Q. Where are the ovaries?

A. The ovaries are above the womb and connected to it by two short tubes (the Fallopian tubes). This means that they are below and to either side of the navel.

 

Q. How common is ovarian cancer?

A. In the year 2000 (the most recent for which figures are available) there were 6,734 cases of ovarian cancer diagnosed in the UK. In the USA the estimated 2004 incidence is 25,500 cases. Overall about one woman in 50 will get ovarian cancer at some time during her life.

 

Q. How dangerous are ovarian cancers?

A. In 2002, 4,687 women in the UK died of ovarian cancer, making it a more common cause of death than cervical and uterine cancer combined. In the USA it is estimated that 16,000 women will die from ovarian cancer in 2004.

 

Q. What are the risk factors for ovarian cancer?

A. Like most cancers it is more common with increasing age. The other risk factor is if you carry certain genes (see below). Having children reduces the risk: women with three or four children have only half the risk of a childless woman. Infertile women (i.e. women who cannot conceive despite trying for several years) appear to have an even higher risk than other childless women. Taking the contraceptive pill reduces the risk of ovarian cancer by somewhere between a third and a half, depending on how long it is taken for.

Although the effect of hormone replacement therapy (HRT) on ovarian cancer risk has been studied, the results are unclear. Some studies have found an increased risk, but analysis of all the published research shows conflicting results.

There have been some reports claiming that using talc in the genital area increases the risk of ovarian cancer. However, most of the research conducted on this has not produced reliable findings and there is no good evidence to support these claims.

 

Q. Does the diet affect the risk of ovarian cancer?

A. There is some evidence that being overweight can increase your risk of ovarian cancer. Some research has suggested that beta-carotene in the diet can reduce the risk of this cancer, although this finding has not yet been confirmed.

 

Q. Does ovarian cancer run in families?

A. There are several genes, which are known to carry increased risks of various cancers, which can run in families. The BRCA1 and BRCA2 genes were originally discovered because they cause an increased risk of breast cancer, but we now know that they also substantially increase the risk of ovarian cancer. The HNPCC gene was discovered because it increases the risk of colon cancer, but women with this gene also have a greater chance of getting ovarian cancer. Overall, if you have one close relative (mother, sister or daughter) who has had ovarian cancer, your risk goes up about 4-fold. If you have two cases amongst close relatives, your risk goes up 10-fold or more.

 

Q. Can we screen for ovarian cancer?

A. There is no reliable method of screening for ovarian cancer. However, both the CA125 blood test and vaginal ultrasound are currently being tested as possible methods for screening women for ovarian cancer.

 

Q. What are the symptoms of ovarian cancer?

A. There are few clear symptoms of ovarian cancer. Typically it can cause pain in the abdomen, a feeling of being bloated, fatigue, weight loss, or problems with urination. However, these can all be caused by a number of other diseases. This makes it difficult to diagnose ovarian cancer by symptoms alone.

 

Q. How is ovarian cancer diagnosed?

A. If ovarian cancer is suspected, two main tests are used to make the diagnosis. First, an ultrasound scan of the abdomen is performed. Sometimes the scan is taken from inside the vagina. The second test is to measure the level of the CA125 marker in the blood. Neither of these tests gives a definite diagnosis of ovarian cancer, but if both tests are positive, the patient is usually referred to a surgeon who will operate to see if the ovaries show any signs of cancer.

 

Q. How is ovarian cancer treated?

A. The treatment used will depend on how advanced the cancer is and how old the patient is. For younger patients with early cancer, limited surgery is used to preserve their fertility. For older patients with more advanced cancers, the ovaries and the womb are usually removed. If the cancer has spread, further tissue may need to be removed to get out as much of the cancer as possible. Chemotherapy is normally used after the surgery to kill any remaining cancer cells. Sometimes it is also used before the surgery to shrink the tumour and make it easier to remove completely.

 

Q. How effective are the treatments?

A. Overall, only about two out of every five women with ovarian cancer can be cured. Like all other cancers, the stage at which ovarian cancer is diagnosed determines how easily it is to cure. If diagnosed and treated while the cancer is still confined to the ovaries, nearly 75% of women can be cured. However, once it has spread into the pelvic cavity, the cure rate drops to one third. If it has spread further, only one quarter to on sixth of patients can be cured. For these figures 'cured' is defined as surviving for five years after the first diagnosis.