Ovarian cancer

Question 1

What is the epidemiology of ovarian cancer?

Answer 1

600 cases/year in Scotland
400 deaths/year in Scotland
30% 5 year survival

Rare <30y
HNPCC/Lynch T1, BRCA1/2

Question 2

What are ovarian cancer symptoms?

Answer 2

Vague
Indigestion/satiety/poor appetite
Altered bowel habit/pain
Bloating and discomfort
Weight gain
Pelvic mass
-Asymptomatic
-Pressure symptoms

Question 3

How is ovarian cancer diagnosed?

Answer 3

Surgical/pathological
USS of abdomen and pelvis
CT scan
Cancer antigen 125 (normally up to 300)

Question 4

What is CA 125?

Answer 4

Glyco-protein antigen
Malignancy 
-Ovary (80%)
-Colon
-Pancreas
-Breast
Benign conditions
-Menstruation/ endometriosis/ PID
-Liver disease/ recent surgery/ effusions

Question 5

What is the Risk of Malignancy Index (RMI)?

Answer 5

RMI = U x M x CA125
U = USS score 
M = Menopausal status

Question 6

What is the staging of ovarian cancer?

Answer 6

1 = limited to ovaries
2 = one or both ovaries with pelvic extension
3 = one or both with implants outside the pelvis or nodes
4 = distant mets

Question 7

What is the treatment of ovarian cancer?

Answer 7

Surgery
Chemo
-Adjuvant
-Neo-adjuvant

Question 8

What is done in ovarian cancer laparotomy?

Answer 8

Obtain tissue diagnosis
Stage disease
Disease clearance
Debulk diseases

Question 9

What happens in ovarian cancer chemo?

Answer 9

First line with taxol
Within 8weeks of surgery
Complete/partial response
Cure unlikely
Average response is 2 years

Question 10

What are the cure rates of ovarian cancer?

Answer 10

1 = 85%
2 = 47%
3 = 15%
4 = 10%

Question 11

What is ovarian cancer screening?

Answer 11

Population screening not proven
High risk
-Cancer gene mutation carriers
-2 or more relatives
Pelvic examination
US of ovaries
CA125

Not recommended, limited sensitivity and specificity