Ovarian cancer is when abnormal cells from the ovary grow in an uncontrolled way. The ovaries are a pair of small organs located low in the tummy. Connected to the womb, the ovaries store a woman’s supply of eggs. It is believed that most cases of ovarian cancer arise from the fallopian tube, hence the term “tubo-ovarian cancer.”
There is no reliable test to screen for ovarian cancer. At present there is no national screening programme. The UKCTOC trial, which was the largest randomised trial in screening for ovarian cancer, suggested multimodal screening using blood test for CA 125, using Risk of Ovarian Cancer Algorithm (ROCA) and transvaginal ultrasound at timely intervals (dependant on individual status) as an effective method. Further data is awaited. Genetic screening is another method to determine the risk and may help with appropriate counselling and prevention.
For certain individuals, who have a genetic link to ovarian cancers, prevention can be offered at anappropriate time. This is individualised and should be offered after careful counselling. Determining the risk of ovarian cancer is important as surveillance strategy can be formulated according to one’s risk. Prevention is usually by surgery to remove fallopian tubes and ovaries. But this has to be timed appropriately to avoid adverse effects of menopause.
It is advisable to seek appropriate specialist advice if you think you are at risk of ovarian cancer or you wish to determine the risk of ovarian cancer. This is particularly important if you have a family member diagnosed with ovarian or breast cancer.
Ovarian cancer is more common with older age and your risk increases if you have any of the following:
Yes, approximately 10-15% of ovarian cancer is linked to faulty genes. A fault in genes such as BRCA1, BRCA2, RAD51C, RAD51D and BRIP-1 are known to be linked with ovarian cancer.
All women should be aware that they can access specialist advice, particularly if they feel anxious regarding their risk of ovarian cancer. Access to tests should not be limited to certain age groups or depend on family history.
BRCA mutation can also affect men and may be linked with increased risk of breast cancer, prostate cancer, pancreatic cancer and melanoma
Gene testing is a blood test. The benefit of having gene test is to formulate an individualised surveillance strategy. Your specialist will be able to offer screening for breast cancer in addition to ovarian cancer if appropriate.
During the consultation, a detailed history including personal and family history is taken. Relevant test for example, blood test for gene testing and CA 125 may be requested. An ultrasound scan to check the ovaries may be requested. Test for ROCA (risk of ovarian cancer algorithm) may be requested. Follow up timelines discussed.
When a test is abnormal, it is natural to have worries and questions. Please discuss with your specialist what the abnormal test means. Having an abnormal test does not mean you have cancer. It will help your specialist to allow counselling in a more effective manner and offer appropriate preventative measures.
