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Ovarian cancer live chat: 15.03.13

Tags: cancer

Expert Malcolm Padwick joined our live chat to answer your questions.

AXA PPP healthcare asked: Welcome to today’s live chat on ovarian cancer with Mr Malcolm Padwick Consultant Gynaecologist at the Spire Bushey Hospital. Please ask a question when you are ready.

fiona asked: What are the main symptoms of ovarian cancer and why aren't they very well publicised? I hear a lot about the symptoms of cervical cancer but not much about ovarian cancer.

Mr Malcolm Padwick Consultant Gynaecologist answered: there are many different presenting symptoms of ovarian cancer but no one sympton is especially common. For instance the commonist symptom in many studys is indigestion and this only makes up 18% of women affected. Abdominal swelling and discomfort is the most common but often is indicative of late stage disease.

NICE (national institute for clinical excellence) is national body that advises on health care in the UK and their website does specify a number of other symptoms. they recommend anybody who presents with any symptoms suggestive of possible ovarian disease to have blood testing in the form of CA125 organised by their GP.

Sharon H at Target Ovarian Cancer commented: Fiona, we've a list of symptoms on the Target Ovarian Cancer website: http://www.targetovariancancer.org.uk/page.asp?section=78§ionTitle=Symptoms+of+ovarian+cancer

Anonymous23 asked:
I lost my best friend to ovarian cancer, aged 24. Many of the health professionals she came in to contact with in the run up to her diagnosis never looked into a pelvic exam or scan as ovarian cancer 'doesn't happen to young people'. If someone is concerned about their symptoms, and they are under 50, how can they make sure that ovarian cancer is an option that is investigated? By the time my friends cancer was caught, it was very advanced and untreatable. This was partly due to her age being a barrier to investigation.

Mr Malcolm Padwick Consultant Gynaecologist answered: It is true that most women who develop ovarian cancer are post menopausal but it does certainly affect younger women. the CA 125 blood test is less reliablein young women as there are anumber of benign reasons for it to be raised. In younger women examination and inparticular pelvic ultrasound scan are probably more useful to try and pick up early disease

Ruth asked: Hi, if you have had benign ovarian cysts and CNIII tissue detected with smears, are you likely to be at more risk of developing ovarian cancer?

Mr Malcolm Padwick Consultant Gynaecologist answered: No. The two diseases are not related. CIN3 is a pre-cancerous condition of the cervix caused by HPV virus.

Heather asked: My best friend lost her mum to ovarian cancer a few years ago now. Should she be concerned about this being hereditary and that the likely hood of her developing it being increased? What measures can she take to reduce her risk if so?

Mr Malcolm Padwick Consultant Gynaecologist answered: There is an increase risk of developing Ovarian cancer in women who have a direct relative affected by the disease and the more direct relatives the higher the risk. Your friend only has one affected relative and so although her risk is slightly raised the risk is not excessive. At the moment  I am afraid there is no proven screening test for this type of patient.

Anonymous24 asked: What are some choices that we make that cause or increase ovarian cancer in your body?

Mr Malcolm Padwick Consultant Gynaecologist answered:
It is thought that ovarian cancer has more chance of forming if you have regular ovulation. It may be that somehow ovulation causes damage to the ovary that can pre dispose to cancer later. As a consequence life style choices that prevent ovulation reduce the risk of ovarian cancer for instance the combined contraceptive pill, pregnancy and breast feeding. Changes which increase the number of ovulation such as fertility treatments might pre dispose to an increase risk of ovarian cancer.

Anonymous25 asked: I suffer from endometriosis. Does this increase my risk of ovarian cancer?

Mr Malcolm Padwick Consultant Gynaecologist answered:
Recent reviews have found a weak association of ovarian cancer and endometriosis. As yet it is not clear if treating the endometriosis surgically reduceses that risk but i believe it probably does.

AXA PPP healthcare asked: We have had a question from Jennifer from Silverhairs Facebook page. Please can you answer the following when you get a minute:
If you have a hysterectomy why do they leave your ovaries, I was 28 yrs old when I had one still got my ovaries, now have very bad osteoporosis I'm 66yrs old now .

Mr Malcolm Padwick Consultant Gynaecologist answered: Most gynaecologists will leave the ovaries if they are healthy in women under the age of 45 years. The reason for this is to avoid those women having to have long term HRT. If you remove tha ovaries in a young women and do not give HRT they will get many symptoms, but most importantly will develop severe osteoproisis at a much younger age.

Anonymous24 asked: How dangerious is stage 1 ovarian cancer?

Mr Malcolm Padwick Consultant Gynaecologist answered:
Stage 1 ovarian cancer is nearly always cured by Surgery alone. Only in stage 1c when the ovary is accidently opened during surgery or the cancer is on the surface of the ovary would the patient need chemotherapy. Overall the survival from stage 1 disease is approximately 90%.

AXA PPP healthcare asked: Please can you answer the following question from Carrie also from silverhairs Facebook. My mum died last year of this and I understand why its known as the silent killer. Can you tell me is it hereditary?

Mr Malcolm Padwick Consultant Gynaecologist answered: approximately 5% of all ovarian cancer has a proven hereditary link. To make this diagnosis you need multiple direct relatives affected by ovarian and or breast cancer. Just one relative is not enough to make the diagnosis although your risk is slightly higher than a women who has no relatives affected by the disease.

becs commented: Hi, Would it be detected by a manual stomach examination???

Mr Malcolm Padwick Consultant Gynaecologist answered: Not necessarily. Ideally you would like to detect an ovarian cancer long before it caused your abdomen to swell. The most sensative test is an ultrasound scan combined with a blood test CA 125.

becs asked: Hi, Would it be detected by a manual stomach examination???

Mr Malcolm Padwick Consultant Gynaecologist answered: Not necessarily. Ideally you would like to detect an ovarian cancer long before it caused your abdomen to swell. The most sensative test is an ultrasound scan combined with a blood test CA 125.

AXA PPP healthcare asked: We have had another question come in:
If you have suffered from polycystic ovary syndrome are you at higher risk of ovarian cancer? Is there any link?

Mr Malcolm Padwick Consultant Gynaecologist answered: I am not aware of any proven link between the two conditions particularly as women with PCOS tend to have reduced ovulations. PCOS however is assosicated with a slight rise in the risk of uterine cancer.

AXA PPP healthcare commented: Thank you

Hannah asked: What are the main types of treatment?

Mr Malcolm Padwick Consultant Gynaecologist answered: Surgery is the main form of treatment and this usually involves hysterectomy and removal of tubes and ovaries. Also a sheet of internal fat called the omentum is removed along with any other organs or tissues that look as if they are affected by the cancer. usually after surgery although occasionaly before surgery chemotherapy is used. If the disease returns after initial treatment it is unusual to need further operations but extra courses of chemotherapy can be given.

Hannah asked: Is this a common type of cancer? You don't hear much about it.

Mr Malcolm Padwick Consultant Gynaecologist commented: There are about 5000 women a year affected by ovarian cancer in England and Wales. It is nothing like as common as breat cancer for which one have a 1 in 10 chance of developing but it is no means a rare type of cancer either.

Mr Malcolm Padwick Consultant Gynaecologist answered: There are about 5000 women a year affected by ovarian cancer in England and Wales but it is nothing like as common as breast cancer where women have a  1 in 10 chance of developing the disease, but it is by no means a rare type of cancer either.

Anonymous7 commented: Hi, does the pill or other types of contraception increase your risk of ovarian cancer?

Mr Malcolm Padwick Consultant Gynaecologist answered: No the combined pill (the one that containes Oestrogen) can significantly reduce your risk of ovarian cancer if you use it for more than three years.

Anonymous26 asked: Are women in a particular age bracket more at risk than others?

Mr Malcolm Padwick Consultant Gynaecologist answered: The most common age for presentaion of ovarian cancer is 65 years old.

Anonymous7 asked: Hi, does the pill or other types of contraception increase your risk of ovarian cancer?

Mr Malcolm Padwick Consultant Gynaecologist answered: No the combined pill (the one that containes Oestrogen) can significantly reduce your risk of ovarian cancer if you use it for more than three years.

Hannah asked: Do you think we will be able to screen for this cancer in the future?

Mr Malcolm Padwick Consultant Gynaecologist answered: It is difficult to say. For screening to be affective you need to identify a pre cancerous change in the ovaries so that treatment can be started before the true cancer occurs . At the moment there is no evidence that this state exists.

Anonymous7 asked: I have had endimetriosis removed twice by laser. and i suffer from polysistic ovarian syndrome. Would these two combined increase my risk?

Mr Malcolm Padwick Consultant Gynaecologist answered: Polycystic ovaries probably do not affect your risk but endometrisos can increase it slightly. I think it is good that you have had your endometriosis removed by the laser as i believe this will reduce the risk a little.

Anonymous7 commented: Thank you. Thats good to know.

AXA PPP healthcare asked: We have been asked the following question: Does being overweight increase your chance of getting ovarian cancer?

Mr Malcolm Padwick Consultant Gynaecologist answered: Unfortunately being overweight seems to be a risk factor for many different cancers and it probably is implicated in ovarian cancer as well.

Anonymous7 asked: Are there any early signs of ovarian cancer that you can look out for because everything i have seen and read has said that it can be hard to diagnose until the later stages?

Mr Malcolm Padwick Consultant Gynaecologist answered: It is true that it is very difficult to diagnose as there are no real symptoms. Some women might get erratic vaginal bleeding or perhaps some pelvic discomfort but there are no common symptoms. As a consquence most women are not detected until the have advanced disease. This is why so many people are trying to find a screening test.

Anonymous7 commented: What do you think the chances are of there being a screening test one day?

Mr Malcolm Padwick Consultant Gynaecologist answered: It is difficult to say. For screening to be affective you need to identify a pre cancerous change in the ovaries so that treatment can be started before the true cancer occurs . At the moment there is no evidence that this state exists.

Anonymous7 commented: Should there be a regular screening to check all women once they reach a certain age to check if they have the desease then if you can't check for a pre cancerous change or would this be too difficult?

Mr Malcolm Padwick Consultant Gynaecologist answered: There is no national screening programme for Ovarian cancer.

AXA PPP healthcare asked: Thank you to Mr Malcolm Padwick for answering today's questions and thank you to everyone who joined. The live chat has now finished.


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