Managing ovarian cancer in young women

Women aged 55 to 63 are most likely to get ovarian cancer, but it can also occurs in younger women. About one-third of cases are in women under 55, and 1 in 10 are under 45. Younger women face unique challenges, such as impacts on careers, children, and future family planning. Fortunately, they often have better long-term outcomes with the most common type of ovarian cancer compared to older women.

Why ovarian cancer happens: Ovarian cancer is more common after menopause. The exact cause is often unknown, but risk factors include:

• Being overweight or obese

• Smoking

• Having children later, or not having children

• Previous breast cancer

• A family history of ovarian, breast, or colorectal cancer

• Inherited cancer syndromes

About 25% of ovarian cancers are linked to inherited gene variants. These genes can increase cancer risk and are inherited from parents. Talk to your doctor if you have a family history or genetic concerns.

Symptoms and diagnosis: Symptoms of ovarian cancer can include unusual vaginal discharge, bloating, loss of appetite, feeling full quickly, abdominal or back pain, frequent or urgent urination, and constipation. Persistent symptoms for more than two weeks should be discussed with a doctor.

Diagnosis involves reviewing medical history, performing a pelvic exam, and conducting tests like ultrasounds, CT scans, MRIs, laparoscopy, biopsies, and blood tests.

Types and stages of ovarian cancer: Most ovarian cancers (epithelial cancers) start on the ovary's surface and are less common in younger women. Other types affecting younger women include:

• Borderline tumours: slow-growing, treated with surgery only.

• Germ cell tumours: start in egg cells, often treated with surgery and chemotherapy.

• Granulosa and Sertoli-Leydig cell tumours: rare, develop in supportive ovarian tissue, usually treated with surgery and sometimes chemotherapy.

Treatment for younger women: Treatment typically involves surgery, possibly including a hysterectomy (removal of the uterus, ovaries, and fallopian tubes) and chemotherapy. For less advanced cancers, fertility-sparing surgery may be possible. This involves removing only one ovary and fallopian tube, allowing for future pregnancies. If fertility-sparing surgery is not an option, freezing eggs or embryos before treatment can preserve fertility.

Some chemotherapy can induce early menopause, so discussing fertility preservation options with specialists is crucial.

Other considerations for younger women: Younger women with ovarian cancer may face financial, career, and family concerns. Social workers can provide financial assistance and work-related support. Communicating simply and honestly with children about the diagnosis helps them cope. Counselling for the patient and family can be beneficial.

Keeping open lines of communication with loved ones and seeking support from those in similar situations can ease the emotional burden. Remember, everyone's coping mechanisms are different, so be patient and seek help when needed.