Did you know that when you go for a smear test, it won’t tell you whether you have ovarian cancer?
The tragic death of Jade Goody undoubtedly saved lives as it encouraged more women to attend for cervical screening – but it’s important to remember smear tests look for abnormal cells in the cervix and can’t tell you whether you have ovarian cancer.
In fact, there is no national screening programme for ovarian cancer like there is for breast and cervical cancers.
This is in part due to no one test being able to pick up or exclude ovarian cancer with the certainty that is needed for a screening programme.
Meanwhile, symptoms of ovarian cancer can be vague and mistaken for other conditions, making it all the more important that women are aware of the warning signs.
Speaking as Ovarian Cancer Awareness Month draws to a close, Dr Ursula Mason, chair of the Royal College of GPs in Northern Ireland, explains: “If it is caught early, ovarian cancer has much better treatment and survival outcomes than if it is diagnosed late.”
Indeed, according to the Northern Ireland Cancer Registry, the five-year survival rate for those diagnosed with stage one ovarian cancer is 90%.
An average of 206 women were diagnosed with ovarian cancer in Northern Ireland between 2016 and 2020, with an average of 128 deaths each year over the same period.
Yet, as Dr Mason stresses, there are a range of symptoms to watch out for that can be associated with ovarian cancer.
These include a swollen tummy or feeling bloated, pain or tenderness in your tummy or pelvis, no appetite or feeling full quickly after eating, an urgent need to urinate or needing to urinate more often.
Other symptoms of ovarian cancer can include indigestion, constipation or diarrhoea, back pain, feeling tired all the time, unexplained weight loss and irregular bleeding, including bleeding after the menopause.
“In the knowledge that the earlier the stage of cancer at diagnosis the better the outcomes for women, I think the most important thing is to be aware of the symptoms and if you are worried, seek help from your GP.”
Dr Mason continues: “A lot of the symptoms of ovarian cancer cross over with symptoms of other conditions and that can present challenges diagnostically for GPs.
“However, there are a number of symptoms that we look out for that we would regard as red flag, such as a new sensation of feeling very full very quickly, new lower abdominal pain and bloating or new urinary frequency.
“The advice we would give is that if you develop new persistent onset of symptoms that you’ve never had before, you should seek advice from your GP.
“These are symptoms that a lot of us experience throughout our lives and they are almost certainly not sinister in most cases but it’s important to talk to your GP about whether they warrant further investigation.”
Typically, this involves an abdominal examination to enable your GP to check whether they can feel anything untoward.
They may also carry out a pelvic examination, a more intimate internal examination.
Dr Mason continues: “It isn’t common to be able to feel the ovaries when you do an examination so if you feel a mass, it usually means there is swelling that shouldn’t be there.”
At this point, GPs can carry out a blood test to establish levels of CA125 protein and while it cannot make a definitive diagnosis, abnormal results also help doctors plan further investigations to help diagnose an ovarian cancer
“If you have symptoms and an elevated CA125 test, that means we have a greater suspicion of ovarian cancer,” says Dr Mason.
The next stage is an ultrasound scan of the tummy, which is usually carried out in a matter of weeks when a GP is particularly concerned.
As well as being aware of the signs of ovarian cancer, Dr Mason says that women should be aware of risk factors for, and proactive steps they can take to reduce the risk of developing the illness.
There are certain circumstances which make it more likely that a woman could develop ovarian cancer.
These include a family history – where two or more relatives from the same side of your family have had ovarian cancer under the age of 50, or there has been more than one case of breast or ovarian cancer in your family.
Age is also important – as older women are more likely to develop ovarian cancer. Other common cancer risk factors are obesity and smoking.
“You cannot change your family history or that fact that we all get older but stopping smoking and trying to maintain a healthy weight will actually help reduce your risk,” says Dr Mason.
“In the knowledge that the earlier the stage of cancer at diagnosis the better the outcomes for women, I think the most important thing is to be aware of the symptoms and if you are worried, seek help from your GP.
“We understand that the process of assessment and investigation can be stressful, but we are here to support you throughout.”