Ovarian cancer

Question 1

histological types of ovarian cancer ?

Answer 1

epithelial (serous most common)
germ cell
sex cord/stromal

Question 2

referral criteria for suggested ovarian cancer ?

Answer 2

urgent referral to any women with ascites and/or unexplained abdominal/pelvic mass

referral for women > 50yrs with;

• abdominal bloating
• abdominal/pelvic pain
• early satiety
• urinary frequency/urgency

Question 3

features of meigs syndrome ?

Answer 3

hydrothorax
ascites
benign ovarian tumour

Question 4

investigations for suspected ovarian cancer ?

Answer 4

1st line: CA125 
if elevated (>35) then pelvic USS

definitive diagnosis is laparotomy and oophorectomy for pathological investigation
- laparoscopic biopsy can disseminate cancer cells

Question 5

risk factors for ovarian cancer ?

Answer 5

family history 
BRCA gene 
nulliparous 
overweight 
smoking 
previous fertility treatment 
incessant ovulation (early menarche, late menopause)
never used OCP

Question 6

protective factors for ovarian cancer ?

Answer 6

OCP
multiparous
breast feeding
early menopause

Question 7

is nulliparous or multiparous a risk factor for ovarian cancer and endometrial cancer ?

Answer 7

nuliparous risk factor for both

Question 8

tumour markers for ovarian cancer ?

Answer 8

CA 125
AFP
bHCG

Question 9

conditions CA 125 is raised in ?

Answer 9

fibroids, endometriosis, pregnancy, ovarian cysts

colon, gastric, lung, pancreatic and breast cancer