By Ian Olver, Cancer Council Australia
Cancer has been a National Health Priority Area since 1996 because of the burden it places on the Australian community. Of course, cancer isn’t just a health and economic burden – it takes an enormous emotional toll on the lives of patients and their families.
But while some cancers have become priorities for research and awareness-raising campaigns, others have lagged behind. And ovarian cancer is one such disease.
As the largest funder of cancer research in Australia, the National Health and Medical Research Council (NHMRC) is to be commended for providing more than A$175 million in 2011. Yet, despite almost a 50% increase in the number of ovarian cancer cases between 1982 and 2006 – from 833 to 1,266 – funding for ovarian cancer research from the NHMRC fell slightly, from A$4.8 million in 2004, to A$4.6 million in 2009.
The latest data from the Australian Institute of Health and Welfare (AIHW) reveals ovarian cancer is the ninth most common cancer diagnosed – and the sixth most common cause of cancer death – in Australian women. By 2015, as Australia’s population continues to age, an estimated 1,434 women are expected to be diagnosed with ovarian cancer.
What is ovarian cancer?
Cancer is a disease of the body’s cells. Normal cells grow and multiply in a controlled way, but if something causes a mistake to occur in the cells’ genetic blueprints, this control can be lost. There are a number of chemical, physical and biological agents that have been shown to trigger the mistakes that lead to cancer. These are known as risk factors, but we still don’t know what causes cancer.
The most common type of ovarian cancer arises from cells on the outside of the ovary. Less common types occur in the cells which produce eggs (germ cells) or the supporting structures.
There is currently no screening test for ovarian cancer but we know that women over 50 and those with a family history are at greater risk. The symptoms are often non-specific and include: persisting abdominal, pelvic or back pain or cramps; bloating or fullness; changing bowel habits or urinary frequency; painful intercourse or vaginal bleeding; and more general symptoms such as tiredness. These could occur with many other conditions, which makes diagnosis difficult.
The outcome for a person with ovarian cancer varies depending on the type and stage of cancer, as well as their age and general health at the time of diagnosis. If the cancer is treated when it is still confined to the ovaries, 93% of patients will be alive in five years. If the cancer has spread to surrounding tissue or organs in the pelvis, this drops to 39%, and if it has spread more distantly, 30%.
While we’ve seen improvements in the outcomes of those diagnosed with ovarian cancer over time – with the five-year survival rate increasing from 33% in the 1980s, to 40% in the 2000s – more work needs to be done to lift the survival rates to the levels of other cancers.
We know the majority of ovarian cancer cases are diagnosed in the late stages, which is why research into prevention, new treatments and survivorship – in addition to early detection for those at high risk – is so critical.
Research must be directed towards finding out what makes these cancers grow and targeting those mechanisms, as well as being able to detect at least the common form of the cancer early.
The large gains made in survival rates for many other cancers have largely been due to the investment made in research. Research spending is often directed to the more common cancers, which then attract more researchers as success is achieved.
We now need the same sort of commitment to improve the outcomes for those diagnosed with ovarian cancer. Early ovarian cancer can be cured and advanced ovarian cancer can be controlled. I hope we won’t have to wait too long before new treatments, particularly targeted therapies, are available and give women with ovarian cancer and their families a greater outlook.
Ian Olver receives funding from the ARC and NHMRC. He voluntarily chairs the Research Committee of Ovarian Cancer Australia