Health Education

In the past, there has been a perception that gynecological cancer means cervical cancer. In reality, cervical cancer is just one of several gynecological cancers, and, with increasing public awareness, cervical screening and vaccination rates, the number of cases in Hong Kong has declined in recent years. A greater cause for concern is ovarian cancer, which is now the second most common gynecological cancer and is more difficult to prevent and detect. NGAN Kai Cheong, Clinical Professor of the Department of Clinical Oncology, Li Ka Shing Faculty of Medicine at the University of Hong Kong, and Specialist in Clinical Oncology at Gleneagles Hospital Hong Kong, points out that because the early symptoms of ovarian cancer are not obvious, many patients aren’t diagnosed until they have already reached stage 3 or 4. What’s more, even when treatment is successful, the risk of recurrence reaches up to 70%. Fortunately, with the combination of chemotherapy and a new targeted therapy, we may better be able to control this risk.

Among the top 10 gynecological cancers, ovarian cancer ranks sixth and mostly affects middle-aged women. The cause is still uncertain, but according to Professor Ngan, it is believed to be closely related to incessant ovulation –ovaries capsule will need repair after monthly ovulation which may lead to uncontrolled cell growth during the process. For this reason, those who have never given birth or whose ovaries have been stimulated to ovulate are considered at higher risk to get ovarian cancer. 

The sooner ovarian cancer is diagnosed, the better a chance for survival. However, as Professor Ngan notes, it’s rarely that easy, due to the mildness of symptoms in the early stages. For most patients, these early symptoms may just feel like a bit of abdominal discomfort, or even indigestion, which ultimately delays diagnosis and treatment. By the time a mass in the abdomen is obvious, the cancer is already in late-stage. In some cases, tumours as large as 20 cm in diameter have been found at the time of diagnosis. And, due to the high recurrence rate, treatment goes beyond simply removing the tumour itself – even if only one ovary is affected, doctors recommend removing both ovaries, the fallopian tubes, and the uterus, and also the surrounding lymphoid tissues. Apart from very early stage ovarian cancers,  treatment after surgery will include chemotherapy &/or targeted therapy to further combat the cancer. Late stage cancers are often first treated by chemotherapy first before surgery. And yet, regardless of the exact treatment undertaken, the chance of recurrence still remains quite high. 

According to Professor Ngan, patients with recurrent ovarian cancer are generally treated with chemotherapy. When combined with the new targeted therapy for the BRCA gene mutation, the results and survival rates are both greatly enhanced. Although we don’t know for certain what causes ovarian cancer and thus can’t entirely prevent it, maintaining a positive, optimistic attitude can absolutely help in the treatment progress.

Most importantly, Professor Ngan reminds us to keep up with regular gynecological check-up and talk to your doctor about an ovarian exam if you have concerns. The most common tests include a blood test to detect CA125 levels and a vaginal ultrasound to check for tumours, both of which could save your life. If ovarian cancer is detected and treated early, the risk of recurrence can be reduced to as little as 20%, and your road to recovery made much easier.