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Fertility options for the 7,000 women diagnosed with ovarian cancer this year

08 March 2016

Consultant Gynaecologist explains the fertility options for women with ovarian cancer

March is ovarian cancer awareness month, an annual event that aims to raise awareness of the biggest gynaecological killer of women in the UK. Over 7,000 women are diagnosed with ovarian cancer in the UK each year and with survival rates in the UK, among the worst in Europe, it’s critical that women are diagnosed early. 

Unfortunately, ovarian cancer treatments can affect fertility, making a diagnosis even more difficult for women who have not yet started a family or who planned on having more children.

With ovarian cancer, the more advanced the cancer is, the higher the risk of treatments affecting fertility. Miss Tania Adib, Consultant Gynaecologist at The Lister Hospital, part of HCA Healthcare UK comments, “Ovarian cancer is the second most common gynaecological cancer but is the deadliest because it is normally diagnosed at an advanced stage where treatment is not as effective as when it is caught early.

“Risk factors for ovarian cancer are related to the number of ovulations a woman has, so if a woman starts her periods early or has a late menopause, then her risk for ovarian cancer is increased. Conversely, we know that taking the oral contraceptive pill, pregnancy and breast-feeding, all of which prevent ovulation, are all associated with a lower risk. Women who are sterilised by having clips on their fallopian tubes have a lower risk. We think this is because it prevents cancer-causing substances from entering the body through the vagina, then passing through the fallopian tubes and affecting the ovaries. Women who use talc in the genital area have an increased risk, and it's likely that it is due to this mechanism.”

Miss Adib continues: “Other risk factors include endometriosis and fertility treatment. Poor diet and lack of exercise have been shown to increase the risk of many cancers, including ovarian cancer. Some studies have shown up to a 60% reduction in risk with moderate to strenuous exercise.”

Symptoms of ovarian cancer are usually vague. However certain symptoms are more suggestive of a possible cancer such as constant abdominal or pelvic pain, distension of the abdomen, pain associated in the bowels, needing to pass urine more frequently, a change in appetite or feeling more full quickly. If women experience any of these symptoms, especially if they are persistent, then they should see their doctor.

Miss Adib provides advice on fertility options for women with ovarian cancer: “Germ cell tumours, which affect very young women, can usually be treated by removing the affected ovary then treating with chemotherapy. Most women retain the function of the remaking ovary and go on to have full term pregnancies. So in the majority of cases it is possible to offer fertility-sparing surgery. Women who develop epithelial ovarian cancers are usually older and often already menopausal. However, in the few who are younger and want to retain their fertility, it is possible to offer fertility sparing surgery if the cancer is contained within the affected ovary. This is usually not the case, however, and a full hysterectomy is performed.”

Miss Adib concludes, “My main advice for women is to eat a healthy diet and do regular, moderate exercise. They should see their doctor as soon as they have symptoms they are worried about and that may indicate they have ovarian cancer. Regular testing and risk-reducing surgery have both been shown to be very effective in the battle against ovarian cancer and women with a strong family history of ovarian cancer should therefore seek genetic testing.”

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