4 min readMay 10, 2025 05:32 AM IST
First published on: May 8, 2025 at 02:27 PM IST
A 27-year-old woman was preparing for her wedding after a routine laparoscopic surgery for an ovarian cyst. However, what was presumed to be a benign condition turned out to be malignant in biopsy. A 48-year-old woman dismissed her heavy periods as symptomatic of her menopause journey till an ultrasound revealed a tumour in her ovaries. A 60-year-old woman thought her persistent stomach pain and bloating were about her weakening gut health. Fact is it was aggressive ovarian cancer.
“Because these symptoms are non-specific, they are often attributed to gastrointestinal issues or other benign conditions, leading to delays in diagnosis. Most ovarian cancers are diagnosed at later stages due to this lack of clear early warning signs,” says Dr Yogesh Kulkarni, Head, Gynecologic Oncology, Robotic Surgeon, Kokilaben Dhirubhai Ambani Hospital, Mumbai.
HOW YOU CAN PRESERVE FERTILITY
Considering the 27-year-old woman patient was looking forward to building a new life and becoming a mother, Dr Kulkarni and his team removed the affected ovary and fallopian tube, saving the uterus and the healthy ovary.
“After surgery, she did a course of chemotherapy to kill remaining cancer cells and prevent recurrence. She was declared cancer-free one to two years after completing her chemotherapy regimen. She was given the go-ahead to conceive and had a twin pregnancy. After delivery, we removed the remaining ovary and uterus to eliminate risks,” says Dr Kulkarni.
This case shows how, even in the face of a malignancy, a tailored conventional approach can work in treating cancer and preserving fertility. “Otherwise, healthy eggs can be retrieved and frozen for later use by the survivor herself or if her uterus has to be removed, by a surrogate,” he adds. What about risks of the eggs being cancerous themselves? “This is rare but the risk can be minimised greatly by isolating and culturing individual ovarian follicles in a lab setting before retrieving eggs,” says Dr Kulkarni.
WHY OVARIAN CANCER IS LINKED TO BREAST CANCER?
Mutations in the BRCA1 and BRCA2 genes increase the risk of both breast and ovarian cancer. These mutations affect the way cells repair DNA, leading to a higher chance of developing cancer in various organs. Besides, the ovaries produce hormones like estrogen, which play a role in breast tissue development. “That’s why we do genetic testing. Once we removed the cancer from the 48-year-old, we put her on targeted therapy. This works when even chemo fails as it blocks or disrupts signals that cause cancer cells to grow, divide and spread, eliminating them,” says Dr Kulkarni. Immunotherapy is showing promise in certain subtypes of ovarian cancer.
IDENTIFYING EARLIEST SIGNS AND SYMPTOMS
Post-menopausal women are at higher risk of developing gynaecological cancers, including ovarian cancer. Delayed menopause can increase lifetime estrogen exposure, a known risk factor. “Regular screening, even in the absence of symptoms, is highly recommended for women in this age group. Do not ignore any unusual signs,” says Dr Rashmi Rekha Bora, Head of Gynaecologic Oncology, Dharamshila Narayana Superspeciality hospital, Delhi, who treated the 60-year-old with bloating issues. “She had never had bloating in her life and it persisted. That was the first red flag. Some might feel full too quickly after eating a small amount, have an increased frequency of urination, and have a vague discomfort, pressure, or pain in the pelvic or abdominal area. There could be constipation or diarrhoea that doesn’t resolve,” she adds.
While pelvic exams can detect some abnormalities, they are not highly effective for early detection of ovarian cancer. Dr Vora suggests the Transvaginal Ultrasound and CA-125 blood tests for early screening.
Post-menopausal women are at higher risk of developing gynaecological cancers, including ovarian cancer. (Photo: Pexels) 
Share
