One woman dies every 48 hours from ovarian cancer in New Zealand. That makes it our fifth-deadliest female cancer and more lethal than melanoma or our annual road toll. To add to that figure, five to seven women are diagnosed with ovarian cancer in New Zealand every week.
Sadly, 85% of ovarian cancer is often diagnosed in the later stages when treatment is more difficult. However, if you know the symptoms well enough to access early treatment, your chance of making a full recovery is excellent.
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Ovarian cancer detected at stage one increases your five-year survival rate to more than 90%. A diagnosis at stage four will see your five-year survival rate plummet to less than 14%.
Cervical smears do not screen for ovarian cancer, and there is no other national screening programme available in New Zealand.
What is ovarian cancer?
Ovaries form part of the female reproductive system. They are almond-sized glands located on each side of the uterus and connected to the fallopian tubes. Ovaries produce the hormones oestrogen and progesterone. They also produce, store, and release an egg each cycle for possible fertilisation.
Ovarian cancer develops when cells in the ovaries begin to grow and multiply uncontrollably. These abnormal cells can develop into solid tumours or tissue masses and eventually spread into other areas of the body, such as the pelvis and abdomen.
Types of ovarian cancer
There are four main types:
- Epithelial cancer begins on the lining of the ovary. It’s responsible for around 90% of ovarian cancers and is especially common after menopause.
- Germ cell cancer begins in cells that would normally develop into eggs. It is more common among women aged 20-30 and is responsible for around 10% of ovarian cancers.
- Stromal cancer begins in the ovarian cells, which make hormones. Stromal cancer Is relatively rare.
- Primary peritoneal cancer is also rare. It begins growing in the pelvic cavity, and can even develop if the ovaries have been removed.
Ovarian cancer symptoms
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Many patients and doctors miss the early symptoms of ovarian cancer because they seem relatively minor or resemble other problems.
Early diagnosis is vital; make sure you seek medical advice for any of the following:
- Pain or discomfort in the abdomen or pelvis
- Bloating (persistent) or increased size of the abdomen
- Pressure in the pelvic or lower back region
- Frequent urination
- Unexplained weight loss
- Unusual fatigue
- Changes in bowel habits - loose bowels or constipation
- Irregular menstrual cycle.
If any of the above signs of ovarian cancer are persistent, severe, and unusual for you, see your doctor as soon as possible.
What causes ovarian cancer?
We do not know exactly what causes this disease, though there are certain factors that may increase your risk. They include:
- A family history of cancer - such as ovarian, breast, and colon cancers.
- Age - Ovarian cancer can affect women of any age, however, the statistics increase with maturity.
- Excess weight increases your risk of developing ovarian cancer.
- Hormone therapy - for example, using oestrogen after menopause.
- Previous breast cancer.
Smoking, having few pregnancies, or being pregnant late in life may also add to your risk of developing ovarian cancer.
How is ovarian cancer diagnosed?
Your doctor will start with a pelvic examination to check for abnormalities in the vagina, ovaries, and fallopian tubes. Unfortunately, most cancers detected in this way will already be at an advanced stage.
Most doctors will also recommend the following tests:
- Ultrasound - a probe placed in your vagina produces sound waves that bounce off the internal walls. The patterns are then recreated as diagnostic images. Although this test can detect tumours or cysts, it is not 100% conclusive.
- CA-125 blood test - the CA-125 protein may increase in the presence of a cancer tumour, but it, too, is not 100% reliable.
- CT scan - produces detailed images of the body and can show how far the cancer has spread.
On their own, these tests are not conclusive, so they should be used together. The only truly reliable way to test for ovarian cancer is through a biopsy (surgical removal of tissue samples for testing).
You should be aware that if your blood tests and pelvic examination are normal, then the government may not pay for your ultrasound.
Poor funding in New Zealand's public health system means patients are often missing out on the essential diagnostic testing required to identify cancer early enough to be treated. A 2019 New Zealand survey indicates that just 25% of ovarian cancer patients were diagnosed within one month of their first visit to a doctor. This is less than half the diagnostic rate in Australia.
Stages of ovarian cancer
Once a diagnosis has been made, your cancer will be classified according to its size and spread. This is known as staging. Doctors also use this information to guide the treatment process.
- Stage I - cancer cells have not spread beyond the ovary or ovaries.
- Stage II - cancer cells are in one or both ovaries and have spread to other organs in the pelvic region, such as the fallopian tubes, bladder, and rectum.
- Stage III - as in stage II but the cancer has also spread to the abdominal lining or lymph nodes.
- Stage IV - cancer has spread to other parts of the body, such as the lungs, liver, and spleen.
Your medical team will also grade the tumour based on its appearance under a microscope when compared with normal cells. The grades range from 1 (slowly growing, and similar to healthy cells) to 3 (fast-growing, and with a very different appearance from healthy cells).
Ovarian cancer treatment
Your medical team will recommend various ovarian cancer treatment options, depending on the stage and grade of your tumours, and will also consider your age, health, and personal preferences.
- Surgery - doctors attempt to remove as much cancer as possible. This may require the removal of the ovaries, fallopian tubes, uterus, lymph nodes, and sometimes even part of the bowel.
- Chemotherapy - uses powerful drugs to eliminate cancer cells. Chemotherapy is used to clean up any missed cells after surgery and when surgery is not appropriate.
- Radiation therapy - usually used only when ovarian cancer is restricted to the pelvic region.
Is there a cure for ovarian cancer?
Survival rates for most ovarian cancers are typically low. The survival rate describes the portion of people who are still alive at a given time period after being diagnosed. The survival rate is only an estimate. It is not a prediction of how long one can live, it only provides an idea of the likelihood of your treatment’s success.
The relative 5-year survival rates for ovarian cancer in New Zealand are:
- Stage 1: 90%
- Stage 2: 55%
- Stage 3: 22%
- Stage 4: 6%
The chance of ovarian cancer returning is also high. The overall survival rate for New Zealand women with ovarian cancer is around 36%. For women in Australia, it sits around 43%. The better outcomes in Australia seem to be mostly because of better, faster access to diagnostics and the public funding of more effective drugs than are available to Kiwis.
Are you prepared for life’s uncertainties?
You may not have cancer and it may not even run in your family but that’s no guarantee it won’t happen to you or someone you love. Remember, ovarian cancer isn’t restricted by family genetics.
You need to think about how health insurance can cover you for that possibility. And not all Health insurance plans are the same. Some plans only pay for a tiny fraction of your cancer treatment expenses.
Don’t let this happen to you. Ask your Policywise insurance adviser about policies that include cancer cover. Make sure you consider maximum benefit amounts for treatments, non-Pharmac cover, inclusions, and any exclusions.
Some health insurance policies also include additional consultations with specialists who can offer second opinions and additional advice about your treatment plans. That’s priceless when dealing with all the questions that come up after your meeting with the specialist.
We provide clear, easy-to-understand plan comparisons from different insurers so you can choose the plan with the best cancer cover. Schedule a 5-minute callback with a Policywise expert. Our service is free to you