Ovarian Cancer Awareness Month Q&A
For Ovarian Cancer Awareness Month, Dr Michelle Lockley from the Barts Cancer Institute answers questions about ovarian cancer.
Dr Michelle Lockley Honorary Consultant Oncology at the Barts Cancer Institute
Dr Michelle Lockley, Honorary Consultant Medical Oncology at Barts Cancer Institute
Ovarian Cancer Awareness Month: What You Need to Know

According to Cancer Research UK, around 7,500 women are diagnosed with ovarian cancer in the UK each year. Ovarian cancer ranks sixth as the most common cancer among women, causing more deaths than any other cancer of the female reproductive system. 

For Ovarian Cancer Awareness Month, we’ve asked Dr Michelle Lockley from Barts Cancer Institute at Queen Mary University of London to answer some pressing questions about ovarian cancer. Here’s what Dr Lockley had to say: 

Q: Is there an ovarian cancer screening test?

At the current time, there is no ovarian cancer screening test that has been proven to be effective. Ovarian cancer is often described as a ‘hidden’ cancer because many women do not experience symptoms until the disease has already spread within the body. We think that we would be able to improve survival if we could detect these cancers before they have spread. There is a great deal of research activity trying to find ways to detect these cancers earlier.  

Q: Can I reduce my risk of ovarian cancer? 

As far as we know, there is very little that women can practically do to reduce their risk of ovarian cancer. The most common symptoms that women experience are abdominal bloating and discomfort and a change in bowel habit. It is definitely worthwhile being attentive to these types of symptoms and seeking medical advice as early as possible.  

Q: Is ovarian cancer hereditary? 

It can be in a minority of cases and the most well characterised mutations that cause ovarian cancer are in BRCA1 and 2, which many people have now heard of. These genes can be passed to a woman by either her mother or her father and they significantly increase the risk of ovarian, breast and other cancers. In families that are known to have these mutations, women will be offered screening and risk-reducing surgery. So this is an example of how certain women can prevent ovarian cancer from occurring. 

Q: Are there different types of ovarian cancer? 

There are many different types of ovarian cancer to the extent that they should be thought of as distinct diseases. As we learn more about these subtypes, we have got better at devising individual treatments for these diverse cancers. In this article I have really been referring to high grade epithelial cancers, which are the most common and most websites and literature tend to focus on this type as well. It is important to emphasise that the different ovarian cancers each have their own behaviour, treatment and outcome so it is not the case that ‘one size fits all’. Health care teams will be able to provide personalised information about each patient’s own cancer and treatment. 

Q: Are there any clinical trials for ovarian cancer? 

Yes! There are a great many clinical trials for ovarian and other cancers. This is the way that we are able to make new treatments available for cancer patients. The major success story in ovarian cancer treatment in recent years has been PARP inhibitors. We are now able to prescribe these effective new tablets to NHS patients and this would not have been possible without clinical trials and the very large number of patients who participated. Clinical trials have specific entry requirements and so cancer doctors will usually signpost trials to their patients. Cancer patients should definitely discuss this clinical trials with their doctors if it is something they may be interested in exploring though. 

Q: How is ovarian cancer diagnosed? 

Ovarian cancer is diagnosed after a woman has told their doctor about their symptoms. This will usually lead to blood tests, particularly to look for tumour markers, the most common of which is CA125. There will also be scans, which might include an ultrasound scan or an MRI. There will almost certainly be a CT scan, which helps us to see how far the cancer has spread. This final diagnosis is made by looking at a sample of the cancer under a microscope, which enables us to say what particular type of cancer each patient has. Not everyone will have all of these tests though. Teams of healthcare professionals in specialist hospitals will review everything at each stage and advise on what is needed for each individual patient. 

Q: What is the treatment for ovarian cancer? 

This is a big question because of the different subtypes of ovarian cancer and of course because every woman is different. In general though, it is a combination of surgery and chemotherapy drugs. These days, many patients will be able to have some form of maintenance treatment once they have completed their chemotherapy and increasingly this is with PARP inhibitor tablets, which can continue for many years. Where possible and relevant, we will always try to include patients in clinical trials so that we can continue to improve our knowledge and prolong survival for women with this diverse group of diseases. 

Barts Charity awarded Dr Lockley approximately £500,000 to investigate a new personalised adaptive therapy treatment approach for ovarian cancer that has returned after previous chemotherapy.

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