Just last week I took an unexpected trip down to South Australia to be with my mother after she had a particularly nasty fall requiring emergency surgery. I was lucky to get a flight out that night and I sat next to a very pleasant lady traveling with her granddaughter. We struck up a conversation almost immediately and she asked me if I had enjoyed my holiday in Bali. So then I told her a little bit about myself, and that Bali was my home, not my holiday, and why I was off to Adelaide in such a hurry.
“Well,” she said, “Bali was a magnificent holiday for me, I have stage 4 ovarian cancer, so I really do LIVE every day.”
Naturally I was taken aback as here I was sitting next to a lady who I definitely did not want to exchange places with, and yet she was strong and defiant and very much living life to the fullest.
“You’re having treatment?” I asked.
“Not any more” she replied. “I’ve had enough of that. Two courses and my markers have not decreased. It made me so sick. Now I have decided to LIVE, and so I will, for as long as I can.”
It is for this lady and the thousands of other women around the globe that will be diagnosed with ovarian cancer this year (1,200 per year in Australia alone), that I dedicate this article.
What is ovarian cancer?
Ovarian cancer is a cancer that affects a woman’s ovaries. Around 90 per cent of ovarian cancers start on the outer covering of the ovary. This is known as epithelial ovarian cancer. Ovarian cancer is a relatively uncommon disease, affecting only about 1200 women each year in Australia. Eight hundred women die of the disease each year. The mortality rate is relatively high as ovarian cancer is usually well progressed by the time the women feels any symptoms.
What are the risk factors for ovarian cancer?
While we don’t know exactly what causes ovarian cancer, the evidence shows that increasing age is a well-established risk factor for the disease, with around 80 per cent of cases occurring in women aged 50 years and over. A small number of women (around 5-10 per cent of all cases) will be at increased risk because they have a family history of ovarian cancer. Their risk increases with the number of relatives who have developed the disease.
What are the symptoms of ovarian cancer and what can you do?
Symptoms of ovarian cancer are often vague and can mimic those of other disorders. This can make ovarian cancer difficult to diagnose in its early stages. (A Pap smear is used to detect cervical cancer and cannot be used to detect ovarian cancer). The best thing women can do is to be aware of the symptoms that may indicate ovarian cancer and see their GP if they experience any unusual and persistent changes. The most common symptoms that may indicate ovarian cancer are:
- abdominal bloating/feeling full
- appetite loss
- unexplained weight gain
- constipation
- heartburn
- back pain
- frequent urination
- abdominal/pelvic pain
- fatigue.
These symptoms can also be present in other illnesses. It is important that you have any unusual or persistent symptoms investigated. In order to establish the cause of your symptoms your GP may refer you for further tests such as an ultrasound.
The CA125 test
As part of the diagnostic process to check for ovarian cancer, a CA125 test may have been suggested by your doctor. In this case, the following information will help you to understand more about the CA125 test. If you have any other questions you should speak to your doctor.
What is CA125?
CA125 is a protein found in the blood. It is known as a tumor or cancer marker as increased levels may indicate that ovarian cancer is present.
Why do I need to have the test?
CA125 can be produced by ovarian cancer cells. If a trans-vaginal ultrasound shows a cyst or tumor on your ovary, a CA125 may be helpful in finding out if these changes are benign or malignant.
What is involved with the test?
A sample of blood will be taken from your arm and sent to a pathologist for analysis. You do not have to fast before the test.
I’ve heard that a CA125 test is all I need to tell me if I have ovarian cancer. Is that correct?
No. There are many other causes for raised CA125 levels such as ovulation, menstruation, endometriosis, fibroids or benign ovarian cysts. Illnesses such as liver or kidney disease can also cause a raised CA125. For these reasons, a CA125 test alone can not be used to diagnose ovarian cancer. A CA125 test is more helpful in diagnosing ovarian cancer in post-menopausal women than in pre-menopausal women.
What happens if my blood test for CA125 is normal?
About 50% of women with early-stage ovarian cancer have normal CA125 levels. If your CA125 levels are normal and symptoms persist or get worse, you should go back to your doctor. Trans-vaginal ultrasound is also used in the investigation of symptoms that may be ovarian cancer. If you have not had a trans-vaginal ultrasound you should request one.
Kim Patra is a qualified registered nurse and midwife who has been living and working in Bali for almost 20 years. She now runs her own private practice and medical referral service from her Kuta office. Kim is happy to discuss any health concerns with you and she may be contacted via e-mail at info@chcbali.com or Hp. 081 2366 0000.
