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HindustanTimes Thu,28 Aug 2014

Ovarian cancer after menopause: Ageing, childlessness, put women at high-risk

Astha Saxena, Hindustan Times  New Delhi, February 03, 2014
First Published: 01:13 IST(3/2/2014) | Last Updated: 02:08 IST(3/2/2014)

When 64-year-old Sudha Tandon gained 20kg in a span of six months, she took it for what it was — simple weight gain because of her indifferent diet and inactive lifestyle.

Not even in her wildest nightmares had she imagined that what was growing inside her abdomen was not fat but a cancerous tumour. It was in September when she spotted a post-menopausal bleeding that set off the alarm bells ringing.

"I had no symptoms for many months. The only thing was that I had gained 20 kg in six months. But I did not pay much heed to the weight gain and then suddenly in September this year, I noticed bleeding. I was surprised as I had attained menopause in my 50s and there was no reason why I would experience any bleeding now," recalls Tandon who hails from Muradabad.

After going through a battery of ultrasound tests and MRIs, doctors found a huge ovarian mass which was displacing her intestines. Doctors suspected it to be cancer. The size of the tumour was 11.5 kg.

"What surprised us the most in this case was that she never felt a lump inside her body. I felt it immediately when I examined her. In fact, it was so huge that it looked as if she was carrying a nine-month old baby," said Dr Neema Sharma, senior consultant, Minimal & Natural Access Gynaecology and Gynae cancer surgery, Fortis hospital, Vasant Kunj.

Take the quiz to assess your risk

Tandon’s story is fairly common for those who have or know someone with ovarian cancer. Most are diagnosed when they are older. According to the doctors, about half of women are diagnosed when they are in the age of 50-60 years. Having family members with ovarian cancer can also increase your risk, although the risk is greater if their mother, sister or daughter had it.

Meena Thakur (name changed) who found she was suffering with ovarian cancer at an age of 57 has had a similar experience. She knew nothing about the disease, and the fact that three other family members had it also didn’t make her suspicious. "Fortunately, I have been regular with my check-ups which is why the cancer was detected at stage I," said Thakur.

Advancing age, obesity, certain fertility medications, never being pregnant, a family history of ovarian cancer, a previous diagnosis of breast, colon, rectum or uterine cancer and inherited gene mutation are some of the factors that put a woman in high-risk category. Post-menopausal bleeding is also a factor.

The treatment involves surgical removal of the tumour, and in advance stages followed by chemotherapy or even radiation therapy.
According to the doctors, one of the major problems with ovarian cancer is it is mostly detected after stage II. Very few patients are diagnosed at an early stage.

"Ovaries are not easily accessible due to which it becomes difficult to detect the cancer at an early stage. There are usually no early warning signs either," said Dr Sudha Prasad, medical professor, obstetrics and gynaecology, Maulana Azad Medical College. "By the time bleeding starts, the tumour is already big enough," she added. The survival rate at Stage III and IV is barely 10%.

In the past few years, young women — 35 and above — are also being detected with ovarian cancer.

Regular check-ups are the only way to catch the disease early. "Women should go for regular check-ups once they attain menopause. A complete gynaecological examination that includes examination of ovaries, abdomen and uterus should be done once in a year for first three years and then once in three years. Pelvic ultrasound, once in a year after hitting 30, is also a must," said Dr Prasad.

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