Ovarian Cancer Flashcards
What does ovarian cancer refer to?
Cancer of the ovaries
Ovarian cancer often presents late due to non-specific symptoms, resulting in a worse prognosis.
What percentage of ovarian cancer cases present after it has spread beyond the pelvis?
More than 70%
Late presentation contributes to a worse prognosis.
What are the types of ovarian cancer?
- Epithelial cell tumours
- Dermoid cysts/germ cell tumours
- Sex cord-stromal tumours
- Metastasis
Each type has distinct characteristics and subtypes.
What is the most common type of ovarian cancer?
Epithelial cell tumours
Epithelial cell tumours include various subtypes.
What is a teratoma?
A benign ovarian tumour derived from germ cells
Teratomas may contain skin, teeth, hair, and bone.
What is a krukenberg tumour?
Metastasis in the ovary, usually from gastrointestinal cancer
Characteristic ‘signet-ring’ cells are seen on histology.
What are some risk factors for ovarian cancer?
- Age (peaks at 60 years)
- BRCA1 and BRCA2 mutations
- Increased number of ovulations
- Obesity
- Smoking
- Recurrent use of clomifene
Factors like early-onset menarche and late-onset menopause increase ovulation frequency.
What are some protective factors against ovarian cancer?
- Combined oral contraceptive pill
- Breastfeeding
- Pregnancy
These factors may reduce the risk of developing ovarian cancer.
What are some non-specific symptoms of ovarian cancer?
- Abdominal bloating
- Early satiety
- Loss of appetite
- Pelvic pain
- Urinary symptoms
- Weight loss
- Abdominal or pelvic mass
- Ascites
- Hip or groin pain
Symptoms may vary and can be mistaken for other conditions.
What are the referral criteria for suspected ovarian cancer?
- Ascites
- Pelvic mass (unless clearly due to fibroids)
- Abdominal mass
Urgent referral is required within 2 weeks for these criteria.
What initial tests are used for ovarian cancer investigations?
- CA125 (>135 significant)
- Pelvic ultrasound
CA125 is a tumor marker, while ultrasound helps visualize ovarian structures.
What does the risk of malignancy index (RMI) include?
- Menopausal status
- Ultrasound findings
- CA125 level
RMI helps assess the likelihood of malignancy in ovarian masses.
What secondary care investigations might be performed for ovarian cancer?
- CT scan
- Histology
- Paracentesis
These tests provide further insight into the diagnosis and staging of ovarian cancer.
What causes raised CA125 levels besides ovarian cancer?
- Endometriosis
- Fibroids
- Adenomyosis
- Pelvic infection
- Liver disease
- Pregnancy
CA125 is not very specific and can be elevated in various conditions.
What is the management approach for ovarian cancer?
- Specialist gynaecological oncology MDT
- Surgery
- Chemotherapy
A multidisciplinary team approach is essential for effective management.
