September is observed as Ovarian Cancer Awareness Month. While I write about the deadly disease, I distinctly remember Mrs. Arti (name changed), a 47 years old, well-educated lady, came to my OPD with complaints of persistent bloating, abdominal discomfort and changes in bowel habit for a year. I immediately asked her, what took her so long to report it to a doctor? I was astonished by her polite reply that, “I thought it might be normal in the menopausal age, so I ignored it”. She had been self-medicating herself with antacids all this while. Needless to say, further investigations were done and it was confirmed that she was suffering from an advanced stage ovarian cancer.
Shocked and baffled by the diagnosis, she asked why couldn’t this be picked up earlier? The answer was simple… her body gave signals, but she IGNORED it!
This scenario is commonly seen in our daily practice. A timely consultation could have detected cancer at a much early stage. Ovarian cancer is the third most common gynaecological cancer in Indian women. Infact, India has the 2nd highest incidence of ovarian cancer globally.
Who are at risk?
- The risk starts increasing from age 35 and reaches a peak between the ages of 55 – 64. ●
- The risk is increased in women:
- Who have never been pregnant
- Had an early menarche and late menopause
- Have family history of ovarian cancer especially in Iast degree
- Carriers of the BRCA1 and BRCA2 gene mutations
- Belong to families with LYNCH II syndrome
- Have history of breast cancer
- Have been on Post-menopausal hormone therapy
Ovarian cancer is a silent disease in the early stages. It is associated with non-specific symptoms but has the worst prognosis amongst gynaecological cancers with is a 5-year survival rate of 45%. This is primarily because most often it is diagnosed in Stage III or IV. The high mortality rates arise because of a lack of definite symptoms related to early-stage disease.
Most gynaecological cancers have similar symptoms and thus might also delay an early diagnosis. But the key lies in reporting to a doctor at the earliest if you find any of the following signs:
- Bloating and abdominal discomfort
- Change in bowel habits
- Indigestion
- Tiredness
- Weight Loss
- Loss of appetite
- Increase in abdominal size
- Nausea and vomiting
- Swelling of the leg due to a deep vein thrombosis
So, what should every woman do to reduce their risk?
- Plan pregnancy timely and breastfeed. Breastfeeding also can help lower your ovarian cancer risk by preventing ovulation.
- Using oral contraceptives (birth control pills) decreases the risk of developing ovarian cancer for average risk women and BRCA mutation carriers, especially among women who use them for several years.
- Both tubal ligation and hysterectomy may reduce the chance of developing certain types of ovarian cancer, but experts agree that these operations should only be done for valid medical reasons — not for their effect on ovarian cancer risk.
- Do not use Hormone Replacement Therapy unless required medically.
- Do not smoke and consume alcohol.
- Eat Healthy and maintaining an ideal weight. Several studies in recent times have shown that there is an association between Obesity and the increased incidence of ovarian cancer. Endometrial, ovarian and post-menopausal breast cancer together make 42% of obesity-related cancers.
Coming back to our patient, her treatment regimen was planned. Having learnt from her mistake of ignorance, she took the entire treatment diligently and timely and did not miss any session. Despite having an advanced cancer, she responded well to the planned therapy, and it has been 5 years now that she is in remission.
Lastly, ladies listen to your body, don’t ignore the signs it shows. Report any abnormality to a doctor immediately.
Know the Writer
Dr (Prof) Meenu Walia is a renowned Medical Oncologist (Cancer Specialist) with over 27 years of experience. She is India’s first DNB, Medical Oncologist and spearheads the Department of Medical Oncology & Hematology at Max Super Specialty Hospital (Patparganj, Vaishali and Noida). She has been decorated with various awards namely Bharat Jyoti Award and Medical Excellence by IMA multiple times. She is a keen cancer researcher and is actively involved with several NGOs working towards the welfare of cancer patients. She is the author of a hugely popular book among cancer patients and caregivers, “Tips for Happiness in The Shadow of Cancer”. She is also a TEDx speaker.
Dr (Prof) Meenu Walia conferred with Lifetime Achievement Award by His Excellency Moe Kyaw Aung, the Ambassador of Myanmar to India at the Crown Global Awards 2021