Dr Cathryn Chan, Astra Women’s Specialists

Ovarian cancer is the fifth commonest cancer in Singapore women and the second most common cancer of the female genital tract. Majority of the ovarian cancers are diagnosed at late stage and hence it is a silent killer. If diagnosed and treated early, there is a good chance of a cure, with 90 – 95% of women living 5 years or more after their treatment.

The commonest types of ovarian cancers (approx 80%) originate from the cells on the external layer of the ovary, fallopian tube and are know as epithelial ovarian cancers. They usually occur in older women or post menopausal women.

Some ovarian tumours have low malignant potential. These tumours do not spread like typical cancers and thus surgery can be more conservative.

Germ cell tumours (10-15%) are derived from the reproductive or egg cells of the ovary. These tumours are more common in younger ladies and children.

Sex cord stromal ovarian tumors (5-10%) often produce sex hormones abnormally and can manifest as abnormal vaginal bleeding and signs of virilism

Symptoms of ovarian cancer

In most cases, there are no symptoms or the symptoms can be vague. Some of these symptoms are

  • Indigestion or heartburn
  • More frequent and urgent urination
  • Abdominal pain
  • Bloatedness
  • Abnormal vaginal bleeding
  • Changes in bowel habits, such as constipation
  • Nausea
  • Weight loss
  • Breathlessness
  • Tiredness
  • Loss of appetite

Unfortunately there are no good screening tests for ovarian cancers. A combination of transvaginal scan and CA 125 may be used.

Surgery with removal of the tumour, ovaries, uterus, omentum and lymph nodes are the mainstay of treatment. When it is not possible to remove all the tumours, debulking surgery can be done. Depending on the stage of the disease, adjuvant chemotherapy may be required.

Early detection and surgery can give good survival rates. Women who have a family history of ovarian, breast or colon cancers and those who have inherited mutations in the BRCA1 and BRCA2 genes are at increased risk of developing ovarian cancers. If you are at risk for ovarian cancer, talk to your doctor about your risk of developing the disease.