10. Ovarian Cancer

Question 1

What is the 5 year survival rate of Ovarian Cancer?

Answer 1

30%

Note - A Lot of Women present Late Stage so is worse

Question 2

What are the Risk Factors for Ovarian Cancer?

Answer 2

1. Older - Usually 50+ (Rare < 30 years old)
2. High Risk Families (Genetic) - BRCA1 / BRCA2 / HNPCC or Lynch Type II Familial Cancer Syndrome
3. Incessant Ovulation
4. Oral Contraceptive Pill is Protective

Question 3

What is Protective of Ovarian Cancer?

Answer 3

Oral Contraceptive Pill

Question 4

What are the Symptoms of Ovarian Cancer?

Answer 4

1. Indigestion / Early Satiety / Poor Apetits
2. Altered Bowel Habit / Pain
3. Bloating / Discomfort / Weight Gain
4. Pelvic Mass (Asymptomatic / Pressure Symptoms)
   Note - The Symptoms are very Vague

Question 5

How is Ovarian Cancer Diagnosed?

Answer 5

1. Ultrasound Scan of the Abdomen and Pelvis
2. CT Scan - Abdomen and Pelvis
3. CA 125 Blood Test
4. Surgery - Laparotomy

Question 6

What features are looked for in an Ultrasound of a Suspected Ovarian Cancer?

Answer 6

1. Multi-Locular
2. Solid Areas
3. Bilateral
4. Ascites
5. Intra-Abdominal

Question 7

What is the CA 125 Blood Test?

Answer 7

1. CA 125 is a Glycoprotein Antigen
2. It is found in Malignancies - Ovary / Colon / Pancreas / Breast
3. It is found in Benign Conitions - Menstruation / Endometriosis / Pelvic Inflammatory Disease / Liver Disease / Recent Surgery / Effusions
   Note - This is a good Post-Menopausal Indicator

Question 8

What is the Purpose of an Ovarian Cancer Laparotomy?

Answer 8

1. Obtain Tissue Diagnosis
2. Stage Disease
3. Disease Clarance
4. Debulk Disease

Question 9

What are the Stages of Ovarian Cancer?

Answer 9

Stage 1 - Limited to Ovaries with Capsule Intact
Stage 2 - 1 / Both Ovaries with Pelvic Extension
Stage 3 - 1 / Both Ovaries with Peritoneal Implants Outside the Pelvis, or + Nodes
Stage 4 - Distant Metastasis

Question 10

What is the treatment of Ovarian Cancer?

Answer 10

1. Surgery

2. Chemotherapy - Adjuvant (After) / Neo-Adjuvant (Upfront)

Question 11

When is Chemotherapy Given in Ovarian Cancer?

Answer 11

1. Within 8 weeks of Surgery - Complete / Partial Response

2. First line is Platinum and Taxane (Taxol)

Question 12

What are the Cure Rates of Ovarian Cancer?

Answer 12

Stage 1 - 85%
Stage 2 - 47%
Stage 3 - 15%
Stage 4 - 10%

Question 13

What is the treatment of Recurrent Ovarian Cancer?

Answer 13

1. Chemotherapy
2. Palliation - Symptomatic Recurrence
3. Platinum if > 6 months
4. Surgery
5. Tamoxifen

Question 14

Who is Screened for Ovarian Cancer?

Answer 14

High Risk Women

Question 15

How are High Risk Women Screened for Ovarian Cancer?

Answer 15

1. Pelvic Examination
2. Ultrasound Scanning of Ovaries
3. CA 125 Blood Test