Dr. Archit Pandit is a senior consultant in department of surgical Oncology at MAX Institute of cancer care, MAX Shalimar Bagh. He was awarded of gold medal for residency in MS General surgery from Karnataka state -university, Rajiv Gandhi university of health sciences. After undergoing his surgical oncology 3 years residency at India’s most premier institute AIIMS, He did fellowship in laparoscopic and Robotic Surgical oncology.

1. Dr. Archit Pandit
Senior consultant , Department of Surgical Oncology
Max Institute of cancer Care
MAX Shalimar Bagh
http://www.drarchitpandit.com/

2. Presentation Objectives
1. Realize the impact of ovarian cancer
2. Recognize the early symptoms
3. Understand the risk factors
4. Know the proper steps to take if you or someone you know has
persistent symptoms and where to go for more information

3. What is Ovarian Cancer?
• A growth of abnormal malignant cells that begins in a
woman’s ovaries
• These ovarian cancer cells can metastasize or spread to
other organs in the pelvis or abdomen

4. Facts about ovarian cancers
• 80% of cases occur in women above 50
• 2nd MC Gynaec cancer in India
• 5th MC cancer in women
• Life time risk is 1 in 50
• Incidence of ovarian cancer has increased by
50% since 1990s

5. Why we need a campaign
• Awareness is low. And cases are picked up later
• Only 3% of women know the symptoms
• Symptoms similar to IBS therefore GP’s done always pick up
• 50% women confuse ovarian with cervical – think screening
detects ovarian.
• 39% present as an emergency
• Ovarian cancer in the most FATAL gynaec canc er.

6. Facts : why the campaign?
• Average 5 yr survival rate from ovarian cancer
decreases with age
– 52% for women 50-59
– 39% for women 60-69
– 28% for women 70-79
• Survival can be upto 70% for women diagnosed
with earlier ovarian cancer compared to 5% of
women who’s cancer is diagnosed with the most
advanced stage of the disease

7. Risk factors
• Age
• Family history
• Lifestyle
• Reproductive history
• Medical history

8. Reproductive history
• A womens risk may be increased if
– She has never given birth
– Had her first child after 30
– Has never taken OCP
– Started Menses at young age
– Late menopause
– Did not breast feed

9. Life style
• Obesity (BMI >30)
• Low physical activity
• Smoking
• Talcum powder

10. Medical history
• Previous cancer
• Family history of cancer
• Endometriosis
• Ovarian cysts

11. Symptoms
• Feeling bloated
• Feeling full or having difficulty in eating
• Urinary symptoms – urgency
• Persistent tummy or pelvic pain
• Change in bowel habit
• Extreme fatigue
• Unexplained weight loss

12. Tests
• If a women is experiencing the most common
symptoms more than 12 times in a month she
should a GP
• CA 125
• USG scan
• 2 week wait referral

15. Risk Reducing Strategies
• Oral contraceptives or birth control pills
• Tubal ligation or hysterectomy
• Pregnancy and breast feeding
• Removal of the ovaries or prophylactic oophrectomy

16. Key messages
• It is not a silent killer – there are signs and one
should not ignore them
• Feeling bloated most days
• Don’t delay to see your GP
• Ovarian cancer is not detected through
screening
• Ovarian cancer risks increase with increasing
age

17. Thank you

18. Impact of Ovarian Cancer
• Strikes 1 in 69 women
• Is the 2nd most common gynecologic cancera and 3rd most common
female cancer in India
• Majority of women diagnosed have no family history of disease
• Affects all women, regardless of race or ethnicity
• Is the deadliest gynecologic cancer

19. Impact of Ovarian Cancer
• Close to 75% of women are diagnosed at an advanced stage after the cancer
has spread beyond the ovary
• Overall 5-year survival rate is 45%
– This rate is even lower for black women at 40%
• When detected early, survival rates greatly improve
– 5-year survival rate is 93% for early-stage disease

20. Compared to Breast Cancer
Ovarian Cancer Breast Cancer
Women’s Risk of
Getting the Cancer in
Lifetime
1 in 69 1 in 15
Percent of Women
Alive Five Years After
Diagnosis
45% 89%
EARLY DETECTION CAN SAVE LIVES

21. The Challenge

22. What All Women Need to Know
• Even in its early stages…
• Research indicates that 95% of women with ovarian cancer had symptoms
and even 90% of women with early-stage disease experience symptoms
OVARIAN CANCER CAUSES
SYMPTOMS

23. Symptoms of Ovarian Cancer
• Bloating
• Pelvic and abdominal heaviness
• Difficulty eating or feeling full quickly
• Urinary symptoms (urgency or frequency).
• Symptoms will vary from woman to woman
– Associated with the location of the tumor and its impact on the surrounding
organs
– Mimic other conditions such as irritable bowel syndrome
• Many of us experience these symptoms from time to time – do not be alarmed
If a woman has a combination or many of these symptoms for more
than a few weeks and they are persistent and unusual for her, she
should see a health care professional, preferably a gynecologist.

24. What the doctor will do?
1. Pelvic examination, including a complete rectovaginal examination
2. Transvaginal or pelvic ultrasound
3. CA-125 blood test
If tests suggest the presence of ovarian cancer, insist on a referral to
a gynecologic oncologist
Gynecologic oncologists are specialists in treating ovarian cancer

25. Risk Factors
• Most women with ovarian cancer do not have any known risk factors
• However, there are several factors that may increase risk of
ovarian cancer
• Having one or more of these risk factors doesn’t mean that ovarian
cancer will develop, but the risk may be higher compared to the
average woman

26. What Puts women at increased risk?
• Inherited genetic mutations –BRCA 1 and BRCA 2
– Often exhibited by a family or personal history of breast,
colorectal or ovarian cancer
• Age
• Reproductive history and infertility
• Obesity

27. Hereditary Ovarian Cancers

28. Increasing Age
• Most ovarian cancers develop after
menopause
– About 69% of women diagnosed are
age 55 or over
• A woman’s risk of ovarian cancer
increases with age through her late 70s
• Although most cases of ovarian cancer
are diagnosed in women over age 55, the
disease can occur in younger women

29. Reproductive History and Infertility
• Women at increased risk if:
– Started menstruating at an early age (before age 12)
– Had no children
– Had first child after age 30
– Experienced menopause after age 50
• In addition, research indicates that infertility increases the
risk of ovarian cancer, even without use of fertility drugs

30. Risk Reduction