Debunking the Myths of Ovarian Cancer - November 2024

With careers to nurture, families to care for, and responsibilities to juggle, it is all too easy for women to overlook the danger that may be lurking within their bodies. Imagine waking up one day and feeling perfectly healthy, only to be blindsided by a diagnosis that could change everything. Ovarian cancer, often overlooked before menopause, does not care about your plans, dreams, or age. Its unpredictability could leave women to ponder the unsettling question: Could I be next? Shattering Common Misconceptions Dr Chong Wen Kiat, Consultant Obstetrician & Gynecologist from Columbia Asia Hospital – Setapak “I notice that ovarian cancer, known as the 'silent killer,' is often misunderstood. This can lead to improper care. By clearing up some misconceptions, we can help women better understand the disease and take proactive steps for early detection and treatment”, says Consultant Obstetrician & Gynecologist from Columbia Asia Hospital – Setapak, Dr Chong Wen Kiat. According to Dr Chong, some of the popular myths making its rounds among women of various ages are: Ovarian cancer only affects older women: Although it is more frequently diagnosed in older women, ovarian cancer can affect women of any age, including those in their 20s and 30s. In Malaysia, it ranks as the fourth most common cancer among women. Ovarian cancer has specific symptoms: In its initial stages, ovarian cancer may not exhibit any noticeable symptoms, or it may only present with vague symptoms that are frequently misinterpreted as signs of less severe ailments. Pap smears can detect ovarian cancer: Pap smears are effective for detecting cervical cancer, but they do not screen for ovarian cancer. You will definitely get ovarian cancer if you have a family history of it: Up to 90 to 95 per cent of ovarian cancer cases occur in women with no family history of the disease. Ovarian cancer is a death sentence: While serious, ovarian cancer is not always fatal. Early-stage diagnoses, like Stage I or II, can have survival rates of 85 to 90 per cent. Advances in treatments, like surgery and chemotherapy, have also improved survival rates. Unseen Threats of Ovarian Cancer Ovarian cancer often goes undetected, with a significant majority—up to 60 per cent—being diagnosed at advanced or late stages. This is due to the fact that ovarian cancer may not exhibit any symptoms in its early stages. “Sometimes, the symptoms can be quite vague and are often mistaken for less serious conditions like gastritis or urinary tract infections”, Dr Chong explains. The period during which ovarian cancer remains undetected varies due to factors like awareness, symptom severity, timely detection of clinical signs, and tumour growth rate. Dr Chong adds that the symptoms of ovarian cancer can manifest as abdominal discomfort, feelings of fullness, indigestion, or increased urinary frequency. Some individuals may also experience constitutional symptoms like fatigue, weight loss, loss of appetite, or even depression. “It is important to recognise that symptoms of ovarian cancer, like changes in menstrual cycles, pelvic discomfort, and abdominal swelling, can often resemble those experienced during menopause”, adds Dr Chong. What Triggers Ovarian Cancer? Several factors can increase the risk of ovarian cancer. A family history of ovarian, breast, or bowel cancer, such as being a BRCA gene mutation carrier, significantly elevates the risk. According to Dr Chong, the likelihood of developing ovarian cancer also increases after the age of 50 due to cumulative factors, including hormonal changes, age-related changes in the ovaries, genetic predispositions, and environmental influences. Besides, long-term use of oestrogen-only hormone replacement therapy after menopause, endometriosis, being overweight or obese, and exposure to chemicals can increase the risk of ovarian cancer. Early Detection Through Screening Ovarian cancer can often be suspected through a detailed medical history, pelvic examination, and imaging tests such as transvaginal ultrasound or CT scan, as well as tumour marker blood tests. However, the normal value of tumour markers does not rule out ovarian cancer due to the test's non-specific nature. Also, these markers may appear normal in the early stages of the disease. Clinical suspicion of ovarian cancer requires surgical evaluation for confirmation. Prognosis of Ovarian Cancer Before and After Menopause Ovarian cancer prognosis is typically more favourable before menopause than after, owing to various factors. “Genetic factors are crucial, and women with mutations like BRCA1 and BRCA2 often consider earlier interventions, such as risk-reducing surgery”, Dr Chong says. “Premenopausal women often respond better to treatment because their tumours are different, they have stronger immune systems, and fewer comorbidities. Also, hormonal changes after menopause can impact tumour growth and treatment outcomes”, elaborates Dr Chong. Lastly, lifestyle choices such as maintaining a balanced diet, regular exercise, and avoiding smoking can impact prognosis, regardless of menopausal status. 8 Steps to Minimise the Risk of Ovarian Cancer Watch your diet: Follow a balanced diet by consuming vegetables, low-glycemic fruits, whole grains, and lean proteins while minimising processed foods, red meats, and sugary drinks. Exercise as a routine: Engage in regular physical activity and stick to a well-rounded diet to control body weight and reduce ovarian cancer risk. Use contraception: Consider oral hormonal contraception since the long-term use of it can lower ovarian cancer risk. However, it should not be the sole prevention method. Breastfeed your baby: Embrace pregnancy and breastfeeding as both can lower ovarian cancer risk by reducing lifetime ovulatory cycles. Consider surgery if high risk: Women at higher risk, like BRCA gene carriers, may opt for risk-reducing surgery, which includes fallopian tubes and ovary removal after family planning. Stop smoking entirely: Smoking increases ovarian cancer risk, so avoid it and minimise exposure to secondhand smoke. Reconsider hormone therapy: Long-term use of Menopausal Hormone Therapy (MHT) may slightly elevate ovarian cancer risk; discuss its pros and cons with your healthcare provider. Analyse family history: Seek genetic counselling and testing, particularly if there is a family history of ovarian, breast, or bowel cancer, or if other risk factors are present. This will help tailor a personalised screening and risk management strategy. Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner. For more insightful stories and fun recipes, stay tuned to Motherhood Story!

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