Number of women diagnosed with ovarian cancer increases
Ovarian cancer is a global concern and much more needs to be done to tackle this disease on all fronts.
By 2040, the number of women around the world diagnosed with ovarian cancer will rise almost 37% to 428 966. The number of women dying from ovarian cancer each year is projected to increase to 313 617 an increase of over 50% from 2020.
Five-year ovarian cancer survival rates vary between countries. In more developed countries, rates range from 36% to 46%. Overall, survival rates fall well below that for other cancers, like breast cancer, where five-year survival rates in many countries are close to 90%.
Ovarian cancer’ is not a singular diagnosis, rather it is an umbrella term for a multitude of different types of cancer that affect the ovaries, fallopian tubes, and the primary peritoneal cavity. It is estimated that there are more than 30 different types of ovarian cancer, and there is a very wide variation in incidence and outlook in terms of the different types.
It is the most lethal of the female cancers for which there is no reliable screening test, and every women is at risk. With delays in diagnoses due to this lack of screening and because symptoms are often confused with other, less severe, illness, most women are diagnosed once the cancer has already spread, making it more difficult to treat.
TYPES
There are different types of ovarian cancer tumours, which are named after the type of cell they come from, the three main cell types that make up the ovary.
Epithelial ovarian cancer
Comes from the surface of the ovary (the epithelium), and is the most common ovarian cancer. Fallopian tube cancer and primary peritoneal cancer are also included in this type of ovarian cancer.
Germ cell ovarian cancer
Comes from the reproductive cells of the ovaries. Germ cell ovarian cancer is rare.
Stromal cells ovarian cancer
Comes from connective tissue cell. Stromal cells ovarian cancer is also very rare.
Small cell carcinoma (SCCO) of the ovary
This is an extremely rare ovarian cancer and it is not certain whether the cells in SCCO are from ovarian epithelial cells, sex-cord stromal cells or germ cells.
Common symptoms include:
a. Persistent bloating
b. Difficulty eating
c. Feeling full quickly
d. Pelvic/abdominal pain
e. Urinary symptoms
Occasionally, there can be other symptoms, such as:
Changes in bowel habits
Abnormal bleeding – Any post-menopausal bleeding should always be checked by your primary health care provider or doctor.
Extreme fatigue
Unexplained weight loss
Often ovarian cancer symptoms are mistaken for other ailments and causes, as they can be subtle and experienced by women who do not have ovarian cancer. They can be confused with symptoms of other less severe illnesses, especially gastrointestinal complaints, leading to frequent misdiagnosis. Most patients are only identified in the advanced stages of the disease when it becomes more difficult to treat.
The World Ovarian Cancer Coalition Every Woman Study™, which is based on the findings of a survey of over 1 500 women living with ovarian cancer worldwide, found that nine in 10 women experienced multiple symptoms prior to diagnosis irrespective of the stage of diagnosis or type of ovarian cancer. Alarmingly, a study also found that over two-thirds of women had not heard of ovarian cancer, or knew anything about it, prior to their diagnosis.
Detection and testing
There is no routine, simple screening test to accurately detect ovarian cancer. Contrary to popular belief, cervical screening (i.e.: Pap smear) will not detect ovarian cancer. Cervical screening is effective in early detection of cervical cancer, but it is not a test for ovarian cancer. The pathway to diagnosis includes:
Pelvic exam
Transvaginal or pelvic ultrasound
CA-125 blood testIn some cases, doctors may also use a CT scan or PET scan as part of the diagnostic process. The only definitive way to determine if a patient has ovarian cancer is through a biopsy.
Risk factors
Age – It is more common in women aged 50 to 79, however, younger women can get it too
Family history – your risk is higher if your family has a history of ovarian, breast, endometrial or colorectal cancer.
Etnicity – Jewish women of Eastern European (Ashkenazi) background have a higher risk.
Genetic mutations – your risk is higher if you have certain genetic mutations associated with ovarian cancer, such as BRCA gene mutations.
Reproductive history – your risk is higher if you have not delivered children.
Hormone replacement – your risk may me higher if you have taken hormone replacement.
Other factors – your risk may be higher if you have a history of a condition called endometriosis.
These factors are primarily known to increase the risk for the most common type of ovarian cancer – epithelial ovarian cancer.
Reducing your risk
While the following may reduce the risk of developing ovarian cancer, it is important to consider the risks, consequences, and potential side effects they may involve, and to remember that although these measures may lower your overall risk, there are currently no steps that you can take to 100% prevent ovarian cancer.
Hysterectomy and/or having your tubes tied
Having your ovaries and fallopian tubes removed significantly reduces your chances of getting ovarian cancer. However, a rarer form of the disease can develop in the lining of the peritoneal cavity, so it does not remove all risk.
Pregnancy and breastfeeding
It is recognized that an increased number of ovulatory cycles raises the risk of ovarian cancer and conversely a decreased number of cycles (for example during pregnancy and breastfeeding) reduces the risk.
The contraceptive pill
The combined contraceptive pill is known to almost halve the risk of ovarian cancer if taken for five years or more.
Genetics
About 20–25% percent of women diagnosed with ovarian cancer have a hereditary tendency to develop the disease. Of those cases, 10–15% are linked to an inherited genetic mutation in one of two genes which are called BRCA1 and BRCA2. Those genes are linked to both ovarian and breast cancer. Eastern European women and women of Ashkenazi Jewish descent are at a higher risk of carrying BRCA1 and BRCA2 mutations.
Individuals with a family history of ovarian, breast or related cancers are encouraged to speak with their doctor or primary health care professional to find out if they are eligible for genetic counseling and testing. Source – worldovariancancercoalition.org
Five-year ovarian cancer survival rates vary between countries. In more developed countries, rates range from 36% to 46%. Overall, survival rates fall well below that for other cancers, like breast cancer, where five-year survival rates in many countries are close to 90%.
Ovarian cancer’ is not a singular diagnosis, rather it is an umbrella term for a multitude of different types of cancer that affect the ovaries, fallopian tubes, and the primary peritoneal cavity. It is estimated that there are more than 30 different types of ovarian cancer, and there is a very wide variation in incidence and outlook in terms of the different types.
It is the most lethal of the female cancers for which there is no reliable screening test, and every women is at risk. With delays in diagnoses due to this lack of screening and because symptoms are often confused with other, less severe, illness, most women are diagnosed once the cancer has already spread, making it more difficult to treat.
TYPES
There are different types of ovarian cancer tumours, which are named after the type of cell they come from, the three main cell types that make up the ovary.
Epithelial ovarian cancer
Comes from the surface of the ovary (the epithelium), and is the most common ovarian cancer. Fallopian tube cancer and primary peritoneal cancer are also included in this type of ovarian cancer.
Germ cell ovarian cancer
Comes from the reproductive cells of the ovaries. Germ cell ovarian cancer is rare.
Stromal cells ovarian cancer
Comes from connective tissue cell. Stromal cells ovarian cancer is also very rare.
Small cell carcinoma (SCCO) of the ovary
This is an extremely rare ovarian cancer and it is not certain whether the cells in SCCO are from ovarian epithelial cells, sex-cord stromal cells or germ cells.
Common symptoms include:
a. Persistent bloating
b. Difficulty eating
c. Feeling full quickly
d. Pelvic/abdominal pain
e. Urinary symptoms
Occasionally, there can be other symptoms, such as:
Changes in bowel habits
Abnormal bleeding – Any post-menopausal bleeding should always be checked by your primary health care provider or doctor.
Extreme fatigue
Unexplained weight loss
Often ovarian cancer symptoms are mistaken for other ailments and causes, as they can be subtle and experienced by women who do not have ovarian cancer. They can be confused with symptoms of other less severe illnesses, especially gastrointestinal complaints, leading to frequent misdiagnosis. Most patients are only identified in the advanced stages of the disease when it becomes more difficult to treat.
The World Ovarian Cancer Coalition Every Woman Study™, which is based on the findings of a survey of over 1 500 women living with ovarian cancer worldwide, found that nine in 10 women experienced multiple symptoms prior to diagnosis irrespective of the stage of diagnosis or type of ovarian cancer. Alarmingly, a study also found that over two-thirds of women had not heard of ovarian cancer, or knew anything about it, prior to their diagnosis.
Detection and testing
There is no routine, simple screening test to accurately detect ovarian cancer. Contrary to popular belief, cervical screening (i.e.: Pap smear) will not detect ovarian cancer. Cervical screening is effective in early detection of cervical cancer, but it is not a test for ovarian cancer. The pathway to diagnosis includes:
Pelvic exam
Transvaginal or pelvic ultrasound
CA-125 blood testIn some cases, doctors may also use a CT scan or PET scan as part of the diagnostic process. The only definitive way to determine if a patient has ovarian cancer is through a biopsy.
Risk factors
Age – It is more common in women aged 50 to 79, however, younger women can get it too
Family history – your risk is higher if your family has a history of ovarian, breast, endometrial or colorectal cancer.
Etnicity – Jewish women of Eastern European (Ashkenazi) background have a higher risk.
Genetic mutations – your risk is higher if you have certain genetic mutations associated with ovarian cancer, such as BRCA gene mutations.
Reproductive history – your risk is higher if you have not delivered children.
Hormone replacement – your risk may me higher if you have taken hormone replacement.
Other factors – your risk may be higher if you have a history of a condition called endometriosis.
These factors are primarily known to increase the risk for the most common type of ovarian cancer – epithelial ovarian cancer.
Reducing your risk
While the following may reduce the risk of developing ovarian cancer, it is important to consider the risks, consequences, and potential side effects they may involve, and to remember that although these measures may lower your overall risk, there are currently no steps that you can take to 100% prevent ovarian cancer.
Hysterectomy and/or having your tubes tied
Having your ovaries and fallopian tubes removed significantly reduces your chances of getting ovarian cancer. However, a rarer form of the disease can develop in the lining of the peritoneal cavity, so it does not remove all risk.
Pregnancy and breastfeeding
It is recognized that an increased number of ovulatory cycles raises the risk of ovarian cancer and conversely a decreased number of cycles (for example during pregnancy and breastfeeding) reduces the risk.
The contraceptive pill
The combined contraceptive pill is known to almost halve the risk of ovarian cancer if taken for five years or more.
Genetics
About 20–25% percent of women diagnosed with ovarian cancer have a hereditary tendency to develop the disease. Of those cases, 10–15% are linked to an inherited genetic mutation in one of two genes which are called BRCA1 and BRCA2. Those genes are linked to both ovarian and breast cancer. Eastern European women and women of Ashkenazi Jewish descent are at a higher risk of carrying BRCA1 and BRCA2 mutations.
Individuals with a family history of ovarian, breast or related cancers are encouraged to speak with their doctor or primary health care professional to find out if they are eligible for genetic counseling and testing. Source – worldovariancancercoalition.org
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