March is Ovarian Cancer Awareness Month. To help raise awareness, Dr Rebecca Leyland, Dr Sarah Haywood-Small and Dr Nicola Jordan-Mahy of our Cancer Research Group (Biomolecular Sciences Research Centre) have kindly provided the following information and advice . . .

According to the latest Cancer Research UK figures, 1 in 50 UK females will be diagnosed with ovarian cancer in their lifetime. Every woman has a different experience of ovarian cancer and the incidence is strongly related to age, with the highest incidence rates being in older women. The incidence rates for ovarian cancer are projected to rise by 15% in the UK between 2014 and 2035 (statistical data from CRUK). With the current COVID-19 pandemic, cancer diagnoses have dropped critically due to people not seeking medical attention. It is crucial that you continue to see your GP if you spot any symptoms.

Symptoms

Some common symptoms, as indicated by the NHS website, include the following:

• Feeling constantly bloated
• A swollen tummy
• Discomfort in the pelvic area
• Feeling full quickly when eating
• Needing to urinate more than often

These symptoms are not always easy to diagnose due to other common conditions such as irritable bowel syndrome and menstrual pains having similar symptoms. It is important to get these symptoms checked with your GP, and even more so if there is a family history of ovarian cancer. You should not feel afraid that you are wasting your GP’s time, or making a fuss. If you notice a change, or you have any of these symptoms, seek help as an early diagnosis could save your life.

Knowing the Risk Factors

The risk factors are being unfit, overweight, over 50-years-old, a family history of ovarian or breast cancer, endometriosis, smoking, using hormone replacement therapy (HRT) and exposure to asbestos.

Prevention

In these challenging times, let’s triangulate some recent ideas surrounding preventive strategies, innovations in diagnosis and personalised, targeted treatments.

TRY TO QUIT SMOKING

Like most diseases a healthy lifestyle can help reduce your chance of having ovarian cancer. Reducing or giving up smoking can be a first step there are many ways you can do this. A good start is to take a look at the advice on the NHS ‘Quit Smoking’ website.

You can also download the NHS Smokefree app.

DO MORE EXERCISE

You can also help yourself by undertaking exercise and getting fit. This does not only help with disease prevention it also helps with your mental health, which we can all do with these days. Anything can help, even a short walk around the block. The NHS has lots of advice to help you get started. You could take part in the Couch to 5k challenge, rope a few friends in, get them to do this with you even if you have to do it virtually via Facebook, WhatsApp, etc; getting started is the hardest part, so let’s get started today!

EAT HEALTHIER

Then we get on to healthy eating! The NHS has a lot of advice about eating well and we are great believers of eating the rainbow, making sure your diet is balanced with a lot of colourful fruit and vegetables, if you eat beige you feel beige. So come on, ladies, let’s change the colour of the food we feed ourselves and our families.

 

Dr Nikki Jordan-Mahy’s research focuses on polyphenols in the treatment of cancer. Interestingly, in laboratory experiments polyphenols naturally found in teas, fruit, vegetables, berries and nuts have been shown to slow down the growth and kill ovarian cancer cells (Quin et al 2020; Niedzwiecki et al 2016; Kwon 2018; Rauf et al 2018). These studies highlight the importance of a healthy diet full of fruit and vegetables, and could help to prevent and possibly one day help to treat ovarian cancer.

 

Targeted and personalised treatments

Dr Rebecca Leyland’s research focuses on targeted cancer treatment and the use of immunotherapy drugs. Treatment of ovarian cancer depends on the type of cancer, how big it is and also the stage. Most women with ovarian cancer have surgery or chemotherapy and there are also targeted drugs which can be used to treat advanced cancer. Some examples of targeted drugs for ovarian cancer include Lynparza and Rubraca. These drugs stop a protein called Poly (ADP-ribose) polymerase from working. This protein helps to repair damaged cells, including cancer cells. There are also immunotherapy drugs in clinical trials for the treatment of ovarian cancer which are showing tremendous potential. These drugs aim to activate a person’s immune system to kill cancer.

New innovations in diagnosis

A major challenge in treating ovarian cancer is that most patients have advanced disease at initial diagnosis. The facts speak for themselves, more than a quarter of ovarian cancers cases in England are diagnosed after presenting as an emergency (latest data from CRUK). Dr Sarah Haywood-Small’s research is in the area of breathomic research for cancer detection. A possible game changer in relation to diagnosis is the observation that exhaled breath can reveal crucial information that may indicate the presence of cancer. Simple, organic compounds can be isolated in exhaled breath as the cancer develops. Obtaining breath is non-invasive and so people can be checked regularly, therefore it follows that cancers can be detected earlier.

 

In 2021, it is more important than ever to keep talking about ovarian cancer. As is said many times with cancer, if in doubt, get it checked out.

REFERENCES:

Ovarian Cancer Statistics [https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/ovarian-cancer]. Cancer Research UK (CRUK).  Accessed [11/03/2021]

Amal, H., Shi, D. Y., Ionescu, R., Zhang, W., Hua, Q. L., Pan, Y. Y., … & Haick, H. (2015). Assessment of ovarian cancer conditions from exhaled breath. International journal of cancer, 136(6), E614-E622.

Raspagliesi, F., Bogani, G., Benedetti, S., Grassi, S., Ferla, S., & Buratti, S. (2020). Detection of Ovarian Cancer through Exhaled Breath by Electronic Nose: A Prospective Study. Cancers, 12(9), 2408.

www.nhs.uk National Health Service – Symptoms and Prevention

Kwon Y. Food-derived polyphenols inhibit the growth of ovarian cancer cells irrespective of their ability to induce antioxidant responses. Heliyon. 2018 Aug 29;4(8):e00753. doi: 10.1016/j.heliyon.2018.e00753. PMID: 30186979; PMCID: PMC6121158.

Niedzwiecki A, Roomi MW, Kalinovsky T, Rath M. Anticancer Efficacy of Polyphenols and Their Combinations. Nutrients. 2016 Sep 9;8(9):552. doi: 10.3390/nu8090552. PMID: 27618095; PMCID: PMC5037537.

Rauf A, Imran M, Butt MS, Nadeem M, Peters DG, Mubarak MS. Resveratrol as an anti-cancer agent: A review. Crit Rev Food Sci Nutr. 2018 Jun 13;58(9):1428-1447. doi: 10.1080/10408398.2016.1263597. Epub 2017 Jul 21. PMID: 28001084.

Qin J, Fu M, Wang J, Huang F, Liu H, Huangfu M, Yu D, Liu H, Li X, Guan X, Chen X. PTEN/AKT/mTOR signaling mediates anticancer effects of epigallocatechin‑3‑gallate in ovarian cancer. Oncol Rep. 2020 Jun;43(6):1885-1896. doi: 10.3892/or.2020.7571. Epub 2020 Mar 31. PMID: 32236585; PMCID: PMC7160558.