00:00Ovarian cancer is one of the leading types of cancer experienced by women.
00:05It is sometimes called a silent killer because it is difficult to detect and is usually diagnosed in the late stages.
00:14That's true, Prof. V.
00:15That's why it's important to know about this because early detection is more effective.
00:22To talk about other important information about ovarian cancer and its symptoms,
00:27we will have Dr. Romelyn Unglao, OB-GYN.
00:32Good morning, Doc.
00:34Good morning, Prof. V.
00:36Good morning, Doctor.
00:37Thank you for being with us this morning.
00:38I understand.
00:39This is also what you woke up for.
00:41We should be with you more often.
00:42But Doc, for our RSP, what is ovarian cancer?
00:49When you say ovary, it is a part of the reproductive organs.
00:54This is where the eggs come from.
00:57For example, we are going to have a baby.
00:59The other parts of the organs for women include the fallopian tube where the eggs pass through.
01:06There is also the matress or the uterus.
01:08The cervix is attached to the matress.
01:11But when we were young, when we were building it, the cells were different.
01:15And of course, the vagina is also involved.
01:17So, the cancer is focused on the ovaries.
01:20So, you are right, you said it is a silent killer.
01:22Because the symptoms of ovarian cancer are hard to detect.
01:27Okay.
01:28Okay.
01:29We mentioned that the cases of ovarian cancer are increasing.
01:33So, how common is this for women?
01:37Okay.
01:38So, for women, maybe not the highest.
01:42Maybe it is the third most common here in the Philippines
01:46because we are a low-middle-income country.
01:49We still have a lot of people with cervical cancer.
01:52The second most common is endometrial cancer.
01:54It is a cancer in the matress.
01:55Then, the ovarian cancer.
01:57The problem with ovarian cancer is that it causes more mortality.
02:01Or it is more aggressive.
02:03So, in terms of mortality in women, it is number one.
02:08But for all cancers that occur in women, it is in the top five.
02:13Top five.
02:14So, in the WHO guidelines, we can see that in a year,
02:19there are a minimum of 6,000 new cases.
02:22So, there are still a lot that are diagnosed every year.
02:26Although it is being coined as a silent killer,
02:28so that our awareness and early detection can increase.
02:31Are there any symptoms that should be monitored?
02:34Okay.
02:35The problem with the symptoms is that it is not very specific.
02:37What is common is that you feel bloated.
02:40You feel bloated.
02:41You feel that you get full quickly.
02:43Early satiety.
02:44So, some of our patients will say that they think they are getting fat.
02:49Because their stomach gets bigger.
02:51But sometimes, some people don't get that big of a stomach.
02:55So, those are the first two.
02:57Others get fat.
02:59Right?
03:00But it is like a late sign.
03:01They can also have changes in how they move their bowels
03:06or when they urinate and pee.
03:08But let's remember that those symptoms mean that they are already big.
03:12They already have a significant size.
03:14That is why they already have compressive symptoms inside.
03:17Okay.
03:18This is a woman's disease.
03:20But who are at risk or are at risk of having ovarian cancer?
03:25Okay.
03:26So, for us, we thought of the risk factors.
03:27Because not all women will have ovarian cancer.
03:31Number one would be the age.
03:34Of course, as we get older, more than 50 years old,
03:38that is when we see that the risk increases.
03:41And that is also when you are already menopause.
03:45So, you will think, why would I have cysts?
03:48I have cysts that happen when you are still regulating.
03:52So, those sometimes resolve.
03:55They disappear on their own.
03:57But when you are already menopause, we will be more careful.
04:01The other than that,
04:02women who are not yet pregnant,
04:05because the theory is that your ovary is always bulging.
04:10There are always changes that can lead to ovarian cancer.
04:15If there is also a history in the family of breast cancer,
04:18it can be related to the genes that you hear,
04:21BRCA1, BRCA2, higher risk.
04:23It can also be if the woman has a history of endometriosis.
04:27It means that the lining of the mattress goes to other places.
04:30That is also a risk.
04:31And of course, the other risk factors are smoking,
04:34because of course, your exposure to carcinogens increases.
04:37Okay.
04:38Doc, how do we assess the occurrence of ovarian cancer?
04:42Okay.
04:43So, in ovarian cancer, there is no good evidence of what screening is.
04:47It is not like cervical cancer prevention and screening, right?
04:51But what I said, if it is high risk,
04:53for example, in your family, there are those who have cancer less than 50 years old,
04:57you should be the one who is more worked up.
04:59Or if you have genes that are predisposed to breast and ovarian cancer,
05:04there are genes that are predisposed to breast cancer,
05:06you can still have ovarian cancer.
05:08You are the one who is earlier to be screened.
05:10So, how about screening?
05:11Ultrasound can be done, transvaginal or transrectal,
05:15to see the organs below,
05:17but it is not that specific.
05:19Because I told you,
05:20if you are still regulating, you can still have cysts.
05:23The other one, we call it cancer antigen 1-2-5.
05:27But even if its name is cancer antigen 1-2-5,
05:31it can increase even if you have an infection or endometriosis.
05:35Whatever irritates the wallpaper inside your stomach,
05:39it can increase.
05:40So, it is better if you have symptoms,
05:43you should consult,
05:44because the doctor will advise you on what is the best workup or diagnosis.
05:49But in terms of screening,
05:50we don't have the best evidence yet.
05:54Okay.
05:55So, when it comes to treatment,
05:56what are the options or treatments for cancer and ovarian cancer?
06:01Okay.
06:02For ovarian cancer,
06:03definitely surgery is the number one.
06:05But for me,
06:06as a gynecologic oncologist,
06:08the first thing I think about is,
06:09for the patient,
06:10what is the best?
06:11Should he go for chemotherapy first,
06:14or should he have surgery?
06:16So, for surgery,
06:17we need to remove all the organs.
06:19Uterus, tubes, ovaries.
06:21But we also remove the colon,
06:24the omentum,
06:26because there's a fat-binding protein there.
06:28The omentum.
06:29Yes, the omentum.
06:30So, there's a fat lying there.
06:33Because that is the source of nutrition for cancer.
06:38But there's also,
06:39for example,
06:40as we said,
06:41sometimes it's already spread,
06:42that's what we call debulking surgery.
06:44Because it can go to the liver,
06:46it can go to the liver.
06:47To different parts.
06:48Yes.
06:49So, ideally,
06:50there should be zero residual,
06:51as much as possible.
06:53So, there's surgery,
06:55there's a chemotherapy component,
06:56and in this day and age,
06:57it's already molecular.
06:59So, we already have targeted therapies
07:02that reduce blood vessels,
07:04or if they have brachygenes,
07:06there are also medications
07:08to improve the survival of patients.
07:11Can this be avoided?
07:12What could be the prevention?
07:13Okay.
07:14So, of course,
07:15the general healthy lifestyle,
07:17we always recommend that.
07:19But the other thing,
07:20maybe there are people who have read
07:22that there's evidence
07:24that oral contraceptive pills
07:26decrease the chances
07:28because you don't always get eggs,
07:30but that doesn't mean
07:31that it's curable.
07:33So, that's that.
07:34And of course,
07:35if you have a family history,
07:36if it's screened earlier,
07:38or if you have endometriosis,
07:40those things should also be addressed
07:42so that it can be avoided.
07:44And earlier,
07:45if the symptoms are detected,
07:47especially if it's persistent,
07:48if it changes,
07:49if you have bloating,
07:51and it changes when you eat or sleep,
07:53it should really be checked.
07:54Alright, Doc,
07:55maybe just a message
07:56to our RSPs.
07:57Okay.
07:58So, of course,
07:59for women,
08:00what we really need is
08:02to listen to our body
08:04so that we don't let our health
08:06go to waste.
08:10Because sometimes,
08:11we think that
08:12there are more important things,
08:14right?
08:15But of course,
08:16it's also important
08:17to take care of yourself.
08:18And actually,
08:19even if it's not an ovary screening,
08:21if you have a cervical cancer screening,
08:24sometimes,
08:25when you go to your OBGYN,
08:27you can also examine
08:28the other parts.
08:29So, it's really better
08:30to have a check-up
08:31and healthy living.
08:32Yearly, right?
08:33Yes.
08:34Thank you so much,
08:35Dr. Romelyn Onglao,
08:36for answering our questions
08:38about ovarian cancer.
08:40So, RSPs,
08:41as we always say,
08:43be aware and take care
08:45of your body
08:46because we don't know
08:47when we'll get infected.
