Making noise about the ‘silent’ cancer
Ovarian cancer seems to be one of the ‘tricky’ cancers. Early detection is difficult, often the exact cause is hard to pin down and early symptoms are non-specific. Despite all this, a discussion on the topic with Gynaecological Oncologist, Dr Adam Pendlebury, unveiled a positive future in fighting the disease.
The Cancer Council Australia suggests that ovarian cancer is the eighth most common cancer affecting women in Australia. In 2018, roughly 1600 cases of ovarian cancer were diagnosed. While this number is increasing, the age-standardised incidence rate is in fact on the way down.
You see, the risk of ovarian cancer increases with age. As Dr Pendlebury explained, as our population ages, it’s no surprise to see the raw numbers of ovarian cancer increasing. But it’s equally encouraging to see the age-standardised incidence rate fall. Whilst the fall in this incidence rate may not be significant, it certainly points to the inroads being made in detecting, treating and preventing such a tricky disease.
So what is it exactly, that makes it so tricky?
Early detection of ovarian cancer is one thing. Sometimes referred to as ‘the silent cancer’, the early symptoms of ovarian cancer can often be quite vague and non-specific. This often results in detection in the later stages of the disease, when the cancer has progressed and ultimately, more difficult to treat. Dr Pendlebury backed up this assertion: “Most patients don’t have very specific symptoms, and majority are advanced stages when we find it. Why? It’s hard to pin down. But it often doesn’t cause symptoms in early stages.
Dr Pendlebury therefore stressed the importance of thorough investigation if you do experience any early symptoms, “If you have symptoms that do suggest ovarian cancer, we need to look into it very carefully, because it could be caused by a whole range of things.”
Interestingly, Adam pointed out that those at greatest risk of developing ovarian cancer only make up a small proportion of cases. “Those with a family history are perhaps at greatest risk. But we’ve been able to make a big impact for those patients, because we can make specific recommendations to reduce their risk.”
The BRCA1 and BRCA2 genes are the main culprits, with the risk increasing significantly if you’ve inherited either of these genes. Perhaps the most famous recent case is that of Angelina Jolie, who announced in 2013 that she carried the BRCA1 gene, and subsequently underwent a preventative double mastectomy, as well as having her ovaries and fallopian tubes removed to reduce her risk of developing ovarian cancer.
However, if someone in your family has experienced ovarian cancer, a thorough investigation into this history is the most important first step. As Dr Pendlebury pointed out, “If someone in your family has had ovarian cancer, it’s important to understand the family history very carefully to get an accurate assessment to see if you have these genes. If you can have that assessment and know whether you are truly at risk, it can really help you to make the right decision about your potential options for preventing ovarian cancer.”
Understanding the disease at such a detailed level has of course contributed to the reduction in the occurrence of the disease, but as Dr Pendlebury pointed out, we still have a wait on our hands to see the true result of all the research currently being undertaken. “Researchers have found recently that the fallopian tubes are where the most common ovarian cancer can begin, so removing these tubes at the time of hysterectomy – but keeping the ovaries, as they’re important for other things – can also help to reduce the risk. It could be a really important development, but unfortunately we won’t really find out how effective this is going to be for about 10 years.”
Dr Adam Pendlebury is a gynaecologist and gynaecological oncologist specialising in the surgical management of complex gynaecological conditions, including abnormal cervical screening tests (colposcopy), ovarian cysts, uterine fibroids and cancers of the female reproductive system (uterus, fallopian tubes, ovaries, cervix, vagina and vulva).
Dr Pendlebury’s consulting rooms are located at:
Suite 109, 320 Victoria Parade,
East Melbourne, Victoria 3002
St Vincent’s Private Hospital Werribee
240 Hoppers Lane, Werribee VIC 3030
Phone: (03) 9419 6619