Ovarian Cancer Is Called The ‘Silent Killer’ As It’s Not Easily Diagnosed Early

Why is Ovarian Cancer, easy to treat in early stages, hardly ever diagnosed until it is nearly too late? What should we know about this ‘silent killer’ of women?

Today, 8th May, is World Ovarian Cancer Awareness Day.

‘And I pray that women will listen to their bodies and pursue further testing if they feel something is wrong’. This one sentence posted on John Hopkins page on patients’ stories captures the common theme of the lessons these survivors of ovarian cancer have learnt and shared online.

Why is ovarian cancer so hard to detect?

Despite being the third most common cancer that impacts women across the world, ovarian cancer is barely discussed, which makes the experience of it incredibly daunting and makes one feel lonely.

Across the world, medical experts talk about this worrying paradox- while ovarian cancer in its early stage is easy to treat it is often diagnosed when it reaches advanced stages.

For one, its symptoms at the early stages are vague and nonspecific. However, a more worrying cause for late diagnosis is the lack of awareness, and a feeling of shame among Indian women to speak of the symptoms as they are to do with genitals. According to research, only 20% of ovarian cancers are detected early.

Which is why World Ovarian Cancer Day, celebrated on the 8th of May, carries so much importance. Awareness can truly save lives and so it was launched in 2013.

Advocates and survivors of ovarian cancer use the colour teal to symbolise the need to amplify information about the disease and to show support to women. Moreover, it highlights the need for women to listen to their bodies. Stories from around the world all fight against the common yet often fatal tendency women have of suppressing warning signs. It’s important to not let the social expectation of being the perfect caretaker take precedence over our own health.

What is Ovarian Cancer?

The word Ovarian points to the ovaries of women’s reproductive systems, which are usually from where this form of cancer begins. The ovaries produce eggs (ova) for reproduction. The ovaries are also the main source of the female hormones estrogen and progesterone.

The type of cell where the cancer begins determines the type of ovarian cancer you have, which are mainly of 3 types – epithelial tumours, stromal tumours, and germ cell tumours. This classification is important in determining the treatment methods, and deciding the prognosis. 90% of ovarian cancers are epithelial tumours.

According to the University of Kansas Cancer Center, ovarian cancer can progress quickly. It can go from early stages to advanced stages within a year. Malignant epithelial carcinoma, which is the most common type of ovarian cancer, can spread within a matter of weeks to months.

Have a family history of ovarian cancer? Catch it early

Ovarian cancer symptoms are very non specific, leading to women disregarding them or ‘dealing with them’ on their own. A look at common ovarian cancer symptoms will explain why women may not take them seriously –

• Abdominal bloating or swelling
• Quickly feeling full when eating
• Weight loss
• Discomfort in the pelvis area
• Changes in bowel habits, such as constipation
• A frequent need to urinate

Hence, it is important for women to keep track of their family’s medical history, specifically keeping note of the female relatives with cancer, and with the help of your doctor, genetic mutation tests can be taken. Between 5-10% of cancers are inherited through genes, but at the same time, having an inherited genetic mutation does not mean you will get cancer. It just means you are at a higher risk for developing a certain type or types of cancer.

Such tests are important because there aren’t specific causes to ovarian cancer. Anyone can get diagnosed with it, regardless of age, location or lifestyle.

Is it possible to prevent ovarian cancer?

To a certain extent, yes. More than that, early detection can prevent any complications that later stages bring with them.

If you have a family history, you’re at a higher risk for ovarian cancer – if you do not want to have children, or have finished with childbearing, one preventive measure suggested is prophylactic surgery. During this procedure, the ovaries and fallopian tubes are removed.

Regular health check-ups in women, that include sonography, are recommended, along with consulting an OBGYN.

There are other specific factors that have been found to be protective against ovarian cancer, though not conferring any sure shot prevention.

• Use of oral contraceptive pill (OCP)
• having at least one full term pregnancy
• breast feeding
• preventive surgery sometimes suggested by the OBGYN in specific cases

How is it usually diagnosed

1 in 72 women are diagnosed with ovarian cancer in their lifetime and it’s one of the most fatal women cancers. India comes second after China when it comes to the number of women diagnosed with this disease.

Doctors usually compile the medical history of the patient and their family, then could ask you to do a CT scan, vaginal sonography, and blood tests – the most important is a test for the C-125 test, which is a protein marker found in those with ovarian cancer.

After getting results of the test, while it is important to be informed, wait for your doctor to come to a conclusion before forming your own. Though easier said than done, having patience and trying to be calm is important.

Ovarian cancer treatment

Typically, treatment plans are based on the type of ovarian cancer, its stage, and any special situations.

• Local treatments – like surgical removal or radiation therapy of the tumour itself.
• Systemic treatments – which include chemotherapy and hormonal therapy among others, which can reach cancer cells almost anywhere in the body.
• Lifestyle changes, alternative medicines, etc, which help improve the quality of life for a survivor.

Being announced cancer free is of course an amazing cause for celebration. getting through this disease at any stage requires the mental and physical strength, from the one with the disease and their support system. However, it’s important to be regular with health check ups for  Ovarian cancer survivors are at higher risk for getting some other types of cancer.

How to heal while being treated

Being diagnosed with cancer is scary and overwhelming. It is a difficult disease no doubt. However, there is more than fear and despair. Many women have shared that they’ve discovered hobbies, appreciation for their friends, and for their own selves.

Manisha Koirala, an iconic Bollywood actress, was devastated when she was diagnosed with the disease. In an interview with India Today, she said that as she struggled with feelings of “hopelessness, helplessness, powerlessness,” her friends and family became a support system that helped her through. In her book on her survival story, she writes, “My vision is sharper, my mind clearer, my perspective realigned. I have succeeded in transforming my passive-aggressive anger and anxiety into more peaceful expressions.”

Model Ella Mayday echoed this sentiment of reflection and self-discovery as she spoke about her diagnosis, “My idea of myself and what women are supposed to feel towards their bodies has changed and evolved into something stronger”.

In a study conducted by the World Ovarian Cancer coalition, a participant was quoted saying “My personality trait is to show a strong face to people, to say I am completely fine but that is not always the case and it is very exhausting… so I spend a lot of time at home on my own doing this [felting and sewing] to calm myself down.” Helping the mind fight the disease is just as important as helping the body.

Along with our loved ones, survivors can also reach out to organisations like Cancer Awakens, Teal Warriors and Sashakt. Such counselling platforms and support groups can offer advice, a listening ear and information to help light up what seems to be a dark journey.

Raising Awareness

There is strength in the collective and if the collective raises its voice, a lot, like ovarian cancer, can be prevented. Sharing and amplifying articles and posts online can be our contributions, which may seem little to us but can have tremendous impact. We can encourage people we know who have or have had this disease to share their stories so that women start looking out for signs and symptoms. Knowledge, as they say, is power.

In India, lack of awareness is one obstacle to diagnosis. The other is the subservient role women are expected to play, where the family comes first. India has not yet reached universal education and the existing education systems do not pay much attention in teaching women basic information about their bodies.

And then there is the taboo on speaking about ‘private parts’. Women are embarrassed to talk about their genitals and reproductive systems with friends and families, and even more so with doctors, who aren’t easily available in rural India. When the average Indian woman knows very little even about her periods, how is she expected to know how to look out for a disease that even doctors find difficult to diagnose? Further, given the intense poverty the majority of Indian women live with, ‘doing everything you can’ is a privilege. This is where the public health system and private health organisations must step in to fill this gap in knowledge.

Let’s break the silence.

Image source: By Ministry of Information & Broadcasting (GODL-India), GODL-India, Link

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