Unveiling Ovarian Cancer - It’s time to raise awareness

29 February 2024 - Susan Helmrich

How can we shed light on the challenges and diagnostic journey of patients?

Fran's Case

Fran's symptoms included abdominal bleeding, lower abdominal pain, pain in the lower rectum, super pubic area discomfort, epigastric pain, nausea, decreased appetite, and irregular periods. The initial diagnosis leaned towards constipation and gastritis linked to stress and lifestyle. However, a follow-up examination revealed persisting symptoms, leading to a broader investigation, including stool samples, blood tests, and a CT scan.

The Turning Point

The CT scan exposed a large ovarian mass highly suggestive of ovarian carcinoma, coupled with ascites. Fran was swiftly admitted to the hospital, underwent ascites drainage, and commenced preoperative chemotherapy. The diagnosis extended to lung and peritoneal metastases, and Fran faced a major post-op complication. Despite ongoing palliative chemotherapy, her prognosis remains grim.

Understanding Ovarian Cancer

Ovarian cancer, as highlighted by Cancer Australia ranks as the ninth most common cancer in Australian women and the sixth leading cause of cancer death. The disease carries a lower five-year survival rate compared to other cancers. Risk factors include age over fifty, genetic predisposition, family history, endometriosis, smoking, and hormone therapy use.

Symptoms and Challenges in Ovarian Cancer Diagnosis

The challenge in diagnosing ovarian cancer lies in its vague symptoms, such as abdominal bloating, indigestion, lack of appetite, and fatigue. These symptoms often mimic common issues and can lead to delayed diagnosis, as seen in Fran's case. Ovarian cancer should be considered in women over forty with persistent symptoms lasting more than four weeks.

Key Takeaways and Recommendations:

Clinical Examination: Performing both pelvic and abdominal examinations, especially in women over forty, is crucial. Fran's case highlighted the potential impact of early detection through pelvic examination.
Imaging: A low threshold for pelvic imaging, particularly transvaginal ultrasound, is recommended for suspected cases. Imaging can aid in identifying pelvic masses and guide further investigations.
Risk Factors: Understanding risk factors, such as genetic predisposition and endometriosis, can help in early identification of potential cases.
Screening: Routine screening for ovarian cancer is not recommended for the general population. The webinar stressed the lack of evidence supporting the effectiveness of screening in improving mortality rates.
Awareness: Healthcare professionals should maintain a heightened awareness of ovarian cancer in women over forty with new or persistent abdominal symptoms.

The Challenge

Diagnosing ovarian cancer due to its non-specific symptoms can be supported by increased awareness. Healthcare practitioners must maintain a vigilant approach, considering ovarian cancer in the differential diagnosis for women presenting with persistent symptoms.

Early detection remains crucial for improving outcomes and enhancing the quality of life for individuals facing this challenging diagnosis. Raising awareness and encouraging patients to keep a symptom journal can help with early recognition and diagnosis to help reduce the mortality of this cancer.

Women's Health in General Practice