Inside Story

May 8 is World Ovarian Cancer Day, and it’s an important time to raise awareness, because while the symptoms may be easy to overlook, the impact isn’t.

What is Ovarian Cancer?

‘Ovarian cancer’ is not a singular diagnosis, rather it is an umbrella term for a multitude of different types of cancer that affect the ovaries, fallopian tubes, and the primary peritoneal cavity. According to the World Ovarian Cancer Coalition (WOCC), it is estimated that there are more than 30 different types of ovarian cancer, and there is a very wide variation in incidence and outlook in terms of the different types.

Ovarian cancer is the most lethal of the female cancers for which there is no reliable screening test, and every person assigned female at birth is at risk.  With delays in diagnoses due to this lack of screening and because symptoms are often confused with other, less severe, illness, most people are diagnosed once the cancer has already spread, making it more difficult to treat. While every woman is at risk, ovarian cancer is overlooked and underfunded.

Types of Ovarian Cancer

There are different types of ovarian cancer tumours, which are named after the type of cell they come from, the three main cell types that make up the ovary. They are:

Epithelial ovarian cancer: Comes from the surface of the ovary (the epithelium), and is the most common ovarian cancer. Fallopian tube cancer and primary peritoneal cancer are also included in this type of ovarian cancer.

Germ cell ovarian cancer: Comes from the reproductive cells of the ovaries. Germ cell ovarian cancer is rare.

Stromal cells ovarian cancer: Comes from connective tissue cell. Stromal cells ovarian cancer is also very rare.

Small cell carcinoma (SCCO) of the ovary: This is an extremely rare ovarian cancer and it is not certain whether the cells in SCCO are from ovarian epithelial cells, sex-cord stromal cells or germ cells.

Symptoms Can Be Vague and Easy to Overlook

Ovarian cancer symptoms can be vague and easy to overlook. Symptoms include:

• Bloating – increased abdominal size that’s persistent and doesn’t go away quickly.
• Eating Complications – difficulty eating and/or feeling full quickly.
• Pain in the abdomen or pelvic areas.
• Needing to pee more urgently or more often.
• Changes in bowel habits.
• Abnormal bleeding (Note: any post-menopausal bleeding should always be checked by your primary health care provider or doctor).
• Extreme fatigue.
• Unexplained weight loss.

Often ovarian cancer symptoms are considered minor or mistaken for other ailments and causes, as they can be subtle and experienced by women who do not have ovarian cancer. They can be confused with symptoms of other less severe illnesses, especially gastrointestinal complaints (ex IBS or Irritable Bowel Syndrome), leading to frequent misdiagnosis and delays. Most patients are only identified in the advanced stages of the disease when it becomes more difficult to treat.

Risk Factors

Anyone with ovaries is at risk for getting ovarian cancer. However, there are some factors that increase your risk, such as age (highest incidences are from 50-79, but can happen earlier), family history (ovarian, breast, colorectal or endometrial cancers), ethnicity (Ashkenazi Jewish women have higher reported cases), genetic mutations (BRCA gene), reproductive history (never given birth), and medical history (endometriosis).

For many women, even getting a diagnosis is a long and difficult journey. Stories of women having their concerns dismissed and being misdiagnosed are disturbingly common. If you, or someone you love, experience any of the symptoms for Ovarian Cancer for two weeks – especially if you are in a higher risk category – you need to see your doctor immediately and request to be tested.

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