Ovarian cancer: vague symptoms lead to late diagnosis

Every year, more than 800 women in Belgium are diagnosed with ovarian cancer. The disease is the second most common gynaecological cancer after cancer of the endometrium. In an early stage, the cancer remains limited to the ovaries, but due to the vague symptoms, there are often already metastases to the abdominal cavity at the time of diagnosis, which makes the disease much more difficult to treat. Ovarian cancer claims 600 lives in our country every year.

“Ironically, cancers for which we can screen, such as breast cancer or colon cancer, receive much more attention than cancers for which we cannot. Ovarian cancer is one of them,” says Prof. Dr. Toon Van Gorp, head of the gynaecological oncology department at the University Hospital Leuven.

Also read: Screening: for which cancers is early detection available?

'Silent Killer'

Dr. Van Gorp: “The ovaries and fallopian tubes are located too high in the abdomen to detect cancer at an early stage. We therefore have to rely on the woman's symptoms. And that is precisely where the problem lies, because the symptoms of ovarian cancer are not pronounced and point more towards organs other than the ovary. As a result, it takes a while for a woman to go to the GP and/or specialist. And if the woman does eventually go to a doctor, it often takes another 6 to 12 months for an ultrasound or scan to provide the correct diagnosis. As a result, the disease is only diagnosed in an advanced stage in 3 out of 4 women. Ovarian cancer is therefore sometimes called the 'silent killer'.”

Also read: What is cancer and how do you get it?

What are the symptoms of ovarian cancer?

Also read: Possible signs and symptoms of cancer

What types of ovarian cancer are there?

1. Epithelial ovarian cancer: About four out of five women get this form of ovarian cancer. The tumor develops in the outer layer of cells of the ovary and/or fallopian tube.
2. Gonadal stromal cell tumor: The tumor arises here in the stroma, a tissue layer of cells that produces hormones.
3. Germ cell tumor: the tumor is formed from germ cells, the immature egg cells that lie in the ovary.

Is ovarian cancer hereditary?

Dr. Van Gorp: “15-20 percent of patients have a hereditary defect, namely a mutation in the BRCA gene. These women have a very high chance of developing ovarian cancer. We will therefore propose to them to remove the ovaries and fallopian tubes as a preventive measure. Since early detection does not work, we must prevent cancer. Prevention is always better than cure.”

How is ovarian cancer treated?

In an early stage of ovarian cancer, when there are no cancer cells in the abdominal cavity, surgery may be sufficient as treatment. In a later stage (from stage 2 to 4), the cancer has spread to the abdominal cavity or outside the abdomen. Treatment then consists of surgery, supplemented with chemotherapy and possibly also radiotherapy.

Also read: Removal of ovaries (or Ovariectomy)

What are the survival rates for ovarian cancer?

With ovarian cancer, the chance of recovery depends on the stage at which the disease is discovered, your age and your general state of health. Whether or not the tumor was removed also plays an important role.

Of those diagnosed with stage 1 ovarian cancer, 87 percent are still alive after five years. In stage 2, that is 68 percent. The five-year survival rate for stage 3 ovarian cancer is 28 percent. In stage 4, that percentage drops to 14 percent.

Unlike our neighbouring countries (France, the Netherlands, the United Kingdom, Scandinavia, etc.), there is no centralisation of care for ovarian cancer patients in Belgium. Dr. Van Gorp: “There are 100 hospitals in Belgium that treat ovarian cancer. In comparison, there are only ten in the Netherlands. This has a major impact on survival rates. A study by the Belgian Health Care Knowledge Centre (KCE) has shown that patients who are treated in hospitals with large numbers of patients live an average of 2.5 years longer than patients who are treated in hospitals with small numbers. If we can centralise care, the support for our patients will also improve: pathway guidance, psychologists, physiotherapists, AYAs (Adolescents & Young Adults who support cancer patients), etc. Centralised care could therefore help our patients enormously.”

In Flanders, women with/after gynaecological cancer, together with their loved ones, can turn to a support group Hope.

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