ovarian cancer

Question 1

symptoms suggestive of ovarian cancer

Answer 1

bloating, abdominal distension, early satiety, loss of appetite, unexplained weight loss, change of bowel habit, fatigue, IBS symptoms >50, urinary freq or urgency, abdo or pelvic pain

Question 2

if Ca 125 is >35 what should be done

Answer 2

refer for abdominal and pelvic ultrasound

Question 3

what is the lifetime risk if 2 close relatives affected

Answer 3

40%

Question 4

what is the BRCA carrier risk of developing carcinoma

Answer 4

40% BRCA1, 25% BRCA2

Question 5

some associated factors

Answer 5

many ovulations- late menopause, early menarche, nulipara; possibly after subfertility treatment. HRT

Question 6

what reduce risk

Answer 6

COC, breastfeeding, hysterectomy, tubal ligation

Question 7

screening

Answer 7

transvaginal ultrasound with tumour blood flow measurement can differentiate between benign and malignant at early stage. Ca125

Question 8

what is the problem with ovarian cancer

Answer 8

causes few symptoms until it has metastasised. poor prognosis

Question 9

staging

Answer 9

1- limited to 1 or both ovaries, 1c- ruptured capsule etc; 2- growth beyond ovaries confined to pelvis; 3- outside pelvis; 4- distant mets

Question 10

what % present with stage 3 or 4

Answer 10

80%

Question 11

treatment adenocarcinomas

Answer 11

surgery and chemo

Question 12

chemotherapy

Answer 12

carboplatin with paclitaxel. radiotherapy

Question 13

treatment advanced or relapsed ovarian cancer

Answer 13

paclitaxel, doxorubicin, topotecan