testing and yet this is likely one of the best tools to identify carriers. According to the CDC, around 10% of ovarian cancer cases are linked to BRCA (meaning in 10% of ovarian cancer cases, the woman has a BRCA gene mutation) – this equates to around 2000 women a year whose lives could potentially be saved, and yet there are so many women who have not heard of the BRCA gene.

At the moment the diagnosis and treatment of ovarian cancers lags behind other high-profile diseases like prostate or breast cancer. More research is needed to prevent deaths through early diagnosis.

Have a question about Ovarian Cancer? Let us know in the comments. We’re here to help.

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