Ovarian Cancer: Early Detection to Treatment with Critical Illness Insurance

Ovarian cancer is a primary cause of death in women diagnosed with gynaecological cancers. According to the National Library of Medicine^[1], it is the fifth most frequent cause of death.

We provide a thorough summary of all the important facts on this dangerous malignancy, including risk factors, symptoms and treatment.

What is ovarian cancer?

This gynaecological cancer originates in one or both ovaries or nearby regions, such as the peritoneum and fallopian tubes. Rapid cell division causes the cells to infiltrate and kill healthy tissue. The ovaries are located in the pelvis, on either side of the uterus. They function to produce eggs and female hormones for reproduction.

There are three main types of ovarian cancers:

• Epithelial ovarian carcinomas.

• Clear cell carcinoma.

• Mucinous neoplasms.

 

Ovarian cancer vs cervical cancer

Ovarian and cervical cancer both affect the female reproductive system. Nonetheless, they have distinct risk factors, symptoms, treatments, and survival rates, in addition to having different origins in various reproductive organs.

Ovariancancer originates in the ovaries. On the other hand, cervical cancer originates in the cervix, the small region at the bottom of the uterus that connects the vaginal end.

Ovarian and cervical cancers can have similar symptoms. However, in contrast to cervical cancer, ovarian cancer presents several additional signs.

Ovarian cancer in Malaysia

According to the Summary of Malaysia National Cancer^[2], cervical cancer ranks third among cancers that affect women. The age group of 70-74 had the most significant incidence in 2012–2016, following a pattern similar to 2007-2011.

A woman’s lifetime risk is about 1 in 144, and according to ethnicity, approximately 1 in 194 for Malays, 1 in 129 for Chinese, and 1 in 157 for Indians. 

Moreover, the Global Cancer Observatory^[3] found that cervix uteri cancer (6.8%) was also the most common and highest-ranking cancer among Malaysian women in 2020.

One of the several causes is a lack of knowledge about the signs, symptoms, and risk factors of ovarian cancer, which can cause people to delay getting help. To support this, a study^[4] concluded that Malaysian women had little awareness of the risk factors for ovarian cancer. 

Ovarian cancer symptoms

The following are the symptoms of ovarian cancer:

• Abdominal bloating or swelling.

• Bloating or difficulty eating.

• Weight loss.

• Pelvic or abdominal discomfort.

• Constipation or diarrhoea.

• Frequent urination.

• Vaginal bleeding after the menopause.

• Irregular menstruation.

 

As signs of ovarian cancer sometimes don't appear until later stages, detection can occasionally be challenging. Hence, knowing the body's typical spectrum of functioning is essential. 

Ovarian cancer staging

To stage ovarian cancer, the International Federation of Gynaecology and Obstetrics (FIGO) approach is frequently employed. This approach considers the tumour's size and its spread to nearby lymph nodes and distant organs.

Stages of ovarian cancer range from I to IV:

• Stage I: The cancer is in the ovary or fallopian tubes and has not progressed to nearby lymph nodes or distant organs.

• Stage II: The cancer has spread to other organs, including the uterus, bladder, sigmoid colon, or rectum. It is not present in distant organs or nearby lymph nodes.

• Stage III: The cancer has spread outside the pelvis to the peritoneum and the lymph nodes in the back of the abdomen.

• Stage IV: The cancer has progressed to other organs, including the lungs and liver.

 

Ovarian cancer causes and risk factors

The specific causes that lead to ovarian cancer are complexly intertwined.

Ovarian cancer is linked to several risk factors. The majority of those affected are postmenopausal women. Also, as a woman's age increases, so does the cancer’s incidence and stage.

Certain mutations are the biggest risk factor for ovarian cancer. Most frequently, Lynch syndrome-causing mutations in breast cancer susceptibility genes 1 and 2 (BRCA1 and BRCA2).

You may be more susceptible to ovarian cancer if there is a history of the disease in your family. There may be a modest increase in risk for women who have previously had breast cancer.

An increased risk of ovarian cancer is linked to reproductive variables, such as the use of oral contraceptives or first-time mothers who become pregnant beyond the age of 35.

Other risk factors include:

• Hormone replacement therapy (HRT), namely on estrogen without progesterone

• Endometriosis or diabetes

• Obesity

• Periods being before 12 years old and late menopause

• Smoking

• Had radiotherapy treatment for a prior cancer.

 

Diagnosis of ovarian cancer

Diagnostic tests for ovarian cancer include:

Blood tests

Women who have ovarian cancer have their blood tested to determine the amount of a protein called CA-125. Elevated CA-125 levels have been linked to cancer. However, CA-125 levels can be normal or even higher in many non-cancerous diseases, even when cancer is present.

For this reason, doctors may combine blood testing with other diagnostic tests.

Imaging tests

Imaging tests can be utilised to detect ovarian cancer and evaluate the extent, location, and growth of tumours.

Standard imaging tests for ovarian cancer include:

• Computed tomography (CT) scan

• Pelvic ultrasound

• Magnetic resonance imaging (MRI)

• Positron emission tomography (PET) scan

• Transvaginal ultrasound (TVUS)

 

Additionally, a biopsy and blood tests are frequently combined with imaging tests to confirm the diagnosis and choose the optimal course of treatment.

Laparoscopic surgery

Doctors make a conclusive diagnosis of ovarian cancer during a surgery called a laparoscopy, which is used to detect abnormal growths, confirm the existence of ovarian cancer, and identify its stage.

The surgeon inserts a thin, lit tube with a camera (laparoscope) through a tiny incision created in the abdomen. It allows a surgeon to visually examine and explore the pelvic and abdominal cavities, ovaries, fallopian tubes, uterus, peritoneum, and surrounding tissues.

The surgeon may take small tissue samples (biopsies) for further examination if abnormal lesions or masses are found. Sometimes, if a tumour is located and can be removed, the doctor will do it immediately during the surgery.

Ovarian cancer treatment

The precise treatment plan depends on various factors, including the stage of the tumour, the type of ovarian cancer, the patient's general health, and personal preferences.

Common ovarian cancer treatments include:

Chemotherapy

Chemotherapy kills cancer by using medications. Since the medications are administered systemically, they permeate almost the whole body through the bloodstream. Chemotherapy can help reduce the size of larger tumours to facilitate surgery and eradicate small numbers of cancer cells that could remain after surgery or cancers that have metastasised.

Chemotherapy is usually administered via injection into a vein orally. In certain instances, chemotherapeutic agents may also be administered intraperitoneally (IV) using a catheter.

Radiation therapy

In radiation therapy, malignant cells are killed by high-energy X-rays or particles. If other treatments are not suitable, radiotherapy is an option to treat advanced cancer and relieve symptoms, including pain, bleeding, or discomfort.

Surgery

For most ovarian cancers, surgery is the primary treatment. How much surgery you need depends on the extent of the cancer's spread and your overall condition.

There are two types of surgery:

• Debulking surgery: Eliminate the tumour as much as possible. The uterus, fallopian tubes, ovaries, abdominal and pelvic visible tumours, and surrounding lymph nodes may all be removed.

• Staging surgery: Performed to measure the spread of cancer. The surgeon evaluates the peritoneal cavity, obtains tissue samples for biopsies, and looks for evidence of metastases in nearby organs.

 

Hormone therapy

Since most ovarian cancers are not hormone-sensitive, hormone therapy is not a common treatment. However, some uncommon forms of ovarian cancer require estrogen.

That being said, with hormone therapy, estrogen synthesis may be inhibited, and cancer development can be stopped.

Precision medicine

Precision medicine is a personalised genomic medicine that considers each person's unique genetics, environment, and behavioural differences. This, in turn, helps medical professionals diagnose ovarian cancer more accurately and treat patients with individualised care and treatment plans.

Ovarian cancer survival rate

A study^[5] result indicated that the overall five-year survival probability of ovarian cancer was 35.2%, with a median survival period of 38 months.

Can ovarian cancer be prevented?

While it is impossible to predict who will get cancer, the following cancer prevention measures may help lower the chance of ovarian cancer:

• Long-term oral contraceptive use

• Tubal ligation

• Hysterectomy, if you have gene mutations and a family history of ovarian cancer. However, this is a drastic preventive measure.

• Breastfeeding your child if you have given birth

• Healthy lifestyle, including balanced meals, exercising and getting adequate rest, amongst other things.

 

Regular gynaecological screenings

Insurance solutions for ovarian cancer

There are times when the unfortunate still happens despite preventive measures being taken. As such, it is vital to be prepared. One way to fight cancer is to ensure that you have insurance and thus allow you access to the treatment needed.

Prudential's PRULady is a critical illness insurance for women that provides coverage for gender-specific illness, fertility care, wellness care and recovery, pregnancy care and baby care.

If you are diagnosed with female carcinoma-in-situ, the payout will be 50% of the Basic Sum Assured. You will get 100% of the Basic Sum Assured if the condition worsens and it is confirmed that you are diagnosed with ovarian cancer after 6 months from the diagnosis date of carcinoma-in-situ.

The amount paid out can be used for your medical expenses and hospital bills and to cover loss of income while you're undergoing treatment.

Furthermore, PRULady covers Recovery, Wellness Care, Fertility Care, Pregnancy Care and Baby Care, and offers Cash Rewards for Life Celebration Benefit from 10 Life Milestones up to a maximum of 9% of the Basic Sum Assured.

How does insurance help with the early detection of ovarian cancer?

Health insurance can be quite helpful in enabling the early identification of ovarian cancer by covering a range of diagnostic and preventative services. If diagnosed with cancer, it ensures that the policyholder is provided with the finances needed for treatment and recovery.

However, it is imperative to understand the specifics of a health insurance plan - what it covers, the terms and conditions and the premiums to be paid, among others. To do this, speak to one of our team at Prudential.

Conclusion

Ovarian cancer awareness is essential so that the disease can be detected early. Critical illness insurance can help with the early detection of gynaecological cancers and provide access to treatments to fight these cancers.

Another serious condition that affects women is breast cancer. Understanding breast cancer's many forms, symptoms, stages, treatments, and recuperation processes is essential. The reason for this is that the likelihood of a successful treatment increases with the early discovery of breast cancer.

Check out Prudential's wide range of insurance solutions and financial products that will protect you if something unfortunate occurs:

Insurance for Young Adults | Investment-linked Life Insurance | Medical Insurance | Critical Illness Insurance | Insurance for Mother & Child

References

^[1] Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment (PDQ®). Available at https://www.ncbi.nlm.nih.gov/books/NBK66007/

^[2] The Summary of Malaysia National Cancer. Available at https://www.moh.gov.my/moh/resources/Penerbitan/Laporan/Umum/2012-2016%20(MNCRR)/Summary_MNCR_2012-2016_-_06112020.pdf

^[3] The Global Cancer Observatory. Available at https://gco.iarc.fr/today/data/factsheets/populations/458-malaysia-fact-sheets.pdf

^[4] Awareness of ovarian cancer risk factors among women in Malaysia: a preliminary study. Available at https://pubmed.ncbi.nlm.nih.gov/25684484/

^[5] Survival study and prognostic factors of ovarian cancer registered in a teaching hospital in Malaysia. https://doi.org/10.17576/jsm-2017-4604-07