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Ovarian Cancer Screening

Ovarian cancer, the 5th most common cancer among women in Singapore
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What is Ovarian Cancer?

Ovarian cancer, the 5th most common cancer among women in Singapore, consists of malignant tumours that occur on the ovaries, nearby fallopian tubes, or even the tissue lining of the pelvis (peritoneum). It can run a subtle clinical presentation until the late stages of cancer where more overt symptoms start to manifest. Early detection of ovarian cancer through screening will reduce the chances of mortality.

Among the different types of cancers, ovarian cancer is also one of the lower survival rate forms of cancers in females, possibly due to late detection of the disease and by then, possible progression of cancer with spread to other parts of the body may have occurred. Hence, it is vital to screen for ovarian cancer during your medical checkup.

There are 3 types of ovarian cancer:

  • Epithelial ovarian carcinomas: the most common type of ovarian cancer, begins on the cells of the outer surface of an ovary and later spreads to other reproductive organs. Unfortunately, this type of ovarian cancer tends to be identified in the later stages.
  • Germ cell tumours: a form of cancer prevalent among young women (below 20 years of age), germ cell tumours are rare and have a higher likelihood of recovery.
  • Stromal cell tumours: the rarest form of ovarian cancer and are often identified in the early

What Causes Ovarian Cancer?

Like most cancers, the exact source of ovarian cancer is ambiguous. Risk factors aside, ovarian cancers occur when a mutation in the cell's DNA (deoxyribonucleic acid) occurs. This mutation manifests as a quick multiplication of cells that eventually form into a tumour. The cancer cells then spread to nearby organs in a process known as metastasis. In the case of ovarian cancer, apart from spreading to nearby organs, they also tend to spread to the liver and lungs in their later stages.

What are the Symptoms of Ovarian Cancer?

It is important to comprehend that in many cases, one may have virtually no symptoms at all. This is why many patients are unaware until they have reached the final stages of cancer. This can be a devastating scenario as the chances of survival become much lower. This is why routine health screening should be conducted.

However, in cases where symptoms are present, they may include:

Unusual vaginal discharge or bleeding
Abdominal pain
Lower back/pelvic pain
Poor appetite
Change of bowel habits –constipation/diarrhoea
Abnormal urinary symptoms – increased urge and frequency to pass urine
Unusual vaginal discharge or bleeding
Abdominal pain
Poor appetite
Change of bowel habits –constipation/diarrhoea
Abnormal urinary symptoms – increased urge and frequency to pass urine
Lower back/pelvic pain

Is Ovarian Cancer Painful?

As mentioned earlier, it is very likely you feel nothing at all in the early stages. However, as the cancer progresses, it is common for discomfort and pain to be felt in your lower extremities.

Is Ovarian Cancer Painful?

There are some factors that may increase your risk of ovarian cancer, these may include:

  • Family history: if your family members (first and second-degree family members) have had ovarian cancer, you may be predisposed to this condition too.
  • Other cancers and health conditions: if you have a history of breast cancer, uterine cancer, colorectal cancer, or endometriosis your risk increases.
  • Obesity: excess weight increases the chances of ovarian cancer.
  • Age: in most cases, women tend to be diagnosed with ovarian cancer after the age of 65.
  • Pregnancy and breastfeeding: women who had late pregnancies (above the age of 35) and women who have never breastfed have an increased risk of ovarian cancer.
  • Menstrual cycle: starting your menstruation at a young age (below the age of 12) or ending your menstrual cycle late (menopause) can increase your risk of ovarian cancer.
  • Genetics: the presence of mutation such as BRCA1, BRCA2, or a history of Lynch syndrome makes one prone to ovarian cancer.
  • Hormonal treatment: women who have been on long-term (over 10 years) oestrogen treatment (without progesterone) or other hormone treatment for fertility have an increased risk for ovarian cancer.

Sexual Health Screening

STD screening tests generally involve blood tests, swab tests and urine tests.

Dr Ben Medical offers STD screening for commonly sexually transmitting conditions such as Chlamydia, Gonorrhea, warts, herpes, HIV, Syphilis and other more – highlighted comprehensively in our packages.

We also offer long term sexual health care and services:

  • Sexual health advice for patient and partners
  • Cervical cancer screening with pap smear, HPV testing
  • Cervical cancer vaccination

How are Ovarian Cancers Diagnosed in Singapore?

There is yet to be a singular, reliable test that can be utilised to detect ovarian cancer. A combination of a few screening types may be required to detect ovarian cancer. It is important that doctors are aware of abnormalities during routine check-ups to give the best chance for patients to proactively seek treatment. Likewise, it is equally important that women conduct routine screenings as changes can be easily picked up by medical professionals.

Types of screening that will aid in diagnosing ovarian cancer include:

  • Physical examination: aids in the identification of palpable lumps and abnormal growths.
  • Blood tests: identifies if there is a spike of cancer antigens such as CA125.
  • Ultrasound: vaginal ultrasounds can identify any solid mass formation of the ovary.
  • CT scans: help to identify the spread of cancer.

What are the Treatment Options for Ovarian Cancer in Singapore?

If suspected of ovarian cancer during screening, you will be referred to a specialist (gynaecologist and oncologist) to seek further treatment. Management of ovarian cancer is usually a joint decision between a patient and the specialists. While choosing a treatment option can be daunting, your doctor will guide you further on the available options based on your type and stage/extent of cancer.

Your doctor will also explain the risks and benefits of individual treatments and their side effects. Treatment options can include surgery, chemotherapy, anti-cancer drug therapy, targeted therapy, hormonal therapy, or a combination of these therapies. You will be made aware of the necessary treatment plan to explore for recovery.

Frequently Asked Questions

You are encouraged to discuss your symptoms with your doctor. Your doctor will also obtain a medical history, a drug and social history, and a family history to screen for risk factors of ovarian cancer. Your doctor will then offer a physical examination of the pelvic region/gynaecological screen. For further evaluation, your doctor may offer an ultrasound of the pelvis or blood tests to screen for cancer markers.

While there is no foolproof way to prevent any form of cancer, you can reduce the risk of ovarian cancer by consuming birth control pills, practising healthy lifestyle habits (not smoking and losing weight if obese), and consuming a healthy diet by actively avoiding carcinogenic foods.

Patients who have their gynaecological organs surgically removed (removal of ovaries, uteri, cervix)/or tubal ligation may also have a lower risk of ovarian cancer. It is important to understand that not all prevention measures are suitable for everyone. Discuss with your doctor if you have concerns and request a proposal for initiatives that will suit you.

There are also cases of fully healthy individuals who are diagnosed with ovarian cancer despite practising all the right measures. Cancer does not discriminate. Your best bet will always be to be on top of your screening routine and be proactive with your health.

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