Ovarian cancer is a gynaecological cancer that begins in the ovaries, fallopian tubes, or peritoneum (the lining of the abdomen). It often develops without noticeable early symptoms, which makes it challenging to diagnose in its early stages. By the time symptoms appear, the cancer may have already spread.

Common signs include persistent bloating, abdominal or pelvic pain, feeling full quickly when eating, and changes in bowel or bladder habits. Risk factors include age (most cases occur in women over 50), family history, and inherited genetic mutations like BRCA1 and BRCA2.

Because early detection improves treatment success, it’s essential to be aware of any persistent or unusual symptoms and seek medical advice. While there is no routine screening test for ovarian cancer, those at higher risk may benefit from genetic testing and regular health check-ups.

Symptoms of ovarian cancer include:

• Persistent abdominal bloating, or an increase in abdominal size
• Abdominal or pelvic pain
• Difficulty eating, loss of appetite or feeling full quickly
• The urge to urinate often

Though patients may also experience additional symptoms such as:

• Indigestion, nausea, diarrhoea or a change in bowel habits
• Lower back pain
• Menstrual inconsistencies (such as bleeding after menopause or between periods)
• Weight fluctuations
• Fatigue
• Discomfort or bleeding during sexual intercourse

As there is no early screening or detection test for ovarian cancer, it is critical that women consult a doctor if they experience the above symptoms for a period of more than three weeks.

Ovarian cancer can develop in women of any age, but certain factors may increase the risk, including:

• Age: Most ovarian cancers occur in women over 50, with the highest risk in those over 60.

• Family history and genetics: A family history of ovarian, breast, or bowel cancer may increase risk, especially if linked to BRCA1 or BRCA2 gene mutations or Lynch syndrome.

• Reproductive history: Women who have never had children, had their first child after 35, or have experienced infertility may have a higher risk.

• Hormonal factors: Long-term use of oestrogen-only hormone replacement therapy (HRT) may slightly increase risk.

• Endometriosis: This condition, where tissue similar to the uterine lining grows outside the uterus, has been linked to a higher risk of ovarian cancer.

• Obesity and lifestyle factors: A diet high in processed foods, smoking, and a lack of regular physical activity may also play a role.

While some risk factors, like age or genetics, can’t be changed, maintaining a healthy lifestyle and discussing family history with your doctor can help assess your risk and determine if genetic testing or screening is appropriate.

There is no reliable screening test for ovarian cancer, so diagnosis usually begins when a woman experiences symptoms. If your doctor suspects ovarian cancer, they may recommend:

• Pelvic examination: A physical exam to check for lumps or swelling in the ovaries.

• CA-125 blood test: Measures levels of CA-125, a protein that can be higher in women with ovarian cancer. However, elevated CA-125 can also be caused by other conditions like endometriosis or fibroids.

• Imaging scans: A transvaginal ultrasound (TVUS) or CT scan may be used to examine the ovaries for abnormal growths or masses.

• Biopsy or surgery: If a suspicious mass is found, surgery may be needed to remove and test tissue for cancer cells. A biopsy is typically performed during surgery, as sampling ovarian tissue beforehand can risk spreading cancer cells.

Because ovarian cancer is often diagnosed at a later stage, being aware of symptoms and discussing any concerns with your doctor can help lead to earlier detection and treatment.

Ovarian cancer treatment depends on the stage of the disease, the type of ovarian cancer, and individual health factors. Common treatment options include:

• Surgery: This is usually the first step and involves removing the ovaries, fallopian tubes, and sometimes the uterus (hysterectomy) and nearby lymph nodes. In advanced cases, surgery may aim to remove as much of the cancer as possible.

• Chemotherapy: Often used after surgery to destroy remaining cancer cells or shrink tumours before surgery. It may also be used for advanced or recurrent ovarian cancer.

• Targeted therapy: Newer treatments like PARP inhibitors work by blocking cancer cells from repairing themselves. These are often used for women with BRCA gene mutations or recurrent ovarian cancer.

• Hormone therapy: Some types of ovarian cancer, such as low-grade serous carcinoma, may respond to hormone-blocking treatments.

• Immunotherapy (clinical trials): Research into using the body’s immune system to fight ovarian cancer is ongoing, and some women may be eligible for clinical trials.

Your healthcare team will develop a treatment plan based on your individual needs. Support services, including counselling, nutrition advice, and peer support groups, can also help you through treatment and recovery.