“It took me 4years before I discovered that I had ovarian cancer. First, I had bloating and sometimes I would feel so full regardless of what I had eaten. I ignored the feeling. It was on and off. But then I started losing weight. None of my clothes were fitting” Anne Cheruiyot an ovarian cancer patient in Chandaria Cancer and chronic disease management centre at MTRH narrates.
There are about 9600 Kenyan women who develop malignant ovarian tumours, while 5500 women die over the same. This makes ovarian cancer the fifth most common cancer among women in Kenya, after breast, Cervical, colorectal and endometrial cancer.
70% of cases of ovarian cancer are not diagnosed until it has reached an advanced stage.
“After some time, I developed a frequent need to urinate. I would go to the toilet and in less than 10min, I’d feel the urge again,” Says Anne. “At first, I thought it was diabetes because it runs in our family. But when I visited the district hospital in Langas Estate, they referred me here. That I was told that I was suffering from ovarian cancer…”
Patients with ovarian cancer have no specific symptoms. According to Dr. Joan Kitagwa an oncologist at Chandaria Cancer Center, MTRH Eldoret, possible symptoms range from abdominal complaints, changes in bowel habits, and unexplained weight loss to massive abdominal swelling.
How do we identify the risks?
In preventing ovarian cancer, it is important to identify women at high risk. The risk factors of ovarian cancer have increased over the years. The most common factors are:
- Family history of ovarian cancer.
- High-fat diet and obesity.
- Personal history of breast, colon, or endometrial cancer (hormone-dependent tumours).
- Increasing Age
- Reproductive History and Infertility
Courtesy; Lousiana Department of Health.
Way forward to reduce Ovarian Cancer?
There are ways ovarian cancer in women can be reduced. All women are at risk of developing ovarian cancer.
A health care professional can help a woman identify ways to reduce her risk as well as decide if further consultation with a genetic counsellor is appropriate.
In Kenya, these are some of the organizations working to alleviate the cancer burden.
- Removal of the Ovaries and Fallopian Tubes
Women can greatly reduce their risk of ovarian cancer by removing their ovaries and fallopian tubes. One recent study suggests that women with BRCA1 mutations gain the most benefit by removing their ovaries before age 35. Although there are risks associated with removing the ovaries and fallopian tubes; women should speak to their doctors about whether this procedure is appropriate for them.
“We think that certainly removing the fallopian tubes will reduce risk. Does it reduce to the same degree as if you take the entire complex of the ovary? We’re not sure. Obviously it doesn’t have the other protective effects that removing the ovary does, such as protection against breast cancer down the line. So the recommendations for treatment today are still the removal of both the ovaries and the fallopian tubes,” Dr. Joan says.
That recommendation may need to be balanced with other factors in some patients. Dr Joan gives the hypothetical example of a 36-year-old woman with a BRCA1 mutation(which are tumour suppressor genes), who has already had breast cancer and will not be able to take hormones to help manage menopausal symptoms.
“Removing her ovaries and fallopian tubes puts her into menopause at the age of 36. That is an option, but there is going to be a change to her quality of life in doing that,” she says.
“So for these individuals, is there an intermediary step: removing the fallopian tubes? Maybe we’re not going to get 100 per cent protection, but we’ll get 97 per cent protection. It seems like a very reasonable strategy to undertake in the right individual.”
- Oral Contraceptive Use
The use of oral contraceptives (birth control pills) decreases the risk of developing ovarian cancer, especially when used for several years. Women who use oral contraceptives for five or more years have about a 50 per cent lower risk of developing ovarian cancer than women who have never used oral contraceptives.
- Pregnancy and Breastfeeding
Pregnancy and breastfeeding are linked with a reduced risk of ovarian cancer, likely because women ovulate less frequently when pregnant or breastfeeding. Multiple pregnancies or having a first full-term pregnancy before the age of 26 decreases risk.
“We don’t want to treat cancer. We want to prevent,” says Dr Joan. “By identifying high-risk individuals, testing and educating the society – we’re going to actually induce that change and move from a treatment perspective to primary prevention.” Says Dr. Joan.
Have you been tested? When was the last time you went for a medical check-up? What was the experience like? Share your journey with us you may just inspire someone to go get tested.