Ovarian cancer

Question 1

Why does ovarian cancer present late in disease process?

Answer 1

Non-specific symptoms

Question 2

1) What is the commonest ovarian cancer?
2) Of this subtype of ovarian, cancer, what is the commonest cancer?
3) What are dermoid cysts/germ cell tumours?
4) What is the term used to describe germ cell tumours?
5) What condition are these tumours associated with?
6) Name a marker in the blood germ cell tumours may cause to raise

Answer 2

1) Epithelial cell tumours
2) Serous tumours
3) Benign ovarian tumours
4) Teratoma
5) Ovarian torsion
6) Alpha fetoprotein, hCG

Question 3

Name 2 risk factors for developing ovarian cancer

Answer 3

• Age (peaks age 60)
• BRCA1 and BRCA2 genes
• Increased number of ovulations (r/f incl. early onset of periods, no pregnancy, late menopause)
• Obesity
• Smoking
• Recurrent use of clomiphene (medication used to treat infertility in women who do not ovulate)

Question 4

Name 2 protective factors

Answer 4

• COCP
• Pregnancy
• Breastfeeding

Question 5

Ovarian cancer can presents with non-specific symptoms, but name 3 symptoms that may indicate ovarian cancer

Answer 5

• Abdominal bloating
• Early satiety
• Loss of appetite
• Pelvic pain
• Urinary symptoms i.e. frequency, urgency
• Weight loss
• Abdominal or pelvic mass
• Ascites

Question 6

What are the 2 initial investigations for ovarian cancer?

Answer 6

• Pelvic ultrasound
• CA125 blood test

Question 7

CA125 is a tumour marker for epithelial ovarian cancer but it’s not very specific - name 2 other causes of a raised CA125

Answer 7

• Endometriosis
• Fibroids
• Adenomyosis
• Pelvic infection
• Liver disease
• Pregnancy

Question 8

The management of ovarian cancer usually involves a combination of what 2 things?

Answer 8

Chemotherapy and surgery