Category Archives: Ovarian Cancer

Frequently asked questions about ovarian cancer screening 2

Frequently asked questions about screening for ovarian cancer

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I have recently put up a post about ovarian cancer and as usual lots of people had question about the symptoms and also about proper screening. Just like many other serious health issues, there are lots of myths out there and why it is important to talk about the facts only.

Before I go into the frequently asked questions about screening for ovarian cancer, I do need to say this. If you do have bloating, or some of the other common symptoms of ovarian cancer, please don’t get all anxious and run off thinking you have ovarian cancer.

Many of these symptoms can be indicative of endometriosis and adenomyosis too. This is why it is important to talk to your healthcare practitioner, or specialist about any concerns you have around any of the symptoms you may be getting. Early intervention and detection is the key to any disease, and ovarian cancer is exactly the same. Either way it is worth seeing someone a specialist in this field.

If you do have any of the symptoms from my post on ovarian cancer, please talk to your healthcare practitioner about a referral to an expert, or specialist in this field and get assessed properly.

Frequently asked questions about ovarian cancer screening

This information covers screening for ovarian cancer i.e. the testing of women at population risk who have no symptoms that might be ovarian cancer. This information has been developed to support discussion with a woman about screening for ovarian cancer. Most of this can be found at the Australian Cancer Council (www.cancer.org.au)and the National Breast and Ovarian Cancer Centre (www.nbocc.org.au)

Is there a screening test for ovarian cancer?

No. There is currently no evidence to support the use of any test, including pelvic examination, CA125 or other biomarkers, ultrasound (including transvaginal ultrasound), or a combination of tests, to screen for ovarian cancer.

A Pap test does not detect ovarian cancer; it is only used to screen for cervical cancer.

What about the CA125 blood test?

CA125 is a protein found in the blood. It is known as a tumour or cancer marker. Increased levels of CA125 may indicate ovarian cancer. However, there are many other conditions that can affect CA125 levels such as ovulation, menstruation, endometriosis, benign ovarian cysts, liver or kidney disease, and other cancers such as breast or lung cancer.

If CA125 levels are not raised, this does not completely rule out ovarian cancer, as about 50% of women with early-stage ovarian cancer have normal CA125 levels.

For these reasons, the CA125 test alone should not be used as a screening test for ovarian cancer. It can be used in the assessment of symptoms that may be ovarian cancer.

Can an ultrasound be used as a screening test?

A transvaginal ultrasound (TVUS) gives the best picture of the ovaries but while able to detect the presence of ovarian disease, a TVUS cannot distinguish between benign and malignant disease.

For this reason, transvaginal ultrasound should not be used as a screening test for ovarian cancer.

What if a woman decides she still wishes to have a CA125 blood test or ultrasound?

She should be informed that if either a CA125 or an ultrasound test is abnormal, it may be necessary to repeat the test, or to undertake further tests, which may include surgery to investigate the abnormal result.

The discovery and investigation of abnormal findings can result in unnecessary anxiety and the investigations can carry significant risks.

Final word

I hope this explains a few of the fact around screening for ovarian cancer and helps people understand why some perceived screening methods are not reliable. For more information, you should always talk to your healthcare practitioner, or specialist, and never ever diagnose yourself based on some stupid google search. Always see a qualified healthcare professional for all your healthcare advice. Your life could depend on it.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-Master of Reproductive Medicine

-The Women’s Health Experts

The link between endometriosis and cancer

The Link Between Endometriosis & Cancer

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One of the most common questions that I get asked from women with endometriosis is “Is there a link between endometriosis and cancer?”

There has been many research papers on this and there is some evidence to suggest that women with endometriosis may have a higher risk of certain cancers such as endometrial cancer and also ovarian cancer.

We all know that Endometriosis is a debilitating disease, but many people don’t realise the possible future implications of this disease, mixed with our highly inflammatory diets and lifestyle. Unfortunately it is a recipe for any inflammatory disease, and for expression of cancer cells.

There have been many reputable studies to date showing the link between inflammation and cancer and endometriosis is definitely an inflammatory disease that needs proper management otherwise some studies are now suggesting it could be a precursor to certain cancers.

This isn’t meant to scare anyone either. It is just to help people realise the possible implications of this disease and to be more proactive around getting yourself and your body healthier and also being properly managed by a qualified health professional. When it come to cancerous states, prevention is key and early intervention is also.

Better education is needed

Given that, we need to really take this disease more seriously than many people with the disease and many in the medical community probably realise. Prevention is always the key to any disease and even though endometriosis cannot be prevented, early intervention and ongoing management of the disease is crucial. This is why I think all young girls should be educated about what a proper menstrual cycle should be like and that period pain is not normal. There also needs to be proper education about diet and lifestyle interventions with inflammatory diseases, such as endometriosis, and how it also needs a multimodality approach to be managed properly.

Endometriosis is like cancer in many ways

Endometriosis, like cancer, is characterised by cell invasion and unrestrained growth. Furthermore, endometriosis and cancer are similar in other aspects, such as the development of new blood vessels and a decrease in the number of cells undergoing apoptosis. In spite of these similarities, endometriosis is not considered a malignant disorder.

The possibility that endometriosis could, however, transform and become cancer has been debated in the literature since 1925. Mutations in the certain genes have been implicated in the cause of endometriosis and in the progression to cancer of the ovary (Swiersz 2006). There is also data to support that ovarian endometriosis could have the potential for malignant transformation. Epidemiologic and genetic studies support this notion. It seems that endometriosis is associated with specific types of ovarian cancer (endometrioid and clear cell) (Vlahos et al, 2010). The relationship between endometriosis and ovarian cancer is an intriguing and still poorly investigated issue. Specifically, histological findings indicate a definitive association between endometriosis and endometrioid/clear cell carcinoma of the ovary (Parihar & Mirge 2009).

Women with endometriosis may be more prone to certain cancers

There are recent studies which have shown that mutations in the certain genes found were identified in 20% of endometrial carcinomas and 20.6% of solitary endometrial cysts, played a part in the development of ovarian cancers. In addition to cancerous transformation at the site of endometriosis, there is recent evidence to indicate that having endometriosis itself may increase a woman’s risk of developing non-Hodgkin’s lymphoma, malignant melanoma, and breast cancer (Swiersz 2014).

Women with endometriosis appear to be more likely to develop certain types of cancer. Brinton, PhD, Chief of the Hormonal and Reproductive Epidemiology branch at the National Cancer Institute has studied the long-term effects of endometriosis, which led her to Sweden about 20 years ago. Using the country’s national inpatient register, she identified more than 20,000 women who had been hospitalised for endometriosis.

After an average follow-up of more than 11 years, the risk for cancer among these women was elevated by 90% for ovarian cancer, 40% for hematopoietic cancer (primarily non-Hodgkin’s lymphoma), and 30% for breast cancer. Having a longer history of endometriosis and being diagnosed at a young age were both associated with increased ovarian cancer risk (Brinton et al, 1997).

Farr Nezhat, MD, Chief of Gynecologic Minimally Invasive Surgery and Robotics at St. Luke’s and Roosevelt Hospitals in New York City and Professor of Obstetrics and Gynecology at Columbia University, spoke on the pathogenesis of endometriosis and ovarian cancer. According to a 2000 study of women with ovarian cancer by Hiroyuki Yoshikawa and colleagues, endometriosis was present in 39% of the women with clear cell tumours and 21% of those with endometrial tumours. The studies clearly suggest that Endometriosis may be the precursor of clear cell, or endometrial ovarian cancer (Yoshikawa et al, 2000).

Inflammation and Estrogens are a big factor in many cancers

If you combine inflammation with oestrogen as with both endometriosis and ovarian or uterine cancers, it’s going to be a vicious circle, as the 2 diseases share numerous other characteristics. For example, both are related to early menstrual cycles and late menopause, infertility, and inability to fall pregnant. Any factors that relieve or offer protection against both conditions need to be explored, including dietary and lifestyle changes etc.

Some authors also suggest that there is an also increased risks of colon cancer, ovarian cancer, thyroid cancer non-Hodgkin’s lymphoma and malignant melanoma in women with endometriosis when compared with the general population (Brinton et al, 2005).

Proper management and early intervention is crucial

If you do have patients with endometriosis you do need to take into consideration the future implications of this disease, not only the pain and turmoil it causes on the way, but also the future possibility that endometriosis could also lead to cervical cancer, ovarian cancer, or many of the other cancers that can be found in the body.

There are certain medications, both natural based and medical that can great assist in the treatments and management of endometriosis and microscopic endometriosis implants. These do need to be explored and we now have the Royal College of Obstetricians and Gynaecologists recommending diet and lifestyle changes and to use complementary medicine such and Chinese Herbal Medicine and Acupuncture for the the management and treatment of endometriosis. This is recommended alongside medical interventions and it does get back to a multimodality approach is the key factor in proper management of this disease.

Diet and lifestyle changes are crucial in cancer prevention

There have been numerous studies showing the benefits of a low inflammatory based diet and reduction in lifestyle factors such as stress. These things are also crucial in any inflammatory disease and certainly in cancer prevention.

Anyone with endometriosis does need to be following anti-inflammatory diet, with reduced refined foods and increased whole foods. This is something I promote whole-heartedly and see great results with on a daily basis. It is also part of my PACE- Diet and Lifestyle program. PACE meaning (Paleo/Primal Ancestral Clean Eating) .

This style of diet is very much like the mediterranean diet which is now shown to be one of the best diets in the world to help with cancer prevention and reduction of cardiovascular disease. It is something that has been shown to assist with inflammatory diseases such as endometriosis. This can be done alongside supplements such as omega 3 oils and antioxidants that also offer protection and prevention against inflammatory diseases too. You should also talk to a qualified healthcare professional about diet and lifestyle interventions and supplementation.

See an Endometriosis Expert

Hope that helps everyone to understand why it is so important to really make some proactive changes if you do have endometriosis. You really need to explore as many options as you can when trying to manage this disease and halt its progression. It is also important to see an endometriosis expert and not try and manage this disease yourself. You just should not be doing this and it is not effective management. Always see an appropriately trained healthcare professional who is trained in endometriosis and other disease states in women. We don’t want to see it end up as cancer later on and this is why it is so important to make sure you are being appropriately managed now.

Final Word

If you do need help with endometriosis, and the associated symptoms of endometriosis, give my friendly staff a call and find out how I can help you. Always remember that early intervention is the key and being managed properly is also crucial.

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine

-Master of Women’s Health Medicine

-The Endometriosis Experts

Cancers in women 1

Bringing Awareness To Cancers In Women

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Over the next week I am going to focus on a very serious subject – Cancers in women.

Having recently focusses on the awareness of endometriosis and adenemyosis, I thought I should bring some awareness to the topic of cancers in women as a whole. This isn’t to scare people either. It is to bring awareness to a very serious topic and to help people understand the importance of early intervention and changes to diet and lifestyle can greatly reduce the risks of this horrible disease.

With cancer rates increasing I am going to focus on the cancers that affect the female reproductive system and impact of reproductive health. This will also include those cancers that increase after menopause too. Whenever I talk about fertility and reproduction, it is referring to the stage in life when women are fertile and are of reproductive age. Menopause is also including because that still comes under the reproductive system.

Cancer has been around a long time

Humankind has been dealing with the impact of cancer and malignancy for its entire history and the first clear description of any cancer is found in the Ebers Papyrus, dating from nearly 3500 years ago. The cancer was very accurate described by the Egyptian writer and what was described was in fact breast cancer. Chinese Medicine has texts dating back for further than that, describing the different forms of cancers and their treatments. Modern medicine does tend to only reference Greek, Egyptian and Roman text.

When these Greek physicians first cut the surface of a breast cancer, it did in fact resemble a crab, because of it solid central body, with extensions into the surrounding tissue resembling legs.

The ancient Greek word for crab is “Karkinos” which in Latin is translated into ‘cancer’- as in the astrological sign. This term was then extended into all cancers and malignancies, not just breast cancer.

Genetic, hereditary and hormonal links to cancer

It is believed that cancer is predominantly caused by a failure in the regulation of genes which govern cell growth and differentiation. Malignant change is most typically the result of a cascade of changes in a number of genes.

These changes in genes can be bought on by hereditary genetic genetic changes, while others may be the incorporation of foreign viral DNA, or a compound that may act as the primary trigger for malignant change. Some cancers and malignancies are also caused by hormonal stimulation both internally and by injection, or ingestion of hormones from an outside source (Drugs, Hormone Replacement etc).

Diet and lifestyle links to cancer

Other cancers are plain and simply caused by the highly inflammatory foods we eat and the lifestyle we live. Obesity and being overweight increases our cancer risks and there are no many studies proving these links. Having excess fat stores, eating highly processed foods, high GI foods and over 3-4 glasses of alcohol per week can increase your cancer risks exponentially. This why we all need to adopt a clean eating approach to foods and look at eating less refined foods and more whole foods.

The incidence of cancers in women is highest in developing western countries and lowest in countries such as Africa and Asia. The difference has more to do with diet than it does genetics. Since there is compelling evidence that alcohol, highly refined foods and obesity increase the risk of cancers in women (and men) I will be focusing greatly on the need for us all to look at changing our diets to not only help in the prevention of certain cancers, but to also help prevention of other disease states that are leading causes of our lives being cut short.

The most common cancer in women

Since breast cancer remains the most common malignancy in women, comprising of 18% of all female cancers, most women will know someone who has had this diagnosis.

I’ll focus on breast cancer firstly and then go into the other cancers so that we can all be educated about how we can prevent these disease states from increasing. If you have any questions, or topics you want discussed around this topic, please let me know

Take care and remember prevention is better than cure. Always talk to your doctor, or healthcare practitioner about cancer risks and always seek early intervention if you find any lumps and bumps that were not there before.

Hope you the topics help you all. If I can save just one person with this information, then I am happy. Lets try and save more than one, so please like and share to spread the word.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-The Women’s Health Experts

Kath Mazzella interview

Gynaecological Cancers & Gynaecological Awareness with Kath Mazzella

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I’m sharing a video link up with Kath Mazzella (OAM) about her journey with being a gynaecological cancer survivor and her passion for now helping women with better understanding of gynaecological, sexual and mental health conditions.
 
Kath Mazzella OAM is a Gynaecological cancer survivor. Kath is now so passionate about creating change in relation to the level of awareness of Gynaecological, Sexual and related Mental Health challenges and to break down the barriers and stigmas associated.
After her gynaecological cancer surgery Kath discovered how little women knew and talked about conditions “down there”, and how many women were suffering in silence. This empowered Kath to go on a journey … a journey that her partner Tony had no choice initially but to go on with her. Now he has stepped up to stand beside her and promote this very worthwhile and necessary message, extending it beyond just the women, but also to the men that surround their worlds. After all, when one woman suffers, all those in her world suffer with her.
Kath and Tony together are powerful advocates for women challenged by gynaecological, sexual and related mental health conditions, personally inspiring women (and a few men also), arguing for institutional and social change that delivers better awareness, prevention, treatment and support.
Kath and Tony are inspirational public speakers and Kath is the founder of the International Gynaecological Awareness Day.
Most recently, Kath was awarded the Jeannie Ferris Cancer Australia Gynaecological Cancers Award, which she handed to Tony upon acceptance, stating that he deserved the award for his patience in supporting her through all the years of her campaigning.
 
In 2012, Kath received the prestigious WA Senior of the Year Award and the Beyond Blue category award, finally having the link between Mental Health and Gynaecological and Sexual health recognised.
 
In 2009 Kath was awarded an Order of Australia Medal for her service of the community through raising the profile of Gynaecological health; was inducted into the 100 Women WA Hall of Fame and also was an inductee to the Hall of Fame – Our Bodies Ourselves Women’s Health Heroes, Boston, US. Kath was shortlisted for the Centre for Women in Leadership Award; and Most Inspiring Woman of the Year – Momentum Women’s Forum. Kath was also presented with the Zonta International “Woman of Achievement Award” for Western Australia and received an Executive Women’s Forum Woman of the Year award, both in 2005.
 
Have a listen to our video link up and don’t forget to get behind the gynaecological awareness day on September 10.
Metformin for ovarian cancer

Could A Diabetes Medication Prevent Ovarian Cancer?

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A laboratory study published in Clinical Cancer Research offers a new hypothesis about how ovarian cancer forms and suggests how an insulin resistance/diabetes medicine may prevent it.

Ovarian Cancer Facts.

  • Ovarian cancer is the fifth most common cancer in women, and
  • Ovarian cancer is a leading cause of cancer death in women
  • The five-year survival rate for ovarian cancer is 45 percent.
  • Women who have a family history of ovarian cancer or a mutation of the BRCA gene are at greatest risk of the disease.
  • There is no reliable screening test to catch this cancer early
  • The only options for prevention are birth control pills, which reduce the risk of ovarian cancer by half, or removing the ovaries and fallopian tubes.
  • Common symptoms are bloating, abdominal pain, gastrointestinal upset and weight loss/gain.

For more information on Ovarian Cancer please click the link to my article Let’s Talk About Ovarian Cancer

The New Research.

The study is the first to show that the natural stiffening of the ovaries called “fibrosis” occurs with age. It also suggests that the diabetes drug metformin may be able to halt this process.

This is an interesting hypothesis, which then begs many questions. It also then leads to looking at other supplements and medications that help with insulin resistance and regulation.

So, should we just be looking at the medications, or looking at the underlying cause of the issue, which seems to be insulin resistance?

After all, insulin resistance is a big driver on inflammation and disease processes in the body. But let’s look at Fibrosis first.

What is Fibrosis?

Fibrosis happens when body tissues are repeatedly injured and inflamed, leaving behind hard collagen fibres that pile up over time, like a scar on the skin. Research has shown that cancer cells tend to like growing in these fibrotic tissues. Fibrosis is also a normal part of aging and usually appears around the menopausal stage of life.

The Findings of The Study

The first part of the investigation was for the team to find out what was causing the fibrosis of the ovaries. They thought the answer might lie in ovulation. Every time an ovary releases an egg it becomes inflamed, creating a monthly cycle of wound and repair.

During the study the research was surprised to find an ovary from a 69-year-old woman that had no fibrosis. The woman’s medical records showed she had been taking metformin, a drug for Type 2 diabetes. What was interesting is that a Taiwanese study had previously noted an 82% reduction of ovarian cancer rates among Type 2 diabetes patients taking metformin.

The research team performed a series of experiments to investigate the links between ovarian fibrosis, aging and metformin.

The first part of the research, the team used mice studies and used a drug to prevent mice from ovulating. They noticed that the treated mice did not develop fibrosis with age, which then suggested that ovulation might be linked to the development of fibrosis. The team also noted that more detailed studies are needed to confirm these findings.

The second part of the research was to examine the ovaries that had been removed from women of all ages. What they found was that the ovaries of most of the postmenopausal women had fibrosis. But, they also notices the when the ovaries of postmenopausal women where were taking metformin were examined, none of these showed any evidence of fibrosis.

With these new finding the team set about looking at the rationale of targeting ovarian fibrosis as new option to reduce the risk of ovarian cancer. They also added in the rationale for the use of metformin to prevent ovarian cancer, based on these findings as well. The team are currently doing more research into learning how fibrosis develops in the ovaries and how metformin may be stopping this from happening.

These findings will need to be confirmed with more studies before clinical trails can take place. But, this could lead to a non-invasive test to measure fibrosis and help with early detection of ovarian cancer.

The team are hoping that metformin may prove to be an effective preventative treatment for younger women who are at high risk of ovarian cancer, but who can’t remove their ovaries because they still want to have children.

Added thoughts

While any research into ovarian cancer is welcomed, as mentioned previously, if metformin is helping with prevention of fibrosis, then surely we need to be looking insulin resistance as being a major cause of this?

It also begs the question, do other natural insulin regulators such as inositol do the same thing and would be better to use because Metformin does have a high side effect profile?

Insulin Resistance and Disease

We do know that insulin is a big driver of inflammation and disease states in the body. Insulin resistance is the name given to when cells of the body don’t respond properly to the hormone insulin.

Insulin resistance is the driving factor that leads to many disease states and health conditions such as:

  • Obesity and being overweight
  • Metabolic Syndrome
  • Type 2 diabetes,
  • Gestational diabetes
  • Pre-diabetes.
  • Stroke
  • Cardiovascular disease
  • Stroke
  • PCOS
  • Reproductive conditions
  • Infertility

Insulin Resistance is linked to certain cancers

Meanwhile, insulin resistance and metabolic syndrome are also linked with higher risk for cancers of the bladder, breast, colon, cervix, pancreas, prostate and uterus. 

The connection: High insulin levels early in insulin resistance seem to fuel the growth of tumours and to suppress the body’s ability to protect itself by killing off malignant cells.

Insulin resistance is closely associated with obesity; however, it is possible to be insulin resistant without being overweight or obese. We see this in women who have PCOS and who are not overweight, or obese.

Modern research has shown that insulin resistance can be combatted by treatment methods that reduce how much insulin the body is producing. Reducing insulin resistance can be achieved by following a grain free, low refined food diet.

Final note

If found to metformin to helping with fibrosis and this then leads to ovarian cancer, surely we need to look at what the root cause it. As mentioned above, one could assume it would have to be insulin resistance and we already know that insulin resistance is a driver of certain cancers and tumours.

Surely then, it would make sense to educate women, especially those with family history of ovarian cancer, about the importance of low GI diets and maintaining optimum health and optimum weight etc, in the prevention of not only ovarian cancer, but other disease states that affect women as well.

There are also valid alternatives to using Metformin, which has a very high side effect profile and has some long-term health consequences. There are valid alternatives such as using inositol, which has lots of research behind it and has been compared to Metformin in several research studies. Something to think about and I always like to give people something to think about important issues such as this. Just remember that you heard it here first.

 

Journal References:

  1. Curtis W. McCloskey, David P. Cook, Brendan S. Kelly, Feryel Azzi, Christian H. Allen, Amanda Forsyth6, Jeremy Upham, Katey J. Rayner, Douglas A. Gray, Robert W. Boyd, Sangeeta Murugkar, Bryan Lo, Dominique Trudel, Mary K. Senterman, Barbara C. Vanderhyden. Metformin abrogates age-associated ovarian fibrosis. Clinical Cancer Research, Oct 9, 2019
  2. Mehri Jamilian; Pegah Farhat; Fatemeh Foroozanfard; Faraneh Afshar Ebrahimi; Esmat Aghadavod; Fereshteh Bahmani; Bita Badehnoosh; Hamidreza Jamilian; Zatollah Asemi. Comparison of Myo-inositol and Metformin on Clinical, Metabolic and Genetic Parameters in Polycystic Ovary Syndrome. A Randomized Controlled Clinical TrialClin Endocrinol. 2017;87(2):194-200.
  3. Fruzzetti F, Perini D, Russo M, et al. Comparison of two insulin sensitizers, metformin and myo-inositol, in women with polycystic ovary syndrome (PCOS). Gynecol Endocrinol. 2017;33:39–42.
  4. Chiu TT, Rogers MS, Law EL, et al. Follicular fluid and serum concentrations of myo-inositol in patients undergoing IVF: relationship with oocyte quality. Hum Reprod. 2002;17:1591–1596.
  5. Artini PG, Di Berardino OM, Papini F, et al. Endocrine and clinical effects of myo-inositol administration in polycystic ovary syndrome. A randomized study. Gynecol Endocrinol. 2013;29:375–379.
  6. Zacche MM, Caputo L, Filippis S, et al. Efficacy of myo-inositol in the treatment of cutaneous disorders in young women with polycystic ovary syndrome. Gynecol Endocrinol. 2009;25:508–513.
  7. Costantino D, Minozzi G, Minozzi E, et al. Metabolic and hormonal effects of myo-inositol in women with polycystic ovary syndrome: a double-blind trial. Eur Rev Med Pharmacol Sci. 2009;13:105–110.
  8. Orgel: The Links Between Insulin Resistance, Diabetes, and Cancer. Curr Diab Rep. 2013 Apr; 13(2): 213–222. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3595327/
  9. Dijiogue S: Insulin resistance and cancer: the role of insulin and IGFs. Endocr Relat Cancer February 1, 2013 20 R1-R17. http://erc.endocrinology-journals.org/content/20/1/R1.full
  10. Orgel: The Links Between Insulin Resistance, Diabetes, and Cancer. Curr Diab Rep. 2013 Apr; 13(2): 213–222. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3595327/

 

Ovarian Cancer Awareness 1

Let’s Talk About Ovarian Cancer

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Ovarian cancer often has no symptoms in the early stages. Later stages are associated with symptoms, but they can be non-specific, such as loss of appetite and weight loss.

Ovarian cancer often goes undetected until it has spread within the pelvis and stomach. At this late stage, ovarian cancer is more difficult to treat and can be fatal. This is why early intervention is something I am very big on and why we all need to not put things off when they present themselves.

Ovarian cancer is the 9th most common cancer diagnosed in Australian women.

Ovarian cancer is the 6th most common cause of cancer death in Australian women.

The present life expectancy of Australian women is 84 years. One in 77 women will be diagnosed with ovarian cancer before the age of 85.The risk of ovarian cancer increases with age. About 83% of all new cases of ovarian cancer diagnosed in 2005 were in women 50 years or older. The median age of first diagnosis is 64 years.

The five year survival rate for ovarian cancer is 45%.

Symptoms
Most women with ovarian cancer experience at least one symptom of the disease in the year prior to their diagnosis. The following can all be signs of ovarian cancer:

  • Abdominal bloating
  • Abdominal or back pain
  • Appetite loss or feeling full quickly
  • Changes in bowel habit
  • Urinary frequency or incontinence
  • Pain during intercourse
  • Menstrual irregularities
  • Unexplained weight loss or gain
  • Indigestion or heartburn

Why is bloating a sign of ovarian cancer?

Ascites (a build-up of fluid in the abdomen and a sign of advanced ovarian cancer) is probably the major cause of bloating in women with ovarian cancer. Therefore, waiting for bloating as a key ‘sign’ is too late and we want to encourage all women to ‘know your normal’ and if this changes, to seek medical help. This is why any changes in the body need to be looked into. Many may think that they are reacting to foods, or they have a gut issue etc, but it may actually be the signs of ovarian cancer. This is why proper investigations and proper differential diagnosis by a trained professional is so important.

Family history
While having a family history of ovarian cancer increases a woman’s risk of developing ovarian cancer, 90-95 per cent of all ovarian cancers occur in women who do not have a family history.

Key factors associated with increased risk include:

  • Multiple relatives on the same side of the family affected by breast cancer (male or female) or ovarian cancer
  • Younger age at cancer diagnosis in relatives
  • Relatives affected by both breast and ovarian cancer
  • Relatives affected with bilateral breast cancer
  • An increase in age
  • Inheriting a faulty gene (called a gene mutation) that increases the risk of ovarian cancer
  • Being Caucasian (white) and living in a Western country with a high standard of living having few or no full-term pregnancies
  • Starting your menstrual cycle early (before the age of 12) and beginning menopause after the age of 50
  • Taking hormone therapy (HT) after menopause. Some studies suggest this may increase your risk of developing ovarian cancer, but others don’t make this connection
  • Never having taken the contraceptive pill – the pill has been found to reduce the risk of cancer of the ovaries and uterus
  • Only five to 10 per cent of all ovarian cancers are associated with a family history. The risk of developing ovarian cancer increases with the number of affected first degree relatives (parents, siblings, children)
  • Ashkenazi Jewish ancestry.

Diagnosis for Ovarian Cancer

There is currently no evidence to support the use of any test, including pelvic examination, CA125 or other biomarkers, ultrasound (including transvaginal ultrasound), or a combination of tests, to screen for ovarian cancer. The only way to properly screen for it is through histology done at the time of laparoscopy.

While CA126 can be a diagnostic, it really has limited value and I have to let people know that it isn’t the best diagnostic at all. 50% of ovarian cancers will actually have a normal CA125 reading.

The cancer council’s guidelines are quite clear about this after numerous research studies show that CA125 has limited diagnostic value for Ovarian cancer. If markers and symptoms are suggestive of Ovarian Cancer, the only true diagnostic is Laparoscopy with histology to really get an accurate diagnosis.

Treatment for Ovarian Cancer

At such an advanced stage, the cancer is more difficult to cure. As ovarian cancer advances, cells from the original tumor can spread (metastasize) throughout the pelvic and abdominal regions and travel to other parts of the body. Cancer cells are carried through the body through lymph vessels and the bloodstream.

If a woman is suspected of having ovarian cancer, she should be referred to a gynaecological oncologist. Research shows survival for women with ovarian cancer is improved when their surgical care is directed by a gynaecological oncologist.

Treatment for ovarian cancer usually involves surgery and chemotherapy. It may also include radiotherapy.

Usually your healthcare practitioner, or GP, will generally arrange for initial tests and looks after your general health as well as coordinating with your specialists. Depending on your treatment you will be seen by several specialists, such as: medical oncologist, radiation oncologist, radiologist, gynaecological pathologist, cancer nurses and other health professionals such as a dietitian, physiotherapist, social worker and a counsellor.

With any condition that affects the body, we often get early warning signs and this is why early intervention and making sure you are investigated and management properly is so important.

Regards

Andrew Orr

-Women’s and Men’s Health crusader

-No Stone Left Unturned

-The Women’s Health Experts

01 Dr Andrew Orr