Ovarian cancer, known as a “silent killer”

Source: The post ovarian cancer, known as a “silent killer” has been created, based on the article “Understanding ovarian cancer: its causes, symptoms, and screening methods” published in “The Hindu” on 11th August 2024

UPSC Syllabus Topic: GS Paper2- Issues relating to development and management of Social Sector/Services relating to Health

Context: The article discusses ovarian cancer, its vague symptoms, risk factors, and challenges in early detection. It highlights genetic links, lifestyle risks, and the lack of reliable screening tests. Raising awareness can improve early diagnosis, treatment, and survival outcomes.

For detailed information on Cancer in India: A status report read this article here

Why is ovarian cancer dangerous and hard to detect?

1. Ovarian cancer is often called a “silent killer” because its symptoms are vague and mimic common ailments.
2. Symptoms include bloating, pelvic pain, loss of appetite, feeling full quickly, and frequent urination. These symptoms are often mistaken for less serious conditions. Because of the overlap with common conditions, ovarian cancer is often diagnosed late, leading to a poor prognosis and high mortality.
3. A 2004 study showed that women with malignant ovarian cancer experienced these symptoms 20 to 30 times per month, much more severely than those without the disease.
4. In 2022, India reported 47,333 new ovarian cancer cases and 32,978 deaths, highlighting its severity.
5. Unlike breast or cervical cancer, there is no reliable screening test for ovarian cancer. The CA125 blood test is not recommended for average-risk women due to its limited accuracy. It may cause false positives and unnecessary treatments.
6. There are two main subtypes: type I and type II. Type I tumors are less common and usually detected early with a better prognosis. Type II tumors are more common, aggressive, and diagnosed late, contributing to most ovarian cancer deaths.

How do genetics and lifestyle factors influence ovarian cancer risk?

1. Genetics: Ovarian cancer is highly heritable, with 65-85% of hereditary cases linked to BRCA1 and BRCA2 gene mutations. Women with BRCA1 mutations have up to a 50% risk, while BRCA2 mutations pose a 15% risk.
2. Genetic Testing: Genetic testing allows for personalized risk management, including tailored clinical surveillance, chemoprevention, and prophylactic surgeries, which help reduce ovarian cancer risk in high-risk women.
3. Endometriosis: Women with endometriosis, a condition where tissue similar to the lining of the uterus grows outside it, have a slightly increased risk of developing specific types of ovarian cancer, such as endometrioid and clear-cell cancers. However, this risk is generally low, and drastic measures like removing the ovaries and fallopian tubes (bilateral salpingo-oophorectomy) are not usually recommended solely to prevent ovarian cancer in these cases.
4. Lifestyle Factors: Use of talcum powder and chemical hair products like dyes and relaxers may increase ovarian cancer risk. Hormone Replacement Therapy (HRT) also raises the risk, even with less than five years of use. More research is needed to confirm these links, especially regarding modern talcum powders and hair products.

What Should be Done?

1. Awareness of ovarian cancer’s risk factors, symptoms, and genetic links can lead to earlier detection and better treatment.
2. Personalized risk management and genetic counseling can reduce the likelihood of developing the disease.

Question for practice:

Discuss why ovarian cancer is considered dangerous and challenging to detect, and how genetics and lifestyle factors influence the risk of developing the disease.