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Keeping an eye on ovarian cancer, the silent disease

Claire wasn’t sure whether it was the food from the new cafeteria at work that had given her persistent tummy pain in the last fortnight or the bowl of fruits she had taken at a roadside stall on her way home that evening.

She couldn’t figure out what had caused the stomach discomfort on the right side. But she knew something was different.

The fatigue worsened every day. She could also barely take the stairs to her third-floor apartment without running out of breath.

By the time she made it to her house every evening thereafter for the next one month, the pain became a constant reminder to see a doctor soon.

On most nights, she had no appetite. Even her favourite meal of rice and curry chicken stew tasted flat.

The persistent pain on her right side of the tummy on a Wednesday in January, sent her right into the doctor’s consultation room. She was diagnosed with a urine infection and sent home with a battery of antibiotics.

However, the pain didn’t go away in another four weeks and she sought a specialist’s consult. An ultra sound scan and a couple of laboratory tests later, she was diagnosed with a cyst, possibly in her right ovary.

Further tests showed that she had ovarian cancer stage 2. She was scheduled for surgery to remove the diseased ovary and a couple of chemotherapy sessions to kill any further traces of cancerous cells. The ovaries, fallopian tubes and the omentum were also removed. The omentum is the fatty tissue that connects the stomach with other abdominal organs.

Clare is currently on follow-up treatment and feels much better after today. She has resumed work and now plays a more active role at work encouraging her colleagues not to ignore unexplained weight-loss, aches and pains.

What is ovarian cancer?

Dr Alfred Mokomba, Obstetrician & Gynaecologist and a Fellow in  Gynaecology Oncology at Kenyatta National Hospital notes that the ovaries main role is to produce a woman’s eggs and female hormones. Each ovary is about the size and shape of an almond.

Whereas ovarian cancer is hard to detect early, the cancerous cells are found inside, near, or on the outer layer of the ovaries.

 Dr Alfred Mokomba,  Obstetrician & Gynaecologist and a Fellow in  Gynaecology Oncology at Kenyatta National Hospital. 

Risk factors

Dr Mokomba notes that the causes of ovarian cancer are no well-known however, some of the risk factors associated include;

• Age-being over the age of 50
• A family history of ovarian or breast
• Exposure to Hormone replacement therapy (HRT) – although any increase in cancer risk is likely to be very small
• Endometriosis
• Being overweight
• Lack of exercise
• A physical exam
• A pelvic exam
• Lab tests
• Ultrasound
• Biopsy- tissue removed for examination

Signs and symptoms

The diagnosis of ovarian cancer is done through various ways, Dr Mokomba notes. This includes a physical exam, a pelvic exam, lab tests, an ultrasound of a biopsy where a tissue is removed for examination in the laboratory.
According to Dr Mokomba, the most common symptoms include;

• Constant bloating
• Swollen tummy
• Discomfort in tummy or pelvic area
• Urinary symptoms like always feeling the urgency to always urinate
• Back pain
• Pain during sex
“As ovarian cancer progresses, it is also possible to report that you are more fatigued than normal, nausea, unexplained weight loss and in some cases, breathlessness while performing chores us also very common,” Dr Mokomba noted.
To manage the pain, ppalliative care to improve patient quality of life is recommended and this can be done to relieve suffering and to address the psychosocial needs of the patient.

Photo by Jaunt and Joy on Unsplash

Stages of ovarian cancer

Dr Mokomba takes time to explain the 4 stages of ovarian cancer
• Stage 1- the cancer has not spread beyond the ovaries
• Stage 2- the cancer is in one or both ovaries and has spread to elsewhere within the pelvis.
• Stage 3- the cancer is found in one or both ovaries, as well as in the lining of the abdomen, or it has spread to lymph nodes in the abdomen
• Stage 4- the cancer has spread to distant areas or organs in your body

Dr Mokomba noted that the treatment depends on the stage of the cancer.

The treatment options include;
• chemotherapy
• radiation
• surgery to stage the cancer and remove the tumour
• targeted therapy
• hormone therapy

“The main stay of treatment for ovarian cancer is chemotherapy where strong medicines are given to kill the cancerous cells. The other option is surgery to remove both ovaries, the women and the fallopian tubes,” Dr Mokomba noted.

What next after surgery?

According to Dr Mokomba says its important to keep the doctor’s appointments as scheduled for follow-up. Dr Mokomba notes that the follow-up treatments are important as they give doctors a chance to be keener and check for signs of cancer recurrence or manage the long-lasting side effects of cancer treatment.

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