Ovarian Cancer: what you need to know
This year I celebrated Ovarian Cancer Awareness Month on Instagram, by sharing information about this disease and different aspects of my lived experience.
Sadly, this is a condition that in the majority of cases is diagnosed late (stage 3 & 4) it’s the deadliest of the ‘female’* cancers. When I was diagnosed in 2013 the five year survival rate was around 46-7%, ten years on its still only 49%. It’s a grim and confronting statistic!
A few more facts about ovarian cancer
- >1550 Australians will be diagnosed with OC this year.
- While the majority will be 50 years or older, children and teenagers can also have a rare form of this cancer.
- Some genes increase the chance of developing OC including BRCA 1 + 2, or Lynch Syndrome but the majority of people diagnosed don’t have these genes.
Symptoms of ovarian cancer
In the early stages there mightn’t be any obvious symptoms. Over time, as the tumour grows larger, spreads or ascites fluid accumulates in the abdomen – one or more of the following might become apparent:
- a distended, bloated or pregnancy bump-like belly
- pain in the pelvis or abdomen
- trouble eating or drinking (pain or feeling of fullness)
- urgent or frequent urination.
symptoms of ovarian cancer silent killer australia
I actually knew the signs and symptoms of ovarian cancer! Did I think my distended belly, scoliosis (spinal defect) aggravated to the point that I couldn’t lie flat without being in excruciating pain was OC? No! But I did know something was wrong and it felt serious.
Seeing a wise GP who sent me for tests immediately, likely saved my life. Due to this, I had an early stage diagnosis.
Tests for ovarian cancer
There is currently no screening test for ovarian cancer. A pap smear won’t detect it! It may be diagnosed by a combination of a CA125 test (a blood test for a cancer marker that’s raised in some but not all cases of OC), pelvic ultrasound and/or MRI.
There are a number of labs in Australia and around the world working on an OC detection test, each researcher is focusing on something different. We are still a long way off from having a definitive test available freely or cheaply. Awareness of symptoms, and persistence to get the above tests, as quickly as possible, is the only option.
Treatment
In Australia the vast majority of people diagnosed with OC will have ‘debulking’ surgery (removing ovaries, fallopian tubes and uterus, and often the omentum, some lymph nodes and appendix are also taken) plus chemotherapy. The chemo drug regime has many side effects and is rarely individualised at this stage. Recurrence within 6 – 24 months is far too common.
A new generation of drugs known as PARP inhibitors are available on the PBS for those with a BRCA gene or tumour mutation (you can have a BRCA tumour without carrying the gene!), or some other types of mutations. This is making a huge difference and is the biggest gamechanger in increasing survival rates.
However, this drug works best on a minority of those with OC. Personalised medicine, where tumour markers are matched with specific drug treatments, ultimately offers the best results. One of the reasons ‘standard’ frontline chemo for OC often doesn’t deter the cancer for long is that it’s not specific enough. Some OC tumours have more in common with other cancers in other parts of the body. Tumour sequencing has now become routine in Australia, though the number of mutations tested, and availability of personal treatment, can vary widely.
Prevention
New research has found that if having a hysterectomy for any reason, removing the fallopian tubes (even when preserving the ovaries) can significantly decrease your personal risk of OC. It’s predicted that an “opportunistic salpingectomy” could decrease overall OC mortality rates by 15%.
A recent study shows a diet high in phytoestrogens, has a slightly preventative effect.
Other than knowing if you have an increased genetic risk of developing OC (BRCA, Lynch Syndrome etc) and having regular surveillance, there are a few factors that have been found to slightly increase your chance of developing this cancer.
Known risk factors include:
-
- Endometriosis: the gift that keeps on giving in my case! Around 1 -2% of people with endo develop OC, so this is a significant factor to be aware of.
- HRT: A recent meta-analysis suggests that HRT may increase the risk of ovarian cancer, especially for serous (the most common type of OC) and endometrioid tumours.
https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2019.00801/full
https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/hormones-and-cancer/does-hormone-replacement-therapy-increase-cancer-risk - Smoking.
- Obesity.
My Story
During Ovarian Cancer Awareness month, fellow survivor and consumer, Jacinta Frawley, interviewed me about my OC story. Take a look.
Naturopathic support for ovarian cancer
When diagnosed with cancer, you’re thrown into an unknown world full of appointments, tests and treatments. You gather your team, the oncologist, surgeons, radio-oncologist, physio, psych…..it’s a busy/lonely/confusing time. Why add a naturopath to your team?
Naturopathy is about working with the ‘whole person’. While going through treatment, you might still suffer from reflux, insomnia, gut problems – even more so than before. You are more than your cancer diagnosis. When life gets complex, part of how I work naturopathically is offering an overview to connect all the parts.
When I was a cancer patient myself I couldn’t be my own therapist (despite decades of working with clients with cancer). I found it invaluable working with an experienced naturopath I trusted. Even more so when after months of intense treatment, to feel abandoned by the conventional medical system and only followed up to see if the cancer had returned. It was naturopathy, that helped restore my body after the rigours of surgery and chemo. It helped my body heal and energy slowly return.
As a practitioner, the golden time to work with a client is the moment conventional treatment ends, to rebuild, repair and restore. I know what this phase is like to live through and what may help you navigate it.
If you’re interested in learning more, take a look at how naturopathy can support your cancer journey.
*A note on language
While ovarian cancer occurs in those assigned female at birth (AFAB), not everyone diagnosed with this disease identifies as female.
Gill Stannard is an ovarian cancer survivor and naturopath. She offers support during and recovery from, conventional treatment, fear of recurrence and general wellbeing.
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