A Guide to Ovarian Cancer & How to Get a Second Opinion

What is Ovarian Cancer?

Ovarian cancer occurs when cells in the ovaries begin to multiply at an abnormally rapid rate and is one of the most common types of cancer in women. Every year over 7,000 women are diagnosed with ovarian cancer in the UK, making up 2% of all cancer cases.

Ovarian cancer is often only diagnosed in the latter stages, and there is no national screening service available at this time. Predominantly found in older women, upwards of 75 years of age, around 45% of cases are diagnosed at stage one and 58% at stages three or four. Of these, more than 70% will survive their first year after diagnosis, 45% for over five years and 35% will survive for over ten years after initial diagnosis.

Types of Ovarian Cancer

Epithelial ovarian cancer

This form of ovarian cancer is the most common type, accounting for about 9 in 10 cases. Cancerous forms of epithelial ovarian tumours start in the lining tissue of the ovary, and many cases go undetected until they reach the later stages.

Germ cell ovarian cancer

This rare type of ovarian cancer occurs in young women often in their twenties.

There are a number of types of germ cell ovarian cancers named after their microscopic appearance:

• choriocarcinoma
• dysgerminomas
• embryonal carcinoma
• polyembryoma
• mixed germ cell tumours
• yolk sac tumours
• immature teratoma

Malignant germ cell ovarian cancers are often treated using chemotherapy and radiotherapy, and success rate is high.

Sex cord stromal cancer (SCST)

This form of ovarian cancer is a rare type, accounting for under 5% of all ovarian cancers. The start in the sex cord stroma, the blood vessel rich connective tissue which binds elements of the ovary together.

There are three main types of SCST:

• Pure sex cord tumours including adult and juvenile granulosa cell tumours
• Pure stromal tumours including fibromas
• Mixed sex cord tumours including Sertoli-leydig cell tumours

Small cell ovarian cancer (SCCO)

Small cell carcinoma of the ovary is a rare and aggressive form of cancer which affects women in their twenties on average, far lower than the average age for other forms of ovarian cancer. It is prone to metastasis making early diagnosis imperative. SCCO accounts of just 0.1% of all ovarian cancer cases.

There are three types of small cell carcinoma of the ovary:

Pulmonary SCCO – Little is known about pulmonary SCCO. Surgery and chemotherapy may be used to treat it but prognosis is generally poor.

Neuro-Endocrine SCCO – Neuro-Endocrine SCCO is a slow growing cancer which is not generally hereditary. A range of treatments are available which may improve prognosis for cancer patients with this type of SCCO.

Hypercalcemic SCCO – This type of ovarian cancer accounts for 60-90% of all ovarian SCCO cases. Symptoms often do not appear until later stages and prognosis is generally poor. Early diagnosis and treatments including chemotherapy and radiotherapy can be used to treat this type of cancer.

Causes of Ovarian Cancer

The occurrence of ovarian cancer increases with age, with most cases occurring post-menopause. Around 80% of all women diagnosed with ovarian cancer are over 50 years of age, though as we have seen some rare ovarian cancers are most common in women in their twenties.

Ovarian cancers are generally thought to be hereditary, though high occurrences of cancer in the family should be taken into consideration during diagnosis. The faulty BRCA1 and 2 genes which indicate a high risk of breast cancer are also associated with ovarian cancer. While 60-90% of women with faulty BRCA1 are likely to develop breast cancer, 40-60% are at a high risk of ovarian cancer.

Women suffering endometriosis may be at slightly higher risk of developing ovarian cancer, however due to the symptoms of endometriosis often requiring attention and treatment fairly often, symptoms of ovarian cancer are likely to be picked up quickly.

Other factors which increase the risk of developing ovarian cancer include lifestyle elements such as obesity and smoking. Exposure to asbestos has also been linked in the development of a number of cancers including ovarian, however exposure to this material these days is unlikely.

The Main Symptoms of Ovarian Cancer

There are a number of common symptoms of ovarian cancer, including:

• Pelvic pain
• Stomach bloating
• Weight loss
• Loss of appetite
• Frequent urination
• Constipation

Many of these are fairly generic issues which can be overlooked in the early stages or mistaken for other conditions such as perimenopause.

How is Ovarian Cancer Diagnosed?

It is important to get a diagnosis as early as possible to ensure maximum effect from treatment options available.

Diagnosis of ovarian cancer will usually begin with a visit to your GP to explain your symptoms. They may want to carry out an internal examination, and take a blood sample to check for CA125 which is produced by some types of ovarian cancer cells, but not all types. If your CA125 results come back high you may be sent for a scan, however there are a number of other factors which can cause high readings and a high CA125 results does not mean you have cancer. Other scans and forms of diagnosis may include an ultrasound, CT scan, x-ray or biopsy.

At this point you may wish to consider getting a second opinion to ensure a diagnosis agreed on by more than one party, and that they agree on the staging diagnosis to determine how advanced the cancer is. Ensuring the right diagnosis is an imperative part of the treatment decision making process, and having all of the information available will help you make the best treatment choices decision for yourself or a loved one.

Getting a Second Opinion for Ovarian Cancer

What Are the Benefits of a Second Opinion & How Can I Obtain One? 

Oncolomed and a large number of reputable hospitals and medical centres believe a second opinion is an important part of ensuring the most accurate diagnosis on which to ensure the most effective treatment.

A cancer diagnosis is a life changing event, and having all the information possible will help you find a treatment plan which works the best for you.  

Ovarian Cancer Treatment Abroad

When it comes to obtaining the best treatment, you may find that not all healthcare systems are able to offer the full range of options. If you have been advised that a treatment may work for you which is not available at home, you may wish to look at getting treatment abroad. It may be that your preferred treatment is available at home but the waiting time is too long, or a type of medication is available which you cannot get at home.

You can read more about treatment abroad in our FAQ section.

How OncoloMed Can Help

OncoloMed can help you explore your treatment options and find the right plan for you by facilitating second opinions and cancer treatment through our network of leading clinics and oncologists.

See how we can compassionately guide you in your cancer treatment journey by exploring our range of services.

Alternatively, read our patient stories to see how we have helped patients across the globe in their fight against cancer.