Ovarian Cancer

Question 1

Describe the epidemiology of ovarian cancer

Answer 1

Ovarian cancer is the fifth most common malignancy in females. The peak age of incidence is 60 years and it generally carries a poor prognosis due to late diagnosis.

Question 2

Describe the pathophysiology of ovarian cancer

Answer 2

Around 90% of ovarian cancers are epithelial in origin, with 70-80% of cases being due to serous carcinomas

Increasingly recognised that the distal end of the fallopian tube is often the site of origin of many ‘ovarian’ cancers

Question 3

What are risk factors for ovarian cancer?

Answer 3

FHx: Mutations of BRCA1 and BRCA2
Many ovulations - early menarche, late menopause, nulliparity

Question 4

What are the clinical features of ovarian cancer?

Answer 4

abdominal distension and bloating
abdominal and pelvic pain
urinary symptoms e.g. Urgency
early satiety
diarrhoea

Symptoms are vague

Question 5

What are the investigations for ovarian cancer?

Answer 5

1. CA125 - Endometriosis, menstruation, benign ovarian cysts and other conditions may also raise the CA125 level. If raised (35 IU/mL or greater), urgent ultrasound of abdomen and pelvis should be ordered.

Diagnostic laparotomy may be needed.

Question 6

How is ovarian cancer managed?

Answer 6

A combination of surgery and platinum-based chemotherapy