This week, Bond star Pierce Brosnan’s daughter Charlotte died from ovarian cancer aged just 42. Charlotte Brosnan’s mother Cassandra, Brosnan’s first wife also lost her life to ovarian cancer in 1991 and her grandmother also died from the disease. So – how common is it, what are the symptoms and what can you do if it’s in your family?
Healthista spoke to Dr Vicki Barber, GP with a special interest in ovarian cancer who has worked with the British Medical Journal (BMJ) to create an education tool to help GPs spot the symptoms of ovarian cancer about exactly what you need to know about this disease.
Pierce Brosnan’s daughter Charlotte’s mother died of ovarian cancer as did her grandmother – how does it run in families and what should I be looking for in my family history?
If you have a first degree relative diagnosed before age of 50 with ovarian or breast cancer – that’s a mother, aunt, sister, daughter or grandmother – talk to your GP as you may be entitled to be referred for genetic counselling on the NHS to a specialist genetics clinic. They will look closely at your family history and give you a risk level – low, intermediate or high – and decide whether you need a genetic test.
There are two gene mutations people at an increased risk of ovarian or breast cancer have called BRAC1 or BRAC2. If you are found to have this you have a 40-50 per cent chance (for BRAC 1) and 20-30 per cent (BRAC 2) of developing ovarian cancer and an 80 per cent chance of developing breast cancer. Your GP and genetics counsellors can help you decide on the next course of action. This may for example be a preventative mastectomy (this is what Angelina Jolie had recently) and / or the removal of your ovaries but it may also be medication that can lower your risk. This is a personal decision that you need to make with your doctor. Some women who are at higher risk of ovarian cancer may be prescribed the contraceptive pill as this can reduce risk, but it may increase the risk of other cancers so again, it’s a personal decision.
If you’re going to your doctor to report symptoms, be armed with any family history even if it’s your aunt Flo and your grandmother that had ovarian or breast cancer – if the relatives are from the same bloodline, your doctor needs to know.
Wow – complicated. Is there a simple way of finding out if my risk is higher?
Yes. OPERA is an online information tool for people concerned about their inherited risk of ovarian and/or breast cancer. It’s developed by doctors and found on the Macmillan Cancer Support website and can give you a low risk or sign post you to seeing your doctor.
What symptoms should we be looking out for?
A few years ago, ovarian cancer was seen by doctors as so difficult to diagnose that by the time the illness was spotted, it was usually too late. But in 2011 the National Institute of Clinical Guidance (NICE) released new guidelines that listed the ‘Big Four’ common ovarian cancer symptoms women need to be aware of and doctors need to act on.
- Abdominal or pelvic pain
- Abdominal distension – not the bloating that comes and goes through the day after eating, it’s about feeling as though your belly is expanding and it never seems to settle
- Urinary frequency – needing to pee more frequently
- Feeling full up – when you’re eating you think ‘Gosh I can’t face any more’ and you’re only halfway through your food or eating normal portions and feeling dreadfully full
Other important symptoms include:
- Changes in bowel habits – sudden constipation or diarrhoea or going to the toilet more often
- Weight loss
- Feeling awfully tired
If you have even one symptom, that’s been happening 2-3 times a week or more than 12 times in a month, be blunt with your doctor and ask to be tested quickly. We need to get away from the idea that doctors are these powerful beings that can’t be challenged. Most doctors are perfectly happy with someone saying ‘Look, I am worried about ovarian cancer. I have this symptom and what are you going to do about it?’
Those symptoms sound a lot like Irritable Bowel Syndrome (IBS)…
Ovarian cancer has been notoriously misdiagnosed in the past, in particular as IBS. Now, the NICE guidelines have created new ‘golden rules’ to help eliminate this and one of them relates to IBS. IBS is usually diagnosed in younger women in their late teens or early 20s so if you have never had IBS symptoms and are suddenly being told by your doctor that you have it and you’re in your 30s, 40s, 50s or beyond, you should query the diagnosis with your doctor and ask to be tested for ovarian cancer.
How else can I differentiate my symptoms from IBS?
Virtually everyone will get these symptoms of bloating, peeing more, feeling extra full at some point. But if they are new, persistent and unusual for you you need to talk to your GP. If you’re worried, keep a symptom diary and if it is happening 2-3 times a week and over a month happens more than 12 times in a month, talk to your doctor and show him / her that diary.
How is ovarian cancer tested?
A CA125 test can look for blood markers that could indicate a possibility of ovarian cancer and this should be accompanied by a trans-vaginal ultrasound scan which would confirm the diagnosis. You GP can organise both of these.
How common is it in the under 50s anyway?
Nine out of ten cases of ovarian cancer will be in the over 50s. Only one in ten cases will be in women under 50 but as 7000 women are diagnosed with ovarian cancer each year that’s still 700 women under 50 diagnosed annually with ovarian cancer.
Why shouldn’t I ignore the symptoms?
If you have ovarian cancer that is caught at stage one you have a 90 per cent chance of being fully cured but if it’s caught in stage four, that drops to a ten per cent chance of survival.
Find out more at Target Ovarian Cancer
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