Content Supplied by NHS Choices

Ovarian cancer

In the UK, around 7,100 women are diagnosed with ovarian cancer each year. It's the fifth most common cancer among women.

In the UK, around 7,100 women are diagnosed with ovarian cancer each year.

It's the fifth most common cancer among women after breast cancer, bowel cancerlung cancer and cancer of the uterus (womb).

Ovarian cancer is most common in women who have been through the menopause (usually over the age of 50), although it can affect women of any age.

As the symptoms of ovarian cancer can be similar to those of other conditions, it can be difficult to recognise. However, there are early symptoms to look out for, such as persistent bloating, pain in the pelvis and lower stomach, and difficulty eating.

It's important to see your GP if you experience these symptoms, particularly over a long period of time. Read more about how ovarian cancer is diagnosed.

The ovaries are a pair of small organs in the female reproductive system that contain and release an egg once a month. This is known as ovulation.

Different types of ovarian cancer affect different parts of the ovaries. Epithelial ovarian cancer, which affects the surface layers of the ovary, is the most common type. This topic focuses on epithelial ovarian cancer.

What causes ovarian cancer?

The exact cause of ovarian cancer is unknown, but certain things are thought to increase a woman's risk of developing the condition, such as age, the number of eggs the ovaries release and whether someone in your family has had ovarian or breast cancer in the past. However, only 1 in 10 cases of ovarian cancer has a genetic link.

Read more about the causes of ovarian cancer.

Treating ovarian cancer 

The treatment you receive for ovarian cancer will depend on several things, including the stage of your cancer and your general health. Chemotherapy is the main treatment for ovarian cancer, but your treatment will usually involve a combination of surgery and chemotherapy.

Read more about how ovarian cancer is treated.

Overall, 72 out of every 100 women (72%) will live for at least one year after being diagnosed with ovarian cancer. Around 46 out of 100 (46%) women will live for at least five years, and about 35 out of 100 (35%) will live for at least 10 years. However, women with advanced ovarian cancer have a poorer survival rate.

As with most types of cancer, the outlook for ovarian cancer will depend on the stage it's at when diagnosed  that is, how far the cancer has advanced. The Cancer Research UK website has more information about the outlook for ovarian cancer.

Being diagnosed with ovarian cancer can affect daily life in many ways. However, support is available for many aspects of living with ovarian cancer, including emotional, financial and long-term health issues.

Ovarian cancer screening

There are methods of screening for ovarian cancer but, currently, they haven't been fully tested. Screening is only available for women who are at high risk of developing the condition due to a strong family history or inheritance of a particular faulty gene. Clinical trials in the UK are currently being carried out to assess the effectiveness of screening in high-risk women and in the general population. A cervical screening test, which used to be called a smear test, can't detect ovarian cancer.

Read more about preventing ovarian cancer.

Content Supplied by NHS Choices

Ovarian cancer

The symptoms of ovarian cancer can be difficult to recognise, particularly in the condition's early stages.

The symptoms of ovarian cancer can be difficult to recognise, particularly in its early stages.

This is because they are often the same as symptoms of other less serious conditions, such as irritable bowel syndrome (IBS) or pre-menstrual syndrome (PMS).

However, three main symptoms are more frequent in women diagnosed with ovarian cancer. They are:

  • increased abdominal size and persistent bloating (not bloating that comes and goes)
  • persistent pelvic and abdominal pain
  • difficulty eating and feeling full quickly, or feeling nauseous

Other symptoms, such as back pain, needing to pass urine more frequently than usual, and pain during sex may be the result of other conditions in the pelvic area. However, they may be present in some women with ovarian cancer.

If you have these types of symptoms, try keeping a diary to record how many of these symptoms you have over a longer period. Bear in mind that ovarian cancer is rare in women under 40 years of age.

See your GP if you have these symptoms regularly (on most days for three weeks or more). Although it's unlikely they're being caused by a serious problem, it's best to check.

If you've already seen your GP and the symptoms continue or get worse, you should go back and explain this. You know your body better than anyone.

Want to know more?

Content Supplied by NHS Choices

Ovarian cancer

Several possible causes of ovarian cancer have been identified, along with risk factors that may make developing the condition more likely.

Several possible causes of ovarian cancer have been identified, along with risks that may make developing the condition more likely.

Cancer begins with a change (mutation) in the structure of the DNA in cells, which can affect how they grow. This means that cells grow and reproduce uncontrollably, producing a lump of tissue called a tumour.

In ovarian cancer, cells in the ovary start to change and grow abnormally. If the cancer isn't identified at an early stage, it can spread to the abdomen and pelvis, including other parts of the female reproductive system.

Increased risk

The exact cause of epithelial ovarian cancer (the main type) isn't known, but certain things may increase your risk of developing it.

Age

Your risk of ovarian cancer increases with age, with most cases occurring after the menopause. More than 8 out of 10 cases of ovarian cancer occur in women who are over 50 years of age.

Family history

If you have two or more close relatives (mother, sister or daughter) who developed ovarian cancer or breast cancer, your risk of also developing the condition may be increased.

If your relatives developed cancer before the age of 50, it's more likely it was the result of an inherited faulty gene. BRCA1 and BRCA2 are faulty genes that are linked to ovarian cancer. They're also known to increase the risk of breast cancer.

Having relatives with ovarian cancer doesn't mean you definitely have a faulty gene in the family  the cancer could have happened by chance. Only 1 in 10 (10%) of ovarian cancers are thought to be caused by a faulty gene.

You may be at a high risk of having a faulty gene if you have:

  • one relative diagnosed with ovarian cancer at any age and at least two close relatives with breast cancer whose average age is under 60; all of these relatives should be on the same side of your family (either your mother's OR father's side)
  • one relative diagnosed with ovarian cancer at any age and at least one close relative diagnosed with breast cancer under the age of 50; both of these relatives should come from the same side of your family
  • two relatives from the same side of the family diagnosed with ovarian cancer at any age 

If you're at a higher risk of having a faulty gene, your GP can refer you for tests to check for faulty BRCA1 and BRCA2 genes.

Ovulation and fertility

Every time an egg is released into the reproductive system, the surface of the ovary breaks to let it out. The surface of the ovary is damaged during this process and needs to be repaired. Each time this happens, there's a greater chance of abnormal cell growth during the repair. 

This may be why the risk of ovarian cancer decreases if you take the contraceptive pill, or have multiple pregnancies or periods of breastfeeding. At these times, eggs aren't released.

There's no strong evidence to show that women who have infertility treatment have an increased risk of developing ovarian cancer. However, it's thought that infertility itself may increase ovarian cancer risk and research into this area is being carried out. 

Hormone replacement therapy (HRT)

Women who take hormone replacement therapy (HRT) have been shown to have a small increased risk of developing ovarian cancer. However, if HRT is stopped, after five years the risk is reduced to the same level as women who've never taken HRT.

Endometriosis

Endometriosis may also increase your risk of ovarian cancer. In endometriosis, the cells that usually line the womb grow elsewhere in the body.

These endometrial cells behave as if they were in the womb, so thickening and bleeding that usually occurs during menstruation occurs in other parts of the body. There's no way for this endometrial tissue to leave the body so it becomes trapped, leading to pain, swelling and bleeding in that area.

More information 

Content Supplied by NHS Choices

Ovarian cancer

See your GP as soon as possible if you have symptoms of ovarian cancer. They will gently feel your tummy and ask about your symptoms, general health and family history.

See your GP as soon as possible if you have any symptoms of ovarian cancer.

Your GP will gently feel your tummy (abdomen) and ask you about your symptoms, general health and whether there's a history of ovarian or breast cancer in your family.

They may carry out an internal examination and may take a blood sample or refer you for an ultrasound scan.

If needed, you may also be referred to a specialist (a gynaecologist or gynaecological oncologist) at a hospital.

In 2015, the National Institute for Health and Care Excellence (NICE) published guidelines to help GPs recognise the signs and symptoms of ovarian cancer and refer people for the right tests faster. To find out if you should be referred for further tests for suspected ovarian cancer, read the NICE 2015 guidelines on Suspected Cancer: Recognition and Referral.

Blood test (CA125)

You may have a blood test to look for a protein called CA125 in your blood. CA125 is produced by some ovarian cancer cells. A very high level of CA125 may indicate that you have ovarian cancer.

However, CA125 isn't specific to ovarian cancer and it can be raised in conditions including endometriosisfibroids, pelvic inflammatory disease and pregnancy, so a raised CA125 level doesn't definitely mean you have ovarian cancer.

The Lab Tests Online UK website has more information on the CA125 test.

The National Institute for Health and Care Excellence (NICE) has produced guidance that recommends testing for CA125 if you frequently experience: 

  • bloating
  • feeling full quickly and/or loss of appetite 
  • pelvic or abdominal pain 
  • needing to urinate urgently and/or frequently  

Read the full NICE guidance about the recognition and initial management of ovarian cancer (PDF, 179kb).

If you experience unexplained weight loss, fatigue or changes in your bowel habits, such as diarrhoea or constipation, you may also be tested for CA125.

If you're 50 or over and you've experienced symptoms that could suggest irritable bowel syndrome (IBS) in the last 12 months, such as bloating, abdominal pain or changes in your bowel habits, your GP should test your CA125 level.

Around half of all women with early stage ovarian cancer have a raised level of CA125 in their blood. If your CA125 level is raised, you'll be referred for an ultrasound scan.

Ultrasound scan

An ultrasound scan uses high-frequency sound waves to create an image of your ovaries. You may have an internal ultrasound where the ultrasound probe is inserted into your vagina, or you may have an external ultrasound, where the probe is put next to your stomach.

The image produced can show the size and texture of your ovaries, plus any cysts or other swellings that are present.

Further tests

If you've been diagnosed with ovarian cancer, you may have further tests to see how large the cancer is and if it's spread. This is called staging.

Other tests you may have include:

  • a chest X-ray
  • a CT scan or MRI scan
  • abdominal fluid aspiration  a thin needle is passed into your abdomen, so that a fluid sample can be taken and tested for cancerous cells 
  • laparoscopy  a thin tube with a camera on the end is inserted through a small incision in your lower abdomen, so that your ovaries can be examined; a small tissue sample may also be taken from your ovaries for testing (a biopsy)

Staging helps your doctors to decide on the best kind of treatment for your condition. However, it's important to remember that the stage of your ovarian cancer alone cannot predict how your condition will progress.

The Cancer Research UK website has more information on further tests for ovarian cancer.

Stages and grades of ovarian cancer

Staging

If your test results indicate that you have ovarian cancer, it will be given a stage. The stage describes the size of the cancer and how far it has spread. The four commonly used stages of ovarian cancer are:

  • stage 1  where the cancer only affects one or both of the ovaries
  • stage 2  where the cancer has spread from the ovary and into the pelvis or womb
  • stage 3  where the cancer has spread to the lining of the abdomen, the surface of the bowel and the lymph nodes in the pelvis
  • stage 4  where the cancer has spread to other parts of the body, such as the liver, spleen or lungs 

This is a simplified guide. Each stage is further divided into categories A, B and C. Ask your doctor if you're not sure what stage you have.

Grading

The grade of cancer refers to the appearance of cells under a microscope. The grades are as follows:

  • low grade  although abnormal, cells appear to be slow-growing
  • moderate grade  cells look more abnormal than low-grade cells
  • high grade  cells look very abnormal and are likely to be fast-growing

The Cancer Research UK website has more information on the stages and grading of ovarian cancer.

Content Supplied by NHS Choices

Ovarian cancer

If you have cancer, a team of specialists will work together to provide you with the best possible treatment and care. This is known as a multidisciplinary team.

Surgery

Most women with ovarian cancer will be considered for surgery. It sometimes isn't possible to confirm the stage of the cancer until surgery is carried out.

Your doctor will discuss what will happen during surgery. It will probably involve removing:

  • both ovaries and the fallopian tubes (a bilateral salpingo-oophorectomy)
  • the womb (a total abdominal hysterectomy)
  • the omentum a fatty layer of tissue within the abdomen (an omentectomy)

The surgeon may also remove the lymph nodes from your pelvis and abdomen, and samples of nearby tissue, to find out whether the cancer has spread.

If it has spread, the surgeon will try to remove as much of it as possible. This is known as "debulking surgery".

If the cancer is confined to one or both ovaries, you may only need to have the ovary or ovaries removed, leaving your womb intact. This means you may still be able to carry a pregnancy.

You will probably be ready to go home three to seven days after your operation, but it can take many weeks to fully recover.

When you go home, you'll need to exercise gently to build up your strength and fitness. Walking and swimming are good exercises that are suitable for most people after treatment for ovarian cancer. Discuss the types of exercise that are suitable for you with your doctor or physiotherapist.

Want to know more?

Chemotherapy

Chemotherapy involves using anti-cancer (cytotoxic) medication to kill cancer cells. It's often given after surgery for ovarian cancer. In some cases, it can be given before surgery to help shrink the tumour and make it easier to remove. This is called "neoadjuvant chemotherapy".

Several different medicines can be used in chemotherapy. A combination is often given. The choice of medicine and how and when it's given depends on the stage of your cancer and how much it has spread. The most common treatment for ovarian cancer is a platinum-containing medicine (carboplatin), which is used alone or in combination with another medicine called paclitaxel.

Chemotherapy is usually given as a drip into the vein, but is sometimes given as tablets. Some studies have looked at giving chemotherapy directly into the abdomen called "intraperitoneal chemotherapy". It is not currently established routine practice in the UK, but it's being assessed in clinical trials.

You will usually have chemotherapy as an outpatient, but you may sometimes need a short stay in hospital. It's usually given in cycles, with a period of treatment followed by a period of rest, to allow the body to recover. Most women have six cycles of chemotherapy.

Is chemotherapy working?

Over the course of your chemotherapy, you'll have tests to monitor how the cancer is responding to treatment. This can be done in a number of ways. For example:

  • if you had higher than normal levels of the protein CA125 in your blood when diagnosed, you may have blood tests to see whether the levels are falling
  • if you had a tumour visible on a CT scan or ultrasound scan when diagnosed, you may have repeated scans to see whether it has shrunk
  • you may have another small operation, known as "second-look surgery", which is carried out in the same way as a laparoscopy

After your chemotherapy treatment, if all of your tests are clear of cancer, you'll be in remission. This means the cancer is under control.

Side effects of chemotherapy

Side effects of chemotherapy include:

  • infections
  • loss of appetite
  • nausea and vomiting
  • tiredness
  • hair loss 
  • sore mouth

Many side effects can be prevented or controlled with medicines your doctor can prescribe.

Chemotherapy for recurring cancer

Ovarian cancer can come back (relapse) after treatment. If this happens, you may have another course of chemotherapy. This is called "second-line treatment".

Want to know more?

Radiotherapy

Radiotherapy uses high energy X-rays. Like chemotherapy, it works by targeting rapidly growing cancer cells.

Radiotherapy isn't usually used to treat ovarian cancer. However, the multidisciplinary team may occasionally recommend it to treat ovarian cancer under very specific circumstances, such as treating pain and bleeding from a localised tumour mass.

Want to know more?

Clinical trials

In recent years, much progress has been made in ovarian cancer treatment. More women are living longer and experiencing fewer side effects. These advances were discovered through clinical trials, where new medicines and combinations of medicines are compared with standard treatment.

All cancer trials in the UK are subject to careful monitoring, to ensure the trial is worthwhile and safely conducted. Participants in clinical trials can often do better overall than in routine care.

If you're asked about taking part in a trial, you'll be offered an information sheet. If you wish to take part, you'll be asked to give your consent (permission) by signing a form. You're always free to refuse or withdraw from a clinical trial without it affecting your care.

Want to know more?

Psychological help

Dealing with cancer can be a huge challenge for patients and their families. It can bring emotional and practical difficulties.

It often helps to talk about your feelings or other difficulties with a trained counsellor or therapist. You can ask for this kind of help at any stage of your illness. There are various ways to find help and support. For example:

  • your hospital doctor, specialist nurse or GP can refer you to a counsellor; talk to your GP if you're feeling depressed; a course of antidepressants may help, or your GP can arrange for you to see a counsellor or psychotherapist
  • it can help to talk to someone who's been through the same thing as you; many organisations have helplines and online forums; they can also put you in touch with other people who have had cancer treatment

Want to know more?

Content Supplied by NHS Choices

Ovarian cancer

How ovarian cancer will affect your daily life depends on the stage your condition is at and what treatment you're having.

Recovery and follow-up

Many women with ovarian cancer have a hysterectomy. This is a major operation, and takes around 6-12 weeks to recover from.

During this time, you'll have to avoid lifting things, such as children and heavy shopping bags, and doing heavy housework. You won't be able to drive for 3-8 weeks after the operation. Most women need 4-12 weeks off work after a hysterectomy.

If your ovaries have been removed and you haven't already been through the menopause, you'll experience the menopause after your treatment. You may decide to take hormone replacement therapy (HRT) to control your symptoms. Your GP will help you decide what's best for you.

Some treatments for ovarian cancer, particularly chemotherapy, can make you feel very tired. You may need a break from your normal activities for a while. Don't be afraid to ask for practical help from family and friends if you need it.

Practical help may also be available from your local authority. Ask your doctor or nurse who to contact.

After your treatment has finished, you'll be invited for regular check-ups to see how well you are responding to treatments. These are usually every 2-3 months to begin with.

Want to know more?

 

Sex and relationships

Relationships with friends and family

Having cancer isn't always easy to talk about, either for you or your family and friends. You may sense that some people avoid you or feel awkward around you.

Being open about how you feel and what your family and friends can do to help may put them at ease. However, don't feel shy about telling them you need some time to yourself.

Want to know more?

Your sex life

Ovarian cancer and its treatment can affect your sex life in several ways.

Early menopause

If you haven't already been through the menopause, removing your ovaries means you'll have an early menopause. You're likely to have symptoms of the menopause, which can include vaginal dryness and loss of sexual desire.

Not feeling like sex

It's common for women to lose interest in sex after treatment for ovarian cancer. Your treatment may leave you feeling very tired, and you may feel shocked, confused or depressed about being diagnosed with cancer.

You may also feel grief about the loss of your fertility. It's understandable that you may not feel like having sex while coping with all this. Share your feelings with your partner. If your feelings about sex aren't improving with time, you may want to consider speaking to a counsellor or sex therapist.

Want to know more?

Money and benefits

If you have to reduce or stop working due to your cancer, you may find it difficult to cope financially. If you have cancer or you're caring for someone with cancer, you may be entitled to financial support. For example:

  • if you have a job but can't work because of your illness, you're entitled to statutory sick pay (SSP) from your employer 
  • if you don't have a job and can't work because of your illness, you may be entitled to employment and support allowance (ESR)
  • if you're caring for someone with cancer, you may be entitled to carer's allowance  
  • you may be eligible for other benefits if you have children living at home, or have a low household income

It's a good idea to find out as soon as possible what help is available to you. You could ask to speak to the social worker at your hospital, who can give you the information you need.

Free prescriptions

If you have cancer, you can apply for an exemption certificate, which gives you free prescriptions for all medication, including those for unrelated conditions.

The certificate is valid for five years. You can apply for it by speaking to your GP or cancer specialist.

Want to know more?

 

Dealing with dying

If you're told that nothing more can be done to treat your ovarian cancer, care will focus on controlling your symptoms and helping you feel as comfortable as possible. This is called palliative care. It also includes psychological, social and spiritual support for you and your family or carers.

Want to know more?

Content Supplied by NHS Choices

Ovarian cancer

There's currently no reliable screening test for ovarian cancer. However, there are a number of things that may help to prevent ovarian cancer.

There's currently no reliable screening test for ovarian cancer. However, there are a number of things that may help to prevent ovarian cancer.

Stopping ovulation and the contraceptive pill

Each time you ovulate, your ovaries are damaged by the egg as it breaks through the surface of the ovary and is released into your reproductive system.

The cells that make up the surface of your ovaries divide and multiply rapidly to repair the damage caused by the egg. It's this rapid cell growth that can occasionally go wrong and result in ovarian cancer.

Anything that stops the process of ovulation can help to minimise your chances of developing ovarian cancer. This includes:

Diet and lifestyle

Research into ovarian cancer has found that the condition may be linked to being overweight or obese. Losing weight through regular exercise and a healthy, balanced diet may to help lower your risk of getting ovarian cancer. Aside from this, regular exercise and a healthy, low-fat diet are extremely beneficial to your overall health, and can help to prevent all forms of cancer and heart disease.

Screening for ovarian cancer

At present, there's no screening method for ovarian cancer that is reliable enough to be used by all women in the UK. Clinical trials into this are continuing.

You may be eligible for screening if you're at high risk of developing the condition due to a strong family history, or if you've inherited a specific abnormal gene.

If you're at high risk, your GP can refer you to your local genetics service or family cancer clinic. You may be screened for ovarian cancer when you're over the age of 35, or when you're five years away from the age at which your youngest relative was diagnosed with the condition. From this point, you'll be screened again once a year.

The screening tests for ovarian cancer are the same as those routinely used to diagnose it. The tests are:

  • blood test for higher-than-normal levels of CA125 (a protein produced by cancer cells)
  • a transvaginal ultrasound  where an ultrasound probe is inserted into your vagina so that the size and texture of your ovaries can be seen, as well as any ovarian cysts that may be present

The tests are used together to produce results that are as accurate as possible. However, as these screening methods are still in the process of being tested, there's no guarantee they'll identify every case of ovarian cancer.

A cervical screening test, previously known as a smear test, can't detect ovarian cancer.

Online personal education and risk assessment (OPERA)

If you're concerned about your risk of developing inherited ovarian cancer, you can use Macmillan's online interactive assessment tool, OPERA.

It's designed to be used by patients and healthcare professionals to assess a person's risk of developing the condition based on their family history of breast cancer and ovarian cancer. This is because the genes that are mainly responsible for ovarian cancer are also linked to breast cancer.

Want to know more?

Cancer Research UK: ovarian cancer screening

Content Supplied by NHS Choices

Ovarian cancer

My problems started in 2003. I’d been having a difficult year, as both my father and brother died within three months of each other.

"My problems started in 2003. I'd been having a difficult year, as both my father and brother died within three months of each other.

"I noticed my abdomen was expanding, even though I was eating less. I also had lower back pain and constipation. A lot of these symptoms at that time were attributed to stress because of my bereavement.

"I was initially diagnosed with irritable bowel syndrome. I had a colonoscopy, which was negative, then an ultrasound scan, which showed I had a large mass in my abdomen. My diagnosis was a complete shock.

"I had surgery to remove the mass, and all my 'female bits' removed. But unfortunately the cancer had spread to my spleen, and I had to have that removed as well. It was a big operation and I'm now on antibiotics for the rest of my life.

"I had six sessions of chemotherapy after surgery, which was quite aggressive. I was warned there would possibly be long-term side effects. I lost the feeling in my toes and my fingers. The feeling in my fingers has come back now, but my toes are still fairly numb.

"Apart from the sense of loss I had already suffered with my bereavements, there was also the loss of my job, identity, femininity and body image. Financially it's been difficult, as I had to give up my job. I'm only able to go back to part-time work.

"I feel fortunate that I'm still here after three years. I'm looking ahead, although I don't know what the long-term outlook will be. I try not to be neurotic, but it's easy to worry about anything that's unusual or different. If I have pain that's not normal for me, I always get it checked out.

"It's difficult to give advice. I think everyone's experience is different. Everyone has different ways of coping with things. My way was to try to keep busy, manically busy. I still try to cram as much into every day and week as possible.

"It's difficult to think long term, but it's important to just hold on to the fact that the treatment now is wonderful, the support you'll have is wonderful, and we don't know what's just around the corner.

"Sheer self-determination helped me get over it. In our family we just get on with things. We don't dwell on things and we keep busy. 'Mind over matter' is how I've been brought up and I think that really helped me.

"The most important thing is to try to not to be afraid. Don't feel stupid or that you're making a fuss about nothing. I think you know your own body and you know when something is different or unusual, so get it checked out."

Content Supplied by NHS Choices

Ovarian cancer

Practice nurse Ruth Payne was diagnosed with ovarian cancer when she was 42.

Practice nurse Ruth Payne was diagnosed with ovarian cancer when she was 42.

"I went to my GP because I had a number of minor symptoms," says Ruth. "I had irritable bowel-type symptoms and went through a period of being very depressed, which I now think may have been related to the cancer. But I also had bloating, which is why I went to see the doctor. I looked seven months pregnant."

Ruth's GP thought she was pregnant. "She put me on the couch, held a sonicaid to my stomach and said, 'There's a very rapid heartbeat'. But then she realised it was my heartbeat."

Ruth was sent to her local hospital for a scan. "The radiographer took a long time. She'd obviously seen something that wasn't right." The results indicated a "suspicious lump". The next morning, the GP referred Ruth to the hospital.

At her first appointment with her consultant, he seemed fairly convinced that it was ovarian cancer. Various tests were organised to help them find out what the problem was. These included blood tests, a CT scan and a kidney function X-ray.

"As a nurse, I knew quite a lot about women's health issues, but I didn't know much about ovarian cancer," says Ruth. "It wasn't talked about much in the study days on women's cancers I attended. I just knew it as the 'silent killer'.

By the time I was admitted for surgery, I was so large I could hardly walk. Whatever it was obviously needed removing. The day before surgery, one of the scans suggested that there could be a problem with my liver, which meant having a liver scan done just before my operation. Fortunately, the scan revealed no problem."

During the surgery, doctors performed a frozen section biopsy to give them some idea of whether Ruth had cancer. This type of biopsy isn't always possible and it isn't 100% reliable. In Ruth's case, however, results showed that it was cancer. The ovaries were removed and a hysterectomy was carried out, and other tissues were sampled to check that the cancer hadn't spread to other parts of her body.

Ruth says, "The oncologist came to see me several days later. He said that although the cancer was at an early stage, I needed chemotherapy as well, because it was an aggressive tumour. He gave me the option of having standard chemotherapy, or participating in a trial of another kind of chemotherapy as well. I decided to go for the standard treatment."

The doctor told Ruth the worst side effect she would feel from the chemotherapy was tiredness. "I don't think 'tired' is quite the word!" she says. "I know it varies from person to person, but some days I felt like I'd been poleaxed. I even found it difficult to walk."

Ruth also cut her hours as a practice nurse, as she was concerned about picking up an infection. She had six cycles of chemotherapy, one every three weeks. Her chemotherapy treatment lasted for 18 weeks.

After the chemotherapy, Ruth didn't need any more treatment. She's still cancer-free, although she has only just been discharged. It took Ruth a long time to recover fully from the chemotherapy. "I got tired very easily and I was infected by any bug going around. For a long time it was easy to think that any ache or pain was the cancer returning, but this gradually lessened as time went on."

She advises women diagnosed with ovarian cancer to take things one day at a time. "It's natural to want to know what's going to happen in a year's time. But if you think about all the things that might happen, you can't cope. Make the most of your friends. If they offer help, give them specific things to do, like taking you to hospital, cooking meals when you might be feeling sick, collecting the children from school, and just being there if you need to talk.

"Don't be surprised if you don't feel on top of the world when you get to the end of treatment: it can often feel like an anti-climax. After all the medical attention you have received, you might feel very vulnerable without all the checks you've had at the hospital. It's sometimes at this stage that the enormity of all that's happened suddenly hits you.

"You might find it helpful to speak to others who've been in a similar position. Ask if there are any support groups, but this might not be for everyone. Be careful about searching on the internet, as there can be a lot of information, which can be quite overwhelming and a bit scary. It sometimes helps if you can get a friend to look for you. Some information may be out-of-date and it won't all apply to you."

Share this page