Article by: Dr. Meenu Walia, Senior Director, Max Super Specialty Hospital, New Delhi.
Noting that ovarian cancer is the third most common gynecological cancer in Indian women, doctors have cautioned against the rising number of cases. As estimated by 2035, the country may witness 371,000 cases every year, which is a 55 per cent increase from the current incidence, while the death rate may touch 254,000 per annum, an increase of 67 per cent. The risk of this deadly disease in women starts increasing from the age of 35 and reaches a peak between the ages of 55–64. This is primarily because most often it is diagnosed in Stage III or IV. It has the worst prognosis amongst gynaecological cancers which has a 5-year survival rate of 45 per cent. Most cases are diagnosed in the late stage where the 5-year survival rate further drops to 28 per cent.
Only 15 per cent of cases are diagnosed in the early stage where the 5-year survival rate can be as high as 94 per cent. Women with late marriages, late pregnancy, no pregnancy & obesity were found to be more vulnerable to ovarian cancer. This is a worrying trend that is likely to continue in the coming years due to poor lifestyle choices and the level of awareness regarding ovarian cancer. Even in big cities like Delhi, lack of awareness has been found to be one of the major contributing factors to ovarian cancer cases and their poor prognosis.
Being unmarried increases ovarian cancer
Early menarche (the first occurrence of menstruation), nulliparity (never been pregnant) and late menopause are some of the key risk factors that increase the risk of ovarian cancer. The other risk factors include family history of ovarian cancer especially in last degree, carrying BRCA1 and BRCA2 gene mutations, belonging to families with LYNCH II syndrome, history of breast cancer, post-menopausal hormone therapy, obesity, cigarette smoking and alcohol consumption. Tell-tale signs of ovarian cancer include bloating and abdominal discomfort, change in bowel habits, indigestion, tiredness, weight loss, loss of appetite, increase in abdominal size, nausea and vomiting, swelling of the leg due to a deep vein thrombosis. In India, the incidence of ovarian cancer is between 0.9 – 8.4/1,00,000. According to a report, unmarried women were found to be at a significantly higher risk of developing ovarian cancer.
Early diagnosis is the key
However, the good news is that timely diagnosis of ovarian cancer can lead to speedy recovery and reduces chances of mortality. The treatment of ovarian cancer depends on the stage, size of the tumor, location, and various other factors at the time of diagnosis which vary from person to person. There are multiple types of ovarian cancers. Only three out of these are the main types of cancer: epithelial, germ cell, and stromal. Germ cell and stromal tumors have a much better prognosis and are often curable because they are more likely to be detected at early stages. Approximately 20 per cent of women with advanced ovarian cancer survive beyond 12 years after treatment and are effectively cured. Therapy for ovarian cancer comprises surgery, chemotherapy, targeted therapy, hormonal therapy among others. These are given in different sequences and combinations as per the patient’s diagnosis with the goal of eradicating as many cancer cells as possible.
Make those lifestyle modifications
Lifestyle changes can work as preventive measures against ovarian cancer, such as exercising daily, eating a well-balanced diet, avoiding smoking and alcohol, and regularly breastfeeding the child. Detailed investigations such as scans and biopsies when something looks suspicious are still not routine in most parts of India. We need to make sure every woman and general practitioner (GP) knows about ovarian cancer and its symptoms. Currently 90 per cent of women don’t know about symptoms and until we sensitize the women & their physicians this is one of the ways we can ensure more cases are diagnosed early
Even the World is navigating a new normal. But, every day the same cancer threat remains. During Covid times – even women with cancer symptoms did not get their checkup done. Cancer isn’t waiting for things to go back to normal. If you have symptoms; if you have paused treatment or cancelled routine health check-up, contact your doctor.
