Ovarian cancer is one of the most serious gynaecological cancers, both globally and in South Africa.

It is therefore crucial to understand the factors that may put you at a higher risk for this kind of cancer, and how to recognise the signs and symptoms that may be associated with ovarian cancer as symptoms can be mistaken for other conditions.

Common symptoms:

• Abdominal bloating or swelling: Persistent bloating that doesn't come and go, or an increase in abdominal size.
• Pelvic pain: Discomfort or pain in the lower abdomen or pelvic area.
• Difficulty eating or feeling full quickly: A reduced appetite or feeling full after eating small amounts of food.
• Changes in bowel habits: Constipation, diarrhoea, or other digestive issues.
• Urinary frequency or urgency: Needing to urinate more often or with a greater sense of urgency.
• Fatigue: Feeling tired or lacking energy, even after getting enough rest.
• Unexplained weight loss: Losing weight without making any changes to your diet or exercise. 

Other possible symptoms:

• Back pain: Pain in the lower back or flank area. 
• Vaginal discharge or bleeding: Abnormal bleeding after menopause or unusual discharge. 
• Pain during intercourse: Discomfort or pain during sexual intercourse. 
• Indigestion or nausea: Digestive discomfort or feeling sick to your stomach. 

It's important to see a doctor if you experience any of these symptoms, especially if they are persistent or severe. Early detection and diagnosis are crucial for successful treatment of ovarian cancer. 

While there is no standard screening test for ovarian cancer, methods such as transvaginal ultrasound and CA-125 blood tests can be used for women with symptoms.

Dr Celesté van Drünick, a gynaecologist-oncologist at Life Vincent Pallotti Hospital, emphasises the importance of knowing your family history and highlighting any symptoms that may be associated with ovarian cancer. Patients with higher risk factors or who are experiencing symptoms, should mention this to their health care providers urgently.  This is  crucial for women at high risk, and helps us to identify abnormalities early, allowing for timely intervention and better prognosis."

Risk factors for ovarian cancer ¹

Ovarian cancer risk factors can vary, but several key factors have been identified that may increase a woman's likelihood of developing the disease. 

Understanding the risk factors for ovarian cancer can help in making informed decisions about health and screening practices. Some of the most significant risk factors include:

• Age: The risk increases with age, particularly after menopause.
• Family History: A family history of ovarian cancer increases the risk.
• Genetic Mutations: BRCA1 and BRCA2 genetic mutations significantly increase the risk.
• Personal history of cancer: A history of breast, uterine, or colorectal cancer can increase the risk.
• Reproductive history and infertility: Women who have never given birth or have had trouble getting pregnant are at a slightly higher risk.
• Endometriosis: This condition can increase the risk.
• Obesity: Obesity is linked to a higher risk of many cancers, including ovarian cancer.

Advancements in diagnostic technology

The latest advancements in diagnostic technology, such as PET-CT (Positron Emission Tomography-Computed Tomography), are revolutionising cancer detection and management. PET-CT combines the functional imaging of PET with the anatomical detail of CT, providing a more comprehensive view of the cancer. This technology is particularly useful in detecting metastasis and planning treatment strategies.

Dr. Bruce Young, nuclear physician at TheraMed Nuclear in Gauteng, explains, "PET-CT is recommended in global best practices for the staging and monitoring of a wide range of cancers. These scans combine two imaging techniques - PET & CT - and involve injecting a radioactive tracer into the patient's body to highlight areas of high metabolic activity. These tracers are a critical component of PET-CT scanning, representing part of the next generation of advanced diagnostic imaging technology."

In the context of ovarian cancer, PET-CT scans are particularly valuable for:

• Determining the extent of the disease: PET-CT is excellent at showing whether cancer has spread to the lymph nodes or other parts of the body.
• Evaluating treatment response: PET-CT helps doctors see how well the cancer is responding to treatment and can provide important information about the likely outcome.
• Detecting recurrence: PET-CT can also be used to check if the cancer has come back after treatment.

Ovarian cancer remains a significant health challenge in South Africa and worldwide. By recognising the signs and symptoms, and leveraging advanced diagnostic technologies like PET-CT, we can improve the accuracy in treatment planning, staging of the disease, monitor treatment response and detect recurrence of the disease.

References

1. Ovarian Cancer Risk Factors | Ovarian Cancer | CDC

The information is shared on condition that readers will make their own determination, including seeking advice from a healthcare professional. E&OE. Life Healthcare Group Ltd does not accept any responsibility for any loss or damage suffered by the reader as a result of the information provided.

This article was developed with the assistance of artificial intelligence and has been edited and reviewed by HPCSA registered healthcare professionals.