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There are so many myths about Ovarian Cancer. For this Ovarian Cancer Awareness month, I’d love to share information to help educate as many women, and doctors on ovarian cancer. We need to use the latest science to make sure we prevent as many cancers as possible and diagnose any ovarian cancer as early as possible. 11 women die every day in the UK of ovarian cancer so every woman should know how to reduce their risk.

 

1. Any family history of ovarian cancer matters

About 20% of ovarian cancers happen because of a change or variant in a gene that has been inherited from a parent. You might also hear these called a “gene mutation” or “faulty gene”. 

 

The most common genes involved in this are BRCA1 and BRCA2. If you have inherited a harmful, what we call a “pathological” variant in one of these genes you can have a risk of up to 60% of ovarian cancer in your lifetime. Other genes also increase your risk to lower levels. 

 

Angelina Jolie shared her story of finding out about her BRCA1 variant in 2013, she helped to open the conversation around genetic screening. She sadly lost her mother to cancer due to the same BRCA1 variant. She chose to have risk-reducing surgery to reduce her risk of breast and ovarian cancer. She spoke powerfully of how grateful she was to reduce her cancer risk, likely by over 95%. 

 

2. We need to offer more people genetic screening

We estimate over 95% of women who have inherited a harmful variant in BRCA1 or BRCA2 are undiagnosed in the UK. That’s hundreds of thousands of people who don’t know they are at high risk of ovarian cancer, plus others including breast cancer. 

 

If you have a family history of ovarian cancer it is sensible to consider genetic screening. Because for these groups screening gives the power of prevention. There are two main options for this. Some women will opt to have their ovaries and fallopian tubes removed. Especially if they have already entered menopause, you could say they are no longer serving any purpose so why keep them and add to your cancer risk? There is a brilliant UK study called “Protector” which offers women who want to keep their ovaries the option of removing their fallopian tubes. We think many cancers start at the end of the tubes close to the ovaries so this option could help reduce risk without the negative impact of menopause in younger women.

 

3. Anyone can benefit from genetic screening

Traditional criteria for screening only those with a family history will miss 50% of people with a pathological variant in BRCA1 or BRCA2. 

 

So if you want to get serious about optimising your cancer screening and prevention we think genetic screening is crucial. 

 

I know the truth behind these statistics. I tested positive for a pathological variant in a gene called PALB2 in 2020. I did not meet the normal criteria for testing and would not have known without choosing genetic screening. I feel incredibly lucky I found my gene mutation while I was healthy. I have been able to join Angelina Jolie in having preventative risk-reducing surgery. To be able to reduce my risk of cancer by over 95% feels like a very special gift and I would love to see more women share this. 

 

4. A family history of other cancer could be linked to ovarian cancer

The genes that increase the risk of ovarian cancer are linked to other cancers. If your family history includes breast cancer, pancreatic cancer or prostate cancer it is especially important to consider genetic screening. 

 

We would also encourage men with a family history of these cancers to consider genetic screening, not just for their own health but because it could impact their daughters, granddaughters, nieces, and sisters..

 

5. MYTH: “It doesn’t matter as there is no family history on my Mum’s side.”

This is such a common myth. You can inherit these gene mutations from either your mother or father. Women who inherit from their Dad are more often not tested, that’s because their Dad is less likely to get breast cancer and can’t get ovarian cancer they are less likely to meet those rubbish “family history” criteria.  A history of cancer in a grandmother or aunt, who may have died before you were even born sounds less concerning than if it is your own mother but it is still a really important risk factor. 

 

6. Jewish ancestry is a major RED flag to consider genetic screening

Having a parent or grandparent with this ancestry is a big risk factor for inheriting a BRCA1 or BRCA2 genetic variant, up to a 1 in 40 chance. The NHS has recently started a project offering testing for gene variants which are more common in that background, if you’re interested you can find out more about the project here. You would also be eligible for our genetic screening which will screen not just BRCA1 and BRCA2 but also a wider range of genes linked to cancers which we can reduce or prevent. 

 

7. There are things you can do to look after your health and reduce your risk

There are lots of factors we can focus on to reduce the risk of ovarian cancer. And they will also reduce your risk of lots of other cancers such as breast and colon cancer. Keeping a healthy weight and not smoking are key. The oral contraceptive pill also reduces risk, as does breastfeeding. There has been a lot of concern about using talcum powder on the genital area and ovarian cancer, the evidence is mixed but it is sensible to avoid this. 

 

8. Be symptom aware

For those cancers we can’t prevent, we need to diagnose these as early as possible. Sadly two-thirds of women are diagnosed at a late stage. If we can diagnose women early at stage 1 the survival rate is over 94% at 5 years, versus only 16% for women diagnosed at stage 4. 

 

Symptoms to watch for include:

• Persistent increase in abdominal size or bloating (not bloating that comes and goes)
• Persistent pelvic and abdominal pain
• Unexplained change in bowel habits
• Difficulty eating and feeling full quickly, or feeling nauseous
• Needing to urinate (wee) more regularly

Other symptoms can include tiredness, losing weight, pain during sex, and back pain. These can be symptoms of many other conditions too so don’t panic but see your doctor. They should consider checking a blood test called Ca125 and you may also need an ultrasound scan. 

9. MYTH: “A smear test checks for ovarian cancer.”

This is sadly common, about 1 in 4 women think this is true but sadly not. Cervical screening will not detect ovarian cancer.

10. We can screen for ovarian cancer

We don’t routinely recommend women use ultrasound or the Ca125 blood test for ovarian cancer screening because the biggest UK trial didn’t show this could improve survival in women, it is possible some women were diagnosed at an earlier stage. The test can also give “false alarms”, other conditions like endometriosis or fibroids can cause high Ca125 levels too. 

 

We now have a new blood test that can be used to screen for ovarian cancer. It uses a normal blood sample taken in the clinic and the laboratory to look for ‘circulating tumour cells’, (CTCs). When a cancer or ‘tumour’ starts to grow in the body some of the cells will get into the bloodstream called CTCs. The really exciting part of this is that these CTCs can be found in early-stage 1 cancers.  

 

The blood test is called a Multi Cancer Early Detection test, we offer tests by Trucheck that can either focus on female cancers or screen for up to 70 solid organ tumours. 

Knowledge is power

Many women and doctors lack knowledge of ovarian cancer. A study by Target Ovarian Cancer showed less than 5% of women were confident in knowing the signs of ovarian cancer. Many doctors also falsely believed women only get symptoms of late-stage ovarian cancer.

 

We are passionate about giving women the knowledge and power to make the best choices for their health. If you think any other women in your life would find this useful then please share with them and hopefully, more women will be armed with knowledge. 

 

Dr Lucy Hooper

Private GP

London