Last month saw National Ovarian Cancer awareness week.

This coincided with a very interesting report in The Lancet about a different way of screening for this ‘silent’ disease in the female population which showed much better results than perhaps would have been expected.

Ovarian cancer affects 5400 patients per year in England and Wales and only 1 in 20 cases occur in pre-menopausal women.

But why is it silent? The abdomen is big place and the ovaries are buried deep in the pelvis so problems do not necessarily become apparent until the cancer is quite large or quite advanced.

The ovaries are not easily accessible to physical examination- requiring a deep vaginal examination which is intrusive and relatively inaccurate. Ultrasound examination is relatively straight forward but the ovaries often contain cysts anyhow and it may be difficult to differentiate between early malignant cysts and normal cysts.

Therefore follow up surgical investigations such as laparoscopy or even excision of the ovary may be required for a cyst that is non- cancerous – clearly good news in itself, but not if in the process you have suffered a surgical complication.

The trial used an initial blood screening test for the protein CA125.

In the past this blood test has primarily been performed to monitor the progress of treatment in patients who are being treated for the disease. This study did show that this test could have an important role to play in a future population screening plan although there are currently no plans for this.

So what can women do to try and catch this ‘silent killer’ before it is too late?

The most important thing is to be on the look out for some of the symptoms of this disease and seek advice from your GP if you are worried.

Unfortunately none of these symptoms are specific to this disease and include abdominal distension, bloating, pain, weight loss, constipation and lethargy. If you have an Ultrasound scan, this may well show cysts which may be perfectly normal. A CA125 blood test might be helpful.

Women with a past history or a strong family history of breast cancer should also be vigilant and there are various inherited gene abnormalities which can significantly increase the risk of these two cancers.

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