Ovarian Cancer Flashcards
How common of a malignancy is ovarian cancer?
5th most common malignancy in females
What age are women most commonly affected?
60 years old
What is the prognosis of ovarian cancer and why?
Poor prognosis
Due to late diagnosis
What is the main type of ovarian tumour?
Epithelial ovarian tumour
Where does ovarian cancer originate?
It originates from the epithelium which lines the fimbria of the fallopian tubes or the ovaries
What is the main risk factors of ovarian cancer?
Greater number of ovulations- Early menarche, late menopause
What genes are associated with an increased risk of ovarian cancer?
BRCA 1 and BRCA 2
HNPCC/ Lynch type 2 familial cancer
What is the problem with diagnosing ovarian cancer?
The symptoms are vague and present late
What are clinical features of ovarian cancer?
- Abdominal distension and bloating
- Urinary symptoms- Urgency (pressure symptom)
- Early satiety (feel full after small amount of food)
What can the ovarian tumour produce?
Vascular growth factors
What do vascular growth factors do?
Increase vessel permeability
Cause ascites
What is sometimes palpable with ovarian cancer?
A mass where the cancer is growing
If the patient is symptomatic, what is the initial investigation?
CA 125 level
What is classed as a raised CA 125?
More than 35IU/mL
What is the initial investigation if the patient is asymptomatic?
An ultrasound scan
What are the 2 uses for CA 125?
Diagnosis and monitoring
How is an ovarian tumour diagnosed?
Diagnostic laparotomy
What is stage 1 of ovarian cancer?
Limited to ovaries with capsule intact?
What is stage 2 of ovarian cancer?
One or both ovaries with pelvic extension
What is stage 3 of ovarian cancer?
One or both ovaries with peritoneal implants outside pelvis or positive lymph nodes
What is stage 4 of ovarian cancer?
Distant metastasis
What is the management of ovarian cancer?
Combination of
Surgery
Platinum based chemotherapy (platinum and taxane)
What are other things that can raise CA 125?
Endometriosis
Menstruation
Benign ovarian cyst
What would you do if the patients CA125 was more than 35?
Urgent US scan
What other factors can increase the risk of ovarian cancer?
Obesity
Smoking
What are protective factors for ovarian cancer?
Pregnancy
Breastfeeding
Early menopause
Combined oral contraceptive pill (COCP) use
When would you refer a woman urgently (2 week wait) for suspected ovarian cancer?
Ascites
Unexplained pelvic/abdominal mass.
How can ovarian cancer cause hip/groin pain?
An ovarian mass may press on the obturator nerve and cause referred hip or groin pain
What type of ovarian tumor are women under the age of 40 usually affected by?
Germ cell tumour:
What is the management of stage 2-4 ovarian cancer?
Surgical excision
Followed by chmotherapy
