Ovarian cancer is the sixth most common cancer in females in the UK, with around 7,500 women diagnosed every year.

The charity Target Ovarian Cancer recently conducted a poll from 1,000 women which revealed that 79 per cent did not know that bloating was a symptom of ovarian cancer. I was shocked to read that ovarian cancer is often misdiagnosed as irritable bowel syndrome (IBS). Sadly, the reason for this is because the symptoms of ovarian cancer can be subtle and mimic those of more minor conditions, meaning that ovarian cancer is often diagnosed at a later and more advanced stage.

We want to be able to help more women spot the symptoms of ovarian cancer during Ovarian Cancer Awareness Month, which is happening this March.

Ovarian cancer is the deadliest out of the five gynaecological cancers (womb, cervical, ovarian, vaginal and vulval). It is hoped that with greater awareness, more women and healthcare professionals will be able to identify symptoms much earlier to provide the best possible treatment for patients.

What is ovarian cancer?

The ovaries are two small organs (roughly the size and shape of an almond) which form part of the female reproductive system.

Their function is to:

1.    Produce, store and release eggs for reproduction.

2.    Produce the female sex hormones, oestrogen and progesterone.

Ovarian cancer develops when abnormal cells in the ovary multiply uncontrollably to form a tumour. Tumours can either be benign (non-cancerous) or malignant (cancerous). If the tumour is malignant, and left untreated, it can spread to other parts of the body. 

There are three types of ovarian cancer, some of which are more common than others. The type of ovarian cancer a woman develops can depend on her age. The most common stage it develops is post menopause, although ovarian cancer can strike at any age.

Types of ovarian cancer

• Epithelial ovarian cancer
• Germ cell ovarian cancer
• Sex-cord stromal ovarian cancer

Epithelial ovarian cancer is the most common type of ovarian cancer.

Germ cell ovarian cancer mainly affects younger women.

Sex-cord stromal ovarian cancer tumours are rare and usually benign. They are found in the connective tissue of the ovary. Depending on the type of sex-cord stromal ovarian cancer, this can affect women in the early menopause, women in their 20s and 30s, younger women and even children.

Other cancers such as primary peritoneal and fallopian tube cancers can be closely linked to ovarian cancer.

You can find out more about the different types of ovarian cancer on the Target Ovarian Cancer website.

Symptoms of ovarian cancer

There is currently no national screening for ovarian cancer, nor can ovarian cancer be detected from a smear test which makes it even more crucial to know the symptoms to look out for.

According to Target Ovarian Cancer, the four main symptoms include:

• Persistent bloating (which doesn’t go away)
• Feeling full more quickly/ difficulty eating
• Persistent abdominal pain
• Needing to pass urine more frequently or urgently than normal

It is also worth noting if your symptoms are:

• Persistent - don’t come and go
• Frequent - usually happen more than 12 times a month
• Severe
• Out of the ordinary for you

Other symptoms of ovarian cancer can be:

• Changes in bowel habit (diarrhoea or constipation)
• Extreme tiredness for no obvious reason
• Unexplained weight loss
• Back pain

It is important to remember that any bleeding after the menopause should always be investigated by a GP.

Diagnosis and treatment

If you experience any of the above symptoms or anything that is unusual for you, please make an appointment with your GP.

Ovarian Cancer Action have detailed what to expect from your GP appointment. Your GP will take a detailed history of your symptoms, how frequently they occur and their severity. It is also helpful to note any family history of ovarian cancer or breast cancer. A physical examination of your abdomen will be performed to check for any abnormalities. You may also have an internal vaginal examination; this may feel slightly uncomfortable but should not be painful.

If your GP suspects something like ovarian cancer you will be referred for a ‘CA125 blood test’. CA125 is a protein found in the blood. The level of CA125 in a woman’s blood is usually less than 35 units per millilitre (U/mL). An elevated reading can indicate a number of conditions, such as a chest infection or pregnancy. In some cases, it may be a sign of ovarian cancer. An increased level of CA125 in the blood does not necessarily mean that you have ovarian cancer and is not a diagnosis in itself but does warrant further investigations such as an ultrasound scan.  

Again, an ultrasound scan alone can’t diagnose ovarian cancer. If any abnormalities are identified from the scan, you will be referred to a gynaecologist for more in-depth investigations. 

If you are diagnosed with ovarian cancer, your treatment will depend on the type of cancer and stage of your diagnosis. Treatment can range from surgery, hormonal therapy, targeted therapies (medication to delay the progression of ovarian cancer), chemotherapy and radiotherapy.

A recent news article from Metro shared the story of one woman who had been experiencing bloating and abdominal pain. She had initially thought the bloating may have been linked to her menstrual cycle and had there been more awareness of the symptoms of ovarian cancer, she would have gone to her GP much sooner.  When she did see her GP, she was referred for an ultrasound scan and CT scan which revealed a mass on her ovaries. She was diagnosed with Stage I ovarian cancer at the age of 32. She later underwent a full hysterectomy, and now takes hormone replacement therapy (HRT), having reached early menopause. Thankfully she is now cancer free and helps to raise awareness for ovarian cancer, having taken part in a 15,000ft skydive in April 2019 in support of Target Ovarian Cancer.

Who can help?

There are a number of charities that provide helpful information and support for anyone worried or affected by ovarian cancer.

• Target Ovarian Cancer
• Ovarian Cancer Action
• GRACE (Gynae-oncology Research and Clinical Excellence)  
• The Eve Appeal

JMW’s specialist clinical negligence team have also helped families successfully investigate delayed diagnosis of cancer claims. If you or a loved one has been affected by a missed diagnosis of cancer, please get in touch with a member of the clinical negligence team for an informal chat.

Early detection is key. If the public and healthcare professionals can identify symptoms of ovarian cancer sooner, we can help more women get diagnosed earlier, avoid more invasive treatment, and save lives.