Saturday, May 8, 2021 is World Ovarian Cancer Awareness Day.

In May 2020, I “sat down” for a virtual chat with Dr. Patti Power, a gynecologic oncologist with Eastern Health who specializes in gynecological cancers, to learn more about what is considered to be the most lethal female cancer – and to learn what steps women can take to better protect themselves.

“One of the most satisfying aspects our specialty,” says Dr. Power, “is our long-term relationship with patients.  We meet women at diagnosis, perform their surgeries, administer their chemotherapy and then follow patients for years.  We get to know our patients and families really well, which is really important in battling this insidious disease.”

 

According to the Oxford dictionary, the definition for insidious is, proceeding in a gradual, subtle way, but with harmful effects.  

 

The challenge with ovarian cancer is that its presentation can be subtle and often there are few warning signs or symptoms until disease is quite advanced. Symptoms such as bloating or abdominal distention are often downplayed by women as normal signs of aging or menopause.  

  

There are four stages of cancer. For ovarian cancer, stage one means that the cancer is confined to the ovary and has not spread to other parts of the body. 

 

Dr. Power says 80 per cent of woman have advanced stage three disease at presentation. Women are often shocked at their diagnosis because they have just begun to have symptoms of something wrong. This likely relates to how vague the presentation can be. 

 

The earlier a cancer is detected, the better the outcomes for patients in terms of prognosis, treatment options, quality of life and survival rates. 

 

In fact, the five-year survival rate for stage one ovarian cancer is greater than 90 per cent, while the five-year survival rate for women who present at very advanced stages is less than 50 per cent.  

 

Added to that, there is still no reliable screening test to detect this cancer. Which debunks the most common myth – that a Pap test can be used to detect ovarian cancer.  

 

“Many of my patients say, ‘I had my Pap test last year. How can I have ovarian cancer?’”  

 

While a Pap test is a key tool in diagnosing the precursor changes related to cervical cancer, “it has a limited role in detecting ovarian cancer, and often provides women with a false sense of gynecological good health,” stresses Dr. Power. 

 

So what are the biggest risk factors?
Family history 
Did your mother have ovarian cancer? An aunt? A grandmother?

Without a good screening test, it is very important for every woman to know if she might be at increased risk of an ovarian or fallopian tube cancer. While most ovarian cancers happen spontaneously, there are some genetic mutations that can increase a woman’s risk.  Once diagnosed, 15-20 per cent of ovarian cancer patients will end up having a genetic mutation identified.

“With only a few exceptions based on tumor type, all of our ovarian cancer patients are offered genetic testing,” says Dr. Power. “That’s important because new clinical trials with targeted drug therapies have demonstrated improved survival in women with certain gene mutations. We now have access to such targeted drugs.”

She added: “Testing is also important for family members.  If a woman has a gene mutation identified, other relatives could potentially have inherited the same mutation. In these situations, prophylactic or preventative surgeries could greatly minimize the cancer risk in male and female relatives.”

Males are included because some of gene mutations are associated with other cancers, not just ovarian cancer.

“One little abnormality in a strand of DNA may cause a constellation of diseases in men and women, not just one disease,” she says.

Other risk factors
While the reason is still not fully understood, women who have never been pregnant or who have never taken oral contraceptive pills have increased rates of ovarian cancer.

The other common risk factor is age. In fact, the average age of women diagnosed with ovarian cancer is 60. This explains why vague symptoms are often confused with symptoms of menopause.

Women who have a new and persistent symptoms lasting greater than two weeks are advised to seek medical attention.

The signs and symptoms may include

• Persistent bloating or abdominal distention
• Poor appetite or difficulty eating
• Feeling full quickly
• Pelvic/abdominal pain or pressure
• New urinary symptoms or change in bowel habits
• Night sweats
• Unexplained weight loss

What’s new in treatment?
Active research is underway seeking new screening tools to help with earlier detection. Expanded surgical techniques are also improving outcomes and quality of life for women with ovarian cancer.

Also exciting, according to Dr. Power, are new targeted therapies that are resulting in ovarian cancer patients living for longer periods of time with much improved quality of life between chemotherapy treatments.

What woman can do to protect themselves? 

Dr. Power says that early detection and identifying your own personal risk factors is critical. Talk to family members and your family doctor – be proactive.   

 

“Women should never minimize a new, persistent change that lasts more than two-weeks,” says Dr. Power. “These women need to see their family doctor, especially if they’re post-menopausal. Listen to your body. Watch for changes. Ask questions. That’s the bottom line.”

Resources and Support
Ovarian Cancer Canada – https://ovariancanada.org/Home?lang=en-CA 

Women of Hope Ovarian Cancer NL support group founded by Ovarian Cancer survivor, Susan Glynn – Facebook page link – https://www.facebook.com/Womenofhopenl/ 

 

Belles with Balls, non-profit group supporting ovarian cancer research and education in NL – https://belleswithballsnl.com/ 

 

World Ovarian Cancer Awareness Day – https://ovariancancerday.org/  ■

This story was written by Robyn Lush, a communications specialist with Eastern Health.