Ovarian cancer is a significant yet often overlooked health concern for women in Kenya. It is the fifth most common cancer affecting women in the country after breast, cervix, oesophageal, and colorectal cancers. In 2022, there were about 1245 new cases, with about 895 deaths, according to GLOBOCAN statistics. Global cancer observatory. It is a disease that often goes undetected due to its vague symptoms and limited screening methods.
What do we look out for?
Ovarian cancer symptoms are often vague and can mimic other common conditions, making early detection difficult. Women may experience:
- persistent bloating,
- Abdominal or pelvic pain
- Difficulty eating
- Frequent urination or feeling full quickly.
- In more advanced stages, symptoms can include abdominal swelling from fluid buildup (ascites).
- Shortness of breath due to fluid around the lungs (pleural effusion).
- Bowel obstruction, or even blood clots.
- Less commonly, unusual vaginal bleeding or discharge may occur, especially in fallopian tube cancers. Symptoms that are new, frequent (occur-ring almost daily), and more severe than usual should prompt medical evaluation, as early diagnosis significantly improves treatment outcomes.
Risk Factors for Ovarian Cancer
- Never having been pregnant
- Early onset of menstruation (before age 12)
- Late menopause (after age 52)
- Family history of ovarian, breast, or endometrial (uterine) cancer
- Inherited BRCA1 or BRCA2 gene mutations
- Family history of Lynch syndrome (hereditary nonpolyposis colorectal cancer)
Diagnosis
The diagnostic evaluation of ovarian cancer in Kenya involves a stepwise approach beginning with a physical examination, pelvic ultrasound, and blood tests to detect any abnormal pelvic masses or elevated tumor markers. If cancer is suspected, further imaging like CT or MRI scans is used to assess the extent of disease spread and check for metastasis. diagnosis
In cases with fluid buildup, samples from the abdomen or chest may be taken for cytological analysis. A biopsy is not usually necessary for diagnosing ovarian cancer, especially in early stages, as it can risk spreading cancer cells and potentially upstage the tumor. Instead, diagnosis and staging are often achieved through surgery, which allows for direct examination and safe removal of the tumor. Diagnostic laparoscopy may be used to assess whether the cancer can be surgically removed. Early referral to a gynecologic oncologist is essential for accurate diagnosis and appropriate treatment planning.
Treatment.
Treatment for ovarian cancer in Kenya depends on the stage at diagnosis and may
include:
- Surgery: To remove the tumor and affected tissues, including the ovaries, fallopian tubes, and sometimes the uterus.
- Chemotherapy: Commonly administered after surgery to eliminate any remaining cancer cells and reduce the risk of recurrence. In cases where the cancer is widespread, it may also be given before surgery—known as neoadjuvant chemotherapy—to shrink tumors and make surgical removal more effective and less complex.
- Radiation therapy: Rarely used but may be recommended in some cases.
- Targeted therapy: Newer treatments that specifically target cancer cells, though access is still limited in Kenya due to cost and availability. At KUTRRH we provide comprehensive cancer care services, including diagnostics, surgery, chemotherapy, and follow-up, helping to expand access to timely and specialized treatment
Common Types of Ovarian Cancer
1 Epithelial ovarian cancer: The most common type, originating from the outer lining of the ovaries. More common in older women.
2 Germ cell tumors: Start from the cells that produce meggs; more common in younger women.
3 Sex chord -Stromal tumors: Arise from hormone producing cells. Can occur across all age groups.
Prevention and Risk Reduction
While there is no guaranteed way to prevent ovarian cancer, the following steps may reduce risk:
- Regular gynecological check-ups Oral contraceptives: Long-term use has been shown to reduce risk of epithelial ovarian cancer.
- Healthy lifestyle: Maintaining a balanced diet, avoiding smoking, and regular exercise.
- Genetic counseling and testing: Women with a family history of ovarian or breast cancer should seek advice on genetic risks (e.g., BRCA gene mutations).
- Surgical options: In high-risk women, removal of the ovaries and fallopian tubes may be recommended after completion of family size.
Staging
Ovarian cancer is classified into four stages:
√ Stage I: Cancer is confined to one or both ovaries.
√ Stage II: Cancer has spread to the pelvic organs.
√ Stage III: Cancer has spread to the abdominal cavity or lymph nodes.
√ Stage IV: Cancer has spread to distant organs such as the liver or lungs.
√ Early-stage cancers (Stage I or II) have a much higher survival rate, underscoring the importance of early detection. ovarian stages
Screening
There is no reliable screening method for ovarian cancer.Tests like the tumor marker-CA 125 and pelvic ultrasound have limitations and can give misleading results. Screening is not recommended for low-risk individuals but may be considered for those at high risk, such as people with genetic risks like the BRCA1/BRCA2 mutations or Lynch syndrome. People with a strong family history or genetic risk should discuss screening options with their doctor.
Conclusion
Ovarian cancer in Kenya is often diagnosed late due to low awareness and limited care
access.
- No effective screening exists for the general population; tests like CA 125
- ultrasounds have limitations.
- Biopsy for early-stage ovarian cancer is not essential for surgical intervention.
- Screening is recommended for high-risk women with genetic mutations or strong family history.
- Women should know symptoms and seek medical advice for persistent health changes.