Ovarian cancer is rising silently, often detected only in advanced stages due to vague early symptoms like bloating and appetite loss. In this in-depth discussion, Dr. Shruthi Shivdas, Consultant Gynaecologic Oncologist at Cytecare Hospitals, Bengaluru, explains how age, lifestyle, and genetic factors increase cancer risk. She highlights modern treatment options like HIPEC, PIPAC, and personalized medicine that can greatly improve quality of life. The conversation also sheds light on social stigma, the emotional impact on caregivers, and the urgent need for early detection. Women’s health awareness, timely screening, and lifestyle changes are key to prevention and better outcomes.

Shahid Akhter, Editor, HealthYouOnline, spoke to Dr. Shruthi Shivdas, Consultant Gynaecologic Oncologist at Cytecare Hospitals, Bengaluru, to understand the silent rise of ovarian cancer, the challenges women face in diagnosis and treatment, and the latest advancements in targeted therapies, genetic testing, and palliative care. Dr. Shivdas sheds light on why awareness, early detection, and lifestyle changes are crucial in improving both survival and quality of life for women battling gynaecologic cancers.

Cancer Concern today 

Cancer is something that has significantly increased in the last few years. Any cancer in any part of the body, any organ of the body occurs because of some abnormality that develops in the genes of your DNA. So a particular gene in a particular organ of your body going abnormal is how a cancer ultimately develops. Gene abnormalities increase with age. So that each passing year of your life you are increasing your chance of developing cancer because you are exposed to mutation, creating, factors in your environment, which may be in ultraviolet radiation, it might be your mobile phone, it might be some carcinogenic, factor in the food that you eat. It might be the pollutants in the air.

But each passing year of your life are increasing your chance of developing cancer. So that is one of the reasons why earlier people would die of liver, of cardiac issues or diabetes. But now people live all the way up to 90 and 100 years. And, and once you are past your 50 years, your chance of developing cancer is high. 

And the same applies to women cancers. Women are now reporting with cancer, at least reporting to the doctor early on. So the pick up of women's cancers have also increased with breast cancer, followed by cervical cancer, ovarian cancer and then uterine cancer. So, most of these cancers have been more or less in the same trend. 

Cervical cancer is linked with HPV infection and can be prevented. A significant extent by HPV vaccination as well as pap smear, ovarian cancer. The only way out is, you know, recognising your symptoms and going to the doctor early on. Now coming to uterine cancer, This is a cancer which was much lower down in that list of cancers and has now rapidly gone up because, uterine cancer is more or less a lifestyle disease. There is a huge scope for lifestyle modification to prevent the occurrence of the cancer. 

Gynaecologic Oncologist

So the women who should visit a gynecologic oncology, I'd say, are women with any symptoms which have specifically related to the reproductive tract. 

So this could be in terms of menstrual irregularities, you know, your period irregularities. This could be heavy periods for women having persistently heavy bleeding, even in the younger age group, women with long standing polycystic ovary who have bleeding irregularities. Women who have stopped their bleeding, meaning they have attained the menopause, but still again, after a few years of not having bleeding, they again start to re bleed.  

Ovarian Cancer: Advancement 

Ovarian cancer currently stands at around maybe the third in position with respect to women's cancers, and the treatment options for ovarian cancers have significantly improved, both in terms of surgical as well as non-surgical options. So in surgical options, there are additional treatments like, improved treatments in terms of something that we call HIPEC, where chemotherapy is delivered into the abdomen at the time of surgery. 

There are advanced medical treatment options based on targeted therapies, where the tumor is tested for some particular changes and treatments are prescribed based on those changes, something that we call personalized medicine. And even in cases of cancer, where it is beyond the cure, as we would call it, there are surgical options.

Ovarian Cancer: Challenges

Some of the challenges that we face in this domain are

one, percolating the information to the general public. Is that, people are generally closed with respect to women's health. So even among women, we encourage the women's who have survived the cancer to talk about their journey of, through the treatment of cancer. 

Women do not want to talk about it. They prefer that other people around them, should not know about what they've suffered from. Another major stigma that they have is the hair loss that occurs with chemotherapy, which significantly affects women. So they do not come to treatment or they do not let others know about their treatment. So they want to be completely hidden during that. 

And as long as women do not speak up about their journey and that does not encourage or rather it discourages other women, for going forward for, cancer therapy. 

OV Cancer: Signs & Symptoms 

The ovarian cancer, unfortunately, is a disease which does not have significant symptoms in the initial phase. As a matter of fact, it has very nonspecific symptoms. You know, people, ladies, usually women who are about the age of 50 are the ones who develop ovarian cancer. 

And they have nonspecific symptoms, like, bloating after you had food. Don't feel like eating reduced appetite, things like that. So, even doctors ourselves are guilty of ignoring some of these because you know, the patient, you know, or a relative of yours will come up to you until I have these symptoms.

Or we can just take an antacid. Even general physicians end up, you know, prescribing antacids to the patient, and the patient ignores the symptoms for several months until finally, her abdomen bloats up. So this is the next symptom that we are going to expect is bloating of the abdomen with water or fluid inside. So that is usually a sign of very advanced cancer.

Ovarian Cancer: Need to improve Quality of Life 

This is a cancer that presents in later stages. And when it comes back, despite our treatment, it again comes back in the same stage as it was in the first part.

First appearance. So with a lot of bloating, the person is not able to take in food. There might be blockages in your food tract. You end up vomiting out. So this leads to the person you know losing weight significantly, not being able to eat anything. So this is not dramatic just for the person. This is also traumatic for the caregiver, meaning the relatives at home to see your loved one losing weight every day and not being able to do anything about it.

So you go to doctors, the doctors  also not being able to do much. However, this has changed in the last few years. Once we have, separate departments called palliative medicine, which will handle these issues, which will help them deal with, loss of appetite, pain and your food tract blocks. There are, options to improve the quality of life currently. 

Ovarian Cancer & Prevention 

So ovarian cancer has definitely come up, higher on the list of cancers affecting women from before. And you should know that a good majority of ovarian cancers are familial, had hereditary, which means that this can run across the women in your families. So you have to be aware of whether there is a family history of these cancers in your family. 

You have to be aware of your body and you have to be persistent on taking care of your health.

If you have a persistent and do not, do not ignore it for the rest of your family. So it is very important if you have to be there for your family. It is very important that women take care of their health first.