Ovarian Cancer Awareness: Understanding Symptoms and Age-Related Risks
It is often easy to dismiss a bloated stomach or changes in bathroom habits as typical menopausal symptoms. However, staying attuned to your body is crucial, as persistent changes should never be ignored. With Ovarian Cancer Awareness Month arriving this March, we have gathered expert insights to help differentiate between midlife shifts and more serious concerns. Camilla Foster spoke with Professor Christina Fotopoulou, a leading consultant gynaecologist at King Edward VII’s Hospital, to explore how risks evolve with age.
The Science Behind Ovarian Cancer
According to Cancer Research UK, ovarian cancer begins when abnormal cells in the ovaries or fallopian tubes grow uncontrollably, forming a tumour. The origin of any cancer lies in a mutation during cell division, leading to uncontrolled duplication instead of regulated replication. Professor Fotopoulou explains that aging increases this risk: "The longer you live, the higher the risk is of getting mutations in the body. I often say to my patients that cancer cells are like little zombies, which just multiply without any control."
The Link Between Ovulation and Age
The natural process of releasing an egg each month can contribute to the accumulation of cellular mistakes over time. Professor Fotopoulou notes that the constant cycle of repair required by the ovaries can sometimes lead to genetic glitches. "During ovulation, you have an egg that disrupts the surface of the ovary, which creates a wound that needs to be repaired, and all these repair mechanisms may accumulate mistakes," she says. "That is why, for example, contraceptives that inhibit ovulation are a protective factor against ovarian cancer."
While often perceived as a disease affecting older generations, data highlights specific age windows for increased vigilance:
- The 45+ increase: Risk levels begin to climb more steeply once women reach their mid-40s.
- The peak age: Statistics from Cancer Research UK show the highest diagnosis rates occur in those aged 75 to 79.
- The over-65s: "Over half the cases of ovarian cancer are diagnosed when patients are aged over 65," says Fotopoulou.
Can Younger Women Be Affected?
It is a common misconception that ovarian cancer is exclusively a post-menopausal concern. Younger women can still be at risk, particularly with rare subtypes like low-grade serous ovarian cancer (LGSOC), which is more frequently seen in younger patients. "There are some subtypes of ovarian cancer, such as the low-grade serous ovarian cancer (LGSOC) that affects more younger women, but this is much more rare," says Fotopoulou. "However, I operated on a 15-year-old who had ovarian cancer for the first time the other day, so nothing can be excluded. That's why symptoms should not be dismissed, and everybody should be checked out."
Spotting the 'Silent' Symptoms
One of the biggest challenges in fighting ovarian cancer is the lack of a standard UK screening test. Diagnosis typically relies on patients noticing physical changes and visiting their GP for an ultrasound or scan. "Unfortunately, there are currently no screening tests available for ovarian cancer, so ovarian cancer is usually diagnosed when a woman goes to see a GP or a gynaecologist with symptoms such as abdominal pain, discomfort and bloating," says Fotopoulou.
Red flags to monitor include:
- Permanent bloating: Feeling swollen or 'full' constantly, rather than bloating that comes and goes.
- Appetite changes: Feeling full very quickly after starting a meal or experiencing nausea.
- Pain: Any persistent discomfort in the pelvic area or tummy.
- Bathroom habits: Needing to urinate more often or noticing shifts in bowel movements.
"The problem with ovarian cancer is that the whole symptomatology is very non-specific," emphasises Fotopoulou. "Therefore, very often there is a delayed diagnosis of ovarian cancer because either the patients dismiss the symptoms as being perimenopausal or due to IBS, or GPs mistake the symptoms for IBS or a food intolerance."
When to Seek Medical Advice
If you notice new symptoms that linger for more than a few weeks, it is time to book an appointment with your doctor. While it may likely be IBS or menopause, getting a professional opinion provides essential peace of mind. "Whenever a woman has persistent new symptoms that don't go away within a few weeks or a couple of months, she needs to ask for help to make sure a diagnosis of ovarian cancer isn't missed," says Fotopoulou. "In most cases, it won't be ovarian cancer; it might be IBS or menopausal symptoms, but it's always worth going to a doctor to get it checked out. Afterwards, if you still have a strong feeling that there's a problem, go and see your doctor again."
Fotopoulou adds: "Due to the nature of the disease, 75% of patients with ovarian cancer will be diagnosed at a later stage (stage 3 or 4), when the disease has already spread outside the pelvis. Therefore, in the majority of cases, the treatment is a combination of surgery, chemotherapy and targeted medicines. However, in cases of very early ovarian cancer where everything is contained in the ovary, you may only need surgery."
