How to recognise ovarian cancer risk and help improve outcomes

Ovarian cancer may not be as well known as some other female cancers, but it is the fifth most common cancer in women in the UK.

More than 7,000 cases are diagnosed every year, yet treatments for ovarian cancer have not progressed much in the past 20 years and the UK has one of the lowest survival rates in western Europe.

Prognosis is poor for women diagnosed in the UK; a woman dies from the disease every two hours, equating to 4,300 deaths annually, and the five-year survival rate is just 43 per cent.

Nurses have an extremely important role to play in helping to improve ovarian cancer survival rates. We need better recognition of symptoms, a better understanding of who might be at high risk, and to speed up diagnosis and referral rates.

Risk factors
Ovarian cancer is a fairly rare condition, but there are factors that can increase this risk, the two most important being age and family history. 

More than 80 per cent of cases occur in women who are aged 50 or over, and between 10 and 15 per cent of cases occur in women who have a family history of cancer. This increase in risk is most often due to the inherited genetic mutations BRCA1 and BRCA2.

BRCA gene mutations are associated with breast as well as ovarian cancer. Those who have a BRCA gene mutation have a 35-60 per cent chance of developing ovarian cancer, and an 80 per cent chance of developing breast cancer.

Other factors that slightly increase the risk of developing ovarian cancer include obesity, endometriosis, the use of hormone replacement therapy, and not having children. A woman’s risk decreases with each pregnancy, and risk is also lowered by breastfeeding and taking the contraceptive pill.

Symptoms
The symptoms of ovarian cancer can be challenging to recognise because they are similar to symptoms of a number of non-serious conditions. But if a woman presents with the following symptoms on a persistent and frequent basis (i.e. more than 12 times a month), ovarian cancer should be suspected and ruled out, especially if she is aged 50 or over:
• Persistent abdominal distention or bloating.
• Pelvic or abdominal pain.
• Early satiety and/or loss of appetite.
• Increased urinary urgency and/or frequency.

Women may also present with the following symptoms:
• Back pain.
• Changes in bowel habit (diarrhoea or constipation).
• Fatigue.

The key features that might suggest ovarian cancer are persistence, and symptoms that are unusual and new to the patient and get progressively worse.

What can you do?
Aside from learning about the signs and symptoms of ovarian cancer, here at Ovarian Cancer Action we encourage women to be BRCA aware – if your patient has a BRCA gene mutation, her risk of developing ovarian cancer rises from one in 52 to one in two.

Furthermore, knowing her BRCA status can be beneficial to a woman whether she has ovarian cancer or not. Women who know their BRCA status can make more informed treatment decisions, and pass this information on to at-risk family members. Even if they do not have cancer, it gives them the option of thinking about preventative measures.

We have created an online BRCA risk assessment tool to help patients determine whether they could carry a BRCA gene mutation. The online calculator helps people explore their family history and make an informed decision about whether they should consider being tested for the BRCA 1/2 gene mutations.

You can access the tool on the Ovarian Cancer website.

About the author

Abi Begho is healthcare project manager at Ovarian Cancer Action