Disease of the month: Ovarian cancer

6,500 women are diagnosed with ovarian cancer every year, making it the fifth most common cancer in women, according to cancer research. Mary Randell outlines its insurance ramifications.

Symptoms during the early stages of ovarian cancer are usually vague and frequently overlooked.

As a result, the condition is often only discovered by chance or by the time the cancer has reached the advanced stages of the disease.

Causes and risks

Epithelial ovarian cancer (cancer of the surface layers of the ovary) makes up 90% of all ovarian cancers.

It is not fully understood what causes epithelial ovarian cancer, however, certain factors have been identified that may increase the risk.

Like many cancers the risk of developing ovarian cancer increases as you get older and most cases of ovarian cancer are in women who have had their menopause.

The main factor in older lives is related to how the ovaries work. When an egg is ready to be released from the ovary it has to burst through the surface layer of the ovary.

The surface cells then divide to repair the damage. The more eggs produced during a woman’s life time, the more cells need to divide and the higher the chance that damage will occur that could lead to cancer.

Apart from getting older, the next most common cause is a hereditary one.

About one in ten ovarian cancers are caused by an inherited faulty gene, these include BRCA1 and BRCA2  the same genes that also increase the risk of breast cancer.

Women with a family history of ovarian cancer, have a two to three times greater risk of developing the condition than a woman without a family history.

In addition, women who have had breast cancer have twice the risk of also developing ovarian cancer compared to other women, and if the breast cancer was diagnosed before the age of 40, the risk is almost four times higher.

Research studies are continuous. One such study showed there was an increased risk of ovarian cancer in women with endometriosis or a history of ovarian cysts.

Other smaller studies have also shown links between ovarian cancer and infertility, prolonged use of HRT, obesity and even the use of talcum powder.

There is evidence that some factors actually reduce the risk of developing ovarian cancer.

These include taking the contraceptive pill. This is because eggs are not produced whilst taking the pill and therefore there is no damage to the surface layer of the ovaries. The longer the pill is taken, the greater reduction in risk.

It is considered that this ‘protection’ lasts for 20 years after stopping taking the pill. Having children, as well as breast feeding also lowers the risk for the same reason.

Diet can also play its part. Phytoestrogens found in soy foods, pulses (beans, lentils and peas), plus tea, coffee and cereals are said to reduce ovarian cancer risks.

Other studies on risk factors are inconclusive, with some studies even showing both a reduction and an increase in risk, such as taking aspirin or paracetamol.

Signs and symptoms

As previously noted, the symptoms of early ovarian cancer can be very vague, and can be put down to other less serious conditions such as IBS (Irritable Bowel Syndrome).

Early symptoms (Stage 1) can include pain and/or bloating in the abdomen which many women dismiss and don’t bother consulting their doctor about.

Once the cancer starts spreading outside the ovary, (Stage 2) the tumour can cause symptoms anywhere within the pelvic cavity.

As well as abdominal pain and bloating or swelling, there may be back pain, frequency of urination, constipation or pain during sex.

Women may also have irregular periods or bleeding after the menopause.

Again some women may see these symptoms as an irritant or minor condition rather than something more serious and whilst this is usually the case, continuing symptoms should always be checked out so that ovarian cancer can be excluded.

Advanced ovarian cancer (Stage 3 and 4) usually causes more significant symptoms because the cancer has spread to other parts of the body.

In addition to the symptoms above, they can include sickness, tiredness, shortness of breath, or a more noticeable swelling of the abdomen.

There may also be a loss of appetite, weight loss, feeling full after eating or a general feeling of fullness in the abdomen.