BHWC Information (Updated 1.12.2021) :

Due to the number of staff sick with COVID19, we are changing our services for a limited time.

To keep everyone safe we will be operating a phone appointment service for routine appointments and we will be closing our front door from Thursday 2nd December. We will no longer book routine appointments for 1 week and then review. You may attend the surgery if you have a pre-booked blood test, immunisation or review booked. There may be delays in contacting you or last-minute cancellations or changes.

We sincerely apologise for the disruption – we will return to normal services just as soon as possible. Thank you for your understanding.

* PLEASE WEAR A MASK OR FACE COVERING WHEN ATTENDING THE PRACTICE *

News Archive

Ovarian cancer, symptoms and risk factors

What is cancer?

Our bodies are made up of millions of cells. Our body is constantly replacing worn out cells with new ones, either to maintain good health or when we hurt ourselves (for example, get a cut or graze).

When our body destroys an old cell, one of the remaining cells will make a copy of itself by dividing into two, replacing the old cell. This process is usually carefully controlled so that the number of new cells created is the same as the number that were destroyed.

However, sometimes a cell can go out of control and can’t respond to the signals that tell it to stop dividing. The cell divides again and again, making more and more copies of itself, eventually forming a lump called a tumour. When these tumours grow uncontrollably and invade surrounding tissues or spread further away, this is termed cancer.

Tumours

A tumour (also known as a neoplasm) is any abnormal mass of tissue (collection of cells). Like a cyst, a tumour can form in any part of the body. A tumour can be benign (non-cancerous), malignant (cancerous) or borderline (between malignant and benign).

Benign (non-cancerous) tumours may cause symptoms but in most cases they don’t come back after surgical removal (having an operation). Cells in benign tumours don’t spread to other parts of the body.

Malignant (cancerous) tumours are made up of cells that grow out of control. Cells in these tumours can invade nearby tissues and spread to other parts of the body.

Sometimes cells move away from the original (primary) cancer site and spread to other organs and areas through the bloodstream or the lymphatic system (tiny vessels similar to blood vessels passing clear fluid towards the heart) where they can continue to grow and form another tumour at that site. This is known as metastatic or secondary cancer. Metastases keep the name of the original cancer location, so ovarian cancer that has spread to the liver is still called ovarian cancer.

Borderline tumours are rare types of growth, and although the cells look abnormal they rarely have the tendency to grow out of control.

To determine whether a cyst or tumour is benign or malignant, a sample of the affected tissue – or in some cases the entire suspicious area – is removed and studied under a microscope. This is known as a biopsy.

Ovarian cancer

The ovaries are two small organs, each about the size and shape of an almond, located low in the tummy area called the pelvis, just behind the pubic area in women. They form part of a woman’s reproductive and hormonal systems, storing a woman’s supply of eggs.

Diagram showing the location of the ovaries in the body

Each month an egg is released from one of the ovaries through the fallopian tubes into the womb ready for fertilisation. The ovaries are also responsible for making the female hormones oestrogen and progesterone.

A close-up illustration of the ovaries, fallopian tubes, womb and vagina

Ovarian cancer is cancer arising from the cells in and around the ovary and fallopian tubes. There are many different types of ovarian tumours classified by the types of cells and tissue they originate from.

Ovarian cancer metastases or secondary cancers are lumps formed in other parts of the body because of the spread of ovarian cancer cells.

Ovarian cancer cells tend to spread on the surface of the tummy (abdomen) called the peritoneum (a large, thin, flexible sheet of transparent tissue that covers the organs inside your abdomen) and often form lumps on the surface of the bowels, the omentum (a fatty layer of tissue that extends downwards from the stomach), the liver surface and, rarely, within the liver, the spleen or the lungs. These lumps (metastases) often produce excess fluid in the tummy called ascites, which can cause significant bloating and uncomfortable symptoms.

Side view of the body showing the ovaries and surrounding organs

Understanding the type of cancer (the histotype), if and how it has spread (the stage), and the potential aggressiveness of the cancer (the grade) can help you when discussing your diagnosis, treatment and prognosis with your specialist. However, some women may not wish to know so much detail – it’s a personal choice.

What are risk factors?

A risk factor is something that can increase your chances of developing a cancer. Different cancers have different risk factors although there are some risks associated with more than one cancer.

When you know the risk, you’re empowered to make choices to reduce that risk. It’s not about scaring people, it’s about giving them the chance to be realistic.

There are a number of possible causes of ovarian cancer but these are not yet fully understood. The most important risk factors are age and a family history of ovarian or breast cancer.

This information is not intended to provide information about risk or prevention of ovarian cancer returning for women already diagnosed.

It’s worth noting that nine out of ten cases of ovarian cancer are a type called epithelial ovarian cancer and the risk factors explained here are specific to this type of cancer. Find out more about types of ovarian cancer

Age

As with most cancers the risk of developing ovarian cancer increases as a woman gets older. Women over the age of 50 have a higher risk, and most cases of ovarian cancer occur in women who have already gone through the menopause. More than half the cases of ovarian cancer diagnosed are women over 65 years.

Although it’s not common for younger women to get ovarian cancer, there are instances of ovarian cancer in pre-menopausal women; 1000 women under the age of 50 develop ovarian cancer every year which is why it’s important that all women should be aware of the symptoms of ovarian cancer. This is especially important if women have a family history of ovarian or breast cancer.

Family history

80–85 per cent of ovarian cancer cases are ‘sporadic’. This means they are one-offs, not inherited and close female relatives face no significant increase in their risk of developing the disease themselves. This is important to remember, as it can be worrying if a close family member is affected by ovarian cancer. In most cases women can be reassured.

The remaining 15–20 per cent of cases are believed to be caused by an inherited faulty (or mutated) gene, which is often the BRCA1 or BRCA2 gene. Women who inherit a mutated copy of the BRCA1 or BRCA2 gene (BReast CAncer 1 and 2) have a much higher risk of developing breast and/or ovarian cancer than the general population.

There are some other genes which have also been linked to ovarian cancer such as RAD51C and RAD51D, STK11, BRIP1 (FABCJ) and those linked to Lynch Syndrome (also known as hereditary non polyposis colorectal cancer, HNPCC). The chance of developing cancer of the stomach, liver, kidney, bladder, skin and brain can also be increased by having a mutation in one of the Lynch Syndrome genes.

If there are two or more cases of ovarian cancer and/or breast cancer on either your mother or father’s side of the family, you should speak to your GP who will offer you more information about your level of risk. Your GP may then refer you to a genetic counsellor to help you decide whether or not to undergo genetic testing to see if you carry a mutation in a gene such as BRCA1 or BRCA2, which may increase your risk of developing ovarian or breast cancer.

Your genetic counsellor and specialist team will support you through this process and help you to understand your risk and offer advice on risk management options.

What are the symptoms?

  • Persistent bloating – not bloating that comes and goes
  • Feeling full quickly and/or loss of appetite
  • Pelvic or abdominal pain (that’s your tummy and below)
  • Urinary symptoms (needing to wee more urgently or more often than usual)

Occasionally there can be other symptoms:

  • Changes in bowel habit (eg diarrhoea or constipation)
  • Extreme fatigue (feeling very tired)
  • Unexplained weight loss
  • Any bleeding after the menopause should always be investigated by a GP

Symptoms will be:

  • Frequent – they usually happen more than 12 times a month
  • Persistent – they don’t go away
  • New – they’re not normal for you

Worried about your symptoms?

If you regularly experience any one or more of these symptoms, which are not normal for you, it’s important that you see your GP. It’s unlikely that your symptoms are caused by a serious problem, but it’s important to get checked out. Take a look at  top tips for speaking to your GP.

Ovarian cysts in pre-menopausal women can produce symptoms similar to those for ovarian cancer but are not known to increase the risk of ovarian cancer.

Other conditions such as irritable bowel syndrome (IBS) have symptoms similar to ovarian cancer but if your symptoms do not clear up, go back to your GP or seek a second opinion, even if you’ve had tests.

If you think you might have symptoms of ovarian cancer, it’s important to see your GP. We’ve created this guide to help you talk to your GP about the symptoms you’re experiencing and what information you might like to gather before booking an appointment.

  1. Know the symptoms of ovarian cancer
    Symptoms include persistent bloating, feeling full quickly and/or loss of appetite, pelvic or abdominal pain and urinary symptoms. You should go to your GP if you have any of these symptoms and they are new for you, don’t go away or happen more than 12 times a month. Full details on symptoms
  2. Know what’s normal for you 
    There can also be other symptoms including changes in bowel habit (e.g. diarrhoea or constipation), extreme fatigue (feeling very tired) and unexplained weight loss. Act early if you feel something is wrong. You know your body best.
  3. Make an appointment with your GP
    Tell us you are worried about cancer and need to be seen as soon as possible.
  4. Keep a symptoms diary
    Keep a symptoms diary to track your symptoms. This can be very useful not only for you but also for your GP. Download our symptoms diary [PDF].
  5. Think about your family history
    Think about whether anyone in your family has had ovarian or breast cancer, on either your mother’s or father’s side. It might be helpful to ask relatives about this. If you do have a family history of ovarian and/or breast cancer, make sure you tell your GP.
  6. Give your GP as much information as possible
    Write down anything you want to discuss with the GP or any specific concerns you have and take this with you to your appointment. Tell your GP that you’re worried about ovarian cancer. They’ll be glad you’ve shared your concerns.
  7. Be aware – smear tests don’t detect ovarian cancer
    Cervical screening tests – known as smear tests – do NOT detect ovarian cancer. All new symptoms should be discussed with your GP.
  8. Be persistent with your GP
    Keep going back to your GP if your symptoms do not improve even if any tests and investigations are negative. You can always take a friend or family member to support you at your follow-up appointments.
  9. Find out more about ovarian cancer
    For more information on symptoms and the tests your GP should do, or if you are worried about ovarian cancer, call our support line for confidential information, support and signposting on 020 7923 5475.

Ovarian cysts are fluid-filled pockets called sacs that can form in the ovaries. They are very common and can affect women of any age, although they are more frequent in women of childbearing age because they are linked to ovulation. Often a cyst develops and disappears without the woman even knowing that she had one. Cysts in pre-menopausal women can produce symptoms similar to those for ovarian cancer but are not known to increase the risk of ovarian cancer.

Ovarian cysts

The most common type of cyst is called a functional cyst. Other types of cysts include:

  • polycystic ovaries (numerous cysts sitting under the surface of the ovaries)
  • cysts caused by endometriosis, also known as endometriomas – this is a condition where the lining of the womb (endometrium) grows outside the body of the womb
  • cystenadomas and dermoid cysts (containing a mix of different tissues).

Managing functional cysts

The approach to managing functional cysts will depend on a number of factors, mainly your age, symptoms and your medical and family history. If you’re experiencing symptoms because of a cyst, your GP may recommend a CA125 blood test and transvaginal ultrasound (TVU). The result of these will be combined with other factors, including whether you’ve been through the menopause yet, to calculate the likelihood/chance (risk) of the cyst being malignant (cancerous).

Many cysts will disappear on their own. Others that are considered low-risk will be monitored every three to six months by further ultrasound scans. Surgery is only considered if the cyst has the potential for being cancerous, or because it’s large and could cause complications or uncomfortable symptoms.

Tumours

A tumour (also known as a neoplasm) is any abnormal mass of tissue (collection of cells). Like a cyst, a tumour can form in any part of the body. A tumour can be benign (non-cancerous), malignant (cancerous) or borderline (between malignant and benign).

Non-cancerous tumours

Benign (non-cancerous) tumours may cause symptoms both in most cases they do not come back after surgical removal (having an operation.) Cells in benign tumours do not spread to other parts of the body.

Cancerous tumours

Malignant (cancerous) tumours are made up of cells that grow out of control. Cells in these tumours can invade nearby tissues and spread to other parts of the body. Sometimes cells move away from the original (primary) cancer site and spread to other organs and areas through the bloodstream or lymphatic vessels (tiny vessels similar to blood vessels passing clear fluid towards the heart) where they can continue to grow and form another tumour at that site. This is known as metastatic or secondary cancer. Metastases keep the name of the original cancer location, so ovarian cancer that has spread to the liver is still called ovarian cancer.

Borderline tumours

Borderline tumours are rare types of growths, and although the cells look abnormal, they rarely have the tendency to grow out of control.

To determine whether a cyst or tumour is benign, malignant or borderline, a sample of the affected tissue – or, in some cases, the entire suspicious lump – is removed and studied under a microscope. This is known as a biopsy. In most cases, this can be done using a needle under a CT scan or ultrasound scan with local anaesthesia, but occasionally a tummy/abdomen cut (laparotomy) or keyhole operation (laparoscopy) is necessary under general anaesthesia.

For more information visit https://targetovariancancer.org.uk/

 

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