Ovarian cancer

Question 1

Peak age of incidence?

Answer 1

60 years

Question 2

What is the most common type of ovarian cancer?

Answer 2

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

Question 3

What is often the site of origin of many ovarian cancers?

Answer 3

The distal end of the fallopian tube

Question 4

Risk factors?

Answer 4

• Mutations of the BRCA1 or BRCA2 gene

- many ovulations: early menarche, late menopause, nulliparity

Question 5

Symptoms?

Answer 5

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

Question 6

Investigations?

Answer 6

• CA125
• Ultrasound
• Laparotomy

Question 7

What is the diagnostic test?

Answer 7

Laparotomy

Question 8

What test should be performed initially?

Answer 8

CA125

Question 9

What may also raise the CA125 level?

Answer 9

• Endometriosis
• Menstruation
• Benign ovarian cysts
  + other conditions

Question 10

What should happen if the CA125 is raised (35 IU/mL or greater)?

Answer 10

Order an urgent ultrasound scan of abdomen and pelvis

Question 11

Management?

Answer 11

A combination of surgery and platinum-based chemotherapy

Question 12

Prognosis?

Answer 12

• 80% of women have advanced disease at presentation

- All stage 5-year survival is 46%

Question 13

Protective factors?

Answer 13

The combined oral contraceptive pill and having many pregnancies