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Image Credit: National Cancer Institute
Recently, the well-known Malaysian actress and singer Adibah Noor passed away on 18 June 2022 due to stage 4 ovarian cancer. According to her close friend, she was diagnosed with stage 4 ovarian cancer 3 months ago.
The presenting symptoms related to ovarian cancer are usually vague and thus often mistaken and frequently ignored as gastrointestinal problems including constipation, indigestion, irritable bowel, gastritis, depression etc. This delays further diagnosis and treatment for this condition.
Is there a way to unmask this silent killer? How can we recognise these symptoms to prevent misdiagnosis and late detection? Let’s find out more!
In Malaysia, ovarian cancer is ranked as the fourth most common cancer among women, with approximately 500 women being diagnosed with ovarian cancer every year.
The female reproductive system contains 2 ovaries, one on each side of the uterus. The almond-sized ovaries function as an important female organ to store eggs (ova) for reproduction and to produce female sex hormones, oestrogen and progesterone. When cells are formed and grow out of control in the ovaries, ovarian cancer occurs. These cells will quickly multiply, infiltrate, and attack healthy human tissues.
The 2 main risk factors for ovarian cancer are:
Advanced age: The highest incidence was in those aged 65-69 years old
Family history: if you have a family history of ovarian or breast cancer, there is an increased risk due to the inheritance of faulty mutations in the BRCA1 or BRCA2 genes
Other risk factors include being overweight or obese, taking postmenopausal hormone replacement therapy, having endometriosis, never being pregnant, and beginning menstruation at an early age or starting menopause at a later age.
Types of ovarian cancer are determined by the type of cell where the cancer begins.
Epithelial ovarian cancer is the most common form
Stromal tumors (rare tumors) are typically discovered at an earlier stage
Germ cell tumors (rare tumors) typically occur at a younger age
There are 4 stages of ovarian cancer:
Image Credit: Vecteezy
Staging of Ovarian Cancer is based on FIGO (International Federation of Gynecology and Obstetrics) system.
There is currently no effective and reliable screening test for early detection of ovarian cancer unlike for cervical and breast cancer. Majority of ovarian cancer cases (>80%) are already in stage 3 or above, when detected for the first time. Most of the time, symptoms experienced in the early stages are misdiagnosed by doctors or ignored by women as symptoms are subtle and non-specific.
A study has shown that ovarian cancer can be identified with these 6 important symptoms:
Increased abdominal size
Feeling full quickly
These symptoms should be present for more than 12 days a month and last for less than a year.
To simplify it, you can use this acronym (BEAT!):
B: bloating that is persistent and doesn’t come and go
E: eating difficulty and feeling full more quickly
A: abdominal & pelvic pain
T: toilet habit change
Image credit: breakthrough cancer research
Do consult your family doctor or gynaecologist if you feel suspicious or worried that you might have ovarian cancer. Tests that will be done by your doctor include pelvic examination, transvaginal ultrasound, computed tomography (CT) scan, Magnetic resonance imaging (MRI), and A positron emission tomography (PET) scan.
Treatment includes surgery, chemotherapy, radiation, or a combination of these methods depending on the staging and severity of your disease. Factors such as age, stage, type of cancer, and overall health will determine the outcome of ovarian cancer. Early detection is critical as survival rates decrease with the advanced stages of ovarian cancer (stages 3 and 4).
Medically reviewed by Ashwini Nair, MB BCh BAO.
New Straits Times. Majority of ovarian cancer cases in Malaysia detected at stage 3 or above. Majority of ovarian cancer cases in Malaysia detected at stage 3 or above. Accessed 25 June 2022. https://www.nst.com.my/news/nation/2022/06/806894/majority-ovarian-cancer-cases-malaysia-detected-stage-3-or-above
Mayo Clinic. Ovarian Cancer. Accessed 25 June 2022. https://www.mayoclinic.org/diseases-conditions/ovarian-cancer/symptoms-causes/syc-20375941#:~:text=Ovarian%20cancer%20is%20a%20type,and%20destroy%20healthy%20body%20tissue.
The Stars. (2022). Ovarian cancer is often diagnosed late because of its vague symptoms. Accessed 25 June 2022. https://www.thestar.com.my/lifestyle/health/the-doctor-says/2022/03/15/the-vague-symptoms-of-ovarian-cancer-make-it-difficult-to-pick-up
The Conversation. Ovarian cancer is not a silent killer – recognizing its symptoms could help reduce misdiagnosis and late detection. Accessed 25 June 2022. https://theconversation.com/ovarian-cancer-is-not-a-silent-killer-recognizing-its-symptoms-could-help-reduce-misdiagnosis-and-late-detection-181415
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